tier development group: Topics by Science.gov

Sample records for tier development group

Development and Evaluation of a Three-Tier Diagnostic Test to Assess Undergraduate Primary Teachers' Understanding of Ecological Footprint

NASA Astrophysics Data System (ADS)

Liampa, Vasiliki; Malandrakis, George N.; Papadopoulou, Penelope; Pnevmatikos, Dimitrios

2017-08-01

This study focused on the development and validation of a three-tier multiple-choice diagnostic instrument about the ecological footprint. Each question in the three-tier test comprised by; (a) the content tier, assessing content knowledge; (b) the reason tier, assessing explanatory knowledge; and (c) the confidence tier that differentiates lack of knowledge from misconception through the use of a certainty response index. Based on the literature, the propositional knowledge statements and the identified misconceptions of 97 student-teachers, a first version of the test was developed and subsequently administered to another group of 219 student-teachers from Primary and Early Childhood Education Departments. Due to the complexity of the ecological footprint concept, and that it is a newly introduced concept, unknown to the public, both groups have been previously exposed to relevant instruction. Experts in the field established face and content validity. The reliability, in terms of Cronbach's alpha, was found adequate (α = 0.839), and the test-retest reliability, as indicated by Pearson r, was also satisfactory (0.554). The mean performance of the students was 56.24% in total score, 59.75% in content tiers and 48.05% in reason tiers. A variety of concepts about the ecological footprint were also observed. The test can help educators to understand the alternative views that students hold about the ecological footprint concept and assist them in developing the concept through appropriately designed teaching methods and materials.
An algal model for predicting attainment of tiered biological criteria of Maine's streams and rivers

USGS Publications Warehouse

Danielson, Thomas J.; Loftin, Cyndy; Tsomides, Leonidas; DiFranco, Jeanne L.; Connors, Beth; Courtemanch, David L.; Drummond, Francis; Davies, Susan

2012-01-01

State water-quality professionals developing new biological assessment methods often have difficulty relating assessment results to narrative criteria in water-quality standards. An alternative to selecting index thresholds arbitrarily is to include the Biological Condition Gradient (BCG) in the development of the assessment method. The BCG describes tiers of biological community condition to help identify and communicate the position of a water body along a gradient of water quality ranging from natural to degraded. Although originally developed for fish and macroinvertebrate communities of streams and rivers, the BCG is easily adapted to other habitats and taxonomic groups. We developed a discriminant analysis model with stream algal data to predict attainment of tiered aquatic-life uses in Maine's water-quality standards. We modified the BCG framework for Maine stream algae, related the BCG tiers to Maine's tiered aquatic-life uses, and identified appropriate algal metrics for describing BCG tiers. Using a modified Delphi method, 5 aquatic biologists independently evaluated algal community metrics for 230 samples from streams and rivers across the state and assigned a BCG tier (1–6) and Maine water quality class (AA/A, B, C, nonattainment of any class) to each sample. We used minimally disturbed reference sites to approximate natural conditions (Tier 1). Biologist class assignments were unanimous for 53% of samples, and 42% of samples differed by 1 class. The biologists debated and developed consensus class assignments. A linear discriminant model built to replicate a priori class assignments correctly classified 95% of 150 samples in the model training set and 91% of 80 samples in the model validation set. Locally derived metrics based on BCG taxon tolerance groupings (e.g., sensitive, intermediate, tolerant) were more effective than were metrics developed in other regions. Adding the algal discriminant model to Maine's existing macroinvertebrate discriminant model will broaden detection of biological impairment and further diagnose sources of impairment. The algal discriminant model is specific to Maine, but our approach of explicitly tying an assessment tool to tiered aquatic-life goals is widely transferrable to other regions, taxonomic groups, and waterbody types.
Tiers of intervention in kindergarten through third grade.

PubMed

O'Connor, Rollanda E; Harty, Kristin R; Fulmer, Deborah

2005-01-01

This study measured the effects of increasing levels of intervention in reading for a cohort of children in Grades K through 3 to determine whether the severity of reading disability (RD) could be significantly reduced in the catchment schools. Tier 1 consisted of professional development for teachers of reading. The focus of this study is on additional instruction that was provided as early as kindergarten for children whose achievement fell below average. Tier 2 intervention consisted of small-group reading instruction 3 times per week, and Tier 3 of daily instruction delivered individually or in groups of two. A comparison of the reading achievement of third-grade children who were at risk in kindergarten showed moderate to large differences favoring children in the tiered interventions in decoding, word identification, fluency, and reading comprehension.
A tiered approach for the human health risk assessment for consumption of vegetables from with cadmium-contaminated land in urban areas.

PubMed

Swartjes, Frank A; Versluijs, Kees W; Otte, Piet F

2013-10-01

Consumption of vegetables that are grown in urban areas takes place worldwide. In developing countries, vegetables are traditionally grown in urban areas for cheap food supply. In developing and developed countries, urban gardening is gaining momentum. A problem that arises with urban gardening is the presence of contaminants in soil, which can be taken up by vegetables. In this study, a scientifically-based and practical procedure has been developed for assessing the human health risks from the consumption of vegetables from cadmium-contaminated land. Starting from a contaminated site, the procedure follows a tiered approach which is laid out as follows. In Tier 0, the plausibility of growing vegetables is investigated. In Tier 1 soil concentrations are compared with the human health-based Critical soil concentration. Tier 2 offers the possibility for a detailed site-specific human health risk assessment in which calculated exposure is compared to the toxicological reference dose. In Tier 3, vegetable concentrations are measured and tested following a standardized measurement protocol. To underpin the derivation of the Critical soil concentrations and to develop a tool for site-specific assessment the determination of the representative concentration in vegetables has been evaluated for a range of vegetables. The core of the procedure is based on Freundlich-type plant-soil relations, with the total soil concentration and the soil properties as variables. When a significant plant-soil relation is lacking for a specific vegetable a geometric mean of BioConcentrationFactors (BCF) is used, which is normalized according to soil properties. Subsequently, a 'conservative' vegetable-group-consumption-rate-weighted BioConcentrationFactor is calculated as basis for the Critical soil concentration (Tier 1). The tool to perform site-specific human health risk assessment (Tier 2) includes the calculation of a 'realistic worst case' site-specific vegetable-group-consumption-rate-weighted BioConcentrationFactor. © 2013 Elsevier Inc. All rights reserved.
A tiered approach for the human health risk assessment for consumption of vegetables from with cadmium-contaminated land in urban areas

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

Swartjes, Frank A., E-mail: frank.swartjes@rivm.nl; Versluijs, Kees W.; Otte, Piet F.

Consumption of vegetables that are grown in urban areas takes place worldwide. In developing countries, vegetables are traditionally grown in urban areas for cheap food supply. In developing and developed countries, urban gardening is gaining momentum. A problem that arises with urban gardening is the presence of contaminants in soil, which can be taken up by vegetables. In this study, a scientifically-based and practical procedure has been developed for assessing the human health risks from the consumption of vegetables from cadmium-contaminated land. Starting from a contaminated site, the procedure follows a tiered approach which is laid out as follows. Inmore » Tier 0, the plausibility of growing vegetables is investigated. In Tier 1 soil concentrations are compared with the human health-based Critical soil concentration. Tier 2 offers the possibility for a detailed site-specific human health risk assessment in which calculated exposure is compared to the toxicological reference dose. In Tier 3, vegetable concentrations are measured and tested following a standardized measurement protocol. To underpin the derivation of the Critical soil concentrations and to develop a tool for site-specific assessment the determination of the representative concentration in vegetables has been evaluated for a range of vegetables. The core of the procedure is based on Freundlich-type plant–soil relations, with the total soil concentration and the soil properties as variables. When a significant plant–soil relation is lacking for a specific vegetable a geometric mean of BioConcentrationFactors (BCF) is used, which is normalized according to soil properties. Subsequently, a ‘conservative’ vegetable-group-consumption-rate-weighted BioConcentrationFactor is calculated as basis for the Critical soil concentration (Tier 1). The tool to perform site-specific human health risk assessment (Tier 2) includes the calculation of a ‘realistic worst case’ site-specific vegetable-group-consumption-rate-weighted BioConcentrationFactor. -- Highlights: • A scientifically-based and practical procedure has been developed for assessing the human health risks from the consumption of vegetables. • Uptake characteristics of cadmium in a series of vegetables is represented by a vegetable-group-consumption-rate-weighted BioConcentrationFactor. • Calculations and measurement steps are combined.« less
Development of a tiered and binned genetic counseling model for informed consent in the era of multiplex testing for cancer susceptibility.

PubMed

Bradbury, Angela R; Patrick-Miller, Linda; Long, Jessica; Powers, Jacquelyn; Stopfer, Jill; Forman, Andrea; Rybak, Christina; Mattie, Kristin; Brandt, Amanda; Chambers, Rachelle; Chung, Wendy K; Churpek, Jane; Daly, Mary B; Digiovanni, Laura; Farengo-Clark, Dana; Fetzer, Dominique; Ganschow, Pamela; Grana, Generosa; Gulden, Cassandra; Hall, Michael; Kohler, Lynne; Maxwell, Kara; Merrill, Shana; Montgomery, Susan; Mueller, Rebecca; Nielsen, Sarah; Olopade, Olufunmilayo; Rainey, Kimberly; Seelaus, Christina; Nathanson, Katherine L; Domchek, Susan M

2015-06-01

Multiplex genetic testing, including both moderate- and high-penetrance genes for cancer susceptibility, is associated with greater uncertainty than traditional testing, presenting challenges to informed consent and genetic counseling. We sought to develop a new model for informed consent and genetic counseling for four ongoing studies. Drawing from professional guidelines, literature, conceptual frameworks, and clinical experience, a multidisciplinary group developed a tiered-binned genetic counseling approach proposed to facilitate informed consent and improve outcomes of cancer susceptibility multiplex testing. In this model, tier 1 "indispensable" information is presented to all patients. More specific tier 2 information is provided to support variable informational needs among diverse patient populations. Clinically relevant information is "binned" into groups to minimize information overload, support informed decision making, and facilitate adaptive responses to testing. Seven essential elements of informed consent are provided to address the unique limitations, risks, and uncertainties of multiplex testing. A tiered-binned model for informed consent and genetic counseling has the potential to address the challenges of multiplex testing for cancer susceptibility and to support informed decision making and adaptive responses to testing. Future prospective studies including patient-reported outcomes are needed to inform how to best incorporate multiplex testing for cancer susceptibility into clinical practice.Genet Med 17 6, 485-492.
40 CFR 79.54 - Tier 3.

Code of Federal Regulations, 2011 CFR

2011-07-01

... emission control equipment. (3) A manufacturer or group may be required to conduct biological and/or... Requiring Tier 3 Testing. (1) Tier 3 testing shall be required of a manufacturer or group of manufacturers... products. Tier 3 testing may be conducted either on an individual basis or a group basis. If performed on a...
40 CFR 79.54 - Tier 3.

Code of Federal Regulations, 2014 CFR

2014-07-01

... emission control equipment. (3) A manufacturer or group may be required to conduct biological and/or... Requiring Tier 3 Testing. (1) Tier 3 testing shall be required of a manufacturer or group of manufacturers... products. Tier 3 testing may be conducted either on an individual basis or a group basis. If performed on a...
40 CFR 79.54 - Tier 3.

Code of Federal Regulations, 2012 CFR

2012-07-01

... emission control equipment. (3) A manufacturer or group may be required to conduct biological and/or... Requiring Tier 3 Testing. (1) Tier 3 testing shall be required of a manufacturer or group of manufacturers... products. Tier 3 testing may be conducted either on an individual basis or a group basis. If performed on a...
40 CFR 79.54 - Tier 3.

Code of Federal Regulations, 2010 CFR

2010-07-01

... emission control equipment. (3) A manufacturer or group may be required to conduct biological and/or... Requiring Tier 3 Testing. (1) Tier 3 testing shall be required of a manufacturer or group of manufacturers... products. Tier 3 testing may be conducted either on an individual basis or a group basis. If performed on a...
40 CFR 79.54 - Tier 3.

Code of Federal Regulations, 2013 CFR

2013-07-01

... emission control equipment. (3) A manufacturer or group may be required to conduct biological and/or... Requiring Tier 3 Testing. (1) Tier 3 testing shall be required of a manufacturer or group of manufacturers... products. Tier 3 testing may be conducted either on an individual basis or a group basis. If performed on a...
Accelerating chronically unresponsive children to tier 3 instruction: what level of data is necessary to ensure selection accuracy?

PubMed

Compton, Donald L; Gilbert, Jennifer K; Jenkins, Joseph R; Fuchs, Douglas; Fuchs, Lynn S; Cho, Eunsoo; Barquero, Laura A; Bouton, Bobette

2012-01-01

Response-to-intervention (RTI) approaches to disability identification are meant to put an end to the so-called wait-to-fail requirement associated with IQ discrepancy. However, in an unfortunate irony, there is a group of children who wait to fail in RTI frameworks. That is, they must fail both general classroom instruction (Tier 1) and small-group intervention (Tier 2) before becoming eligible for the most intensive intervention (Tier 3). The purpose of this article was to determine how to predict accurately which at-risk children will be unresponsive to Tiers 1 and 2, thereby allowing unresponsive children to move directly from Tier 1 to Tier 3. As part of an efficacy study of a multitier RTI approach to prevention and identification of reading disabilities (RD), 129 first-grade children who were unresponsive to classroom reading instruction were randomly assigned to 14 weeks of small-group, Tier 2 intervention. Nonresponders to this instruction (n = 33) were identified using local norms on first-grade word identification fluency growth linked to a distal outcome of RD at the end of second grade. Logistic regression models were used to predict membership in responder and nonresponder groups. Predictors were entered as blocks of data from least to most difficult to obtain: universal screening data, Tier 1 response data, norm referenced tests, and Tier 2 response data. Tier 2 response data were not necessary to classify students as responders and nonresponders to Tier 2 instruction, suggesting that some children can be accurately identified as eligible for Tier 3 intervention using only Tier 1 data, thereby avoiding prolonged periods of failure to instruction.
Prioritizing pesticide compounds for analytical methods development

USGS Publications Warehouse

Norman, Julia E.; Kuivila, Kathryn; Nowell, Lisa H.

2012-01-01

The U.S. Geological Survey (USGS) has a periodic need to re-evaluate pesticide compounds in terms of priorities for inclusion in monitoring and studies and, thus, must also assess the current analytical capabilities for pesticide detection. To meet this need, a strategy has been developed to prioritize pesticides and degradates for analytical methods development. Screening procedures were developed to separately prioritize pesticide compounds in water and sediment. The procedures evaluate pesticide compounds in existing USGS analytical methods for water and sediment and compounds for which recent agricultural-use information was available. Measured occurrence (detection frequency and concentrations) in water and sediment, predicted concentrations in water and predicted likelihood of occurrence in sediment, potential toxicity to aquatic life or humans, and priorities of other agencies or organizations, regulatory or otherwise, were considered. Several existing strategies for prioritizing chemicals for various purposes were reviewed, including those that identify and prioritize persistent, bioaccumulative, and toxic compounds, and those that determine candidates for future regulation of drinking-water contaminants. The systematic procedures developed and used in this study rely on concepts common to many previously established strategies. The evaluation of pesticide compounds resulted in the classification of compounds into three groups: Tier 1 for high priority compounds, Tier 2 for moderate priority compounds, and Tier 3 for low priority compounds. For water, a total of 247 pesticide compounds were classified as Tier 1 and, thus, are high priority for inclusion in analytical methods for monitoring and studies. Of these, about three-quarters are included in some USGS analytical method; however, many of these compounds are included on research methods that are expensive and for which there are few data on environmental samples. The remaining quarter of Tier 1 compounds are high priority as new analytes. The objective for analytical methods development is to design an integrated analytical strategy that includes as many of the Tier 1 pesticide compounds as possible in a relatively few, cost-effective methods. More than 60 percent of the Tier 1 compounds are high priority because they are anticipated to be present at concentrations approaching levels that could be of concern to human health or aquatic life in surface water or groundwater. An additional 17 percent of Tier 1 compounds were frequently detected in monitoring studies, but either were not measured at levels potentially relevant to humans or aquatic organisms, or do not have benchmarks available with which to compare concentrations. The remaining 21 percent are pesticide degradates that were included because their parent pesticides were in Tier 1. Tier 1 pesticide compounds for water span all major pesticide use groups and a diverse range of chemical classes, with herbicides and their degradates composing half of compounds. Many of the high priority pesticide compounds also are in several national regulatory programs for water, including those that are regulated in drinking water by the U.S. Environmental Protection Agency under the Safe Drinking Water Act and those that are on the latest Contaminant Candidate List. For sediment, a total of 175 pesticide compounds were classified as Tier 1 and, thus, are high priority for inclusion in analytical methods available for monitoring and studies. More than 60 percent of these compounds are included in some USGS analytical method; however, some are spread across several research methods that are expensive to perform, and monitoring data are not extensive for many compounds. The remaining Tier 1 compounds for sediment are high priority as new analytes. The objective for analytical methods development for sediment is to enhance an existing analytical method that currently includes nearly half of the pesticide compounds in Tier 1 by adding as many additional Tier 1 compounds as are analytically compatible. About 35 percent of the Tier 1 compounds for sediment are high priority on the basis of measured occurrence. A total of 74 compounds, or 42 percent, are high priority on the basis of predicted likelihood of occurrence according to physical-chemical properties, and either have potential toxicity to aquatic life, high pesticide useage, or both. The remaining 22 percent of Tier 1 pesticide compounds were either degradates of Tier 1 parent compounds or included for other reasons. As with water, the Tier 1 pesticide compounds for sediment are distributed across the major pesticide-use groups; insecticides and their degradates are the largest fraction, making up 45 percent of Tier 1. In contrast to water, organochlorines, at 17 percent, are the largest chemical class for Tier 1 in sediment, which is to be expected because there is continued widespread detection in sediments of persistent organochlorine pesticides and their degradates at concentrations high enough for potential effects on aquatic life. Compared to water, there are fewer available benchmarks with which to compare contaminant concentrations in sediment, but a total of 19 Tier 1 compounds have at least one sediment benchmark or screening value for aquatic organisms. Of the 175 compounds in Tier 1, 77 percent have high aquatic-life toxicity, as defined for this process. This evaluation of pesticides and degradates resulted in two lists of compounds that are priorities for USGS analytical methods development, one for water and one for sediment. These lists will be used as the basis for redesigning and enhancing USGS analytical capabilities for pesticides in order to capture as many high-priority pesticide compounds as possible using an economically feasible approach.
Tier Two Interventions Implemented within the Context of a Tiered Prevention Framework

ERIC Educational Resources Information Center

Mitchell, Barbara S.; Stormont, Melissa; Gage, Nicholas A.

2011-01-01

Despite a growing body of evidence demonstrating the value of Tier 1 and Tier 3 interventions, significantly less is known about Tier 2 level treatments when they are added within the context of a tiered continuum of support. The purpose of this article is to systematically review the existing research base for Tier 2 small group intervention…
Impact of 3-tier formularies on drug treatment of attention-deficit/hyperactivity disorder in children.

PubMed

Huskamp, Haiden A; Deverka, Patricia A; Epstein, Arnold M; Epstein, Robert S; McGuigan, Kimberly A; Muriel, Anna C; Frank, Richard G

2005-04-01

Expenditures for medications used to treat attention-deficit/hyperactivity disorder (ADHD) in children have increased rapidly. Many employers and health plans have adopted 3-tier formularies in an attempt to control costs for these and other drugs. To assess the effect of copayment increases associated with 3-tier formulary adoption on use and spending patterns for ADHD medications for children. Observational study using quasi-experimental design to compare effects on ADHD medication use and spending for children enrolled as dependents in an employer-sponsored plan that made major changes to its pharmacy benefit design and a comparison group of children covered by the same insurer. The plan simultaneously moved from a 1-tier (same copayment required for all drugs) to a 3-tier formulary and implemented an across-the-board copayment increase. The plan later moved 3 drugs from tier 3 to tier 2. An intervention group of 20 326 and a comparison group of 15 776 children aged 18 years and younger. Monthly probability of using an ADHD medication; plan, enrollee, and total ADHD medication spending; and medication continuation. A 3-tier formulary implementation resulted in a 17% decrease in the monthly probability of using medication (P<.001), a 20% decrease in expected total medication expenditures, and a substantial shifting of costs from the plan to families (P<.001). Intervention group children using medications in the pre-period were more likely to change to a medication in a different tier after 3-tier adoption, relative to the comparison group (P = .08). The subsequent tier changes resulted in increased plan spending (P<.001) and decreased patient spending (P = .003) for users but no differences in continuation. The copayment increases associated with 3-tier formulary implementation by 1 employer resulted in lower total ADHD medication spending, sizeable increases in out-of-pocket expenditures for families of children with ADHD, and a significant decrease in the probability of using these medications.
Primary health care, mental health, and the dietitian's role.

PubMed

Davison, Karen

2006-01-01

Individuals with mental illness are at nutritional risk because of health, social, and economic factors. To address this problem, the Canadian Collaborative Mental Health Initiative (CCMHI) and Dietitians of Canada (DC) commissioned the development of a toolkit that outlines the role of the registered dietitian (RD) and advocates for RDs in primary health care (PHC) mental health programs. The development of the toolkit followed a four-stage process: a comprehensive literature review, a focus group discussion with a national working group, interviews with consumers about RD services, and evaluation of the toolkit. The costs of mental illness in Canada are at least US dollars 6.85 billion per year. Currently, little evidence exists on how RD services can reduce these expenses. The focus group identified accessibility as the predominant issue facing individuals with mental illness. To explain consumer experiences with RD services, a three-tier theory based on in-depth interviews was developed. Consumer experiences with RDs occur in five categories: financial concerns, perception of service, status of mental illness, engagement, and self-esteem (tier 1). These are further influenced by five individual and contextual factors, e.g., social environment, the mental illness (tier 2), which are weighed as benefits and barriers instrumental in determining actions (tier 3). The evaluation of the final draft of the RD toolkit confirmed that it reflected the visions of PHC. The toolkit is intended to act as a blueprint for action. Dietitians are encouraged to use its contents to advocate for positions in mental health PHC settings.
Prioritization of constituents for national- and regional-scale ambient monitoring of water and sediment in the United States

USGS Publications Warehouse

Olsen, Lisa D.; Valder, Joshua F.; Carter, Janet M.; Zogorski, John S.

2013-01-01

A total of 2,541 constituents were evaluated and prioritized for national- and regional-scale ambient monitoring of water and sediment in the United States. This prioritization was done by the U.S. Geological Survey (USGS) in preparation for the upcoming third decade (Cycle 3; 2013–23) of the National Water-Quality Assessment (NAWQA) Program. This report provides the methods used to prioritize the constituents and the results of that prioritization. Constituents were prioritized by the NAWQA National Target Analyte Strategy (NTAS) work group on the basis of available information on physical and chemical properties, observed or predicted environmental occurrence and fate, and observed or anticipated adverse effects on human health or aquatic life. Constituents were evaluated within constituent groups that were determined on the basis of physical or chemical properties or on uses or sources. Some constituents were evaluated within more than one constituent group. Although comparable objectives were used in the prioritization of constituents within the different constituent groups, differences in the availability of information accessed for each constituent group led to the development of separate prioritization approaches adapted to each constituent group to make best use of available resources. Constituents were assigned to one of three prioritization tiers: Tier 1, those having the highest priority for inclusion in ambient monitoring of water or sediment on a national or regional scale (including NAWQA Cycle 3 monitoring) on the basis of their likelihood of environmental occurrence in ambient water or sediment, or likelihood of effects on human health or aquatic life; Tier 2, those having intermediate priority for monitoring on the basis of their lower likelihood of environmental occurrence or lower likelihood of effects on human health or aquatic life; and Tier 3, those having low or no priority for monitoring on the basis of evidence of nonoccurrence or lack of effects on human health or aquatic life, or of having insufficient evidence of potential occurrence or effects to justify placement into Tier 2. Of the 1,081 constituents determined to be of highest priority for ambient monitoring (Tier 1), 602 were identified for water and 686 were identified for sediment (note that some constituents were evaluated for both water and sediment). These constituents included various types of organic compounds, trace elements and other inorganic constituents, and radionuclides. Some of these constituents are difficult to analyze, whereas others are mixtures, isomers, congeners, salts, and acids of other constituents; therefore, modifications to the list of high-priority constituents for ambient monitoring could be made on the basis of the availability of suitable methods for preparation, extraction, or analysis. An additional 1,460 constituents were placed into Tiers 2 or 3 for water or sediment, including some constituents that had been placed into Tier 1 for a different matrix; 436 constituents were placed into Tier 2 for water and 246 constituents into Tier 2 for sediment; 979 constituents were placed into Tier 3 for water and 779 constituents into Tier 3 for sediment.
24 CFR 203.605 - Loss mitigation performance.

Code of Federal Regulations, 2010 CFR

2010-04-01

... performance. (1) HUD will measure and advise mortgagees of their loss mitigation performance through the Tier... mitigation attempts, defaults, and claims. Based on the ratios, HUD will group mortgagees in four tiers (Tiers 1, 2, 3, and 4), with Tier 1 representing the highest or best ranking mortgagees and Tier 4...
Examining the Predictive Validity of a Dynamic Assessment of Decoding to Forecast Response to Tier 2 Intervention

ERIC Educational Resources Information Center

Cho, Eunsoo; Compton, Donald L.; Fuchs, Douglas; Fuchs, Lynn S.; Bouton, Bobette

2014-01-01

The purpose of this study was to examine the role of a dynamic assessment (DA) of decoding in predicting responsiveness to Tier 2 small-group tutoring in a response-to-intervention model. First grade students (n = 134) who did not show adequate progress in Tier 1 based on 6 weeks of progress monitoring received Tier 2 small-group tutoring in…
Developing a new, national approach to surveillance for ventilator-associated events*.

PubMed

Magill, Shelley S; Klompas, Michael; Balk, Robert; Burns, Suzanne M; Deutschman, Clifford S; Diekema, Daniel; Fridkin, Scott; Greene, Linda; Guh, Alice; Gutterman, David; Hammer, Beth; Henderson, David; Hess, Dean; Hill, Nicholas S; Horan, Teresa; Kollef, Marin; Levy, Mitchell; Septimus, Edward; VanAntwerpen, Carole; Wright, Don; Lipsett, Pamela

2013-11-01

To develop and implement an objective, reliable approach to surveillance for ventilator-associated events in adult patients. The Centers for Disease Control and Prevention (CDC) convened a Ventilator-Associated Pneumonia (VAP) Surveillance Definition Working Group in September 2011. Working Group members included representatives of stakeholder societies and organizations and federal partners. The Working Group finalized a three-tier, adult surveillance definition algorithm for ventilator-associated events. The algorithm uses objective, readily available data elements and can identify a broad range of conditions and complications occurring in mechanically ventilated adult patients, including but not limited to VAP. The first tier definition, ventilator-associated condition (VAC), identifies patients with a period of sustained respiratory deterioration following a sustained period of stability or improvement on the ventilator, defined by changes in the daily minimum fraction of inspired oxygen or positive end-expiratory pressure. The second tier definition, infection-related ventilator-associated complication (IVAC), requires that patients with VAC also have an abnormal temperature or white blood cell count, and be started on a new antimicrobial agent. The third tier definitions, possible and probable VAP, require that patients with IVAC also have laboratory and/or microbiological evidence of respiratory infection. Ventilator-associated events surveillance was implemented in January 2013 in the CDC's National Healthcare Safety Network. Modifications to improve surveillance may be made as additional data become available and users gain experience with the new definitions.

Effectiveness of a 10-week tier-1 response to intervention program in improving fine motor and visual-motor skills in general education kindergarten students.

PubMed

Ohl, Alisha M; Graze, Hollie; Weber, Karen; Kenny, Sabrina; Salvatore, Christie; Wagreich, Sarah

2013-01-01

This study examined the efficacy of a 10-wk Tier 1 Response to Intervention (RtI) program developed in collaboration with classroom teachers to improve the fine motor and visual-motor skills of general education kindergarten students. We recruited 113 students in six elementary schools. Two general education kindergarten classrooms at each school participated in the study. Classrooms were randomly assigned to the intervention and control groups. Fine motor skills, pencil grip, and visual-motor integration were measured at the beginning of the school year and after the 10-wk intervention. The intervention group demonstrated a statistically significant increase in fine motor and visual-motor skills, whereas the control group demonstrated a slight decline in both areas. Neither group demonstrated a change in pencil grip. This study provides preliminary evidence that a Tier 1 RtI program can improve fine motor and visual-motor skills in kindergarten students. Copyright © 2013 by the American Occupational Therapy Association, Inc.
Large scale commissioning and operational experience with tier-2 to tier-2 data transfer links in CMS

NASA Astrophysics Data System (ADS)

Letts, J.; Magini, N.

2011-12-01

Tier-2 to Tier-2 data transfers have been identified as a necessary extension of the CMS computing model. The Debugging Data Transfers (DDT) Task Force in CMS was charged with commissioning Tier-2 to Tier-2 PhEDEx transfer links beginning in late 2009, originally to serve the needs of physics analysis groups for the transfer of their results between the storage elements of the Tier-2 sites associated with the groups. PhEDEx is the data transfer middleware of the CMS experiment. For analysis jobs using CRAB, the CMS Remote Analysis Builder, the challenges of remote stage out of job output at the end of the analysis jobs led to the introduction of a local fallback stage out, and will eventually require the asynchronous transfer of user data over essentially all of the Tier-2 to Tier-2 network using the same PhEDEx infrastructure. In addition, direct file sharing of physics and Monte Carlo simulated data between Tier-2 sites can relieve the operational load of the Tier-1 sites in the original CMS Computing Model, and already represents an important component of CMS PhEDEx data transfer volume. The experience, challenges and methods used to debug and commission the thousands of data transfers links between CMS Tier-2 sites world-wide are explained and summarized. The resulting operational experience with Tier-2 to Tier-2 transfers is also presented.
ATLAS WORLD-cloud and networking in PanDA

NASA Astrophysics Data System (ADS)

Barreiro Megino, F.; De, K.; Di Girolamo, A.; Maeno, T.; Walker, R.; ATLAS Collaboration

2017-10-01

The ATLAS computing model was originally designed as static clouds (usually national or geographical groupings of sites) around the Tier 1 centres, which confined tasks and most of the data traffic. Since those early days, the sites’ network bandwidth has increased at 0(1000) and the difference in functionalities between Tier 1s and Tier 2s has reduced. After years of manual, intermediate solutions, we have now ramped up to full usage of World-cloud, the latest step in the PanDA Workload Management System to increase resource utilization on the ATLAS Grid, for all workflows (MC production, data (re)processing, etc.). We have based the development on two new site concepts. Nuclei sites are the Tier 1s and large Tier 2s, where tasks will be assigned and the output aggregated, and satellites are the sites that will execute the jobs and send the output to their nucleus. PanDA dynamically pairs nuclei and satellite sites for each task based on the input data availability, capability matching, site load and network connectivity. This contribution will introduce the conceptual changes for World-cloud, the development necessary in PanDA, an insight into the network model and the first half-year of operational experience.
User and group storage management the CMS CERN T2 centre

NASA Astrophysics Data System (ADS)

Cerminara, G.; Franzoni, G.; Pfeiffer, A.

2015-12-01

A wide range of detector commissioning, calibration and data analysis tasks is carried out by CMS using dedicated storage resources available at the CMS CERN Tier-2 centre. Relying on the functionalities of the EOS disk-only storage technology, the optimal exploitation of the CMS user/group resources has required the introduction of policies for data access management, data protection, cleanup campaigns based on access pattern, and long term tape archival. The resource management has been organised around the definition of working groups and the delegation to an identified responsible of each group composition. In this paper we illustrate the user/group storage management, and the development and operational experience at the CMS CERN Tier-2 centre in the 2012-2015 period.
Variations in patient response to tiered physician networks.

PubMed

Sinaiko, Anna D

2016-06-01

Prior studies found that tiered provider networks channel patients to preferred providers in certain contexts. This paper evaluates whether the effects of tiered physician networks vary for different types of patients. Cross-sectional analysis of fiscal year 2009 to 2010 administrative enrollment and claims data on nonelderly beneficiaries in Massachusetts Group Insurance Commission health plans. Main outcome measures are physician market share among new patients and the percent of physician's patients who switch away. We utilized estimated fixed effects linear regression models that were stratified by patient characteristics. Physicians with the worst tier rankings had lower market share among new patients who are older and sicker, or male, representing losses in market share of 10% and 15%, respectively, than other tiered physicians. A poor tier ranking did not affect physician market share of new patients who are female or younger. There was no effect of a physician's tier ranking on the proportion of patients who switch to other doctors among any groups of patients. Loyalty to their own physicians is pervasive across groups of patients. Physicians with poor tier rankings lost market share among new patients who are older and sicker, and among new male patients. Together, these findings suggest that tiered network designs have the potential for the greatest impact on value in healthcare over time, as more patients seek new relationships with physicians.
An Examination of the Efficacy of a Multitiered Intervention on Early Reading Outcomes for First Grade Students at Risk for Reading Difficulties.

PubMed

Fien, Hank; Smith, Jean Louise M; Smolkowski, Keith; Baker, Scott K; Nelson, Nancy J; Chaparro, Erin

2015-01-01

This article presents findings of an efficacy trial examining the effect of a multitiered instruction and intervention model on first grade at-risk students' reading outcomes. Schools (N = 16) were randomly assigned to the treatment or control condition. In the fall of Grade 1, students were assigned to an instructional tier on the basis of Stanford Achievement Test-10th Edition scores (31st percentile and above = Tier 1; from the 10th to the 30th percentile = Tier 2). In both conditions, students identified as at risk (i.e., Tier 2; n = 267) received 90 min of whole group instruction (Tier 1) and an additional 30 min of daily small group intervention (Tier 2). In the treatment condition, teachers were trained to enhance core reading instruction by making instruction more explicit and increasing practice opportunities for students in Tier 1. In addition, at-risk readers were provided an additional 30-min daily small group intervention with content that was highly aligned with the Tier 1 core reading program. Results indicate significant, positive effects of the intervention on students' decoding and first semester fluent reading and potentially positive effects on reading comprehension and total reading achievement. © Hammill Institute on Disabilities 2014.
The effect of a three-tier formulary on antidepressant utilization and expenditures.

PubMed

Hodgkin, Dominic; Parks Thomas, Cindy; Simoni-Wastila, Linda; Ritter, Grant A; Lee, Sue

2008-06-01

Health plans in the United States are struggling to contain rapid growth in their spending on medications. They have responded by implementing multi-tiered formularies, which label certain brand medications 'non-preferred' and require higher patient copayments for those medications. This multi-tier policy relies on patients' willingness to switch medications in response to copayment differentials. The antidepressant class has certain characteristics that may pose problems for implementation of three-tier formularies, such as differences in which medication works for which patient, and high rates of medication discontinuation. To measure the effect of a three-tier formulary on antidepressant utilization and spending, including decomposing spending allocations between patient and plan. We use claims and eligibility files for a large, mature nonprofit managed care organization that started introducing its three-tier formulary on January 1, 2000, with a staggered implementation across employer groups. The sample includes 109,686 individuals who were continuously enrolled members during the study period. We use a pretest-posttest quasi-experimental design that includes a comparison group, comprising members whose employer had not adopted three-tier as of March 1, 2000. This permits some control for potentially confounding changes that could have coincided with three-tier implementation. For the antidepressants that became nonpreferred, prescriptions per enrollee decreased 11% in the three-tier group and increased 5% in the comparison group. The own-copay elasticity of demand for nonpreferred drugs can be approximated as -0.11. Difference-in-differences regression finds that the three-tier formulary slowed the growth in the probability of using antidepressants in the post-period, which was 0.3 percentage points lower than it would have been without three-tier. The three-tier formulary also increased out-of-pocket payments while reducing plan payments and total spending. The results indicate that the plan enrollees were somewhat responsive to the changed incentives, shifting away from the drugs that became nonpreferred. However, the intervention also resulted in cost-shifting from plan to enrollees, indicating some price-inelasticity. The reduction in the proportion of enrollees filling any prescriptions contrasts with results of prior studies for non-psychotropic drug classes. Limitations include the possibility of confounding changes coinciding with three-tier implementation (if they affected the two groups differentially); restriction to continuous enrollees; and lack of data on rebates the plan paid to drug manufacturers. The results of this study suggest that the impact of the three-tier formulary approach may be somewhat different for antidepressants than for some other classes. Policymakers should monitor the effects of three-tier programs on utilization in psychotropic medication classes. Future studies should seek to understand the reasons for patients' limited response to the change in incentives, perhaps using physician and/or patient surveys. Studies should also examine the effects of three-tier programs on patient adherence, quality of care, and clinical and economic outcomes.
A Randomised Control Trial of a Tier-2 Small-Group Intervention ("MiniLit") for Young Struggling Readers

ERIC Educational Resources Information Center

Buckingham, Jennifer; Wheldall, Kevin; Beaman, Robyn

2012-01-01

The response-to-intervention model is predicated upon increasingly intensive tiers of instruction. The aim of the present study was to examine the efficacy of a Tier-2 small-group literacy intervention ("MiniLit") designed for young readers who are still struggling after experiencing whole-class initial instruction. A total of 22…
The effect of incentive-based formularies on prescription-drug utilization and spending.

PubMed

Huskamp, Haiden A; Deverka, Patricia A; Epstein, Arnold M; Epstein, Robert S; McGuigan, Kimberly A; Frank, Richard G

2003-12-04

Many employers and health plans have adopted incentive-based formularies in an attempt to control prescription-drug costs. We used claims data to compare the utilization of and spending on drugs in two employer-sponsored health plans that implemented changes in formulary administration with those in comparison groups of enrollees covered by the same insurers. One plan simultaneously switched from a one-tier to a three-tier formulary and increased all enrollee copayments for medications. The second switched from a two-tier to a three-tier formulary, changing only the copayments for tier-3 drugs. We examined the utilization of angiotensin-converting-enzyme (ACE) inhibitors, proton-pump inhibitors, and 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins). Enrollees covered by the employer that implemented more dramatic changes experienced slower growth than the comparison group in the probability of the use of a drug and a major shift in spending from the plan to the enrollee. Among the enrollees who were initially taking tier-3 statins, more enrollees in the intervention group than in the comparison group switched to tier-1 or tier-2 medications (49 percent vs. 17 percent, P<0.001) or stopped taking statins entirely (21 percent vs. 11 percent, P=0.04). Patterns were similar for ACE inhibitors and proton-pump inhibitors. The enrollees covered by the employer that implemented more moderate changes were more likely than the comparison enrollees to switch to tier-1 or tier-2 medications but not to stop taking a given class of medications altogether. Different changes in formulary administration may have dramatically different effects on utilization and spending and may in some instances lead enrollees to discontinue therapy. The associated changes in copayments can substantially alter out-of-pocket spending by enrollees, the continuation of the use of medications, and possibly the quality of care. Copyright 2003 Massachusetts Medical Society
A SOA-Based Platform to Support Clinical Data Sharing.

PubMed

Gazzarata, R; Giannini, B; Giacomini, M

2017-01-01

The eSource Data Interchange Group, part of the Clinical Data Interchange Standards Consortium, proposed five scenarios to guide stakeholders in the development of solutions for the capture of eSource data. The fifth scenario was subdivided into four tiers to adapt the functionality of electronic health records to support clinical research. In order to develop a system belonging to the "Interoperable" Tier, the authors decided to adopt the service-oriented architecture paradigm to support technical interoperability, Health Level Seven Version 3 messages combined with LOINC (Logical Observation Identifiers Names and Codes) vocabulary to ensure semantic interoperability, and Healthcare Services Specification Project standards to provide process interoperability. The developed architecture enhances the integration between patient-care practice and medical research, allowing clinical data sharing between two hospital information systems and four clinical data management systems/clinical registries. The core is formed by a set of standardized cloud services connected through standardized interfaces, involving client applications. The system was approved by a medical staff, since it reduces the workload for the management of clinical trials. Although this architecture can realize the "Interoperable" Tier, the current solution actually covers the "Connected" Tier, due to local hospital policy restrictions.
A SOA-Based Platform to Support Clinical Data Sharing

PubMed

Gazzarata, R; Giannini, B; Giacomini, M

2017-01-01

The eSource Data Interchange Group, part of the Clinical Data Interchange Standards Consortium, proposed five scenarios to guide stakeholders in the development of solutions for the capture of eSource data. The fifth scenario was subdivided into four tiers to adapt the functionality of electronic health records to support clinical research. In order to develop a system belonging to the “Interoperable” Tier, the authors decided to adopt the service-oriented architecture paradigm to support technical interoperability, Health Level Seven Version 3 messages combined with LOINC (Logical Observation Identifiers Names and Codes) vocabulary to ensure semantic interoperability, and Healthcare Services Specification Project standards to provide process interoperability. The developed architecture enhances the integration between patient-care practice and medical research, allowing clinical data sharing between two hospital information systems and four clinical data management systems/clinical registries. The core is formed by a set of standardized cloud services connected through standardized interfaces, involving client applications. The system was approved by a medical staff, since it reduces the workload for the management of clinical trials. Although this architecture can realize the “Interoperable” Tier, the current solution actually covers the “Connected” Tier, due to local hospital policy restrictions. © 2017 R. Gazzarata et al.
A SOA-Based Platform to Support Clinical Data Sharing

PubMed Central

Gazzarata, R.; Giannini, B.

2017-01-01

The eSource Data Interchange Group, part of the Clinical Data Interchange Standards Consortium, proposed five scenarios to guide stakeholders in the development of solutions for the capture of eSource data. The fifth scenario was subdivided into four tiers to adapt the functionality of electronic health records to support clinical research. In order to develop a system belonging to the “Interoperable” Tier, the authors decided to adopt the service-oriented architecture paradigm to support technical interoperability, Health Level Seven Version 3 messages combined with LOINC (Logical Observation Identifiers Names and Codes) vocabulary to ensure semantic interoperability, and Healthcare Services Specification Project standards to provide process interoperability. The developed architecture enhances the integration between patient-care practice and medical research, allowing clinical data sharing between two hospital information systems and four clinical data management systems/clinical registries. The core is formed by a set of standardized cloud services connected through standardized interfaces, involving client applications. The system was approved by a medical staff, since it reduces the workload for the management of clinical trials. Although this architecture can realize the “Interoperable” Tier, the current solution actually covers the “Connected” Tier, due to local hospital policy restrictions. PMID:29065576
Research and development of web oriented remote sensing image publication system based on Servlet technique

NASA Astrophysics Data System (ADS)

Juanle, Wang; Shuang, Li; Yunqiang, Zhu

2005-10-01

According to the requirements of China National Scientific Data Sharing Program (NSDSP), the research and development of web oriented RS Image Publication System (RSIPS) is based on Java Servlet technique. The designing of RSIPS framework is composed of 3 tiers, which is Presentation Tier, Application Service Tier and Data Resource Tier. Presentation Tier provides user interface for data query, review and download. For the convenience of users, visual spatial query interface is included. Served as a middle tier, Application Service Tier controls all actions between users and databases. Data Resources Tier stores RS images in file and relationship databases. RSIPS is developed with cross platform programming based on Java Servlet tools, which is one of advanced techniques in J2EE architecture. RSIPS's prototype has been developed and applied in the geosciences clearinghouse practice which is among the experiment units of NSDSP in China.
The Development and Validation of a Three-Tier Diagnostic Test Measuring Pre-Service Elementary Education and Secondary Science Teachers' Understanding of the Water Cycle

ERIC Educational Resources Information Center

Schaffer, Dannah Lynn

2013-01-01

The main goal of this research study was to develop and validate a three-tier diagnostic test to determine pre-service teachers' (PSTs) conceptual knowledge of the water cycle. For a three-tier diagnostic test, the first tier assesses content knowledge; in the second tier, a reason is selected for the content answer; and the third tier allows…
Comparison of tiered formularies and reference pricing policies: a systematic review

PubMed Central

Morgan, Steve; Hanley, Gillian; Greyson, Devon

2009-01-01

Objectives To synthesize methodologically comparable evidence from the published literature regarding the outcomes of tiered formularies and therapeutic reference pricing of prescription drugs. Methods We searched the following electronic databases: ABI/Inform, CINAHL, Clinical Evidence, Digital Dissertations & Theses, Evidence-Based Medicine Reviews (which incorporates ACP Journal Club, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Database of Abstracts of Reviews of Effectiveness, Health Technology Assessments and NHS Economic Evaluation Database), EconLit, EMBASE, International Pharmaceutical Abstracts, MEDLINE, PAIS International and PAIS Archive, and the Web of Science. We also searched the reference lists of relevant articles and several grey literature sources. We sought English-language studies published from 1986 to 2007 that examined the effects of either therapeutic reference pricing or tiered formularies, reported on outcomes relevant to patient care and cost-effectiveness, and employed quantitative study designs that included concurrent or historical comparison groups. We abstracted and assessed potentially appropriate articles using a modified version of the data abstraction form developed by the Cochrane Effective Practice and Organisation of Care Group. Results From an initial list of 2964 citations, 12 citations (representing 11 studies) were deemed eligible for inclusion in our review: 3 studies (reported in 4 articles) of reference pricing and 8 studies of tiered formularies. The introduction of reference pricing was associated with reduced plan spending, switching to preferred medicines, reduced overall drug utilization and short-term increases in the use of physician services. Reference pricing was not associated with adverse health impacts. The introduction of tiered formularies was associated with reduced plan expenditures, greater patient costs and increased rates of non-compliance with prescribed drug therapy. From the data available, we were unable to examine the hypothesis that tiered formulary policies result in greater use of physician services and potentially worse health outcomes. Conclusion The available evidence does not clearly differentiate between reference pricing and tiered formularies in terms of policy outcomes. Reference pricing appears to have a slight evidentiary advantage, given that patients’ health outcomes under tiered formularies have not been well studied and that tiered formularies are associated with increased rates of medicine discontinuation. PMID:21603047
Regulatory Compliance in Multi-Tier Supplier Networks

NASA Technical Reports Server (NTRS)

Goossen, Emray R.; Buster, Duke A.

2014-01-01

Over the years, avionics systems have increased in complexity to the point where 1st tier suppliers to an aircraft OEM find it financially beneficial to outsource designs of subsystems to 2nd tier and at times to 3rd tier suppliers. Combined with challenging schedule and budgetary pressures, the environment in which safety-critical systems are being developed introduces new hurdles for regulatory agencies and industry. This new environment of both complex systems and tiered development has raised concerns in the ability of the designers to ensure safety considerations are fully addressed throughout the tier levels. This has also raised questions about the sufficiency of current regulatory guidance to ensure: proper flow down of safety awareness, avionics application understanding at the lower tiers, OEM and 1st tier oversight practices, and capabilities of lower tier suppliers. Therefore, NASA established a research project to address Regulatory Compliance in a Multi-tier Supplier Network. This research was divided into three major study efforts: 1. Describe Modern Multi-tier Avionics Development 2. Identify Current Issues in Achieving Safety and Regulatory Compliance 3. Short-term/Long-term Recommendations Toward Higher Assurance Confidence This report presents our findings of the risks, weaknesses, and our recommendations. It also includes a collection of industry-identified risks, an assessment of guideline weaknesses related to multi-tier development of complex avionics systems, and a postulation of potential modifications to guidelines to close the identified risks and weaknesses.
Response to Intervention: Evaluation Report and Executive Summary

ERIC Educational Resources Information Center

Gorard, Stephen; Siddiqui, Nadia; See, Beng Huat

2014-01-01

Response to Intervention (RTI) is a targeted programme that uses a tiered approach to identify the needs of low achieving pupils. The approach begins with whole class teaching (Tier 1), followed by small group tuition (Tier 2) for those who need more attention, and one to one tutoring (Tier 3) for those who do not respond to the small group…
Evaluation of a Two-Phase Implementation of a Tier-2 (Small Group) Reading Intervention for Young Low-Progress Readers

ERIC Educational Resources Information Center

Buckingham, Jennifer; Wheldall, Kevin; Beaman-Wheldall, Robyn

2014-01-01

In a response to intervention (RtI) model, reading is taught in increasingly intensive tiers of instruction. The aim of the study was to examine the efficacy of a Tier-2 (small group) literacy intervention for young struggling readers. This article focuses on the second phase of a randomised control trial involving 14 students in kindergarten as…
A comparison of Tier 1 and Tier 3 medical homes under Oklahoma Medicaid program.

PubMed

Kumar, Jay I; Anthony, Melody; Crawford, Steven A; Arky, Ronald A; Bitton, Asaf; Splinter, Garth L

2014-04-01

The patient-centered medical home (PCMH) is a team-based model of care that seeks to improve quality of care and control costs. The Oklahoma Health Care Authority (OHCA) directs Oklahoma's Medicaid program and contracts with 861 medical home practices across the state in one of three tiers of operational capacity: Tier 1 (Basic), Tier 2 (Advanced) and Tier 3 (Optimal). Only 13.5% (n = 116) homes are at the optimal level; the majority (59%, n = 508) at the basic level. In this study, we sought to determine the barriers that prevented Tier 1 homes from advancing to Tier 3 level and the incentives that would motivate providers to advance from Tier 1 to 3. Our hypotheses were that Tier 1 medical homes were located in smaller practices with limited resources and the providers are not convinced that the expense of advancing from Tier 1 status to Tier 3 status was worth the added value. We analyzed OHCA records to compare the 508 Tier 1 (entry-level) with 116 Tier 3 (optimal) medical homes for demographic differences with regards to location: urban or rural, duration as medical home, percentage of contracts that were group contracts, number of providers per group contract, panel age range, panel size, and member-provider ratio. We surveyed all 508 Tier 1 homes with a mail-in survey, and with focused follow up visits to identify the barriers to, and incentives for, upgrading from Tier 1 to Tier 2 or 3. We found that Tier 1 homes were more likely to be in rural areas, run by solo practitioners, serve exclusively adult panels, have smaller panel sizes, and have higher member-to-provider ratios in comparison with Tier 3 homes. Our survey had a 35% response rate. Results showed that the most difficult changes for Tier 1 homes to implement were providing 4 hours of after-hours care and a dedicated program for mental illness and substance abuse. The results also showed that the most compelling incentives for encouraging Tier 1 homes to upgrade their tier status were less"red tape"with prior authorizations, higher pay, and help with panel member follow-up. Multiple interventions may help medical homes in Oklahoma advance from the basic to the optimal level such as sharing of resources among nearby practices, expansion of OHCA online resources to help with preauthorizations and patient follow up, and the generation and transmission of data on the benefits of medical homes.
An Integrated Social, Economic, and Ecologic Conceptual (ISEEC) framework for considering rangeland sustainability

USGS Publications Warehouse

Fox, W.E.; McCollum, D.W.; Mitchell, J.E.; Swanson, L.E.; Kreuter, U.P.; Tanaka, J.A.; Evans, G.R.; Theodore, Heintz H.; Breckenridge, R.P.; Geissler, P.H.

2009-01-01

Currently, there is no standard method to assess the complex systems in rangeland ecosystems. Decision makers need baselines to create a common language of current rangeland conditions and standards for continued rangeland assessment. The Sustainable Rangeland Roundtable (SRR), a group of private and public organizations and agencies, has created a forum to discuss rangeland sustainability and assessment. The SRR has worked to integrate social, economic, and ecological disciplines related to rangelands and has identified a standard set of indicators that can be used to assess rangeland sustainability. As part of this process, SRR has developed a two-tiered conceptual framework from a systems perspective to study the validity of indicators and the relationships among them. The first tier categorizes rangeland characteristics into four states. The second tier defines processes affecting these states through time and space. The framework clearly shows that the processes affect and are affected by each other. ?? 2009 Taylor & Francis Group, LLC.

Examining the Predictive Validity of a Dynamic Assessment of Decoding to Forecast Response Tier 2 to Intervention

PubMed Central

Cho, Eunsoo; Compton, Donald L.; Fuchs, Doug; Fuchs, Lynn S.; Bouton, Bobette

2013-01-01

The purpose of this study was to examine the role of a dynamic assessment (DA) of decoding in predicting responsiveness to Tier 2 small group tutoring in a response-to-intervention model. First-grade students (n=134) who did not show adequate progress in Tier 1 based on 6 weeks of progress monitoring received Tier 2 small-group tutoring in reading for 14 weeks. Student responsiveness to Tier 2 was assessed weekly with word identification fluency (WIF). A series of conditional individual growth curve analyses were completed that modeled the correlates of WIF growth (final level of performance and growth). Its purpose was to examine the predictive validity of DA in the presence of 3 sets of variables: static decoding measures, Tier 1 responsiveness indicators, and pre-reading variables (phonemic awareness, rapid letter naming, oral vocabulary, and IQ). DA was a significant predictor of final level and growth, uniquely explaining 3% – 13% of the variance in Tier 2 responsiveness depending on the competing predictors in the model and WIF outcome (final level of performance or growth). Although the additional variances explained uniquely by DA were relatively small, results indicate the potential of DA in identifying Tier 2 nonresponders. PMID:23213050
Examining the predictive validity of a dynamic assessment of decoding to forecast response to tier 2 intervention.

PubMed

Cho, Eunsoo; Compton, Donald L; Fuchs, Douglas; Fuchs, Lynn S; Bouton, Bobette

2014-01-01

The purpose of this study was to examine the role of a dynamic assessment (DA) of decoding in predicting responsiveness to Tier 2 small-group tutoring in a response-to-intervention model. First grade students (n = 134) who did not show adequate progress in Tier 1 based on 6 weeks of progress monitoring received Tier 2 small-group tutoring in reading for 14 weeks. Student responsiveness to Tier 2 was assessed weekly with word identification fluency (WIF). A series of conditional individual growth curve analyses were completed that modeled the correlates of WIF growth (final level of performance and growth). Its purpose was to examine the predictive validity of DA in the presence of three sets of variables: static decoding measures, Tier 1 responsiveness indicators, and prereading variables (phonemic awareness, rapid letter naming, oral vocabulary, and IQ). DA was a significant predictor of final level and growth, uniquely explaining 3% to 13% of the variance in Tier 2 responsiveness depending on the competing predictors in the model and WIF outcome (final level of performance or growth). Although the additional variances explained uniquely by DA were relatively small, results indicate the potential of DA in identifying Tier 2 nonresponders. © Hammill Institute on Disabilities 2012.
[Influence of contractual medical association on inpatient service performance].

PubMed

Wu, Zhi-jun; Jian, Wei-yan

2015-06-18

To study the influence of contractual medical association on inpatient service performance. The data came from "Database of Inpatient Record" administered by Department of Medical Insurance. Using diagnosis related groups (DRG) as the tool of risk-adjustment, the third-tier general hospitals and second-tier general hospitals in medical alliance as the intervention group, and the average level of the same grade local hospitals as the control group, the influence of medical alliance on inpatient service performance was evaluated. The difference in difference (DID) method was used for the data analysis. The assessing indicators included the number of DRG group, case mix index (CMI), the total weight, cost efficiency index and time efficiency index. After the establishment of medical association, compared with the average level of the same grade local hospitals, in the third-tier general hospitals of medical alliance, the growth rate of the total weight had declined, and cost efficiency index had increased, while in the second-tier general hospitals of medical alliance, the CMI value had declined, and the cost efficiency index had increased. Contractual medical association played a role of triage patients, and improved the service levels and management efficiency of the second-tier general hospitals.
Wind energy development: methods for assessing risks to birds and bats pre-construction

USGS Publications Warehouse

Katzner, Todd E.; Bennett, Victoria; Miller, Tricia A.; Duerr, Adam E.; Braham, Melissa A.; Hale, Amanda

2016-01-01

Wind power generation is rapidly expanding. Although wind power is a low-carbon source of energy, it can impact negatively birds and bats, either directly through fatality or indirectly by displacement or habitat loss. Pre-construction risk assessment at wind facilities within the United States is usually required only on public lands. When conducted, it generally involves a 3-tier process, with each step leading to more detailed and rigorous surveys. Preliminary site assessment (U.S. Fish and Wildlife Service, Tier 1) is usually conducted remotely and involves evaluation of existing databases and published materials. If potentially at-risk wildlife are present and the developer wishes to continue the development process, then on-site surveys are conducted (Tier 2) to verify the presence of those species and to assess site-specific features (e.g., topography, land cover) that may influence risk from turbines. The next step in the process (Tier 3) involves quantitative or scientific studies to assess the potential risk of the proposed project to wildlife. Typical Tier-3 research may involve acoustic, aural, observational, radar, capture, tracking, or modeling studies, all designed to understand details of risk to specific species or groups of species at the given site. Our review highlights several features lacking from many risk assessments, particularly the paucity of before-and-after-control- impact (BACI) studies involving modeling and a lack of understanding of cumulative effects of wind facilities on wildlife. Both are essential to understand effective designs for pre-construction monitoring and both would help expand risk assessment beyond eagles.
Identifying important life stages for monitoring and assessing risks from exposures to environmental contaminants: results of a World Health Organization review.

PubMed

Cohen Hubal, Elaine A; de Wet, Thea; Du Toit, Lilo; Firestone, Michael P; Ruchirawat, Mathuros; van Engelen, Jacqueline; Vickers, Carolyn

2014-06-01

In this paper, we summarize exposure-related issues to consider in determining the most appropriate age ranges and life stages for risk assessment. We then propose a harmonized set of age bins for monitoring and assessing risks from exposures to chemicals for global use. The focus is on preconception through adolescence, though the approach should be applicable to additional life stages. A two-tiered set of early life age groups is recommended. The first tier involves the adoption of guidance similar to the childhood age groups recommended by the U.S. Environmental Protection Agency, whereas the second tier consolidates some of those age groups to reduce the burden of developing age-specific exposure factors for different regions. While there is no single "correct" means of choosing a common set of age groups to use internationally in assessing early life exposure and risk, use of a set of defined age groups is recommended to facilitate comparisons of potential exposures and risks around the globe, the collection of data and analyses of aggregate exposure and cumulative risk. Application of these age groups for robust assessment of exposure and risk for specific populations will require region-specific exposure factors as well as local environmental monitoring data. Copyright © 2013 World Health Organization. Published by Elsevier Inc. All rights reserved.
Analysis of the American Society of Anesthesiologists Physical Status Classification System and Caprini Risk Assessment Model in Predicting Venous Thromboembolic Outcomes in Plastic Surgery Patients.

PubMed

Shaikh, Mohammad-Ali; Jeong, Haneol S; Mastro, Andrew; Davis, Kathryn; Lysikowski, Jerzy; Kenkel, Jeffrey M

2016-04-01

Venous thromboembolism (VTE) can be a fatal outcome of plastic surgery. Risk assessment models attempt to determine a patient's risk, yet few studies have compared different models in plastic surgery patients. The authors investigated preoperative ASA physical status and 2005 Caprini scores to determine which model was more predictive of VTE. A retrospective chart review examined 1801 patients undergoing contouring and reconstructive procedures from January 2008 to January 2012. Patients were grouped into risk tiers for ASA scores (1-2 = low, 3+ = high) with 2 cutoffs for Caprini scores (1-4 = low, 5+ high; 1-5 = low, 6+ = high), then re-stratified into 3 tiers using Caprini score cutoffs (1-4 = low, 5-8 = high, 9+ = highest; 1-5 = low, 6-8 = high, 9+ = highest). Median scores of VTE patients were compared to those without VTE. Odds ratio and chi-squared analyses were performed. Of the 1598 patients included in the study, 1.50% developed VTE. Median ASA scores differed significantly between comparison groups but Caprini scores did not vary regardless of cutoff. When examining the 2-tiered Caprini scores, using low risk = 1-5 showed a significant relationship between risk tier and DVT development (P = 0.0266). The ASA system yielded the highest odds ratio of VTE development between low and high-risk patients. The Caprini model captured more patients with VTE in its high-risk category. Combining the two models for a more heuristic approach to preoperative care may identify patients at higher risk. 4 Risk. © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.
To What Interventions Are Students Responding?

ERIC Educational Resources Information Center

Lipson, Marjorie Y.; Wixson, Karen K.

2012-01-01

Intervention is a central tenet of the various (multitiered) approaches used to implement Response to Intervention (RTI). It appears in Tier 1 core instruction in the form of differentiation, in Tier 2 in the form of supplemental small groups, and in Tier 3 and 4 instruction in the form of more intensive, often individualized support from…
Examining Proportional Representation of Ethnic Groups within the SWPBIS Model

ERIC Educational Resources Information Center

Jewell, Kelly

2012-01-01

The quantitative study seeks to analyze if School-wide Positive Behavior Intervention and Support (SWPBIS) model reduces the likelihood that minority students will receive more individualized supports due to behavior problems. In theory, the SWPBIS model should reflect a 3-tier system with tier 1 representing approximately 80%, tier 2 representing…
The impact of tiered physician networks on patient choices.

PubMed

Sinaiko, Anna D; Rosenthal, Meredith B

2014-08-01

To assess whether patient choice of physician or health plan was affected by physician tier-rankings. Administrative claims and enrollment data on 171,581 nonelderly beneficiaries enrolled in Massachusetts Group Insurance Commission health plans that include a tiered physician network and who had an office visit with a tiered physician. We estimate the impact of tier-rankings on physician market share within a plan of new patients and on the percent of a physician's patients who switch to other physicians with fixed effects regression models. The effect of tiering on consumer plan choice is estimated using logistic regression and a pre-post study design. Physicians in the bottom (least-preferred) tier, particularly certain specialist physicians, had lower market share of new patient visits than physicians with higher tier-rankings. Patients whose physician was in the bottom tier were more likely to switch health plans. There was no effect of tier-ranking on patients switching away from physicians whom they have seen previously. The effect of tiering appears to be among patients who choose new physicians and at the lower end of the distribution of tiered physicians, rather than moving patients to the "best" performers. These findings suggest strong loyalty of patients to physicians more likely to be considered their personal doctor. © Health Research and Educational Trust.
The 2016 ACCP Pharmacotherapy Didactic Curriculum Toolkit.

PubMed

Schwinghammer, Terry L; Crannage, Andrew J; Boyce, Eric G; Bradley, Bridget; Christensen, Alyssa; Dunnenberger, Henry M; Fravel, Michelle; Gurgle, Holly; Hammond, Drayton A; Kwon, Jennifer; Slain, Douglas; Wargo, Kurt A

2016-11-01

The 2016 American College of Clinical Pharmacy (ACCP) Educational Affairs Committee was charged with updating and contemporizing ACCP's 2009 Pharmacotherapy Didactic Curriculum Toolkit. The toolkit has been designed to guide schools and colleges of pharmacy in developing, maintaining, and modifying their curricula. The 2016 committee reviewed the recent medical literature and other documents to identify disease states that are responsive to drug therapy. Diseases and content topics were organized by organ system, when feasible, and grouped into tiers as defined by practice competency. Tier 1 topics should be taught in a manner that prepares all students to provide collaborative, patient-centered care upon graduation and licensure. Tier 2 topics are generally taught in the professional curriculum, but students may require additional knowledge or skills after graduation (e.g., residency training) to achieve competency in providing direct patient care. Tier 3 topics may not be taught in the professional curriculum; thus, graduates will be required to obtain the necessary knowledge and skills on their own to provide direct patient care, if required in their practice. The 2016 toolkit contains 276 diseases and content topics, of which 87 (32%) are categorized as tier 1, 133 (48%) as tier 2, and 56 (20%) as tier 3. The large number of tier 1 topics will require schools and colleges to use creative pedagogical strategies to achieve the necessary practice competencies. Almost half of the topics (48%) are tier 2, highlighting the importance of postgraduate residency training or equivalent practice experience to competently care for patients with these disorders. The Pharmacotherapy Didactic Curriculum Toolkit will continue to be updated to provide guidance to faculty at schools and colleges of pharmacy as these academic pharmacy institutions regularly evaluate and modify their curricula to keep abreast of scientific advances and associated practice changes. Access the current Pharmacotherapy Didactic Curriculum Toolkit at http://www.accp.com/docs/positions/misc/Toolkit_final.pdf. © 2016 Pharmacotherapy Publications, Inc.
Assessing the nutritional quality of diets of Canadian children and adolescents using the 2014 Health Canada Surveillance Tool Tier System.

PubMed

Jessri, Mahsa; Nishi, Stephanie K; L'Abbe, Mary R

2016-05-10

Health Canada's Surveillance Tool (HCST) Tier System was developed in 2014 with the aim of assessing the adherence of dietary intakes with Eating Well with Canada's Food Guide (EWCFG). HCST uses a Tier system to categorize all foods into one of four Tiers based on thresholds for total fat, saturated fat, sodium, and sugar, with Tier 4 reflecting the unhealthiest and Tier 1 the healthiest foods. This study presents the first application of the HCST to examine (i) the dietary patterns of Canadian children, and (ii) the applicability and relevance of HCST as a measure of diet quality. Data were from the nationally-representative, cross-sectional Canadian Community Health Survey 2.2. A total of 13,749 participants aged 2-18 years who had complete lifestyle and 24-hour dietary recall data were examined. Dietary patterns of Canadian children and adolescents demonstrated a high prevalence of Tier 4 foods within the sub-groups of processed meats and potatoes. On average, 23-31 % of daily calories were derived from "other" foods and beverages not recommended in EWCFG. However, the majority of food choices fell within the Tier 2 and 3 classifications due to lenient criteria used by the HCST for classifying foods. Adherence to the recommendations presented in the HCST was associated with closer compliance to meeting nutrient Dietary Reference Intake recommendations, however it did not relate to reduced obesity as assessed by body mass index (p > 0.05). EWCFG recommendations are currently not being met by most children and adolescents. Future nutrient profiling systems need to incorporate both positive and negative nutrients and an overall score. In addition, a wider range of nutrient thresholds should be considered for HCST to better capture product differences, prevent categorization of most foods as Tiers 2-3 and provide incentives for product reformulation.
A single, continuous metric to define tiered serum neutralization potency against HIV

DOE PAGES

Hraber, Peter Thomas; Korber, Bette Tina Marie; Wagh, Kshitij; ...

2018-01-19

HIV-1 Envelope (Env) variants are grouped into tiers by their neutralization-sensitivity phenotype. This helped to recognize that tier 1 neutralization responses can be elicited readily, but do not protect against new infections. Tier 3 viruses are the least sensitive to neutralization. Because most circulating viruses are tier 2, vaccines that elicit neutralization responses against them are needed. While tier classification is widely used for viruses, a way to rate serum or antibody neutralization responses in comparable terms is needed. Logistic regression of neutralization outcomes summarizes serum or antibody potency on a continuous, tier-like scale. It also tests significance of themore » neutralization score, to indicate cases where serum response does not depend on virus tiers. The method can standardize results from different virus panels, and could lead to high-throughput assays, which evaluate a single serum dilution, rather than a dilution series, for more efficient use of limited resources to screen samples from vaccinees.« less
A single, continuous metric to define tiered serum neutralization potency against HIV

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

Hraber, Peter Thomas; Korber, Bette Tina Marie; Wagh, Kshitij

HIV-1 Envelope (Env) variants are grouped into tiers by their neutralization-sensitivity phenotype. This helped to recognize that tier 1 neutralization responses can be elicited readily, but do not protect against new infections. Tier 3 viruses are the least sensitive to neutralization. Because most circulating viruses are tier 2, vaccines that elicit neutralization responses against them are needed. While tier classification is widely used for viruses, a way to rate serum or antibody neutralization responses in comparable terms is needed. Logistic regression of neutralization outcomes summarizes serum or antibody potency on a continuous, tier-like scale. It also tests significance of themore » neutralization score, to indicate cases where serum response does not depend on virus tiers. The method can standardize results from different virus panels, and could lead to high-throughput assays, which evaluate a single serum dilution, rather than a dilution series, for more efficient use of limited resources to screen samples from vaccinees.« less
Comparing a Behavioral Check-In/Check-Out (CICO) Intervention to Standard Practice in an Urban Middle School Setting Using an Experimental Group Design

ERIC Educational Resources Information Center

Simonsen, Brandi; Myers, Diane; Briere, Donald E., III

2011-01-01

Students who continue to demonstrate at-risk behaviors after a school implements schoolwide primary (Tier 1) interventions require targeted-group secondary (Tier 2) interventions. This study was conducted to compare the effectiveness of a targeted-group behavioral check-in/check-out (CICO) intervention with the school's standard practice (SP) with…
Supplementing research ethics training in psychiatry residents: A five-tier approach.

PubMed

Viswanath, Biju; Jayarajan, Rajan Nishanth; Chandra, Prabha S; Chaturvedi, Santosh K

2018-04-01

Ethics training is a key step in the research supervision of psychiatry trainees and there is need for a structured educational module. We developed a new research ethics training module for psychiatry residents - The Five-Tier Approach. Twenty-five first year psychiatry residents of an academic psychiatric training centre in India participated in this multi-session workshop. Module 1 included the completion of NIH online certification course for research ethics training. Module 2 was a one-hour interactive group discussion on ethical principles in research. Module 3 was a two-hour session consisting of case-based group discussion of nine selected research vignettes. Module 4 involved preparation of an informed consent form. Module 5 was a mock ethics committee role-played by seven students while the larger group observed using a Fish Bowl technique and provided feedback. Assessments were done during the third and final modules. During the third module, understanding regarding certain areas - autonomy, benefits and justice was found to be inadequate. In the final step, all ethical aspects were covered by the students. This five-tier approach seems like a superior tool for research ethics training in academic institutions, especially in Southeast Asia, where the student-teacher ratios are generally very high. Copyright © 2018 Elsevier B.V. All rights reserved.
34 CFR 75.224 - What are the procedures for using a multiple tier review process to evaluate applications?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 1 2010-07-01 2010-07-01 false What are the procedures for using a multiple tier... applications received. (d) The Secretary may, in any tier— (1) Use more than one group of experts to gain... procedures for using a multiple tier review process to evaluate applications? (a) The Secretary may use a...
Response to Instruction in Preschool: Results of Two Randomized Studies with Children At Significant Risk of Reading Difficulties

PubMed Central

Lonigan, Christopher J.; Phillips, Beth M.

2015-01-01

Although response-to-instruction (RTI) approaches have received increased attention, few studies have evaluated the potential impacts of RTI approaches with preschool populations. This manuscript presents results of two studies examining impacts of Tier II instruction with preschool children. Participating children were identified as substantially delayed in the acquisition of early literacy skills despite exposure to high-quality, evidence-based classroom instruction. Study 1 included 93 children (M age = 58.2 months; SD = 3.62) attending 12 Title I preschools. Study 2 included 184 children (M age = 58.2 months; SD = 3.38) attending 19 Title I preschools. The majority of children were Black/African American, and about 60% were male. In both studies, eligible children were randomized to receive either 11 weeks of need-aligned, small-group instruction or just Tier I. Tier II instruction in Study 1 included variations of activities for code- and language-focused domains with prior evidence of efficacy in non-RTI contexts. Tier II instruction in Study 2 included instructional activities narrower in scope, more intensive, and delivered to smaller groups of children. Impacts of Tier II instruction in Study 1 were minimal; however, there were significant and moderate-to-large impacts in Study 2. These results identify effective Tier II instruction but indicate that the context in which children are identified may alter the nature of Tier II instruction that is required. Children identified as eligible for Tier II in an RTI framework likely require more intensive and more narrowly focused instruction than do children at general risk of later academic difficulties. PMID:26869730
Mapping of the US Domestic Influenza Virologic Surveillance Landscape.

PubMed

Jester, Barbara; Schwerzmann, Joy; Mustaquim, Desiree; Aden, Tricia; Brammer, Lynnette; Humes, Rosemary; Shult, Pete; Shahangian, Shahram; Gubareva, Larisa; Xu, Xiyan; Miller, Joseph; Jernigan, Daniel

2018-07-17

Influenza virologic surveillance is critical each season for tracking influenza circulation, following trends in antiviral drug resistance, detecting novel influenza infections in humans, and selecting viruses for use in annual seasonal vaccine production. We developed a framework and process map for characterizing the landscape of US influenza virologic surveillance into 5 tiers of influenza testing: outpatient settings (tier 1), inpatient settings and commercial laboratories (tier 2), state public health laboratories (tier 3), National Influenza Reference Center laboratories (tier 4), and Centers for Disease Control and Prevention laboratories (tier 5). During the 2015-16 season, the numbers of influenza tests directly contributing to virologic surveillance were 804,000 in tiers 1 and 2; 78,000 in tier 3; 2,800 in tier 4; and 3,400 in tier 5. With the release of the 2017 US Pandemic Influenza Plan, the proposed framework will support public health officials in modeling, surveillance, and pandemic planning and response.
Evaluation of a Two-Phase Experimental Study of a Small Group ("MultiLit") Reading Intervention for Older Low-Progress Readers

ERIC Educational Resources Information Center

Buckingham, Jennifer; Beaman-Wheldall, Robyn; Wheldall, Kevin

2014-01-01

The study reported here examined the efficacy of a small group (Tier 2 in a three-tier Response to Intervention model) literacy intervention for older low-progress readers (in Years 3-6). This article focuses on the second phase of a two-phase, crossover randomized control trial involving 26 students. In Phase 1, the experimental group (E1)…
Designing and Implementing Group Contingencies in the Classroom: A Teacher's Guide

ERIC Educational Resources Information Center

Chow, Jason C.; Gilmour, Allison F.

2016-01-01

Group contingencies are a positive, proactive classroom management technique that works well as Tier 1 of a multi-tiered system of behavior support. These programs are adaptable to student and classroom needs and work well to support the behavior of students with disabilities in general education classrooms. Off-the-shelf programs exist, but…

Multi-Tiered System of Support: Best Differentiation Practices for English Language Learners in Tier 1

ERIC Educational Resources Information Center

Izaguirre, Cecilia

2017-01-01

Purpose: This qualitative case study explored the best practices of differentiation of Tier 1 instruction within a multi-tiered system of support for English Language Learners who were predominately Spanish speaking. Theoretical Framework: The zone of proximal development theory, cognitive theory, and the affective filter hypothesis guided this…
Tier 1 and Tier 2 Early Intervention for Handwriting and Composing

ERIC Educational Resources Information Center

Berninger, Virginia W.; Rutberg, Judith E.; Abbott, Robert D.; Garcia, Noelia; Anderson-Youngstrom, Marci; Brooks, Allison; Fulton, Cynthia

2006-01-01

Three studies evaluated Tier 1 early intervention for handwriting at a critical period for literacy development in first grade and one study evaluated Tier 2 early intervention in the critical period between third and fourth grades for composing on high stakes tests. The results contribute to knowledge of research-supported handwriting and…
Status and Trends in Networking at LHC Tier1 Facilities

NASA Astrophysics Data System (ADS)

Bobyshev, A.; DeMar, P.; Grigaliunas, V.; Bigrow, J.; Hoeft, B.; Reymund, A.

2012-12-01

The LHC is entering its fourth year of production operation. Most Tier1 facilities have been in operation for almost a decade, when development and ramp-up efforts are included. LHC's distributed computing model is based on the availability of high capacity, high performance network facilities for both the WAN and LAN data movement, particularly within the Tier1 centers. As a result, the Tier1 centers tend to be on the leading edge of data center networking technology. In this paper, we analyze past and current developments in Tier1 LAN networking, as well as extrapolating where we anticipate networking technology is heading. Our analysis will include examination into the following areas: • Evolution of Tier1 centers to their current state • Evolving data center networking models and how they apply to Tier1 centers • Impact of emerging network technologies (e.g. 10GE-connected hosts, 40GE/100GE links, IPv6) on Tier1 centers • Trends in WAN data movement and emergence of software-defined WAN network capabilities • Network virtualization
33 CFR 154.1135 - Response plan development and evaluation criteria.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Operating in Prince William Sound, Alaska § 154.1135 Response plan development and evaluation criteria. The following response times must be used in determining the on scene arrival time in Prince William Sound for the response resources required by § 154.1045: Tier 1 (hrs.) Tier 2 (hrs.) tier 3 (hrs.) Prince...
The proposed tier 2 medaka extended one generation reproduction test (MEOGRT)

EPA Science Inventory

The Food Quality Protection Act of 1996 requires EPA to develop and implement a program using valid tests for determining the potential endocrine effects from pesticides. The EPA established advisory group, the Endocrine Disruptor Screening and Testing Advisory Committee (EDSTAC)...
Testing SLURM open source batch system for a Tierl/Tier2 HEP computing facility

NASA Astrophysics Data System (ADS)

Donvito, Giacinto; Salomoni, Davide; Italiano, Alessandro

2014-06-01

In this work the testing activities that were carried on to verify if the SLURM batch system could be used as the production batch system of a typical Tier1/Tier2 HEP computing center are shown. SLURM (Simple Linux Utility for Resource Management) is an Open Source batch system developed mainly by the Lawrence Livermore National Laboratory, SchedMD, Linux NetworX, Hewlett-Packard, and Groupe Bull. Testing was focused both on verifying the functionalities of the batch system and the performance that SLURM is able to offer. We first describe our initial set of requirements. Functionally, we started configuring SLURM so that it replicates all the scheduling policies already used in production in the computing centers involved in the test, i.e. INFN-Bari and the INFN-Tier1 at CNAF, Bologna. Currently, the INFN-Tier1 is using IBM LSF (Load Sharing Facility), while INFN-Bari, an LHC Tier2 for both CMS and Alice, is using Torque as resource manager and MAUI as scheduler. We show how we configured SLURM in order to enable several scheduling functionalities such as Hierarchical FairShare, Quality of Service, user-based and group-based priority, limits on the number of jobs per user/group/queue, job age scheduling, job size scheduling, and scheduling of consumable resources. We then show how different job typologies, like serial, MPI, multi-thread, whole-node and interactive jobs can be managed. Tests on the use of ACLs on queues or in general other resources are then described. A peculiar SLURM feature we also verified is triggers on event, useful to configure specific actions on each possible event in the batch system. We also tested highly available configurations for the master node. This feature is of paramount importance since a mandatory requirement in our scenarios is to have a working farm cluster even in case of hardware failure of the server(s) hosting the batch system. Among our requirements there is also the possibility to deal with pre-execution and post-execution scripts, and controlled handling of the failure of such scripts. This feature is heavily used, for example, at the INFN-Tier1 in order to check the health status of a worker node before execution of each job. Pre- and post-execution scripts are also important to let WNoDeS, the IaaS Cloud solution developed at INFN, use SLURM as its resource manager. WNoDeS has already been supporting the LSF and Torque batch systems for some time; in this work we show the work done so that WNoDeS supports SLURM as well. Finally, we show several performance tests that we carried on to verify SLURM scalability and reliability, detailing scalability tests both in terms of managed nodes and of queued jobs.
Development of two tier test to assess conceptual understanding in heat and temperature

NASA Astrophysics Data System (ADS)

Winarti; Cari; Suparmi; Sunarno, Widha; Istiyono, Edi

2017-01-01

Heat and temperature is a concept that has been learnt from primary school to undergraduate levels. One problem about heat and temperature is that they are presented abstractly, theoretical concept. A student conceptual frameworks develop from their daily experiences. The purpose of this research was to develop a two-tier test of heat and temperature concept and measure conceptual understanding of heat and temperature of the student. This study consist of two method is qualitative and quantitative method. The two-tier test was developed using procedures defined by Borg and Gall. The two-tier test consisted of 20 question and was tested for 137 students for collecting data. The result of the study showed that the two-tier test was effective in determining the students’ conceptual understanding and also it might be used as an alternative for assessment and evaluation of students’ achievement
DOE Office of Scientific and Technical Information (OSTI.GOV)

Bobyshev, A.; DeMar, P.; Grigaliunas, V.

The LHC is entering its fourth year of production operation. Most Tier1 facilities have been in operation for almost a decade, when development and ramp-up efforts are included. LHC's distributed computing model is based on the availability of high capacity, high performance network facilities for both the WAN and LAN data movement, particularly within the Tier1 centers. As a result, the Tier1 centers tend to be on the leading edge of data center networking technology. In this paper, we analyze past and current developments in Tier1 LAN networking, as well as extrapolating where we anticipate networking technology is heading. Ourmore » analysis will include examination into the following areas: Evolution of Tier1 centers to their current state Evolving data center networking models and how they apply to Tier1 centers Impact of emerging network technologies (e.g. 10GE-connected hosts, 40GE/100GE links, IPv6) on Tier1 centers Trends in WAN data movement and emergence of software-defined WAN network capabilities Network virtualization« less
Status of forensic odontology in metro and in tier 2 city in urban India.

PubMed

Khare, Parul; Chandra, Shaleen; Raj, Vineet; Verma, Poonam; Subha, G; Khare, Abhishek

2013-07-01

Dentist can play a significant role in identifying the victims or perpetrators of crime as well as in disasters. Knowledge about the various aspects of forensic science as well as dental and related evidences can help a dental practitioner in assisting the civil agencies in such cases. To evaluate the awareness and knowledge of forensic odontology among dentists in a metropolitan and a tier 2 city. Seven hundred and seventy four dentists were included in this survey. Questionnaire was designed to assess the knowledge, aptitude, and status of practice of forensic odontology. Data was analyzed by comparing overall awareness of forensic odontology among dentists in metro and tier 2 city as well as between the different groups. Apart from the source of knowledge, no significant differences were seen in respondents of metropolitan and tier 2 city. Significantly higher proportion of subjects in metro reported journals as source of knowledge (P < 0.001), whereas it was newspaper in tier 2 city (P = 0.001). On comparing the mean scores of knowledge (k), aptitude (a), and practice (p) among different study groups, it was found that all the three scores were highest for practitioner cum academician (PA) group (k - 2.37, a - 0.69, P - 0.17). Knowledge scores were minimum for pure practitioner (PP) group (1.98), and attitude and practice scores of pure academician (A) group were minimum (a - 0.53, P - 0.06). Respondents had low knowledge about the applications of forensic odontology in routine practice; hence, steps must be taken to educate the dental practitioners about its clinical applications.
A Responsive Tier 2 Process for a Middle School Student with Behavior Problems

ERIC Educational Resources Information Center

McDaniel, Sara C.; Bruhn, Allison L.; Mitchell, Barbara S.

2017-01-01

Students requiring Tier 2 behavioral supports frequently display behavioral deficits in multiple domains (e.g., emotional symptoms and peer problems). The Tier 2 framework developed by McDaniel, Bruhn, & Mitchell (2015a) is a responsive structure for identifying and intervening at Tier 2. This process is described with a practical case example…
Small Groups, Big Gains: Efficacy of a Tier 2 Phonological Awareness Intervention with Preschoolers with Early Literacy Deficits

ERIC Educational Resources Information Center

Kruse, Lydia G.; Spencer, Trina D.; Olszewski, Arnold; Goldstein, Howard

2015-01-01

Purpose: The purpose of the present study was to evaluate the efficacy of a phonological awareness (PA) intervention, designed for Tier 2 instruction in a Response to Intervention (RTI) model, delivered to small groups of preschoolers. Method: A multiple-baseline design across participants was used to evaluate the efficacy of the intervention on…
Promoting the hydrostatic conceptual change test (HCCT) with four-tier diagnostic test item

NASA Astrophysics Data System (ADS)

Purwanto, M. G.; Nurliani, R.; Kaniawati, I.; Samsudin, A.

2018-05-01

Hydrostatic Conceptual Change Test (HCCT) is a diagnostic test instrument to identify students’ conception on Hydrostatic field. It is very important to support the learning process in the classroom. Based on that point of view, the researcher decided to develop HCCT instrument test into four-tier test diagnostic items. The resolve of this research is planned as the first step of four-tier test-formatted HCCT development as one of investigative test instrument on Hydrostatic. The research method used the 4D model which has four comprehensive steps: 1) defining, 2) designing, 3) developing and 4) disseminating. The instrument developed has been tried to 30 students in one of senior high schools. The data showed that four-tier- test-formatted HCCT is able to identify student’s conception level of Hydrostatic. In conclusion, the development of four-tier test-formatted HCCT is one of potential diagnostic test instrument that able to classify the category of students who misconception, no understanding, understanding, partial understanding and no codeable about concept of Hydrostatic.
The Application of a Three-Tier Model of Intervention to Parent Training

PubMed Central

Phaneuf, Leah; McIntyre, Laura Lee

2015-01-01

A three-tier intervention system was designed for use with parents with preschool children with developmental disabilities to modify parent–child interactions. A single-subject changing-conditions design was used to examine the utility of a three-tier intervention system in reducing negative parenting strategies, increasing positive parenting strategies, and reducing child behavior problems in parent–child dyads (n = 8). The three intervention tiers consisted of (a) self-administered reading material, (b) group training, and (c) individualized video feedback sessions. Parental behavior was observed to determine continuation or termination of intervention. Results support the utility of a tiered model of intervention to maximize treatment outcomes and increase efficiency by minimizing the need for more costly time-intensive interventions for participants who may not require them. PMID:26213459
A Data-Driven Preschool PD Model for Literacy and Oral Language Instruction

ERIC Educational Resources Information Center

Abbott, Mary; Atwater, Jane; Lee, Younwoo; Edwards, Liesl

2011-01-01

The purpose of this article is to describe the professional development (PD) model for preschool literacy and language instruction that took place in a 3-year, 2-tiered Early Reading First project in 9 Head Start and community-based school classrooms. In our tiered model, the Tier 1 level was classroom instruction and Tier 2 was intervention…
Development of a tier 1 R5 clade C simian-human immunodeficiency virus as a tool to test neutralizing antibody-based immunoprophylaxis.

PubMed

Siddappa, Nagadenahalli B; Hemashettar, Girish; Wong, Yin Ling; Lakhashe, Samir; Rasmussen, Robert A; Watkins, Jennifer D; Novembre, Francis J; Villinger, François; Else, James G; Montefiori, David C; Ruprecht, Ruth M

2011-04-01

While some recently transmitted HIV clade C (HIV-C) strains exhibited tier 1 neutralization phenotypes, most were tier 2 strains (J Virol 2010; 84:1439). Because induction of neutralizing antibodies (nAbs) through vaccination against tier 2 viruses has proven difficult, we have generated a tier 1, clade C simian-human immunodeficiency virus (SHIV-C) to permit efficacy testing of candidate AIDS vaccines against tier 1 viruses. SHIV-1157ipEL was created by swapping env of a late-stage virus with that of a tier 1, early form. After adaptation to rhesus macaques (RM), passaged SHIV-1157ipEL-p replicated vigorously in vitro and in vivo while maintaining R5 tropism. The virus was reproducibly transmissible intrarectally. Phylogenetically, SHIV-1157ipEL-p Env clustered with HIV-C sequences. All RM chronically infected with SHIV-1157ipEL-p developed high nAb titers against autologous as well as heterologous tier 1 strains. SHIV-1157ipEL-p was reproducibly transmitted in RM, induced cross-clade nAbs, and represents a tool to evaluate anti-HIV-C nAb responses in primates. © 2010 John Wiley & Sons A/S.
The combined approach to lysis utilizing eptifibatide and rt-PA in acute ischemic stroke: the CLEAR stroke trial.

PubMed

Pancioli, Arthur M; Broderick, Joseph; Brott, Thomas; Tomsick, Thomas; Khoury, Jane; Bean, Judy; del Zoppo, Gregory; Kleindorfer, Dawn; Woo, Daniel; Khatri, Pooja; Castaldo, John; Frey, James; Gebel, James; Kasner, Scott; Kidwell, Chelsea; Kwiatkowski, Thomas; Libman, Richard; Mackenzie, Richard; Scott, Phillip; Starkman, Sidney; Thurman, R Jason

2008-12-01

Multiple approaches are being studied to enhance the rate of thrombolysis for acute ischemic stroke. Treatment of myocardial infarction with a combination of a reduced-dose fibrinolytic agent and a glycoprotein (GP) IIb/IIIa receptor antagonist has been shown to improve the rate of recanalization versus fibrinolysis alone. The combined approach to lysis utilizing eptifibatide and recombinant tissue-type plasminogen activator (rt-PA) (CLEAR) stroke trial assessed the safety of treating acute ischemic stroke patients within 3 hours of symptom onset with this combination. The CLEAR trial was a National Institutes of Health/National Institute of Neurological Disorders and Stroke-funded multicenter, double-blind, randomized, dose-escalation and safety study. Patients were randomized 3:1 to either low-dose rt-PA (tier 1=0.3 mg/kg, tier 2=0.45 mg/kg) plus eptifibatide (75 microg/kg bolus followed by 0.75 microg/kg per min infusion for 2 hours) or standard-dose rt-PA (0.9 mg/kg). The primary safety end point was the incidence of symptomatic intracerebral hemorrhage within 36 hours. Secondary analyses were performed regarding clinical efficacy. Ninety-four patients (40 in tier 1 and 54 in tier 2) were enrolled. The combination group of the 2 dose tiers (n=69) had a median age of 71 years and a median baseline National Institutes of Health Stroke Scale (NIHSS) score of 14, and the standard-dose rt-PA group (n=25) had a median age of 61 years and a median baseline NIHSS score of 10 (P=0.01 for NIHSS score). Fifty-two (75%) of the combination treatment group and 24 (96%) of the standard treatment group had a baseline modified Rankin scale score of 0 (P=0.04). There was 1 (1.4%; 95% CI, 0% to 4.3%) symptomatic intracranial hemorrhage in the combination group and 2 (8.0%; 95% CI, 0% to 19.2%) in the rt-PA-only arm (P=0.17). During randomization in tier 2, a review by the independent data safety monitoring board demonstrated that the safety profile of combination therapy at the tier 2 doses was such that further enrollment was statistically unlikely to indicate inadequate safety for the combination treatment group, the ultimate outcome of the study. Thus, the study was halted. There was a trend toward increased clinical efficacy of standard-dose rt-PA compared with the combination treatment group. The safety of the combination of reduced-dose rt-PA plus eptifibatide justifies further dose-ranging trials in acute ischemic stroke.
Professional Development to Differentiate Kindergarten Tier 1 Instruction: Can Already Effective Teachers Improve Student Outcomes by Differentiating Tier 1 Instruction?

ERIC Educational Resources Information Center

Al Otaiba, Stephanie; Folsom, Jessica S.; Wanzek, Jeanne; Greulich, Luana; Waesche, Jessica; Schatschneider, Christopher; Connor, Carol M.

2016-01-01

Two primary purposes guided this quasi-experimental within-teacher study: (a) to examine changes from baseline through 2 years of professional development (Individualizing Student Instruction) in kindergarten teachers' differentiation of Tier 1 literacy instruction; and (b) to examine changes in reading and vocabulary of 3 cohorts of the teachers'…
Development and Application of a Four-Tier Test to Assess Pre-Service Physics Teachers' Misconceptions about Geometrical Optics

ERIC Educational Resources Information Center

Kaltakci-Gurel, Derya; Eryilmaz, Ali; McDermott, Lillian Christie

2017-01-01

Background: Correct identification of misconceptions is an important first step in order to gain an understanding of student learning. More recently, four-tier multiple choice tests have been found to be effective in assessing misconceptions. Purpose: The purposes of this study are (1) to develop and validate a four-tier misconception test to…
Developing energy and momentum conceptual survey (EMCS) with four-tier diagnostic test items

NASA Astrophysics Data System (ADS)

Afif, Nur Faadhilah; Nugraha, Muhammad Gina; Samsudin, Achmad

2017-05-01

Students' conceptions of work and energy are important to support the learning process in the classroom. For that reason, a diagnostic test instrument is needed to diagnose students' conception of work and energy. As a result, the researcher decided to develop Energy and Momentum Conceptual Survey (EMCS) instrument test into four-tier test diagnostic items. The purpose of this research is organized as the first step of four-tier test-formatted EMCS development as one of diagnostic test instruments on work and Energy. The research method used the 4D model (Defining, Designing, Developing and Disseminating). The instrument developed has been tested to 39 students in one of Senior High Schools. The resulting research showed that four-tier test-formatted EMCS is able to diagnose students' conception level of work and energy concept. It can be concluded that the development of four-tier test-formatted EMCS is one of potential diagnostic test instruments that able to obtain the category of students who understand concepts, misconceptions and do not understand about Work and Energy concept at all.
Train the trainer? A randomized controlled trial of a multi-tiered oral health education programme in community-based residential services for adults with intellectual disability.

PubMed

Mac Giolla Phadraig, Caoimhin; Guerin, Suzanne; Nunn, June

2013-04-01

To assess the impact of a multi-tiered oral health education programme on care staff caring for people with intellectual disability (ID). Postal questionnaires were sent to all care staff of a community-based residential care service for adults, randomly assigned to control and intervention groups. A specifically developed training programme was delivered to residential staff nominees, who then trained all staff within the intervention group. The control group received no training. Post-test questionnaires were sent to both groups. Paired-samples t-test was used to compare oral health-related knowledge (K) and behaviour, attitude and self-efficacy (BAS) scores. Of the initial 219 respondents, 154 (response rate between 40% and 35.8%, with attrition rate of 29.7% from baseline to repeat) returned completed questionnaires at post-test (M=8.5 months, range=6.5-11 months). Control and intervention groups were comparable for general training, employment and demographic variables. In the intervention group, mean Knowledge Index score rose from K=7.2 to K=7.9 (P<0.001) and mean BAS scale score rose from BAS=4.7 to BAS=5.4 (P<0.001). There was no statistically significant increase in mean scores from test (K=7.0, BAS=4.7) to post-test (K=7.2, BAS=4.9) for the control group. Mean scores regarding knowledge, attitude, self-efficacy and reported behaviour increased significantly at 8.5 months in staff where training was provided. The results indicate that a multi-tiered training programme improved knowledge, attitude, self-efficacy and reported behaviour amongst staff caring for people with ID. © 2012 John Wiley & Sons A/S.

State of education regarding ultrasound-guided interventions during pain fellowships in Korea: a survey of recent fellows

PubMed Central

Kim, Hyung Tae; Kim, Sae Young; Byun, Gyung Jo; Shin, Byung Chul; Lee, Jin Young; Choi, Eun Joo; Choi, Jong Bum; Hong, Ji Hee; Choi, Seung Won

2017-01-01

Background Recently, the use of ultrasound (US) techniques in regional anesthesia and pain medicine has increased significantly. However, the current extent of training in the use of US-guided pain management procedures in Korea remains unknown. The purpose of the present study was to assess the current state of US training provided during Korean Pain Society (KPS) pain fellowship programs through the comparative analysis between training hospitals. Methods We conducted an anonymous survey of 51 pain physicians who had completed KPS fellowships in 2017. Items pertained to current US practices and education, as well as the types of techniques and amount of experience with US-guided pain management procedures. Responses were compared based on the tier of the training hospital. Results Among the 51 respondents, 14 received training at first- and second-tier hospitals (Group A), while 37 received training at third-tier hospitals (Group B). The mean total duration of pain training during the 1-year fellowship was 7.4 months in Group A and 8.4 months in Group B. Our analysis revealed that 36% and 40% of respondents in Groups A and B received dedicated US training, respectively. Most respondents underwent US training in patient-care settings under the supervision of attending physicians. Cervical root, stellate ganglion, piriformis, and lumbar plexus blocks were more commonly performed by Group B than by Group A (P < 0.05). Conclusions Instruction regarding US-guided pain management interventions varied among fellowship training hospitals, highlighting the need for the development of educational standards that mandate a minimum number of US-guided nerve blocks or injections during fellowships in interventional pain management. PMID:29123624
Just healthcare? The moral failure of single-tier basic healthcare.

PubMed

Meadowcroft, John

2015-04-01

This article sets out the moral failure of single-tier basic healthcare. Single-tier basic healthcare has been advocated on the grounds that the provision of healthcare should be divorced from ability to pay and unequal access to basic healthcare is morally intolerable. However, single-tier basic healthcare encounters a host of catastrophic moral failings. Given the fact of human pluralism it is impossible to objectively define "basic" healthcare. Attempts to provide single-tier healthcare therefore become political processes in which interest groups compete for control of scarce resources with the most privileged possessing an inherent advantage. The focus on outputs in arguments for single-tier provision neglects the question of justice between individuals when some people provide resources for others without reciprocal benefits. The principle that only healthcare that can be provided to everyone should be provided at all leads to a leveling-down problem in which advocates of single-tier provision must prefer a situation where some individuals are made worse-off without any individual being made better-off compared to plausible multi-tier alternatives. Contemporary single-tier systems require the exclusion of noncitizens, meaning that their universalism is a myth. In the light of these pathologies, it is judged that multi-tier healthcare is morally required. © The Author 2015. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
A Three-Tier Diagnostic Test to Assess Pre-Service Teachers' Misconceptions about Global Warming, Greenhouse Effect, Ozone Layer Depletion, and Acid Rain

ERIC Educational Resources Information Center

Arslan, Harika Ozge; Cigdemoglu, Ceyhan; Moseley, Christine

2012-01-01

This study describes the development and validation of a three-tier multiple-choice diagnostic test, the atmosphere-related environmental problems diagnostic test (AREPDiT), to reveal common misconceptions of global warming (GW), greenhouse effect (GE), ozone layer depletion (OLD), and acid rain (AR). The development of a two-tier diagnostic test…
Reclassification of serous ovarian carcinoma by a 2-tier system: a Gynecologic Oncology Group Study.

PubMed

Bodurka, Diane C; Deavers, Michael T; Tian, Chunqiao; Sun, Charlotte C; Malpica, Anais; Coleman, Robert L; Lu, Karen H; Sood, Anil K; Birrer, Michael J; Ozols, Robert; Baergen, Rebecca; Emerson, Robert E; Steinhoff, Margaret; Behmaram, Behnaz; Rasty, Golnar; Gershenson, David M

2012-06-15

A study was undertaken to use the 2-tier system to reclassify the grade of serous ovarian tumors previously classified using the International Federation of Gynecology and Obstetrics (FIGO) 3-tier system and determine the progression-free survival (PFS) and overall survival (OS) of patients treated on Gynecologic Oncology Group (GOG) Protocol 158. The authors retrospectively reviewed demographic, pathologic, and survival data of 290 patients with stage III serous ovarian carcinoma treated with surgery and chemotherapy on GOG Protocol 158, a cooperative multicenter group trial. A blinded pathology review was performed by a panel of 6 gynecologic pathologists to verify histology and regrade tumors using the 2-tier system. The association of tumor grade with PFS and OS was assessed. Of 241 cases, both systems demonstrated substantial agreement when combining FIGO grades 2 and 3 (overall agreement, 95%; kappa statistic, 0.68). By using the 2-tier system, patients with low-grade versus high-grade tumors had significantly longer PFS (45.0 vs 19.8 months, respectively; P = .01). By using FIGO criteria, median PFS for patients with grade 1, 2, and 3 tumors was 37.5, 19.8, and 20.1 months, respectively (P = .07). There was no difference in clinical outcome in patients with grade 2 or 3 tumors in multivariate analysis. Woman with high-grade versus low-grade tumors demonstrated significantly higher risk of death (hazard ratio, 2.43; 95% confidence interval, 1.17-5.04; P = .02). Women with high-grade versus low-grade serous carcinoma of the ovary are 2 distinct patient populations. Adoption of the 2-tier grading system provides a simple yet precise framework for predicting clinical outcomes. Copyright © 2011 American Cancer Society.
EMERGING TECHNOLOGIES FOR THE MANAGEMENT AND UTILIZATION OF LANDFILL GAS

EPA Science Inventory

The report gives information on emerging technologies that are considered to be commercially available (Tier 1), currently undergoing research and development (Tier 2), or considered as potentially applicable (Tier 3) for the management of landfill gas (LFG) emissions or for the ...
Moving branded statins to lowest copay tier improves patient adherence.

PubMed

Chen, Shih-Yin; Shah, Sonali N; Lee, Yuan-Chi; Boulanger, Luke; Mardekian, Jack; Kuznik, Andreas

2014-01-01

Statins are efficacious in reducing the risk of major cardiovascular events for both primary and secondary prevention, yet long-term adherence is poor. Their effectiveness could be compromised in actual practice when patients are not adherent to the treatments. Higher copayments have been shown to be associated with lower adherence to statins. To assess the effect on patient adherence of moving branded atorvastatin and rosuvastatin from the second to the first tier by a Medicare Part D plan sponsor. Pharmacy claims and eligibility records between July 1, 2009, and July 31, 2011, of Medicare Part D members not receiving the low-income subsidy were analyzed. New atorvastatin and rosuvastatin users in January 2010 (2010 cohort) were compared with those in January 2011 (2011 cohort) after this formulary tier change (tier-reduction group). Adherence was defined by the proportion of days covered (PDC) over 6 months. The impact of tier reduction on adherence was evaluated via logistic regression for binary outcome (PDC≥0.8) and generalized linear regression for continuous PDC by comparing the 2011 cohort with the 2010 cohort, adjusting for demographic and clinical characteristics. Other statin users (97% on generic statins) were also analyzed, serving as a nontier-reduction comparator group. We identified 12,437 members in the tier-reduction group. Between the 2010 and 2011 cohorts, mean PDC increased from 0.77 to 0.83, and the proportion of members with high adherence increased from 62.0% to 72.9% (both P < 0.001). After regression adjustment, members in the 2011 cohort were more likely to be adherent (OR=1.68; 95% CI=1.55-1.82) and had a 5.9% increase in PDC (P < 0.05). There was no significant increase in adherence observed in the comparator nontier-reduction group. Findings from this study suggest that financial incentives may improve medication adherence. Future studies should evaluate whether such formulary strategies improve long-term adherence and patient outcomes.
Operationally Responsive Space: Creating Responsive Space for America

DTIC Science & Technology

2008-06-20

programs. Items identified for improvement include: 1 ) Fractured management and accounting , 2 ) Satellite availability, 3) Facilities (Processing...enveloped by our three output tiers. The three tiers: • Tier 1 is an immediate response taking minutes to days. • Tier 2 is a mid term response taking...needs to improve. 2 . Develop a philosophy. 3. Set a direction with specific goals (Fuchs 1 -7). The Department of Space should follow these
Developing the Capacity to Implement Tier 2 and Tier 3 Supports: How Do We Support Our Faculty and Staff in Preparing for Sustainability?

ERIC Educational Resources Information Center

Oakes, Wendy Peia; Lane, Kathleen Lynne; Germer, Kathryn A.

2014-01-01

School-site and district-level leadership teams rely on the existing knowledge base to select, implement, and evaluate evidence-based practices meeting students' multiple needs within the context of multitiered systems of support. The authors focus on the stages of implementation science as applied to Tier 2 and Tier 3 supports; the…
Advanced Networks in Motion Mobile Sensorweb

NASA Technical Reports Server (NTRS)

Ivancic, William D.; Stewart, David H.

2011-01-01

Advanced mobile networking technology applicable to mobile sensor platforms was developed, deployed and demonstrated. A two-tier sensorweb design was developed. The first tier utilized mobile network technology to provide mobility. The second tier, which sits above the first tier, utilizes 6LowPAN (Internet Protocol version 6 Low Power Wireless Personal Area Networks) sensors. The entire network was IPv6 enabled. Successful mobile sensorweb system field tests took place in late August and early September of 2009. The entire network utilized IPv6 and was monitored and controlled using a remote Web browser via IPv6 technology. This paper describes the mobile networking and 6LowPAN sensorweb design, implementation, deployment and testing as well as wireless systems and network monitoring software developed to support testing and validation.
A Tiered Model for Linking Students to the Community

ERIC Educational Resources Information Center

Meyer, Laura Landry; Gerard, Jean M.; Sturm, Michael R.; Wooldridge, Deborah G.

2016-01-01

A tiered practice model (introductory, pre-internship, and internship) embedded in the curriculum facilitates community engagement and creates relevance for students as they pursue a professional identity in Human Development and Family Studies. The tiered model integrates high-impact teaching practices (HIP) and student engagement pedagogies…
Collective screening tools for early identification of dyslexia

PubMed Central

Andrade, Olga V. C. A.; Andrade, Paulo E.; Capellini, Simone A.

2015-01-01

Current response to intervention models (RTIs) favor a three-tier system. In general, Tier 1 consists of evidence-based, effective reading instruction in the classroom and universal screening of all students at the beginning of the grade level to identify children for early intervention. Non-responders to Tier 1 receive small-group tutoring in Tier 2. Non-responders to Tier 2 are given still more intensive, individual intervention in Tier 3. Limited time, personnel and financial resources derail RTI’s implementation in Brazilian schools because this approach involves procedures that require extra time and extra personnel in all three tiers, including screening tools which normally consist of tasks administered individually. We explored the accuracy of collectively and easily administered screening tools for the early identification of second graders at risk for dyslexia in a two-stage screening model. A first-stage universal screening based on collectively administered curriculum-based measurements was used in 45 7 years old early Portuguese readers from 4 second-grade classrooms at the beginning of the school year and identified an at-risk group of 13 academic low-achievers. Collectively administered tasks based on phonological judgments by matching figures and figures to spoken words [alternative tools for educators (ATE)] and a comprehensive cognitive-linguistic battery of collective and individual assessments were both administered to all children and constituted the second-stage screening. Low-achievement on ATE tasks and on collectively administered writing tasks (scores at the 25th percentile) showed good sensitivity (true positives) and specificity (true negatives) to poor literacy status defined as scores ≤1 SD below the mean on literacy abilities at the end of fifth grade. These results provide implications for the use of a collectively administered screening tool for the early identification of children at risk for dyslexia in a classroom setting. PMID:25667575
Differential exposure and acute health impacts of inhaled solid-fuel emissions from rudimentary and advanced cookstoves in female CD-1 mice.

PubMed

Gibbs-Flournoy, Eugene A; Gilmour, M Ian; Higuchi, Mark; Jetter, James; George, Ingrid; Copeland, Lisa; Harrison, Randy; Moser, Virginia C; Dye, Janice A

2018-02-01

There is an urgent need to provide access to cleaner end user energy technologies for the nearly 40% of the world's population who currently depend on rudimentary cooking and heating systems. Advanced cookstoves (CS) are designed to cut emissions and solid-fuel consumption, thus reducing adverse human health and environmental impacts. We hypothesized that, compared to a traditional (Tier 0) three-stone (3-S) fire, acute inhalation of solid-fuel emissions from advanced natural-draft (ND; Tier 2) or forced-draft (FD; Tier 3) stoves would reduce exposure biomarkers and lessen pulmonary and innate immune system health effects in exposed mice. Across two simulated cooking cycles (duration ~ 3h), emitted particulate mass concentrations were reduced 80% and 62% by FD and ND stoves, respectively, compared to the 3-S fire; with corresponding decreases in particles visible within murine alveolar macrophages. Emitted carbon monoxide was reduced ~ 90% and ~ 60%, respectively. Only 3-S-fire-exposed mice had increased carboxyhemoglobin levels. Emitted volatile organic compounds were FD ≪ 3-S-fire ≤ ND stove; increased expression of genes involved in xenobiotic metabolism (COX-2, NQO1, CYP1a1) was detected only in ND- and 3-S-fire-exposed mice. Diminished macrophage phagocytosis was observed in the ND group. Lung glutathione was significantly depleted across all CS groups, however the FD group had the most severe, ongoing oxidative stress. These results are consistent with reports associating exposure to solid fuel stove emissions with modulation of the innate immune system and increased susceptibility to infection. Lower respiratory infections continue to be a leading cause of death in low-income economies. Notably, 3-S-fire-exposed mice were the only group to develop acute lung injury, possibly because they inhaled the highest concentrations of hazardous air toxicants (e.g., 1,3-butadiene, toluene, benzene, acrolein) in association with the greatest number of particles, and particles with the highest % organic carbon. However, no Tier 0-3 ranked CS group was without some untoward health effect indicating that access to still cleaner, ideally renewable, energy technologies for cooking and heating is warranted. Published by Elsevier Inc.
Assessment of the concordance among 2-tier, 3-tier, and 5-tier fetal heart rate classification systems.

PubMed

Gyamfi Bannerman, Cynthia; Grobman, William A; Antoniewicz, Leah; Hutchinson, Maria; Blackwell, Sean

2011-09-01

In 2008, a National Institute of Child Health and Human Development/Society for Maternal-Fetal Medicine-sponsored workshop on electronic fetal monitoring recommended a new fetal heart tracing interpretation system. Comparison of this 3-tier system with other systems is lacking. Our purpose was to determine the relationships between fetal heart rate categories for the 3 existing systems. Three Maternal-Fetal Medicine specialists reviewed 120 fetal heart rates. All tracings were from term, singleton pregnancies with known umbilical artery pH. The fetal heart rates were classified by a 2-tier, 3-tier, and 5-tier system. Each Maternal-Fetal Medicine examiner reviewed 120 fetal heart rate segments. When compared with the 2-tier system, 0%, 54%, and 100% tracings in categories 1, 2, and 3 were "nonreassuring." There was strong concordance between category 1 and "green" as well as category 3 and "red" tracings. The 3-tier and 5-tier systems were similar in fetal heart rate interpretations for tracings that were either very normal or very abnormal. Whether one system is superior to the others in predicting fetal acidemia remains unknown. Copyright © 2011 Mosby, Inc. All rights reserved.
Partnering with women collectives for delivering essential women's nutrition interventions in tribal areas of eastern India: a scoping study.

PubMed

Sethi, Vani; Bhanot, Arti; Bhalla, Surbhi; Bhattacharjee, Sourav; Daniel, Abner; Sharma, Deepika Mehrish; Gope, Rajkumar; Mebrahtu, Saba

2017-05-22

We examined the feasibility of engaging women collectives in delivering a package of women's nutrition messages/services as a funded stakeholder in three tribal-dominated districts of Odisha, Jharkhand and Chhattisgarh States, in eastern India. These districts have high prevalence of child stunting and poor government service outreach. Conducted between July 2014 and March 2015, an exploratory mix-methods design was adopted (review of coverage data and government reports, field interviews and focus group discussion with multiple stakeholders and intended communities) to assess coverage of women's nutrition services. A capacity assessment tool was developed to map all types of community collectives and assess their awareness, institutional and programme capacity as a funded stakeholder for delivering women's nutrition services/behaviour promotion. Limited targeting of pre-pregnancy period, delays in first trimester registration of pregnant women, and low micronutrient supplementation supply and awareness issues emerged as key bottlenecks in improving women's nutrition in these districts. Amongst the 18 different types of community collectives mapped, Self Help Groups (SHGs) and their federations (tier 2 and tier 3), with total membership of over 650,000, emerged as the most promising community collective due to their vast network, governance structure, bank linkage, and regular interface. Nearly 400,000 (or 20% of women) in these districts can be reached through the mapped 31,919 SHGs. SHGs with organisational readiness for receiving and managing grants for income generation and community development activities varied from 41 to 94% across study districts. Stakeholders perceived that SHGs federations managing grants from government and be engaged for nutrition promotion and service delivery and SHG weekly meetings can serve as community interface for discussing/resolving local issues impeding access to services. Women SHGs (with tier 2 and tier 3) can become direct grantees for strengthening coverage of women's nutrition interventions in these tribal districts/pockets, provided they are capacitated, supervised and given safe guards against exploitation and violence.
A New Generation of Networks and Computing Models for High Energy Physics in the LHC Era

NASA Astrophysics Data System (ADS)

Newman, H.

2011-12-01

Wide area networks of increasing end-to-end capacity and capability are vital for every phase of high energy physicists' work. Our bandwidth usage, and the typical capacity of the major national backbones and intercontinental links used by our field have progressed by a factor of several hundred times over the past decade. With the opening of the LHC era in 2009-10 and the prospects for discoveries in the upcoming LHC run, the outlook is for a continuation or an acceleration of these trends using next generation networks over the next few years. Responding to the need to rapidly distribute and access datasets of tens to hundreds of terabytes drawn from multi-petabyte data stores, high energy physicists working with network engineers and computer scientists are learning to use long range networks effectively on an increasing scale, and aggregate flows reaching the 100 Gbps range have been observed. The progress of the LHC, and the unprecedented ability of the experiments to produce results rapidly using worldwide distributed data processing and analysis has sparked major, emerging changes in the LHC Computing Models, which are moving from the classic hierarchical model designed a decade ago to more agile peer-to-peer-like models that make more effective use of the resources at Tier2 and Tier3 sites located throughout the world. A new requirements working group has gauged the needs of Tier2 centers, and charged the LHCOPN group that runs the network interconnecting the LHC Tierls with designing a new architecture interconnecting the Tier2s. As seen from the perspective of ICFA's Standing Committee on Inter-regional Connectivity (SCIC), the Digital Divide that separates physicists in several regions of the developing world from those in the developed world remains acute, although many countries have made major advances through the rapid installation of modern network infrastructures. A case in point is Africa, where a new round of undersea cables promises to transform the continent.
XENOENDOCRINE DISRUPTERS-TIERED SCREENING AND TESTING: FILLING KEY DATA GAPS

EPA Science Inventory

The US Environmental Protection Agency (EPA) is developing a screening and testing program for endocrine disrupting chemicals (EDCs). High priority chemicals would be evaluated in the Tier 1 Screening (T1S) battery. Chemicals positive in T1S would then be tested (Tier 2). T1S...
Self-Regulated Strategy Development as a Tier 2 Writing Intervention

ERIC Educational Resources Information Center

Johnson, Evelyn S.; Hancock, Christine; Carter, Deborah R.; Pool, Juli L.

2013-01-01

In a response to intervention framework, the implication of limited writing instruction suggests an immediate need for Tier 2 interventions to support struggling writers while at the same time addressing instructional gaps in Tier 1. Many schools struggle with implementing writing intervention, partly because of the limited number of…
Responsiveness to Intervention in Reading: Architecture and Practices

ERIC Educational Resources Information Center

Jenkins, Joseph R.; Schiller, Ellen; Blackorby, Jose; Thayer, Sara Kalb; Tilly, W. David

2013-01-01

This article describes how a purposeful sample of 62 elementary schools from 17 states implemented a Response to Intervention (RtI) framework for reading. School informants answered surveys and were interviewed about differentiated instruction in Tier 1, screening/benchmarking, where Tier 2 interventions were located, typical group size and the…
Explicit Instructional Interactions: Exploring the Black Box of a Tier 2 Mathematics Intervention

ERIC Educational Resources Information Center

Doabler, Christian T.; Clarke, Ben; Stoolmiller, Mike; Kosty, Derek B.; Fien, Hank; Smolkowski, Keith; Baker, Scott K.

2017-01-01

A critical aspect of intervention research is investigating the active ingredients that underlie intensive interventions and their theories of change. This study explored the rate of instructional interactions within treatment groups to determine whether they offered explanatory power of an empirically validated Tier 2 kindergarten mathematics…
What Is Intensive Instruction and Why Is It Important?

ERIC Educational Resources Information Center

Fuchs, Douglas; Fuchs, Lynn S.; Vaughn, Sharon

2014-01-01

In this article, the authors present two models of intensive instruction for students with and without disabilities who are having difficulties with Response to Intervention (RTI) currently in practice (Tier 1: general instruction that all students receive in mainstream classrooms, and Tier 2: programs often involving small group instruction). The…

The Effects of a Tier 3 Intervention on the Mathematics Performance of Second Grade Students With Severe Mathematics Difficulties.

PubMed

Bryant, Brian R; Bryant, Diane Pedrotty; Porterfield, Jennifer; Dennis, Minyi Shih; Falcomata, Terry; Valentine, Courtney; Brewer, Chelsea; Bell, Kathy

2016-01-01

The purpose of this study was to determine the effectiveness of a systematic, explicit, intensive Tier 3 (tertiary) intervention on the mathematics performance of students in second grade with severe mathematics difficulties. A multiple-baseline design across groups of participants showed improved mathematics performance on number and operations concepts and procedures, which are the foundation for later mathematics success. In the previous year, 12 participants had experienced two doses (first and second semesters) of a Tier 2 intervention. In second grade, the participants continued to demonstrate low performance, falling below the 10th percentile on a researcher-designed universal screener and below the 16th percentile on a distal measure, thus qualifying for the intensive intervention. A project interventionist, who met with the students 5 days a week for 10 weeks (9 weeks for one group), conducted the intensive intervention. The intervention employed more intensive instructional design features than the previous Tier 2 secondary instruction, and also included weekly games to reinforce concepts and skills from the lessons. Spring results showed significantly improved mathematics performance (scoring at or above the 25th percentile) for most of the students, thus making them eligible to exit the Tier 3 intervention. © Hammill Institute on Disabilities 2014.
Do Students Know What They Know and What They Don't Know? Using a Four-Tier Diagnostic Test to Assess the Nature of Students' Alternative Conceptions

ERIC Educational Resources Information Center

Caleon, Imelda S.; Subramaniam, R.

2010-01-01

This study reports on the development and application of a four-tier multiple-choice (4TMC) diagnostic instrument, which has not been reported in the literature. It is an enhanced version of the two-tier multiple-choice (2TMC) test. As in 2TMC tests, its answer and reason tiers measure students' content knowledge and explanatory knowledge,…
Extending surgeon response times in tier 2 traumas does not adversely affect patient outcomes.

PubMed

Zimmerman, Steven Anthony; Reed, Christopher S; Reed, Alexander N; Jones, Ronald J; Chard, Annette; Reed, Donald N

2018-06-01

The presence of a trauma surgeon during patient resuscitations is required at most American College of Surgeons-verified trauma centers despite little evidence showing improved patient outcomes in the less-than-critically injured (Tier 2) trauma patients. This study was designed to identify the impact of extending required surgeon response times on outcomes in tier 2 trauma patients. An American College of Surgeons-verified level 2 trauma center extended the maximum allowed surgeon response time for tier 2 activations from 60 min to 120 min on November 1, 2011. Surgeon response time and patient outcomes of the retrospective control group (January 1, 2008-October 31, 2011) were then compared with the prospective test group (November 1, 2011-December 31, 2014). Primary outcomes included mortality and hospital length of stay (HLOS). Secondary outcomes were emergency department length of stay, and time from ED arrival to CT scan. A subset analysis of all patients evaluated by a surgeon within 60 min of arrival versus those evaluated by a surgeon after 60 min was also performed. The control and test groups were composed of 757 and 792 patients, and their mean injury severity score was 9.0 and 6.0, respectively. Emergency department length of stay showed a statistically significant increase of 12 min, whereas HLOS was unchanged throughout the study. Mortality was not significantly different between the groups. Subset analysis revealed a median surgeon arrival time of 15 min in the <60-min group and 85 min in the >60-min group, whereas the injury severity score, HLOS, and mortality were not significantly different between these subsets. No correlation existed between these outcomes and surgeon arrival time. Doubling required surgeon response time in tier 2 trauma patients does not produce negative outcomes in this patient group. Mandatory surgeon response times in similar patient groups can be re-evaluated to allow for greater flexibility of a limited surgeon workforce while still providing safe care. Copyright © 2018 Elsevier Inc. All rights reserved.
Effectiveness of a Class-Wide Peer-Mediated Elementary Math Differentiation Strategy

ERIC Educational Resources Information Center

Lloyd, Jason D.

2017-01-01

Approximately 60% of classroom students have insufficient math skills. Within a Multi-Tiered Systems of Support (MTSS) framework, teachers can implement core differentiation strategies targeted at improving math skills of an entire class of students. Differentiation programs are developed in order to target academic skills of groups of students…
Employability, Managerialism, and Performativity in Higher Education: A Relational Perspective

ERIC Educational Resources Information Center

Kalfa, Senia; Taksa, Lucy

2017-01-01

This article combines Bourdieu's concepts of field, habitus and cultural capital with Lyotard's account of performativity to construct a three-tiered framework in order to explore how managerialism has affected the academic habitus. Specifically, this article examines the adoption of group assignments as a means of developing teamwork skills in…
The advantage of calculating emission reduction with local emission factor in South Sumatera region

NASA Astrophysics Data System (ADS)

Buchari, Erika

2017-11-01

Green House Gases (GHG) which have different Global Warming Potential, usually expressed in CO2 equivalent. German has succeeded in emission reduction of CO2 in year 1990s, while Japan since 2001 increased load factor of public transports. Indonesia National Medium Term Development Plan, 2015-2019, has set up the target of minimum 26% and maximum 41% National Emission Reduction in 2019. Intergovernmental Panel on Climate Change (IPCC), defined three types of accuracy in counting emission of GHG, as tier 1, tier 2, and tier 3. In tier 1, calculation is based on fuel used and average emission (default), which is obtained from statistical data. While in tier 2, calculation is based fuel used and local emission factors. Tier 3 is more accurate from those in tier 1 and 2, and the calculation is based on fuel used from modelling method or from direct measurement. This paper is aimed to evaluate the calculation with tier 2 and tier 3 in South Sumatera region. In 2012, Regional Action Plan for Greenhouse Gases of South Sumatera for 2020 is about 6,569,000 ton per year and with tier 3 is about without mitigation and 6,229,858.468 ton per year. It was found that the calculation in tier 3 is more accurate in terms of fuel used of variation vehicles so that the actions of mitigation can be planned more realistically.
A Four-Tier Differentiation Model: Engage All Students in the Learning Process

ERIC Educational Resources Information Center

Herrelko, Janet M.

2013-01-01

This study details the creation of a four-tiered format designed to help preservice teachers write differentiated lesson plans. A short history of lesson plan differentiation models is described and how the four-tier approach was developed through collaboration with classroom teachers and university faculty. The unifying element for the format…
Collection and Characterization of Samples for Establishment of a Serum Repository for Lyme Disease Diagnostic Test Development and Evaluation

PubMed Central

Molins, Claudia R.; Sexton, Christopher; Young, John W.; Ashton, Laura V.; Pappert, Ryan; Beard, Charles B.

2014-01-01

Serological assays and a two-tiered test algorithm are recommended for laboratory confirmation of Lyme disease. In the United States, the sensitivity of two-tiered testing using commercially available serology-based assays is dependent on the stage of infection and ranges from 30% in the early localized disease stage to near 100% in late-stage disease. Other variables, including subjectivity in reading Western blots, compliance with two-tiered recommendations, use of different first- and second-tier test combinations, and use of different test samples, all contribute to variation in two-tiered test performance. The availability and use of sample sets from well-characterized Lyme disease patients and controls are needed to better assess the performance of existing tests and for development of improved assays. To address this need, the Centers for Disease Control and Prevention and the National Institutes of Health prospectively collected sera from patients at all stages of Lyme disease, as well as healthy donors and patients with look-alike diseases. Patients and healthy controls were recruited using strict inclusion and exclusion criteria. Samples from all included patients were retrospectively characterized by two-tiered testing. The results from two-tiered testing corroborated the need for novel and improved diagnostics, particularly for laboratory diagnosis of earlier stages of infection. Furthermore, the two-tiered results provide a baseline with samples from well-characterized patients that can be used in comparing the sensitivity and specificity of novel diagnostics. Panels of sera and accompanying clinical and laboratory testing results are now available to Lyme disease serological test users and researchers developing novel tests. PMID:25122862
Guidelines for the diagnosis and antimicrobial therapy of canine superficial bacterial folliculitis (Antimicrobial Guidelines Working Group of the International Society for Companion Animal Infectious Diseases).

PubMed

Hillier, Andrew; Lloyd, David H; Weese, J Scott; Blondeau, Joseph M; Boothe, Dawn; Breitschwerdt, Edward; Guardabassi, Luca; Papich, Mark G; Rankin, Shelley; Turnidge, John D; Sykes, Jane E

2014-06-01

Superficial bacterial folliculitis (SBF) is usually caused by Staphylococcus pseudintermedius and routinely treated with systemic antimicrobial agents. Infection is a consequence of reduced immunity associated with alterations of the skin barrier and underlying diseases that may be difficult to diagnose and resolve; thus, SBF is frequently recurrent and repeated treatment is necessary. The emergence of multiresistant bacteria, particularly meticillin-resistant S. pseudintermedius (MRSP), has focused attention on the need for optimal management of SBF. Provision of an internationally available resource guiding practitioners in the diagnosis, treatment and prevention of SBF. The guidelines were developed by the Antimicrobial Guidelines Working Group of the International Society for Companion Animal Infectious Diseases, with consultation and advice from diplomates of the American and European Colleges of Veterinary Dermatology. They describe optimal methods for the diagnosis and management of SBF, including isolation of the causative organism, antimicrobial susceptibility testing, selection of antimicrobial drugs, therapeutic protocols and advice on infection control. Guidance is given for topical and systemic modalities, including approaches suitable for MRSP. Systemic drugs are classified in three tiers. Tier one drugs are used when diagnosis is clear cut and risk factors for antimicrobial drug resistance are not present. Otherwise, tier two drugs are used and antimicrobial susceptibility tests are mandatory. Tier three includes drugs reserved for highly resistant infections; their use is strongly discouraged and, when necessary, they should be used in consultation with specialists. Optimal management of SBF will improve antimicrobial use and reduce selection of MRSP and other multidrug-resistant bacteria affecting animal and human health. © 2014 ESVD and ACVD.
Development and Application of a Novel Rasch-based Methodology for Evaluating Multi-Tiered Assessment Instruments: Validation and utilization of an undergraduate diagnostic test of the water cycle

NASA Astrophysics Data System (ADS)

Romine, William L.; Schaffer, Dane L.; Barrow, Lloyd

2015-11-01

We describe the development and validation of a three-tiered diagnostic test of the water cycle (DTWC) and use it to evaluate the impact of prior learning experiences on undergraduates' misconceptions. While most approaches to instrument validation take a positivist perspective using singular criteria such as reliability and fit with a measurement model, we extend this to a multi-tiered approach which supports multiple interpretations. Using a sample of 130 undergraduate students from two colleges, we utilize the Rasch model to place students and items along traditional one-, two-, and three-tiered scales as well as a misconceptions scale. In the three-tiered and misconceptions scales, high confidence was indicative of mastery. In the latter scale, a 'misconception' was defined as mastery of an incorrect concept. We found that integrating confidence into mastery did little to change item functioning; however, three-tiered usage resulted in higher reliability and lower student ability estimates than two-tiered usage. The misconceptions scale showed high efficacy in predicting items on which particular students were likely to express misconceptions, and revealed several tenacious misconceptions that all students were likely to express regardless of ability. Previous coursework on the water cycle did little to change the prevalence of undergraduates' misconceptions.
Teaching Strategies for Effective Fifth Grade Math Intervention

ERIC Educational Resources Information Center

Zank, Alicia A.

2015-01-01

The purpose of the study is to determine what effects explicit and systematic math intervention instruction will have on student's performance on math assessments. The study will focus on a small group of fifth grade students that have been identified as needing targeted intervention (tier 2) and intensive interventions (tier 1) through the…
The heterogeneous effects of cigarette prices on brand choice in China: implications for tobacco control policy.

PubMed

Li, Jing; White, Justin S; Hu, Teh-Wei; Fong, Geoffrey T; Yuan, Jiang

2015-07-01

China has long kept its tobacco taxes below international standards. The Chinese government has cited two rationales against raising tobacco tax, namely, the unfair burden it places on low-income smokers and the ability of consumers to switch to cheaper brands. This study examines how different socioeconomic subgroups of Chinese smokers switch brands in response to cigarette price changes. We model smokers' choice of cigarette tier as a function of tier-specific prices. We examine heterogeneous responses to prices by estimating mixed logit models for different income and education subgroups that allow for random variation in smokers' preferences. We use data from three waves of the longitudinal International Tobacco Control China Survey, collected in six large Chinese cities between 2006 and 2009. Low-income and less educated smokers are considerably more likely to switch tiers (including both up-trading and down-trading) than are their high-socioeconomic status (SES) counterparts. For those in the second-to-lowest tier, a ¥1 ($0.16, or roughly 25%) rise in prices increases the likelihood of switching tiers by 5.6% points for low-income smokers and 7.2% points for less educated smokers, compared to 1.6% and 3.0% points for the corresponding high-SES groups. Low-income and less educated groups are also more likely to trade down compared to their high-SES counterparts. Only a small percentage of low-income and less educated Chinese smokers switched to cheaper brands in response to price increases. Hence, the concern of the Chinese government that a cigarette tax increase will lead to large-scale brand switching is not supported by this study. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Development and Application of a Two-Tier Diagnostic Test for High School Students' Understanding of Flowering Plant Growth and Development

ERIC Educational Resources Information Center

Lin, Sheau-Wen

2004-01-01

This study involved the development and application of a two-tier diagnostic test measuring students' understanding of flowering plant growth and development. The instrument development procedure had three general steps: defining the content boundaries of the test, collecting information on students' misconceptions, and instrument development.…
Independent validation of the prognostic capacity of the ISUP prostate cancer grade grouping system for radiation treated patients with long-term follow-up.

PubMed

Spratt, D E; Jackson, W C; Abugharib, A; Tomlins, S A; Dess, R T; Soni, P D; Lee, J Y; Zhao, S G; Cole, A I; Zumsteg, Z S; Sandler, H; Hamstra, D; Hearn, J W; Palapattu, G; Mehra, R; Morgan, T M; Feng, F Y

2016-09-01

There has been a recent proposal to change the grading system of prostate cancer into a five-tier grade grouping system. The prognostic impact of this has been demonstrated in regards only to biochemical recurrence-free survival (bRFS) with short follow-up (3 years). Between 1990 and 2013, 847 consecutive men were treated with definitive external beam radiation therapy at a single academic center. To validate the new grade grouping system, bRFS, distant metastases-free survival (DMFS) and prostate cancer-specific survival (PCSS) were calculated. Adjusted Kaplan-Meier and multivariable Cox regression analyses were performed to assess the independent impact of the new grade grouping system. Discriminatory analyses were performed to compare the commonly used three-tier Gleason score system (6, 7 and 8-10) to the new system. The median follow-up of our cohort was 88 months. The 5-grade groups independently validated differing risks of bRFS (group 1 as reference; adjusted hazard ratio (aHR) 1.35, 2.16, 1.79 and 3.84 for groups 2-5, respectively). Furthermore, a clear stratification was demonstrated for DMFS (aHR 2.03, 3.18, 3.62 and 13.77 for groups 2-5, respectively) and PCSS (aHR 3.00, 5.32, 6.02 and 39.02 for groups 2-5, respectively). The 5-grade group system had improved prognostic discrimination for all end points compared with the commonly used three-tiered system (that is, Gleason score 6, 7 and 8-10). In a large independent radiotherapy cohort with long-term follow-up, we have validated the bRFS benefit of the proposed five-tier grade grouping system. Furthermore, we have demonstrated that the system is highly prognostic for DMFS and PCSS. Grade group 5 had markedly worse outcomes for all end points, and future work is necessary to improve outcomes in these patients.
Progress in landslide susceptibility mapping over Europe using Tier-based approaches

NASA Astrophysics Data System (ADS)

Günther, Andreas; Hervás, Javier; Reichenbach, Paola; Malet, Jean-Philippe

2010-05-01

The European Thematic Strategy for Soil Protection aims, among other objectives, to ensure a sustainable use of soil. The legal instrument of the strategy, the proposed Framework Directive, suggests identifying priority areas of several soil threats including landslides using a coherent and compatible approach based on the use of common thematic data. In a first stage, this can be achieved through landslide susceptibility mapping using geographically nested, multi-step tiered approaches, where areas identified as of high susceptibility by a first, synoptic-scale Tier ("Tier 1") can then be further assessed and mapped at larger scale by successive Tiers. In order to identify areas prone to landslides at European scale ("Tier 1"), a number of thematic terrain and environmental data sets already available for the whole of Europe can be used as input for a continental scale susceptibility model. However, since no coherent landslide inventory data is available at the moment over the whole continent, qualitative heuristic zonation approaches are proposed. For "Tier 1" a preliminary, simplified model has been developed. It consists of an equally weighting combination of a reduced, continent-wide common dataset of landslide conditioning factors including soil parent material, slope angle and land cover, to derive a landslide susceptibility index using raster mapping units consisting of 1 x 1 km pixels. A preliminary European-wide susceptibility map has thus been produced at 1:1 Million scale, since this is compatible with that of the datasets used. The map has been validated by means of a ratio of effectiveness using samples from landslide inventories in Italy, Austria, Hungary and United Kingdom. Although not differentiated for specific geomorphological environments or specific landslide types, the experimental model reveals a relatively good performance in many European regions at a 1:1 Million scale. An additional "Tier 1" susceptibility map at the same scale and using the same or equivalent thematic data as for the one above has been generated for six French departments using a heuristic, weighting-based multi-criteria evaluation model applied also to raster-cell mapping units. In this experiment, thematic data class weights have been differentiated for two stratification areas, namely mountains and plains, and four main landslide types. Separate susceptibility maps for each landslide type and a combined map for all types have been produced. Results have been validated using BRGM's BDMvT landslide inventory. Unlike "Tier 1", "Tier 2" assessment requires landslide inventory data and additional thematic data on conditioning factors which may not be available for all European countries. For the "Tier 2", a nation-wide quantitative landslide susceptibility assessment has been performed for Italy by applying a statistical model. In this assessment, multivariate analysis was applied using bedrock, soil and climate data together with a number of derivatives from SRTM90 DEM. In addition, separate datasets from a historical landslide inventory were used for model training and validation respectively. The mapping units selected were based on administrative boundaries (municipalities). The performance of this nation-wide, quantitative susceptibility assessment has been evaluated using multi-temporal landslide inventory data. Finally, model limitations for "Tier 1" are discussed, and recommendations for enhanced Tier 1 and Tier 2 models including additional thematic data for conditioning factors are drawn. This project is part of the collaborative research carried out within the European Landslide Expert Group coordinated by JRC in support to the EU Soil Thematic Strategy. It is also supported by the International Programme on Landslides of the International Consortium on Landslides.
Exploring Students' Understanding of Electrochemical Cells Using an Enhanced Two-Tier Diagnostic Instrument

ERIC Educational Resources Information Center

Loh, Adrian Sin Loy; Subramaniam, R.; Tan, Kim Chwee Daniel

2014-01-01

Background: The development of two-tier multiple-choice questions has permitted the diagnosis of students' understanding on various topics in the sciences as well as helped to ascertain the alternative conceptions they have. A limitation of two-tier diagnostic instruments that has been noted in the literature, but which has not been…
Health risk assessment of organic micropollutants in greywater for potable reuse.

PubMed

Etchepare, Ramiro; van der Hoek, Jan Peter

2015-04-01

In light of the increasing interest in development of sustainable potable reuse systems, additional research is needed to elucidate the risks of producing drinking water from new raw water sources. This article investigates the presence and potential health risks of organic micropollutants in greywater, a potential new source for potable water production introduced in this work. An extensive literature survey reveals that almost 280 organic micropollutants have been detected in greywater. A three-tiered approach is applied for the preliminary health risk assessment of these chemicals. Benchmark values are derived from established drinking water standards for compounds grouped in Tier 1, from literature toxicological data for compounds in Tier 2, and from a Threshold of Toxicological Concern approach for compounds in Tier 3. A risk quotient is estimated by comparing the maximum concentration levels reported in greywater to the benchmark values. The results show that for the majority of compounds, risk quotient values were below 0.2, which suggests they would not pose appreciable concern to human health over a lifetime exposure to potable water. Fourteen compounds were identified with risk quotients above 0.2 which may warrant further investigation if greywater is used as a source for potable reuse. The present findings are helpful in prioritizing upcoming greywater quality monitoring and defining the goals of multiple barriers treatment in future water reclamation plants for potable water production. Copyright © 2014 Elsevier Ltd. All rights reserved.
Pitfalls in Health Communication: Healthcare Policy, Institution, Structure, & Process

PubMed Central

Calderón, José L; Beltrán, Robert A

2004-01-01

The state of health communication for a given population is a function of several tiers of structure and process: government policy, healthcare directives, healthcare structure and process, and the ethnosocial realities of a multicultural society. Common yet specific to these tiers of health communication is the interpersonal and intergroup use of language in all its forms. Language is the most common behavior exhibited by humankind. Its use at all tiers determines quality of healthcare and quality of life for healthcare consumers: patients and their families. Of note, at the consumer end, mounting evidence demonstrates that barriers to health communication contribute to poorer access to care, quality of care, and health outcomes. The lack of comprehensible and usable written and spoken language is a major barrier to health communication targeting primary and secondary disease prevention and is a major contributor to the misuse of healthcare, patient noncompliance, rising healthcare costs. In this paper, we cursorily examine the relationship among government policy, institutional directives, and healthcare structure and process and its influence on the public health, especially vulnerable populations. We conclude that limited health communication in the context of changing healthcare environments and diverse populations is an important underpinning of rising healthcare costs and sustained health disparities. More research is needed to improve communication about health at all tiers and to develop health communication interventions that are usable by all population groups. PMID:15208522
Evaluating Secondary Students' Scientific Reasoning in Genetics Using a Two-Tier Diagnostic Instrument

NASA Astrophysics Data System (ADS)

Tsui, Chi-Yan; Treagust, David

2010-05-01

While genetics has remained as one key topic in school science, it continues to be conceptually and linguistically difficult for students with the concomitant debates as to what should be taught in the age of biotechnology. This article documents the development and implementation of a two-tier multiple-choice instrument for diagnosing grades 10 and 12 students' understanding of genetics in terms of reasoning. The pretest and posttest forms of the diagnostic instrument were used alongside other methods in evaluating students' understanding of genetics in a case-based qualitative study on teaching and learning with multiple representations in three Western Australian secondary schools. Previous studies have shown that a two-tier diagnostic instrument is useful in probing students' understanding or misunderstanding of scientific concepts and ideas. The diagnostic instrument in this study was designed and then progressively refined, improved, and implemented to evaluate student understanding of genetics in three case schools. The final version of the instrument had Cronbach's alpha reliability of 0.75 and 0.64, respectively, for its pretest and the posttest forms when it was administered to a group of grade 12 students (n = 17). This two-tier diagnostic instrument complemented other qualitative data collection methods in this research in generating a more holistic picture of student conceptual learning of genetics in terms of scientific reasoning. Implications of the findings of this study using the diagnostic instrument are discussed.
DEVELOPMENT, STANDARDIZATION AND VALIDATION OF THE MAMMALIAN IN VIVO ASSAYS IN THE PROPOSED TIER I SCREENING BATTERY FOR ENDOCRINE DISRUPTORS

EPA Science Inventory

This research directly supports the development, standardization and validation of several Tier 1 screening mammalian in vivo assays. Through the development and use of many of these assays for testing specific hypothesis in their respective research programs, these investigato...

Expert and Advocacy Group Consensus Findings on the Horizon of Public Health Genetic Testing

PubMed Central

Modell, Stephen M.; Greendale, Karen; Citrin, Toby; Kardia, Sharon L. R.

2016-01-01

Description: Among the two leading causes of death in the United States, each responsible for one in every four deaths, heart disease costs Americans $300 billion, while cancer costs Americans $216 billion per year. They also rank among the top three causes of death in Europe and Asia. In 2012 the University of Michigan Center for Public Health and Community Genomics and Genetic Alliance, with the support of the Centers for Disease Control and Prevention Office of Public Health Genomics, hosted a conference in Atlanta, Georgia to consider related action strategies based on public health genomics. The aim of the conference was consensus building on recommendations to implement genetic screening for three major heritable contributors to these mortality and cost figures: hereditary breast and ovarian cancer (HBOC), familial hypercholesterolemia (FH), and Lynch syndrome (LS). Genetic applications for these three conditions are labeled with a “Tier 1” designation by the U.S. Centers for Disease Control and Prevention because they have been fully validated and clinical practice guidelines based on systematic review support them. Methodology: The conference followed a deliberative sequence starting with nationally recognized clinical and public health presenters for each condition, followed by a Patient and Community Perspectives Panel, working group sessions for each of the conditions, and a final plenary session. The 74 conference participants represented disease research and advocacy, public health, medicine and nursing, genetics, governmental health agencies, and industry. Participants drew on a public health framework interconnecting policy, clinical intervention, surveillance, and educational functions for their deliberations. Results: Participants emphasized the importance of collaboration between clinical, public health, and advocacy groups in implementing Tier 1 genetic screening. Advocacy groups could help with individual and institutional buy-in of Tier 1 programs. Groups differed on funding strategies, with alternative options such as large-scale federal funding and smaller scale, incremental funding solutions proposed. Piggybacking on existing federal breast and colorectal cancer control programs was suggested. Public health departments need to assess what information is now being collected by their state cancer registries. The groups advised that information on cascade screening of relatives be included in toolkits for use by states. Participants stressed incorporation of family history into health department breast cancer screening programs, and clinical HBOC data into state surveillance systems. The carrying out of universal LS screening of tumors in those with colorectal cancer was reviewed. Expansion of universal screening to include endometrial tumors was discussed, as was the application of guidelines recommending cholesterol screening of children 9–11 years old. States more advanced in terms of Tier 1 testing could serve as models and partners with other states launching screening and surveillance programs. A multidisciplinary team of screening program champions was suggested as a means of raising awareness among the consumer and health care communities. Participants offered multiple recommendations regarding use of electronic health records, including flagging of at-risk family members and utilization of state-level health information exchanges. The paper contains an update of policy developments and happenings for all three Tier 1 conditions, as well as identified gaps. Conclusions: Implementation of cascade screening of family members for HBOC and FH, and universal screening for LS in CRC tumors has reached a point of readiness within the U.S., with creative solutions at hand. Facilitating factors such as screening coverage through the Patient Protection and Affordable Care Act, and state health information exchanges can be tapped. Collaboration is needed between public health departments, health care systems, disease advocacy groups, and industry to fully realize Tier 1 genetic screening. State health department and disease networks currently engaged in Tier 1 screening can serve as models for the launch of new initiatives. PMID:27417602
Student understanding development in chemistry concepts through constructivist-informed laboratory and science camp process in secondary school

NASA Astrophysics Data System (ADS)

Pathommapas, Nookorn

2018-01-01

Science Camp for Chemistry Concepts was the project which designed to provide local students with opportunities to apply chemistry concepts and thereby developing their 21st century skills. The three study purposes were 1) to construct and develop chemistry stations for encouraging students' understandings in chemistry concepts based on constructivist-informed laboratory, 2) to compare students' understandings in chemistry concepts before and after using chemistry learning stations, and 3) to study students' satisfactions of using their 21st century skills in science camp activities. The research samples were 67 students who attended the 1-day science camp. They were levels 10 to 11 students in SumsaoPittayakarn School, UdonThani Province, Thailand. Four constructivist-informed laboratory stations of chemistry concepts were designed for each group. Each station consisted of a chemistry scenario, a question, answers in tier 1 and supporting reasons in tier 2, and 4 sets of experimental instruments. Four to five-member subgroups of four student groups parallel participated in laboratory station for an hour in each station. Student activities in each station concluded of individual pretest, group prediction, experimental design, testing out and collection data, interpreting the results, group conclusion, and individual post-test. Data collection was done by station mentors using two-tier multiple choice questions, students' written work and interviews. Data triangulation was used for interpreting and confirming students' understandings of chemistry concepts which divided into five levels, Sound Understanding (SU), Partial Understanding (PU), Specific Misconception (SM), No Understanding (NU) and No Response (NR), before and after collaborating at each station. The study results found the following: 1) four constructivist-laboratory stations were successfully designed and used to investigate student' understandings in chemistry concepts via collaborative workshop of chemistry teachers and researcher, 2) the percentage of students having understandings of chemistry concepts before and after learning at the four stations ranged from 15.92-54.23% and 83.89-97.02%, respectively, and 3)students' opinions of using their 21st century skills in the science camp after finishing the camp activities were at a high level of satisfactions, ranged from 4.09-4.47 of 5 rating scores.
Stuttering, Induced Fluency, and Natural Fluency: A Hierarchical Series of Activation Likelihood Estimation Meta-Analyses

PubMed Central

Budde, Kristin S.; Barron, Daniel S.; Fox, Peter T.

2015-01-01

Developmental stuttering is a speech disorder most likely due to a heritable form of developmental dysmyelination impairing the function of the speech-motor system. Speech-induced brain-activation patterns in persons who stutter (PWS) are anomalous in various ways; the consistency of these aberrant patterns is a matter of ongoing debate. Here, we present a hierarchical series of coordinate-based meta-analyses addressing this issue. Two tiers of meta-analyses were performed on a 17-paper dataset (202 PWS; 167 fluent controls). Four large-scale (top-tier) meta-analyses were performed, two for each subject group (PWS and controls). These analyses robustly confirmed the regional effects previously postulated as “neural signatures of stuttering” (Brown 2005) and extended this designation to additional regions. Two smaller-scale (lower-tier) meta-analyses refined the interpretation of the large-scale analyses: 1) a between-group contrast targeting differences between PWS and controls (stuttering trait); and 2) a within-group contrast (PWS only) of stuttering with induced fluency (stuttering state). PMID:25463820
Implications of limiting mechanical thrombectomy to patients with emergent large vessel occlusion meeting top tier evidence criteria.

PubMed

Bhole, Rohini; Goyal, Nitin; Nearing, Katherine; Belayev, Andrey; Doss, Vinodh T; Elijovich, Lucas; Hoit, Daniel A; Tsivgoulis, Georgios; Alexandrov, Andrei V; Arthur, Adam S; Alexandrov, Anne W

2017-03-01

Recent guidelines for endovascular management of emergent large vessel occlusion (ELVO) award top tier evidence to the same selective criteria in recent trials. We aimed to understand how guideline adherence would have impacted treatment numbers and outcomes in a cohort of patients from a comprehensive stroke center. A retrospective observational study was conducted using consecutive emergent endovascular patients. Mechanical thrombectomy (MT) was performed with stent retrievers or large bore clot aspiration catheters. Procedural outcomes were compared between patients meeting, and those failing to meet, top tier evidence criteria. 126 patients receiving MT from January 2012 to June 2015 were included (age 31-89 years, National Institutes of Health Stroke Scale (NIHSS) score 2-38); 62 (49%) patients would have been excluded if top tier criteria were upheld: pretreatment NIHSS score <6 (10%), Alberta Stroke Program Early CT score <6 (6.5%), premorbid modified Rankin Scale (mRS) score ≥2 (27%), M2 occlusion (10%), posterior circulation (32%), symptom to groin puncture >360 min (58%). 26 (42%) subjects had more than one top tier exclusion. Symptomatic intracerebral hemorrhage (sICH) and systemic hemorrhage rates were similar between the groups. 3 month mortality was 45% in those lacking top tier evidence compared with 26% (p=0.044), and 3 month mRS score 0-2 was 33% versus 46%, respectively (NS). After adjusting for potential confounders, top tier treatment was not associated with neurological improvement during hospitalization (β -8.2; 95% CI -24.6 to -8.2; p=0.321), 3 month mortality (OR=0.38; 95% CI 0.08 to 1.41), or 3 month favorable mRS (OR=0.97; 95% CI 0.28 to 3.35). Our study showed that with strict adherence to top tier evidence criteria, half of patients may not be considered for MT. Our data indicate no increased risk of sICH and a potentially higher mortality that is largely due to treatment of patients with basilar occlusions and those treated at an extended time window. Despite this, good functional recovery is possible, and consideration of MT in patients not meeting top tier evidence criteria may be warranted. 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/.
Early Numeracy Intervention Program for First-Grade Students with Mathematics Difficulties

ERIC Educational Resources Information Center

Bryant, Diane Pedrotty; Bryant, Brian R.; Roberts, Greg; Vaughn, Sharon; Pfannenstiel, Kathleen Hughes; Porterfield, Jennifer; Gersten, Russell

2011-01-01

The purpose of this study was to determine the effects of an early numeracy preventative Tier 2 intervention on the mathematics performance of first-grade students with mathematics difficulties. Researchers used a pretest-posttest control group design with randomized assignment of 139 students to the Tier 2 treatment condition and 65 students to…
The Effects of a Tier 3 Intervention on the Mathematics Performance of Second Grade Students with Severe Mathematics Difficulties

ERIC Educational Resources Information Center

Bryant, Brian R.; Bryant, Diane Pedrotty; Porterfield, Jennifer; Dennis, Minyi Shih; Falcomata, Terry; Valentine, Courtney; Brewer, Chelsea; Bell, Kathy

2016-01-01

The purpose of this study was to determine the effectiveness of a systematic, explicit, intensive Tier 3 (tertiary) intervention on the mathematics performance of students in second grade with severe mathematics difficulties. A multiple-baseline design across groups of participants showed improved mathematics performance on number and operations…
Key Learnings from the Endocrine Disruptor Screening Program (EDSP) Tier 1 Rodent Uterotrophic and Hershberger Assays

PubMed Central

Marty, M Sue; O'Connor, John C

2014-01-01

In 2009, companies began screening compounds using the US Environmental Protection Agency's Endocrine Disruptor Screening Program (EDSP). EDSP has two tiers: Tier 1 includes 11 assays to identify compounds with potential endocrine activity. This article describes two laboratories' experiences conducting Tier 1 uterotrophic and Hershberger assays. The uterotrophic assay detects estrogen receptor agonists through increases in uterine weight. The advantages of the uterotrophic rat models (immature vs. adult ovariectomized) and exposure routes are discussed. Across 29 studies, relative differences in uterine weights in the vehicle control group and 17α-ethynylestradiol–positive control group were reasonably reproducible. The Hershberger assay detects androgen receptor (AR) agonists, antagonists, and 5α-reductase inhibitors through changes in accessory sex tissue (AST) weights. Across 23 studies, AST weights were relatively reproducible for the vehicle groups (baseline), testosterone propionate (TP) groups (androgenic response), and flutamide + TP groups (antiandrogenic response). In one laboratory, one and four compounds were positive in the androgenic and antiandrogenic portions of the assay, respectively. Each compound was also positive for AR binding. In the other laboratory, three compounds showed potential antiandrogenic activity, but each compound was negative for AR binding and did not fit the profile for 5α-reductase inhibition. These compounds induced hepatic enzymes that enhanced testosterone metabolism/clearance, resulting in lower testosterone and decreased capacity to maintain AST weights. The Hershberger androgenic and antiandrogenic performance criteria were generally attainable. Overall, the uterotrophic and Hershberger assays were easily adopted and function as described for EDSP screening, although the mode of action for positive results may not be easily determined. PMID:24515841
77 FR 52344 - Information Collection Request Sent to the Office of Management and Budget (OMB) for Approval...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-29

... responses time per burden per nonhour response hours response burden cost Tier 1 (Desktop Analysis... developers of these small-scale projects do the desktop analysis described in Tier 1 or Tier 2 using publicly... published in the Federal Register (77 FR 19683) a notice of our intent to request that OMB renew approval...
Implementation of Grid Tier 2 and Tier 3 facilities on a Distributed OpenStack Cloud

NASA Astrophysics Data System (ADS)

Limosani, Antonio; Boland, Lucien; Coddington, Paul; Crosby, Sean; Huang, Joanna; Sevior, Martin; Wilson, Ross; Zhang, Shunde

2014-06-01

The Australian Government is making a AUD 100 million investment in Compute and Storage for the academic community. The Compute facilities are provided in the form of 30,000 CPU cores located at 8 nodes around Australia in a distributed virtualized Infrastructure as a Service facility based on OpenStack. The storage will eventually consist of over 100 petabytes located at 6 nodes. All will be linked via a 100 Gb/s network. This proceeding describes the development of a fully connected WLCG Tier-2 grid site as well as a general purpose Tier-3 computing cluster based on this architecture. The facility employs an extension to Torque to enable dynamic allocations of virtual machine instances. A base Scientific Linux virtual machine (VM) image is deployed in the OpenStack cloud and automatically configured as required using Puppet. Custom scripts are used to launch multiple VMs, integrate them into the dynamic Torque cluster and to mount remote file systems. We report on our experience in developing this nation-wide ATLAS and Belle II Tier 2 and Tier 3 computing infrastructure using the national Research Cloud and storage facilities.
Development and Application of a Two-Tier Multiple-Choice Diagnostic Test for High School Students' Understanding of Cell Division and Reproduction

ERIC Educational Resources Information Center

Sesli, Ertugrul; Kara, Yilmaz

2012-01-01

This study involved the development and application of a two-tier diagnostic test for measuring students' understanding of cell division and reproduction. The instrument development procedure had three general steps: defining the content boundaries of the test, collecting information on students' misconceptions, and instrument development.…
HIV Neutralizing Antibodies Induced by Native-like Envelope Trimers

PubMed Central

Sanders, Rogier W.; van Gils, Marit J.; Derking, Ronald; Sok, Devin; Ketas, Thomas J.; Burger, Judith A.; Ozorowski, Gabriel; Cupo, Albert; Simonich, Cassandra; Goo, Leslie; Arendt, Heather; Kim, Helen J.; Lee, Jeong Hyun; Pugach, Pavel; Williams, Melissa; Debnath, Gargi; Moldt, Brian; van Breemen, Mariëlle J.; Isik, Gözde; Medina-Ramírez, Max; Back, Jaap Willem; Koff, Wayne; Julien, Jean-Philippe; Rakasz, Eva G.; Seaman, Michael S.; Guttman, Miklos; Lee, Kelly K.; Klasse, Per Johan; LaBranche, Celia; Schief, William R.; Wilson, Ian A.; Overbaugh, Julie; Burton, Dennis R.; Ward, Andrew B.; Montefiori, David C.; Dean, Hansi; Moore, John P.

2015-01-01

A challenge for HIV-1 immunogen design is inducing neutralizing antibodies (NAbs) against neutralization-resistant (Tier-2) viruses that dominate human transmissions. We show that a soluble recombinant HIV-1 envelope glycoprotein trimer that adopts a native conformation (BG505 SOSIP.664) induced NAbs potently against the sequence-matched Tier-2 virus in rabbits and similar but weaker responses in macaques. The trimer also consistently induced cross-reactive NAbs against more sensitive (Tier-1) viruses. Tier-2 NAbs recognized conformational epitopes that differed between animals and in some cases overlapped with those recognized by broadly neutralizing antibodies (bNAbs), whereas Tier-1 responses targeted linear V3 epitopes. A second trimer, B41 SOSIP.664, also induced a strong autologous Tier-2 NAb response in rabbits. Thus, native-like trimers represent a promising starting point for developing HIV-1 vaccines aimed at inducing bNAbs. PMID:26089353
Effect of electronic prescribing with formulary decision support on medication use and cost.

PubMed

Fischer, Michael A; Vogeli, Christine; Stedman, Margaret; Ferris, Timothy; Brookhart, M Alan; Weissman, Joel S

2008-12-08

Electronic prescribing (e-prescribing) with formulary decision support (FDS) prompts prescribers to prescribe lower-cost medications and may help contain health care costs. In April 2004, 2 large Massachusetts insurers began providing an e-prescribing system with FDS to community-based practices. Using 18 months (October 1, 2003, to March 31, 2005) of administrative data, we conducted a pre-post study with concurrent controls. We first compared the change in the proportion of prescriptions for 3 formulary tiers before and after e-prescribing began, then developed multivariate longitudinal models to estimate the specific effect of e-prescribing when controlling for baseline differences between intervention and control prescribers. Potential savings were estimated using average medication costs by formulary tier. More than 1.5 million patients filled 17.4 million prescriptions during the study period. Multivariate models controlling for baseline differences between prescribers and for changes over time estimated that e-prescribing corresponded to a 3.3% increase (95% confidence interval, 2.7%-4.0%) in tier 1 prescribing. The proportion of prescriptions for tiers 2 and 3 (brand-name medications) decreased correspondingly. e-Prescriptions accounted for 20% of filled prescriptions in the intervention group. Based on average costs for private insurers, we estimated that e-prescribing with FDS at this rate could result in savings of $845,000 per 100,000 patients. Higher levels of e-prescribing use would increase these savings. Clinicians using e-prescribing with FDS were significantly more likely to prescribe tier 1 medications, and the potential financial savings were substantial. Widespread use of e-prescribing systems with FDS could result in reduced spending on medications.
Towards a model-based inventory of soil organic carbon in agricultural soils for the Swiss greenhouse gas reporting

NASA Astrophysics Data System (ADS)

Staudt, K.; Leifeld, J.; Bretscher, D.; Fuhrer, J.

2012-04-01

The Swiss inventory submission under the United Nations Framework Convention on Climate Change (UNFCCC) reports on changes in soil organic carbon stocks under different land-uses and land-use changes. The approach currently employed for cropland and grassland soils combines Tier 1 and Tier 2 methods and is considered overly simplistic. As the UNFCC encourages countries to develop Tier 3 methods for national greenhouse gas reporting, we aim to build up a model-based inventory of soil organic carbon in agricultural soils in Switzerland. We conducted a literature research on currently employed higher-tier methods using process-based models in four countries: Denmark, Sweden, Finland and the USA. The applied models stem from two major groups differing in complexity - those belonging to the group of general ecosystem models that include a plant-growth submodel, e.g. Century, and those that simulate soil organic matter turnover but not plant-growth, e.g. ICBM. For the latter group, carbon inputs to the soil from plant residues and roots have to be determined separately. We will present some aspects of the development of a model-based inventory of soil organic carbon in agricultural soils in Switzerland. Criteria for model evaluation are, among others, modeled land-use classes and land-use changes, spatial and temporal resolution, and coverage of relevant processes. For model parameterization and model evaluation at the field scale, data from several long-term agricultural experiments and monitoring sites in Switzerland is available. A subsequent regional application of a model requires the preparation of regional input data for the whole country - among others spatio-temporal meteorological data, agricultural and soil data. Following the evaluation of possible models and of available data, preference for application in the Swiss inventory will be given to simpler model structures, i.e. models without a plant-growth module. Thus, we compared different allometric relations for the estimation of plant carbon inputs to the soil from yield data that are usually provided with the models. Calculated above- and below-ground carbon inputs vary substantially between methods and exhibit different sensitivities to yield data. As a benchmark, inputs to the soil from above- and below-ground crop residues are calculated with the IPCC default method. Furthermore, the suitability of these estimation methods for Swiss conditions is tested.
Comparison of one-tier and two-tier newborn screening metrics for congenital adrenal hyperplasia.

PubMed

Sarafoglou, Kyriakie; Banks, Kathryn; Gaviglio, Amy; Hietala, Amy; McCann, Mark; Thomas, William

2012-11-01

Newborn screening (NBS) for the classic forms of congenital adrenal hyperplasia (CAH) is mandated in all states in the United States. Compared with other NBS disorders, the false-positive rate (FPR) of CAH screening remains high and has not been significantly improved by adjusting 17α-hydroxyprogesterone cutoff values for birth weight and/or gestational age. Minnesota was the first state to initiate, and only 1 of 4 states currently performing, second-tier steroid profiling for CAH. False-negative rates (FNRs) for CAH are not well known. This is a population-based study of all Minnesota infants (769,834) born 1999-2009, grouped by screening protocol (one-tier with repeat screen, January 1999 to May 2004; two-tier with second-tier steroid profiling, June 2004 to December 2009). FPR, FNR, and positive predictive value (PPV) were calculated per infant, rather than per sample, and compared between protocols. Overall, 15 false-negatives (4 salt-wasting, 11 simple-virilizing) and 45 true-positives were identified from 1999 to 2009. With two-tier screening, FNR was 32%, FPR increased to 0.065%, and PPV decreased to 8%, but these changes were not statistically significant. Second-tier steroid profiling obviated repeat screens of borderline results (355 per year average). In comparing the 2 screening protocols, the FPR of CAH NBS remains high, the PPV remains low, and false-negatives occur more frequently than has been reported. Physicians should be cautioned that a negative NBS does not necessarily rule out classic CAH; therefore, any patient for whom there is clinical concern for CAH should receive immediate diagnostic testing.
Tier 2 Supports to Improve Motivation and Performance of Elementary Students with Behavioral Challenges and Poor Work Completion

ERIC Educational Resources Information Center

Oakes, Wendy Peia; Lane, Kathleen Lynne; Cox, Meredith; Magrane, Ashley; Jenkins, Abbie; Hankins, Katy

2012-01-01

We offer a methodological illustration for researchers and practitioners of how to conduct a development study consistent with the parameters delineated by the Institute of Education Sciences (IES; U.S. Department of Education [USDE], 2010) to explore the utility of an existing Tier 1 intervention applied as a Tier 2 support within a three-tiered…
Understanding Unresponsiveness to Tier 2 Reading Intervention: Exploring the Classification and Profiles of Adequate and Inadequate Responders in First Grade

ERIC Educational Resources Information Center

Toste, Jessica R.; Compton, Donald L.; Fuchs, Douglas; Fuchs, Lynn S.; Gilbert, Jennifer K.; Cho, Eunsoo; Barquero, Laura A.; Bouton, Bobette D.

2014-01-01

The purpose of the current study was to examine academic and cognitive profiles of first graders who responded adequately and inadequately to intensive small-group reading intervention (Tier 2), as well as assess how these profiles differ based on the criteria used for classification of unresponsiveness. Nonresponders were identified using two…
Impact of the project P.A.T.H.S. In the junior secondary school years: individual growth curve analyses.

PubMed

Shek, Daniel T L; Ma, Cecilia M S

2011-02-03

The Tier 1 Program of the Project P.A.T.H.S. (Positive Adolescent Training through Holistic Social Programs) is a positive youth development program implemented in school settings utilizing a curricular-based approach. In the third year of the Full Implementation Phase, 19 experimental schools (n = 3,006 students) and 24 control schools (n = 3,727 students) participated in a randomized group trial. Analyses based on linear mixed models via SPSS showed that participants in the experimental schools displayed better positive youth development than did participants in the control schools based on different indicators derived from the Chinese Positive Youth Development Scale, including positive self-identity, prosocial behavior, and general positive youth development attributes. Differences between experimental and control participants were also found when students who joined the Tier 1 Program and perceived the program to be beneficial were employed as participants of the experimental schools. The present findings strongly suggest that the Project P.A.T.H.S. is making an important positive impact for junior secondary school students in Hong Kong.
An Integrated Tiered Service Delivery Model (ITSDM) Based on Local CD4 Testing Demands Can Improve Turn-Around Times and Save Costs whilst Ensuring Accessible and Scalable CD4 Services across a National Programme

PubMed Central

Glencross, Deborah K.; Coetzee, Lindi M.; Cassim, Naseem

2014-01-01

Background The South African National Health Laboratory Service (NHLS) responded to HIV treatment initiatives with two-tiered CD4 laboratory services in 2004. Increasing programmatic burden, as more patients access anti-retroviral therapy (ART), has demanded extending CD4 services to meet increasing clinical needs. The aim of this study was to review existing services and develop a service-model that integrated laboratory-based and point-of-care testing (POCT), to extend national coverage, improve local turn-around/(TAT) and contain programmatic costs. Methods NHLS Corporate Data Warehouse CD4 data, from 60–70 laboratories and 4756 referring health facilities was reviewed for referral laboratory workload, respective referring facility volumes and related TAT, from 2009–2012. Results An integrated tiered service delivery model (ITSDM) is proposed. Tier-1/POCT delivers CD4 testing at single health-clinics providing ART in hard-to-reach areas (<5 samples/day). Laboratory-based testing is extended with Tier-2/POC-Hubs (processing ≤30–40 CD4 samples/day), consolidating POCT across 8–10 health-clinics with other HIV-related testing and Tier-3/‘community’ laboratories, serving ≤40 health-clinics, processing ≤150 samples/day. Existing Tier-4/‘regional’ laboratories serve ≤100 facilities and process <350 samples/day; Tier-5 are high-volume ‘metro’/centralized laboratories (>350–1500 tests/day, serving ≥200 health-clinics). Tier-6 provides national support for standardisation, harmonization and quality across the organization. Conclusion The ITSDM offers improved local TAT by extending CD4 services into rural/remote areas with new Tier-3 or Tier-2/POC-Hub services installed in existing community laboratories, most with developed infrastructure. The advantage of lower laboratory CD4 costs and use of existing infrastructure enables subsidization of delivery of more expensive POC services, into hard-to-reach districts without reasonable access to a local CD4 laboratory. Full ITSDM implementation across 5 service tiers (as opposed to widespread implementation of POC testing to extend service) can facilitate sustainable ‘full service coverage’ across South Africa, and save>than R125 million in HIV/AIDS programmatic costs. ITSDM hierarchical parental-support also assures laboratory/POC management, equipment maintenance, quality control and on-going training between tiers. PMID:25490718
Capacity Development and Multi-Tiered Systems of Support: Guiding Principles

ERIC Educational Resources Information Center

Sugai, George; Simonsen, Brandi; Freeman, Jennifer; La Salle, Tamika

2016-01-01

Implementation of multi-tiered systems of support is occurring within and across a number of countries with an increased recent focus on the development of local system capacity to maintain high levels of practice implementation fidelity. The purpose of this paper is to describe the importance of local capacity development in the high fidelity and…
Development of a Three-Tier Test to Assess Misconceptions about Simple Electric Circuits

ERIC Educational Resources Information Center

Pesman, Haki; Eryilmaz, Ali

2010-01-01

The authors aimed to propose a valid and reliable diagnostic instrument by developing a three-tier test on simple electric circuits. Based on findings from the interviews, open-ended questions, and the related literature, the test was developed and administered to 124 high school students. In addition to some qualitative techniques for…

At the Creation: Chaos, Control, and Automation--Commercial Software Development for Archives.

ERIC Educational Resources Information Center

Drr, W. Theodore

1988-01-01

An approach to the design of flexible text-based management systems for archives includes tiers for repository, software, and user management systems. Each tier has four layers--objective, program, result, and interface. Traps awaiting software development companies involve the market, competition, operations, and finance. (10 references) (MES)
Tiered Internship Model for Undergraduate Students in Geospatial Science and Technology

ERIC Educational Resources Information Center

Kopteva, Irina A.; Arkowski, Donna; Craft, Elaine L.

2015-01-01

This article discusses the development, implementation, and evaluation of a tiered internship program for undergraduate students in geospatial science and technology (TIMSGeoTech). The internship program assists education programs in providing skill development that is relevant and useful, and it aligns graduates and their skills with industry…
Optimal Resource Allocation under Fair QoS in Multi-tier Server Systems

NASA Astrophysics Data System (ADS)

Akai, Hirokazu; Ushio, Toshimitsu; Hayashi, Naoki

Recent development of network technology realizes multi-tier server systems, where several tiers perform functionally different processing requested by clients. It is an important issue to allocate resources of the systems to clients dynamically based on their current requests. On the other hand, Q-RAM has been proposed for resource allocation in real-time systems. In the server systems, it is important that execution results of all applications requested by clients are the same QoS(quality of service) level. In this paper, we extend Q-RAM to multi-tier server systems and propose a method for optimal resource allocation with fairness of the QoS levels of clients’ requests. We also consider an assignment problem of physical machines to be sleep in each tier sothat the energy consumption is minimized.
Development of Two-Tier Diagnostic Test Pictorial-Based for Identifying High School Students Misconceptions on the Mole Concept

NASA Astrophysics Data System (ADS)

Siswaningsih, W.; Firman, H.; Zackiyah; Khoirunnisa, A.

2017-02-01

The aim of this study was to develop the two-tier pictorial-based diagnostic test for identifying student misconceptions on mole concept. The method of this study is used development and validation. The development of the test Obtained through four phases, development of any items, validation, determination key, and application test. Test was developed in the form of pictorial consisting of two tier, the first tier Consist of four possible answers and the second tier Consist of four possible reasons. Based on the results of content validity of 20 items using the CVR (Content Validity Ratio), a number of 18 items declared valid. Based on the results of the reliability test using SPSS, Obtained 17 items with Cronbach’s Alpha value of 0703, the which means that items have accepted. A total of 10 items was conducted to 35 students of senior high school students who have studied the mole concept on one of the high schools in Cimahi. Based on the results of the application test, student misconceptions were identified in each label concept in mole concept with the percentage of misconceptions on the label concept of mole (60.15%), Avogadro’s number (34.28%), relative atomic mass (62, 84%), relative molecule mass (77.08%), molar mass (68.53%), molar volume of gas (57.11%), molarity (71.32%), chemical equation (82.77%), limiting reactants (91.40%), and molecular formula (77.13%).
Evaluation of mercury loads from climate change projections

Treesearch

Paul Conrads; Paul M. Bradley; Stephen T. Benedict; Toby D. Feaster

2016-01-01

McTier Creek is a small coastal plain watershed located in Aiken County, South Carolina.Â McTier Creek forms part of the headwaters for the Edisto River basin, which is notedÂ for having some of the highest recorded fish-tissue mercury concentrations in the UnitedÂ States. A simple water-quality load model, TOPLOAD, which was developed for McTierÂ Creek, utilizes a mass...
A four-tier problem-solving scaffold to teach pain management in dental school.

PubMed

Ivanoff, Chris S; Hottel, Timothy L

2013-06-01

Pain constitutes a major reason patients pursue dental treatment. This article presents a novel curriculum to provide dental students comprehensive training in the management of pain. The curriculum's four-tier scaffold combines traditional and problem-based learning to improve students' diagnostic, pharmacotherapeutic, and assessment skills to optimize decision making when treating pain. Tier 1 provides underpinning knowledge of pain mechanisms with traditional and contextualized instruction by integrating clinical correlations and studying worked cases that stimulate clinical thinking. Tier 2 develops critical decision making skills through self-directed learning and actively solving problem-based cases. Tier 3 exposes students to management approaches taken in allied health fields and cultivates interdisciplinary communication skills. Tier 4 provides a "knowledge and experience synthesis" by rotating students through community pain clinics to practice their assessment skills. This combined teaching approach aims to increase critical thinking and problem-solving skills to assist dental graduates in better management of pain throughout their careers. Dental curricula that have moved to comprehensive care/private practice models are well-suited for this educational approach. The goal of this article is to encourage dental schools to integrate pain management into their curricula, to develop pain management curriculum resources for dental students, and to provide leadership for change in pain management education.
Key learnings from the Endocrine Disruptor Screening Program (EDSP) Tier 1 rodent uterotrophic and Hershberger assays.

PubMed

Marty, M Sue; O'Connor, John C

2014-02-01

In 2009, companies began screening compounds using the US Environmental Protection Agency's Endocrine Disruptor Screening Program (EDSP). EDSP has two tiers: Tier 1 includes 11 assays to identify compounds with potential endocrine activity. This article describes two laboratories' experiences conducting Tier 1 uterotrophic and Hershberger assays. The uterotrophic assay detects estrogen receptor agonists through increases in uterine weight. The advantages of the uterotrophic rat models (immature vs. adult ovariectomized) and exposure routes are discussed. Across 29 studies, relative differences in uterine weights in the vehicle control group and 17α-ethynylestradiol-positive control group were reasonably reproducible. The Hershberger assay detects androgen receptor (AR) agonists, antagonists, and 5α-reductase inhibitors through changes in accessory sex tissue (AST) weights. Across 23 studies, AST weights were relatively reproducible for the vehicle groups (baseline), testosterone propionate (TP) groups (androgenic response), and flutamide + TP groups (antiandrogenic response). In one laboratory, one and four compounds were positive in the androgenic and antiandrogenic portions of the assay, respectively. Each compound was also positive for AR binding. In the other laboratory, three compounds showed potential antiandrogenic activity, but each compound was negative for AR binding and did not fit the profile for 5α-reductase inhibition. These compounds induced hepatic enzymes that enhanced testosterone metabolism/clearance, resulting in lower testosterone and decreased capacity to maintain AST weights. The Hershberger androgenic and antiandrogenic performance criteria were generally attainable. Overall, the uterotrophic and Hershberger assays were easily adopted and function as described for EDSP screening, although the mode of action for positive results may not be easily determined. © 2014 Wiley Periodicals, Inc.
Data Driven Professional Development Design for Out-of-School Time Educators Using Planetary Science and Engineering Educational Materials

NASA Astrophysics Data System (ADS)

Clark, J.; Bloom, N.

2017-12-01

Data driven design practices should be the basis for any effective educational product, particularly those used to support STEM learning and literacy. Planetary Learning that Advances the Nexus of Engineering, Technology, and Science (PLANETS) is a five-year NASA-funded (NNX16AC53A) interdisciplinary and cross-institutional partnership to develop and disseminate STEM out-of-school time (OST) curricular and professional development units that integrate planetary science, technology, and engineering. The Center for Science Teaching and Learning at Northern Arizona University, the U.S. Geological Survey Astrogeology Science Center, and the Museum of Science Boston are partners in developing, piloting, and researching the impact of three out of school time units. Two units are for middle grades youth and one is for upper elementary aged youth. The presentation will highlight the data driven development process of the educational products used to provide support for educators teaching these curriculum units. This includes how data from the project needs assessment, curriculum pilot testing, and professional support product field tests are used in the design of products for out of school time educators. Based on data analysis, the project is developing and testing four tiers of professional support for OST educators. Tier 1 meets the immediate needs of OST educators to teach curriculum and include how-to videos and other direct support materials. Tier 2 provides additional content and pedagogical knowledge and includes short content videos designed to specifically address the content of the curriculum. Tier 3 elaborates on best practices in education and gives guidance on methods, for example, to develop cultural relevancy for underrepresented students. Tier 4 helps make connections to other NASA or educational products that support STEM learning in out of school settings. Examples of the tiers of support will be provided.
When Interrupted Intervention Leads to Failure: A Correlation Study of the Three-Tiered Reading Model in Grades K-2

ERIC Educational Resources Information Center

Weis, Beverly Lynn

2012-01-01

The three-tiered reading model is a widely practiced instructional scheme that moves students in and out of reading intervention groups during the school year. Though designed to treat students who need extra help learning to read, this interruption of reading interventions may hinder some students' progress. The purpose of this study was to…
Accelerating Chronically Unresponsive Children to Tier 3 Instruction: What Level of Data Is Necessary to Ensure Selection Accuracy?

ERIC Educational Resources Information Center

Compton, Donald L.; Gilbert, Jennifer K.; Jenkins, Joseph R.; Fuchs, Douglas; Fuchs, Lynn S.; Cho, Eunsoo; Barquero, Laura A.; Bouton, Bobette

2012-01-01

Response-to-intervention (RTI) approaches to disability identification are meant to put an end to the so-called wait-to-fail requirement associated with IQ discrepancy. However, in an unfortunate irony, there is a group of children who wait to fail in RTI frameworks. That is, they must fail both general classroom instruction (Tier 1) and…
Professional development to differentiate kindergarten Tier 1 instruction: Can already effective teachers improve student outcomes by differentiating Tier 1 instruction?

PubMed Central

Otaiba, Stephanie Al; Folsom, Jessica S.; Wanzek, Jeannie; Greulich, Luana; Wasche, Jessica; Schatschneider, Christopher; Connor, Carol

2015-01-01

Two primary purposes guided this quasi-experimental within-teacher study: (1) to examine changes from baseline through two years of professional development (Individualizing Student Instruction) in kindergarten teachers’ differentiation of Tier 1 literacy instruction; (2) to examine changes in reading and vocabulary of three cohorts of the teachers’ students (n = 416). Teachers’ instruction was observed and students were assessed on standardized measures of vocabulary and word reading. Results suggested that teachers significantly increased their differentiation and students showed significantly greater word reading outcomes relative to baseline. No change was observed for vocabulary. Results have implications for supporting teacher effectiveness through technology-supported professional development. PMID:27346927
Professional development to differentiate kindergarten Tier 1 instruction: Can already effective teachers improve student outcomes by differentiating Tier 1 instruction?

PubMed

Otaiba, Stephanie Al; Folsom, Jessica S; Wanzek, Jeannie; Greulich, Luana; Wasche, Jessica; Schatschneider, Christopher; Connor, Carol

Two primary purposes guided this quasi-experimental within-teacher study: (1) to examine changes from baseline through two years of professional development (Individualizing Student Instruction) in kindergarten teachers' differentiation of Tier 1 literacy instruction; (2) to examine changes in reading and vocabulary of three cohorts of the teachers' students ( n = 416). Teachers' instruction was observed and students were assessed on standardized measures of vocabulary and word reading. Results suggested that teachers significantly increased their differentiation and students showed significantly greater word reading outcomes relative to baseline. No change was observed for vocabulary. Results have implications for supporting teacher effectiveness through technology-supported professional development.
Stuttering, induced fluency, and natural fluency: a hierarchical series of activation likelihood estimation meta-analyses.

PubMed

Budde, Kristin S; Barron, Daniel S; Fox, Peter T

2014-12-01

Developmental stuttering is a speech disorder most likely due to a heritable form of developmental dysmyelination impairing the function of the speech-motor system. Speech-induced brain-activation patterns in persons who stutter (PWS) are anomalous in various ways; the consistency of these aberrant patterns is a matter of ongoing debate. Here, we present a hierarchical series of coordinate-based meta-analyses addressing this issue. Two tiers of meta-analyses were performed on a 17-paper dataset (202 PWS; 167 fluent controls). Four large-scale (top-tier) meta-analyses were performed, two for each subject group (PWS and controls). These analyses robustly confirmed the regional effects previously postulated as "neural signatures of stuttering" (Brown, Ingham, Ingham, Laird, & Fox, 2005) and extended this designation to additional regions. Two smaller-scale (lower-tier) meta-analyses refined the interpretation of the large-scale analyses: (1) a between-group contrast targeting differences between PWS and controls (stuttering trait); and (2) a within-group contrast (PWS only) of stuttering with induced fluency (stuttering state). Copyright © 2014 Elsevier Inc. All rights reserved.
Development of Three-Tier Heat, Temperature and Internal Energy Diagnostic Test

ERIC Educational Resources Information Center

Gurcay, Deniz; Gulbas, Etna

2015-01-01

Background: Misconceptions are major obstacles to learning physics, and the concepts of heat and temperature are some of the common misconceptions that are encountered in daily life. Therefore, it is important to develop valid and reliable tools to determine students' misconceptions about basic thermodynamics concepts. Three-tier tests are…
Developing a Classroom Management Plan Using a Tiered Approach

ERIC Educational Resources Information Center

Sayeski, Kristin L.; Brown, Monica R.

2011-01-01

In this article, the authors present a response-to-intervention (RTI) framework that both special and general education teachers can use in evaluating existing class structures and developing comprehensive classroom management plans for the purpose of managing challenging behaviors. They applied the concept of a three-tiered model of support at…
The Effectiveness of a Supplemental Pre-Kindergarten Vocabulary Intervention

ERIC Educational Resources Information Center

Kong, Na Young

2013-01-01

Oral vocabulary is a strong predictor of young children's later reading development. Many children enter kindergarten with weak vocabulary knowledge and could benefit from an extra level or higher tier of intentional instruction in vocabulary that supplements the Tier 1 core curriculum in language. Recent findings from research developing a…
A Team-Based Process for Designing Comprehensive, Integrated, Three-Tiered (CI3T) Models of Prevention: How Does My School-Site Leadership Team Design a CI3T Model?

ERIC Educational Resources Information Center

Lane, Kathleen Lynne; Oakes, Wendy Peia; Jenkins, Abbie; Menzies, Holly Mariah; Kalberg, Jemma Robertson

2014-01-01

Comprehensive, integrated, three-tiered models are context specific and developed by school-site teams according to the core values held by the school community. In this article, the authors provide a step-by-step, team-based process for designing comprehensive, integrated, three-tiered models of prevention that integrate academic, behavioral, and…
Development and implementation of an Integrated Water Resources Management System (IWRMS)

NASA Astrophysics Data System (ADS)

Flügel, W.-A.; Busch, C.

2011-04-01

One of the innovative objectives in the EC project BRAHMATWINN was the development of a stakeholder oriented Integrated Water Resources Management System (IWRMS). The toolset integrates the findings of the project and presents it in a user friendly way for decision support in sustainable integrated water resources management (IWRM) in river basins. IWRMS is a framework, which integrates different types of basin information and which supports the development of IWRM options for climate change mitigation. It is based on the River Basin Information System (RBIS) data models and delivers a graphical user interface for stakeholders. A special interface was developed for the integration of the enhanced DANUBIA model input and the NetSyMod model with its Mulino decision support system (mulino mDss) component. The web based IWRMS contains and combines different types of data and methods to provide river basin data and information for decision support. IWRMS is based on a three tier software framework which uses (i) html/javascript at the client tier, (ii) PHP programming language to realize the application tier, and (iii) a postgresql/postgis database tier to manage and storage all data, except the DANUBIA modelling raw data, which are file based and registered in the database tier. All three tiers can reside on one or different computers and are adapted to the local hardware infrastructure. IWRMS as well as RBIS are based on Open Source Software (OSS) components and flexible and time saving access to that database is guaranteed by web-based interfaces for data visualization and retrieval. The IWRMS is accessible via the BRAHMATWINN homepage: http://www.brahmatwinn.uni-jena.de and a user manual for the RBIS is available for download as well.
SLA-based optimisation of virtualised resource for multi-tier web applications in cloud data centres

NASA Astrophysics Data System (ADS)

Bi, Jing; Yuan, Haitao; Tie, Ming; Tan, Wei

2015-10-01

Dynamic virtualised resource allocation is the key to quality of service assurance for multi-tier web application services in cloud data centre. In this paper, we develop a self-management architecture of cloud data centres with virtualisation mechanism for multi-tier web application services. Based on this architecture, we establish a flexible hybrid queueing model to determine the amount of virtual machines for each tier of virtualised application service environments. Besides, we propose a non-linear constrained optimisation problem with restrictions defined in service level agreement. Furthermore, we develop a heuristic mixed optimisation algorithm to maximise the profit of cloud infrastructure providers, and to meet performance requirements from different clients as well. Finally, we compare the effectiveness of our dynamic allocation strategy with two other allocation strategies. The simulation results show that the proposed resource allocation method is efficient in improving the overall performance and reducing the resource energy cost.
MBA Recruitment Task Group

DTIC Science & Technology

2003-02-05

talented, recent MBA graduates from top-tier U.S. business schools . These graduates bring new ideas, energy and private sector management...sets and school performance may be different, all Fellows are expected to be recent graduates of top-tier business schools who will be performing in...the “CEO/Ambassador” to one of the target business schools where DoD is establishing a physical recruiting presence. The person’s role would be to

Development and Validation of a Two-Tier Instrument to Examine Understanding of Internal Transport in Plants and the Human Circulatory System

ERIC Educational Resources Information Center

Wang, Jing-Ru

2004-01-01

This study is intended to develop an assessment instrument to investigate students' understandings about internal transport in plants and human circulatory system. A refined process of a two-tier diagnostic test was used to develop the instrument. Finally, three versions of the Internal Transport in Plants and the Human Circulatory System test…
The Science behind Curriculum Development and Evaluation: Taking a Design Science Approach in the Production of a Tier 2 Mathematics Curriculum

ERIC Educational Resources Information Center

Doabler, Christian T.; Clarke, Ben; Fien, Hank; Baker, Scott K.; Kosty, Derek B.; Cary, Mari Strand

2015-01-01

The production of an effective mathematics curriculum begins with a scientific development, evaluation, and revision framework. The purpose of this study was to conduct an initial investigation of a recently developed Tier 2 mathematics curriculum designed to improve the outcomes of first grade students at risk for mathematics difficulties (MD).…
Sustainable Energy Solutions for Rural Alaska

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

Allen, Riley; Brutkoski, Donna; Farnsworth, David

2016-04-22

The state of Alaska recognizes the challenges these rural communities face and provides financial support via the Power Cost Equalization (PCE) program. The PCE subsidizes the electricity prices paid by customers of these high-cost utilities. The PCE program is designed to spread the benefits of Alaska’s natural resources more evenly throughout the state. Yet even with this subsidy, electricity is still much more expensive for these rural customers. And beyond the PCE, other forms of assistance to rural utilities are becoming scarce given the state’s current fiscal environment. Nearly 90 percent of Alaska’s unrestricted budget funds in recent years havemore » been tied to oil royalties—a sector experiencing significant declines in production and oil prices. Consequently, as Alaska looks to tighten budgets, the challenge of lowering rural utility costs, while encouraging self-sufficiency, has become more urgent.This study examines reliability, capital and strategic planning, management, workforce development, governance, financial performance and system efficiency in the various communities visited by the research team. Using those attributes, a tier system was developed to categorize rural Alaska utilities into Leading and Innovating Systems (Tier I), Advanced Diesel Systems (Tier II), Basic Systems (Tier III), and Underperforming Systems (Tier IV). The tier approach is not meant to label specific utilities, but rather to provide a general set of benchmarks and guideposts for improvement.« less
AUDIOME: a tiered exome sequencing-based comprehensive gene panel for the diagnosis of heterogeneous nonsyndromic sensorineural hearing loss.

PubMed

Guan, Qiaoning; Balciuniene, Jorune; Cao, Kajia; Fan, Zhiqian; Biswas, Sawona; Wilkens, Alisha; Gallo, Daniel J; Bedoukian, Emma; Tarpinian, Jennifer; Jayaraman, Pushkala; Sarmady, Mahdi; Dulik, Matthew; Santani, Avni; Spinner, Nancy; Abou Tayoun, Ahmad N; Krantz, Ian D; Conlin, Laura K; Luo, Minjie

2018-03-29

PurposeHereditary hearing loss is highly heterogeneous. To keep up with rapidly emerging disease-causing genes, we developed the AUDIOME test for nonsyndromic hearing loss (NSHL) using an exome sequencing (ES) platform and targeted analysis for the curated genes.MethodsA tiered strategy was implemented for this test. Tier 1 includes combined Sanger and targeted deletion analyses of the two most common NSHL genes and two mitochondrial genes. Nondiagnostic tier 1 cases are subjected to ES and array followed by targeted analysis of the remaining AUDIOME genes.ResultsES resulted in good coverage of the selected genes with 98.24% of targeted bases at >15 ×. A fill-in strategy was developed for the poorly covered regions, which generally fell within GC-rich or highly homologous regions. Prospective testing of 33 patients with NSHL revealed a diagnosis in 11 (33%) and a possible diagnosis in 8 cases (24.2%). Among those, 10 individuals had variants in tier 1 genes. The ES data in the remaining nondiagnostic cases are readily available for further analysis.ConclusionThe tiered and ES-based test provides an efficient and cost-effective diagnostic strategy for NSHL, with the potential to reflex to full exome to identify causal changes outside of the AUDIOME test.Genetics in Medicine advance online publication, 29 March 2018; doi:10.1038/gim.2018.48.
Multi-tiered system of support incorporating the R.E.N.E.W. process and its relationship to perception of school safety and office discipline referrals

NASA Astrophysics Data System (ADS)

Flood, Molly M.

This study examined the relationship between the fidelity of multi-tier school-wide positive behavior interventions and supports (SWPBIS) and staff perception of school safety and office discipline referrals. This research provided a case study on multi-tier supports and interventions, and the RENEW person-centered planning process in an alternative special education center following the implementation of a multi-tier SWPBIS model. Pennsylvania is one of several states looking to adopt an effective Tier III behavioral tool. The research described the results of an analysis of implementation fidelity on a multi-tiered school-wide positive behavior support model developed at a special education center operated by a public school system entity. This research explored the fidelity of SWPBIS implementation; analyzed the relationship of SWPBIS to school climate as measured by staff perceptions and reduction of office discipline referrals (ODR); explored tier III supports incorporating a process Rehabilitation and Empowerment, Natural Supports, Education and Work (RENEW); and investigated the potential sustainability of the RENEW process as a multi-tier system of support. This study investigated staff perceptions on integrated supports between schools and communities and identified the degree of relationship to school risk factors, school protective factors, and office discipline referrals following the building of cooperative partnerships between Systems of Care and Local Education Agencies.
Could international compulsory licensing reconcile tiered pricing of pharmaceuticals with the right to health?

PubMed

Ooms, Gorik; Forman, Lisa; Williams, Owain D; Hill, Peter S

2014-12-18

The heads of the Global Fund and the GAVI Alliance have recently promoted the idea of an international tiered pricing framework for medicines, despite objections from civil society groups who fear that this would reduce the leeway for compulsory licenses and generic competition. This paper explores the extent to which an international tiered pricing framework and the present leeway for compulsory licensing can be reconciled, using the perspective of the right to health as defined in international human rights law. We explore the practical feasibility of an international tiered pricing and compulsory licensing framework governed by the World Health Organization. We use two simple benchmarks to compare the relative affordability of medicines for governments - average income and burden of disease - to illustrate how voluntary tiered pricing practice fails to make medicines affordable enough for low and middle income countries (if compared with the financial burden of the same medicines for high income countries), and when and where international compulsory licenses should be issued in order to allow governments to comply with their obligations to realize the right to health. An international tiered pricing and compulsory licensing framework based on average income and burden of disease could ease the tension between governments' human rights obligation to provide medicines and governments' trade obligation to comply with the Agreement on Trade-Related Aspects of Intellectual Property Rights.
Development and Evaluation of the Diagnostic Power for a Computer-Based Two-Tier Assessment

ERIC Educational Resources Information Center

Lin, Jing-Wen

2016-01-01

This study adopted a quasi-experimental design with follow-up interview to develop a computer-based two-tier assessment (CBA) regarding the science topic of electric circuits and to evaluate the diagnostic power of the assessment. Three assessment formats (i.e., paper-and-pencil, static computer-based, and dynamic computer-based tests) using…
Scientific management of Space Telescope

NASA Technical Reports Server (NTRS)

Odell, C. R.

1981-01-01

A historical summay is given on the science management of the Space Telescope, the inception of which began in 1962, when scientists and engineers first recommended the development of a nearly diffraction limited substantial-size optical telescope. Phase A, the feasibility requirements generation phase, began in 1971 and consisted largely of NASA scientists and a NASA design. Phase B, the preliminary design phase, established a tiered structure of scientists, led by the Large Space Telescope operations and Management Work Group. A Mission Operations Working Group headed six instrument definition teams to develop the essential instrument definitions. Many changes took place during Phase B, before design and development, which began in 1978 and still continues today.
Software Measurement Guidebook Version 01.00.00

DTIC Science & Technology

1991-06-01

However, if PTR closures fall off in the presence of declining PTR openings, then the closure procedure is just catching up with the volume of PTRs, and...the activities in the development process in the WBS. The development activi- ties’ cost accounts should tier up to the CSCI total development cost...34* Establish separate WBS cost accounts for each CSCI. Establish separate CSCI-specific cost accounts for each development activity or phase that tier up
Preschool Multi-Tier Prevention-Intervention Model for Language and Early Literacy (Pre-3T): Development Summary and Implementation Guide. CYFS Working Paper No. 2014-3

ERIC Educational Resources Information Center

Clarke, Brandy L.; Knoche, Lisa L.; Abbott, Mary I.; Sheridan, Susan M.; Carta, Judith J.; Sjuts, Tara S.

2014-01-01

The primary objective of this development study was to develop and pilot a three-tiered prevention model (universal, targeted, individualized) in early education for children at risk of reading difficulties. The aims of this study were to: (1) Define and develop a Pre-3T model to address the early literacy and language needs of young children in…
The overall program effects of California's 3-Tier Assessment System pilot on crashes and mobility among senior drivers.

PubMed

Camp, Bayliss J

2013-12-01

In 2007, the California Department of Motor Vehicles (DMV) undertook a pilot study of the 3-Tier Assessment System, the purpose of which was to examine, in a large-scale real-time public agency setting, the effectiveness of this method for both reducing the crash risk of individual drivers and for extending the safe driving years of Californian drivers of all ages. The 3-Tier Assessment System consisted of tiered series of screening tools incorporated into the in-office driver's license renewal process. These screening tools identified drivers with various kinds of functional limitations (physical, visual, and cognitive/perceptual), that might impact safe driving. Paired with the screening tools were educational materials designed to improve drivers' knowledge of their own limitations, including compensating techniques. The present study is a population-based evaluation of the effects of the pilot on subsequent crash risk and mobility outcomes (including delicensure) of participating drivers age 70 and older. Pilot participants were compared with two control groups processed according to standard California DMV license renewal procedures. Because the 3-Tier Assessment System was designed to identify limitations normally associated with aging, the present analyses focus on drivers age 70 and older. However, it should be emphasized that during the 3-Tier pilot the screening tools were applied to drivers of all ages. There were two main findings. First, there were no consistent, statistically significant differences between the pilot and control groups in crash risk in the two years following screening. Second, pilot participants experienced statistically significant effects on mobility. These effects included delays in time to complete their license renewal, an increase in the number of assigned license restrictions, and an increase in the number of customers failing to renew their driving privilege. Based on these findings, suggestions for further research are made. None. © 2013.
Concern-driven integrated approaches to nanomaterial testing and assessment – report of the NanoSafety Cluster Working Group 10

PubMed Central

Oomen, Agnes G.; Bos, Peter M. J.; Fernandes, Teresa F.; Hund-Rinke, Kerstin; Boraschi, Diana; Byrne, Hugh J.; Aschberger, Karin; Gottardo, Stefania; von der Kammer, Frank; Kühnel, Dana; Hristozov, Danail; Marcomini, Antonio; Migliore, Lucia; Scott-Fordsmand, Janeck; Wick, Peter

2014-01-01

Bringing together topic-related European Union (EU)-funded projects, the so-called “NanoSafety Cluster” aims at identifying key areas for further research on risk assessment procedures for nanomaterials (NM). The outcome of NanoSafety Cluster Working Group 10, this commentary presents a vision for concern-driven integrated approaches for the (eco-)toxicological testing and assessment (IATA) of NM. Such approaches should start out by determining concerns, i.e., specific information needs for a given NM based on realistic exposure scenarios. Recognised concerns can be addressed in a set of tiers using standardised protocols for NM preparation and testing. Tier 1 includes determining physico-chemical properties, non-testing (e.g., structure–activity relationships) and evaluating existing data. In tier 2, a limited set of in vitro and in vivo tests are performed that can either indicate that the risk of the specific concern is sufficiently known or indicate the need for further testing, including details for such testing. Ecotoxicological testing begins with representative test organisms followed by complex test systems. After each tier, it is evaluated whether the information gained permits assessing the safety of the NM so that further testing can be waived. By effectively exploiting all available information, IATA allow accelerating the risk assessment process and reducing testing costs and animal use (in line with the 3Rs principle implemented in EU Directive 2010/63/EU). Combining material properties, exposure, biokinetics and hazard data, information gained with IATA can be used to recognise groups of NM based upon similar modes of action. Grouping of substances in return should form integral part of the IATA themselves. PMID:23641967
AMEG: the new SETAC advisory group on aquatic macrophyte ecotoxicology

PubMed Central

Davies, Jo; Dobbs, Michael; Ebke, Peter; Hanson, Mark; Hommen, Udo; Knauer, Katja; Loutseti, Stefania; Maltby, Lorraine; Mohr, Silvia; Poovey, Angela; Poulsen, Véronique

2010-01-01

Introduction and background Primary producers play critical structural and functional roles in aquatic ecosystems; therefore, it is imperative that the potential risks of toxicants to aquatic plants are adequately assessed in the risk assessment of chemicals. The standard required macrophyte test species is the floating (non-sediment-rooted) duckweed Lemna spp. This macrophyte species might not be representative of all floating, rooted, emergent, and submerged macrophyte species because of differences in the duration and mode of exposure; sensitivity to the specific toxic mode of action of the chemical; and species-specific traits (e.g., duckweed's very short generation time). Discussion and perspectives These topics were addressed during the workshop entitled “Aquatic Macrophyte Risk Assessment for Pesticides” (AMRAP) where a risk assessment scheme for aquatic macrophytes was proposed. Four working groups evolved from this workshop and were charged with the task of developing Tier 1 and higher-tier aquatic macrophyte risk assessment procedures. Subsequently, a SETAC Advisory Group, the Macrophyte Ecotoxicology Group (AMEG) was formed as an umbrella organization for various macrophyte working groups. The purpose of AMEG is to provide scientifically based guidance in all aspects of aquatic macrophyte testing in the laboratory and field, including prospective as well as retrospective risk assessments for chemicals. As AMEG expands, it will begin to address new topics including bioremediation and sustainable management of aquatic macrophytes in the context of ecosystem services. PMID:20191396
AMEG: the new SETAC advisory group on aquatic macrophyte ecotoxicology.

PubMed

Arts, Gertie; Davies, Jo; Dobbs, Michael; Ebke, Peter; Hanson, Mark; Hommen, Udo; Knauer, Katja; Loutseti, Stefania; Maltby, Lorraine; Mohr, Silvia; Poovey, Angela; Poulsen, Véronique

2010-05-01

Primary producers play critical structural and functional roles in aquatic ecosystems; therefore, it is imperative that the potential risks of toxicants to aquatic plants are adequately assessed in the risk assessment of chemicals. The standard required macrophyte test species is the floating (non-sediment-rooted) duckweed Lemna spp. This macrophyte species might not be representative of all floating, rooted, emergent, and submerged macrophyte species because of differences in the duration and mode of exposure; sensitivity to the specific toxic mode of action of the chemical; and species-specific traits (e.g., duckweed's very short generation time). These topics were addressed during the workshop entitled "Aquatic Macrophyte Risk Assessment for Pesticides" (AMRAP) where a risk assessment scheme for aquatic macrophytes was proposed. Four working groups evolved from this workshop and were charged with the task of developing Tier 1 and higher-tier aquatic macrophyte risk assessment procedures. Subsequently, a SETAC Advisory Group, the Macrophyte Ecotoxicology Group (AMEG) was formed as an umbrella organization for various macrophyte working groups. The purpose of AMEG is to provide scientifically based guidance in all aspects of aquatic macrophyte testing in the laboratory and field, including prospective as well as retrospective risk assessments for chemicals. As AMEG expands, it will begin to address new topics including bioremediation and sustainable management of aquatic macrophytes in the context of ecosystem services.
R5 clade C SHIV strains with tier 1 or 2 neutralization sensitivity: tools to dissect env evolution and to develop AIDS vaccines in primate models.

PubMed

Siddappa, Nagadenahalli B; Watkins, Jennifer D; Wassermann, Klemens J; Song, Ruijiang; Wang, Wendy; Kramer, Victor G; Lakhashe, Samir; Santosuosso, Michael; Poznansky, Mark C; Novembre, Francis J; Villinger, François; Else, James G; Montefiori, David C; Rasmussen, Robert A; Ruprecht, Ruth M

2010-07-21

HIV-1 clade C (HIV-C) predominates worldwide, and anti-HIV-C vaccines are urgently needed. Neutralizing antibody (nAb) responses are considered important but have proved difficult to elicit. Although some current immunogens elicit antibodies that neutralize highly neutralization-sensitive (tier 1) HIV strains, most circulating HIVs exhibiting a less sensitive (tier 2) phenotype are not neutralized. Thus, both tier 1 and 2 viruses are needed for vaccine discovery in nonhuman primate models. We constructed a tier 1 simian-human immunodeficiency virus, SHIV-1157ipEL, by inserting an "early," recently transmitted HIV-C env into the SHIV-1157ipd3N4 backbone [1] encoding a "late" form of the same env, which had evolved in a SHIV-infected rhesus monkey (RM) with AIDS. SHIV-1157ipEL was rapidly passaged to yield SHIV-1157ipEL-p, which remained exclusively R5-tropic and had a tier 1 phenotype, in contrast to "late" SHIV-1157ipd3N4 (tier 2). After 5 weekly low-dose intrarectal exposures, SHIV-1157ipEL-p systemically infected 16 out of 17 RM with high peak viral RNA loads and depleted gut CD4+ T cells. SHIV-1157ipEL-p and SHIV-1157ipd3N4 env genes diverge mostly in V1/V2. Molecular modeling revealed a possible mechanism for the increased neutralization resistance of SHIV-1157ipd3N4 Env: V2 loops hindering access to the CD4 binding site, shown experimentally with nAb b12. Similar mutations have been linked to decreased neutralization sensitivity in HIV-C strains isolated from humans over time, indicating parallel HIV-C Env evolution in humans and RM. SHIV-1157ipEL-p, the first tier 1 R5 clade C SHIV, and SHIV-1157ipd3N4, its tier 2 counterpart, represent biologically relevant tools for anti-HIV-C vaccine development in primates.
Neurotoxicity profile of supermethrin, a new pyrethroid insecticide.

PubMed

Hornychova, M; Frantik, E; Kubat, J; Formanek, J

1995-11-01

The use of a standard two-tier neurotoxicity screening procedure in the context of risk assessment is exemplified. Testing of a new pyrethroid in rats addressed the following sequence of questions: Does the substance evoke neurotoxic symptoms in sublethal doses? Do these symptoms reflect a primary neurotropic action? What are the dynamic characteristics of injury, the clinical profile of effect, and the relative potency of the tested substance compared to similar compounds? - The testing protocol is an animal analogue of a systematic neurological and psychological examination in man. First tier tests (structured observation, motor activity measurement, simple neurological examination) were applied after the first dose, during repeated dosing phase and in the restitution phase. Facultative tests for the second-tier examination (motor activity pattern, learning/retention test, evoked potentials, dynamic motor performance) were selected on the basis of effects revealed by the first-tier testing. Supermethrin evoked acute neurotoxicity in sublethal doses, ranging from 1/30 to 1/15 of LD50. The clinical pattern was similar to other cyano-substituted pyrethroids. Behavioural inhibition was transient and complete tolerance to it developed after 4-week repeated dosing. No indications of long-lasting changes in neuronal excitability or in learning and memory processes were found. Ataxia and excitomotoric phenomena dominated both the acute and the subchronic picture. Marked and persistent motor disturbances, including symptoms of lower motoneuron injury, were limited to individual animals of the highest, near-lethal dose group (27 mg-kg-1). Compared to lambda-cyhalothrin, the effects of supermethrin were 2 to 3 times weaker, disappeared more rapidly, cumulated less, and had higher tendency to tolerance.
A two-tier atmospheric circulation classification scheme for the European-North Atlantic region

NASA Astrophysics Data System (ADS)

Guentchev, Galina S.; Winkler, Julie A.

A two-tier classification of large-scale atmospheric circulation was developed for the European-North-Atlantic domain. The classification was constructed using a combination of principal components and k-means cluster analysis applied to reanalysis fields of mean sea-level pressure for 1951-2004. Separate classifications were developed for the winter, spring, summer, and fall seasons. For each season, the two classification tiers were identified independently, such that the definition of one tier does not depend on the other tier having already been defined. The first tier of the classification is comprised of supertype patterns. These broad-scale circulation classes are useful for generalized analyses such as investigations of the temporal trends in circulation frequency and persistence. The second, more detailed tier consists of circulation types and is useful for numerous applied research questions regarding the relationships between large-scale circulation and local and regional climate. Three to five supertypes and up to 19 circulation types were identified for each season. An intuitive nomenclature scheme based on the physical entities (i.e., anomaly centers) which dominate the specific patterns was used to label each of the supertypes and types. Two example applications illustrate the potential usefulness of a two-tier classification. In the first application, the temporal variability of the supertypes was evaluated. In general, the frequency and persistence of supertypes dominated by anticyclonic circulation increased during the study period, whereas the supertypes dominated by cyclonic features decreased in frequency and persistence. The usefulness of the derived circulation types was exemplified by an analysis of the circulation associated with heat waves and cold spells reported at several cities in Bulgaria. These extreme temperature events were found to occur with a small number of circulation types, a finding that can be helpful in understanding past variability and projecting future changes in the occurrence of extreme weather and climate events.
The development and validation of a three-tier diagnostic test measuring pre-service elementary education and secondary science teachers' understanding of the water cycle

NASA Astrophysics Data System (ADS)

Schaffer, Dannah Lynn

The main goal of this research study was to develop and validate a three-tier diagnostic test to determine pre-service teachers' (PSTs) conceptual knowledge of the water cycle. For a three-tier diagnostic test, the first tier assesses content knowledge; in the second tier, a reason is selected for the content answer; and the third tier allows test-takers to select how confident they are in their answers for the first two tiers. The second goal of this study was to diagnose any alternative conceptions PSTs might have about the water cycle. The Water Cycle Diagnostic Test (WCDT) was developed using the theoretical framework by Treagust (1986, 1988, and 1995), and in similar studies that developed diagnostic tests (e.g., Calean & Subramaniam, 2010a; Odom & Barrow, 2007; Pesman & Eryilmaz, 2010). The final instrument consisted of 15 items along with a demographic survey that examined PSTs' weather-related experiences that may or may not have affected the PSTs' understanding of the water cycle. The WCDT was administered to 77 PSTs enrolled in science methods courses during the fall of 2012. Among the 77 participants, 37 of the PSTs were enrolled in elementary education (EPST) and 40 in secondary science (SPST). Using exploratory factor analysis, five categories were factored out for the WCDT: Phase Change of Water; Condensation and Storage; Clouds; Global Climate Change; and Movement through the Water Cycle. Analysis of the PSTs' responses demonstrated acceptable reliability (alpha = 0.62) for the instrument, and acceptable difficulty indices and discrimination indices for 12 of the items. Analysis indicated that the majority of the PSTs had a limited understanding of the water cycle. Of the PSTs sampled, SPSTs were significantly more confident in their answers' on the WCDT than the EPSTs. Completion of an undergraduate atmospheric science and/or meteorology course, as well as a higher interest in listening and/or viewing weather-related programs, resulted in PSTs having greater understanding and confidence in their answers on the WCDT. The analysis of the PSTs' responses revealed 49 potential alternative conceptions and areas where PSTs' lack of knowledge was revealed from the WCDT.
Assessing the Nutritional Quality of Diets of Canadian Adults Using the 2014 Health Canada Surveillance Tool Tier System.

PubMed

Jessri, Mahsa; Nishi, Stephanie K; L'Abbé, Mary R

2015-12-12

The 2014 Health Canada Surveillance Tool (HCST) was developed to assess adherence of dietary intakes with Canada's Food Guide. HCST classifies foods into one of four Tiers based on thresholds for sodium, total fat, saturated fat and sugar, with Tier 1 representing the healthiest and Tier 4 foods being the unhealthiest. This study presents the first application of HCST to assess (a) dietary patterns of Canadians; and (b) applicability of this tool as a measure of diet quality among 19,912 adult participants of Canadian Community Health Survey 2.2. Findings indicated that even though most of processed meats and potatoes were Tier 4, the majority of reported foods in general were categorized as Tiers 2 and 3 due to the adjustable lenient criteria used in HCST. Moving from the 1st to the 4th quartile of Tier 4 and "other" foods/beverages, there was a significant trend towards increased calories (1876 kcal vs. 2290 kcal) and "harmful" nutrients (e.g., sodium) as well as decreased "beneficial" nutrients. Compliance with the HCST was not associated with lower body mass index. Future nutrient profiling systems need to incorporate both "positive" and "negative" nutrients, an overall score and a wider range of nutrient thresholds to better capture food product differences.
Development and Application of a Two-Tier Multiple Choice Diagnostic Instrument To Assess High School Students' Understanding of Inorganic Chemistry Qualitative Analysis.

ERIC Educational Resources Information Center

Tan, Kim Chwee Daniel; Goh, Ngoh Khang; Chia, Lian Sai; Treagust, David F.

2002-01-01

Describes the development and application of a two-tier multiple choice diagnostic instrument to assess high school students' understanding of inorganic chemistry qualitative analysis. Shows that the Grade 10 students had difficulty understanding the reactions involved in the identification of cations and anions, for example, double decomposition…

Development of a Three-Tier Test as a Valid Diagnostic Tool for Identification of Misconceptions Related to Carbohydrates

ERIC Educational Resources Information Center

Milenkovic, Dusica D.; Hrin, Tamara N.; Segedinac, Mirjana D.; Horvat, Sasa

2016-01-01

This study describes the development and application of a three-tier test as a valid and reliable tool in diagnosing students' misconceptions regarding some basic concepts about carbohydrates. The test was administrated to students of the Pharmacy Department at the University of Bijeljina (Serb Republic). The results denoted construct and content…
Tier 1, Teacher-Implemented Self-Regulated Strategy Development for Students with and without Behavioral Challenges: A Randomized Controlled Trial

ERIC Educational Resources Information Center

Harris, Karen R.; Lane, Kathleen Lynne; Driscoll, Steven A.; Graham, Steve; Wilson, Kristen; Sandmel, Karin; Brindle, Mary; Schatschneider, Chris

2012-01-01

This study took place in the context of schools collaborating with a local university to implement an evidence-based, 3-tiered model of prevention and supports targeting academic, behavioral, and social goals. We examined whether Self-Regulated Strategy Development (SRSD) instruction, delivered by grade 2 and 3 general education teachers to all…
Supporting Comprehensive, Integrated, Three-Tiered Models of Prevention in Schools: Administrators' Perspectives

ERIC Educational Resources Information Center

Lane, Kathleen Lynne; Carter, Erik W.; Jenkins, Abbie; Dwiggins, Lauren; Germer, Kathryn

2015-01-01

We report findings from a statewide survey of 365 site-level administrators developed to (a) learn about the extent to which schools across the state were implementing components of multi-tiered systems of support and (b) determine the areas in which these schools might need professional development or resources to support them. At least half of…
Identification student’s misconception of heat and temperature using three-tier diagnostic test

NASA Astrophysics Data System (ADS)

Suliyanah; Putri, H. N. P. A.; Rohmawati, L.

2018-03-01

The objective of this research is to develop a Three-Tier Diagnostic Test (TTDT) to identify the student's misconception of heat and temperature. Stages of development include: analysis, planning, design, development, evaluation and revise. The results of this study show that (1) the quality of the three-tier type diagnostic test instrument developed has been expressed well with the following details: (a) Internal validity of 88.19% belonging to the valid category. (b) External validity of empirical construct validity test using Pearson Product Moment obtained 0.43 is classified and result of empirical construct validity test obtained false positives 6.1% and false negatives 5.9% then the instrument was valid. (c) Test reliability by using Cronbach’s Alpha of 0.98 which means acceptable. (d) The 80% difficulty level test is quite difficult. (2) Student misconceptions on the temperature of heat and displacement materials based on the II test the highest (84%), the lowest (21%), and the non-misconceptions (7%). (3) The highest cause of misconception among students is associative thinking (22%) and the lowest is caused by incomplete or incomplete reasoning (11%). Three-Tier Diagnostic Test (TTDT) could identify the student's misconception of heat and temperature.
A hierarchical analysis of terrestrial ecosystem model Biome-BGC: Equilibrium analysis and model calibration

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

Thornton, Peter E; Wang, Weile; Law, Beverly E.

2009-01-01

The increasing complexity of ecosystem models represents a major difficulty in tuning model parameters and analyzing simulated results. To address this problem, this study develops a hierarchical scheme that simplifies the Biome-BGC model into three functionally cascaded tiers and analyzes them sequentially. The first-tier model focuses on leaf-level ecophysiological processes; it simulates evapotranspiration and photosynthesis with prescribed leaf area index (LAI). The restriction on LAI is then lifted in the following two model tiers, which analyze how carbon and nitrogen is cycled at the whole-plant level (the second tier) and in all litter/soil pools (the third tier) to dynamically supportmore » the prescribed canopy. In particular, this study analyzes the steady state of these two model tiers by a set of equilibrium equations that are derived from Biome-BGC algorithms and are based on the principle of mass balance. Instead of spinning-up the model for thousands of climate years, these equations are able to estimate carbon/nitrogen stocks and fluxes of the target (steady-state) ecosystem directly from the results obtained by the first-tier model. The model hierarchy is examined with model experiments at four AmeriFlux sites. The results indicate that the proposed scheme can effectively calibrate Biome-BGC to simulate observed fluxes of evapotranspiration and photosynthesis; and the carbon/nitrogen stocks estimated by the equilibrium analysis approach are highly consistent with the results of model simulations. Therefore, the scheme developed in this study may serve as a practical guide to calibrate/analyze Biome-BGC; it also provides an efficient way to solve the problem of model spin-up, especially for applications over large regions. The same methodology may help analyze other similar ecosystem models as well.« less
CON4EI: Development of testing strategies for hazard identification and labelling for serious eye damage and eye irritation of chemicals.

PubMed

Adriaens, E; Verstraelen, S; Alépée, N; Kandarova, H; Drzewiecka, A; Gruszka, K; Guest, R; Willoughby, J A; Van Rompay, A R

2018-06-01

Assessment of acute eye irritation potential is part of the international regulatory requirements for safety testing of chemicals. In the last decades, many efforts have been made in the search for alternative methods to replace the regulatory in vivo Draize rabbit eye test (OECD TG 405). Success in terms of complete replacement of the regulatory in vivo Draize rabbit eye test has not yet been achieved. The main objective of the CEFIC-LRI-AIMT6-VITO CON4EI (CONsortium for in vitro Eye Irritation testing strategy) project was to develop tiered testing strategies for serious eye damage and eye irritation assessment that can lead to complete replacement of OECD TG 405. A set of 80 reference chemicals (e.g. balanced by important driver of classification and physical state), was tested with seven test methods. Based on the results of this project, three different strategies were suggested. We have provided a standalone (EpiOcular ET-50), a two-tiered and three-tiered strategy, that can be used to distinguish between Cat 1 and Cat 2 chemicals and chemicals that do not require classification (No Cat). The two-tiered and three-tiered strategies use an RhCE test method (EpiOcular EIT or SkinEthic™ EIT) at the bottom (identification No Cat) in combination with the BCOP LLBO (two-tiered strategy) or BCOP OP-KIT and SMI (three-tiered strategy) at the top (identification Cat 1). For our proposed strategies, 71.1% - 82.9% Cat 1, 64.2% - 68.5% Cat 2 and ≥80% No Cat chemicals were correctly identified. Also, similar results were obtained for the Top-Down and Bottom-Up approach. Copyright © 2017 Elsevier Ltd. All rights reserved.
76 FR 33380 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-08

... Two New Pricing Tiers, Investor Tier 1 and Investor Tier 2 June 3, 2011. Pursuant to Section 19(b)(1... Services (the ``Schedule'') to introduce two new pricing tiers, Investor Tier 1 and Investor Tier 2. The... proposes to introduce two new pricing tier levels, Investor Tier 1 and Investor Tier 2. Investor Tier 1...
The New Prostate Cancer Grading System Does Not Improve Prediction of Clinical Recurrence After Radical Prostatectomy: Results of a Large, Two-Center Validation Study.

PubMed

Dell'Oglio, Paolo; Karnes, Robert Jeffrey; Gandaglia, Giorgio; Fossati, Nicola; Stabile, Armando; Moschini, Marco; Cucchiara, Vito; Zaffuto, Emanuele; Karakiewicz, Pierre I; Suardi, Nazareno; Montorsi, Francesco; Briganti, Alberto

2017-02-01

A new prostate cancer (PCa) grading system (namely, Gleason score-GS- ≤6 vs. 3 + 4 vs. 4 + 3 vs. 8 vs. ≥9) was recently proposed and assessed on biochemical recurrence (BCR) showing improved predictive abilities compared to the commonly used three-tier system (GS ≤6 vs. 7 vs. ≥8). We assessed the predictive ability of the five-tier grade group (GG) system on harder clinical endpoint, namely clinical recurrence (CR). Between 2005 and 2014, 9,728 clinically localized PCa patients were treated with radical prostatectomy (RP) at two tertiary referral centers. Kaplan-Meier curves, multivariable Cox regression analyses, and concordance index (C-index) were used to assess CR after treatment according to four Gleason grade classifications at biopsy and RP: Group 1: ≤6 versus 7 versus ≥8; Group 2: ≤6 versus 3 + 4 vs. 4 + 3 versus ≥8; Group 3: ≤6 versus 7 versus 8 versus ≥9; Group 4: ≤6 versus 3 + 4 versus 4 + 3 versus 8 versus ≥9. Same analyses were repeated in patients who had BCR (n = 1,624). Decision curve analyses were performed to evaluate and compare the net benefit associated with the use of the four Gleason grade classifications. Overall, 443 (4.6%) patients had CR. The hazard ratio of the GS 3 + 4, 4 + 3, 8, and ≥9 relative to GS ≤6 were 3.63, 5.93, 11.44, 18.08 and 4.93, 9.99, 15.31 and 25.12 in the pre- and post-treatment models, respectively. The C-index of the five-tier GG system was slightly higher relative to the other 3 Gleason grade classifications both in the pre- (range: 0.001-0.006) and post-treatment models (range: 0-0.008). Similar findings were observed when we focused our analyses in patients with BCR after RP. The use of the five-tier GG system did not result into higher net-benefit relative to the other three Gleason grade classifications. The difference in accuracy between the five-tier GG system and the other Gleason grade classifications, using CR as an endpoint, is clinically negligible. Current evidence suggests that the five-tier GG system represents a simplified user-friendly scheme available for patient counseling rather than a new histopathological diagnostic system that improves the prediction of CR. Prostate 77:263-273, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.
Development of a safe ground to space laser propagation system for the optical communications telescope laboratory

NASA Technical Reports Server (NTRS)

Wu, Janet P.

2003-01-01

Furthering pursuits in high bandwidth communications to future NASA deep space and neat-Earth probes, the Jet Propulsion Laboratory (JPL) is building the Optical communications Telescope Laboratory (OCTL) atop Table Mountain in Southern California. This R&D optical antenna will be used to develop optical communication strategies for future optical ground stations. Initial experiments to be conducted include propagating high-powered, Q-switched laser beams to retro-reflecting satellites. Yet laser beam propagation from the ground to space is under the cognizance of various government agencies, namely: the Occupational Safety and Health Administration (ISHA) that is responsible for protecting workforce personnel; the Federal Aviation Administration (FAA) responsible for protecting pilots and aircraft; and the Laser Clearinghouse of Space Command responsible for protecting space assets. To ensure that laser beam propagation from the OCTL and future autonomously operated ground stations comply with the guidelines of these organizations, JPL is developing a multi-tiered safety system that will meet the coordination, monitoring, and reporting functions required by the agencies. At Tier 0, laser operators will meet OSHA safety standards for protection and access to the high power lasers area will be restricted and interlocked. Tier 1, the area defined from the telescope dome out to a range of 3.4-km, will utilize long wave infrared camera sensors to alert operators of at risk aircraft in the FAA controlled airspace. Tier 2, defined to extend from 3.4-km out to the aircraft service ceiling in FAA airspace, will detect at risk aircraft by radar. Lastly, beam propagation into space, defined as Tier 3, will require coordination with the Laser Clearinghouse. A detailed description of the four tiers is presented along with the design of the integrated monitoring and beam transmission control system.
Techno-Political Space Cooperation: A Longitudinal Analysis of NASA's Bilateral and Multilateral Agreements

NASA Technical Reports Server (NTRS)

Hudiburg, John J.

2004-01-01

NASA's international programs are both numerous and successful, with over two thousand international agreements forming a foundation of U.S. government cooperation that involved over half the United Nation's membership. Previous research, by the author, into these agreements has identified five variables underlying NASA's international cooperation efforts and these variables form a framework for explaining international cooperation behavior on a macro-level. This paper builds upon that research to effectively explain lower-level patterns of cooperation in NASA's experience. Two approaches for analyzing the space agency's history are used: aggregation of all agreements and a cluster (disaggregated) analysis of four key segments. While researchers of NASA's international cooperation often considered individual cases first, and then generalize to macro-level explanations. This study, in contrast, begins by considering all agreements together in order to explain as much as possible at the macro level before proceeding to lower tier explanations. These lower tier assessments are important to understanding regional and political influences on bilateral and multilateral cooperation. In order to accomplish this lower-tier analysis, the 2000 agreements are disaggregated into logical groupings enabling an analysis of important questions and clearer focus on key patterns concerning developing states, such as the role of international institutions or privatization on international cooperation in space technology.
Refining the classification of left ventricular hypertrophy to provide new insights into the progression from hypertension to heart failure.

PubMed

Garg, Sonia; Drazner, Mark H

2016-07-01

Left ventricular hypertrophy (LVH), an important consequence of hypertension, is traditionally classified as either concentric or eccentric based on the presence or absence of increased relative wall thickness. In 2010, we proposed a novel four-tiered classification that accounted for LV dilatation in addition to LV wall thickness. The purpose of this review is to discuss the rationale for this revised classification and highlight subsequent studies that have assessed its utility. A series of recent observational studies have tested whether the four-tiered classification identifies subphenotypes of LVH with differential risk of adverse outcomes, including incident heart failure. The majority have confirmed that eccentric hypertrophy can be subdivided into a high-risk and a low-risk group based on whether LV dilatation is present. Additional studies have shown that LV dilatation is an independent risk factor for the development of heart failure. Incorporation of LV dilatation into the assessment of LVH identifies important subphenotypes within the standard two-tiered classification that have differential risk. Such refinements in the classification of LVH may yield new insights into how LVH progresses to heart failure, help identify risk factors for this transition, and improve therapeutic efforts to prevent its occurrence.
The Heterogeneous Effects of Cigarette Prices on Brand Choice in China: Implications for Tobacco Control Policy

PubMed Central

Li, Jing; White, Justin S.; Hu, Teh-wei; Fong, Geoffrey T.; Jiang, Yuan

2015-01-01

Background China has long kept its tobacco taxes below international standards. The Chinese government has cited as two rationales against raising tobacco tax, namely the unfair burden it places on low-income smokers and the ability of consumers to switch to cheaper brands. Objective This study examines how different socioeconomic subgroups of Chinese smokers switch brands in response to cigarette price changes. Methods We model smokers’ choice of cigarette tier as a function of tier-specific prices. We examine heterogeneous responses to prices by estimating mixed logit models for different income and education subgroups that allow for random variation in smokers’ preferences. We use data from three waves of the longitudinal ITC China Survey, collected in six large Chinese cities between 2006 and 2009. Findings Low-income and less educated smokers are considerably more likely to switch tiers (including both up-trading and down-trading) than are their high-socioeconomic status (SES) counterparts. For those in the second-to-lowest tier, a ¥1 ($0.16, or roughly 25%) rise in prices increases the likelihood of switching tiers by 5.6% points for low-income smokers and 7.2% points for less educated smokers, compared to 1.6% and 3.0% points for the corresponding high-SES groups. Low-income and less educated groups are also more likely to trade down compared to their high-SES counterparts. Conclusion Only a small percentage of low-income and less educated Chinese smokers switched to cheaper brands in response to price increases. Hence, the concern of the Chinese government that a cigarette tax increase will lead to large-scale brand switching is not supported by this study. PMID:25855642
Immunogenicity of NYVAC Prime-Protein Boost Human Immunodeficiency Virus Type 1 Envelope Vaccination and Simian-Human Immunodeficiency Virus Challenge of Nonhuman Primates.

PubMed

Saunders, Kevin O; Santra, Sampa; Parks, Robert; Yates, Nicole L; Sutherland, Laura L; Scearce, Richard M; Balachandran, Harikrishnan; Bradley, Todd; Goodman, Derrick; Eaton, Amanda; Stanfield-Oakley, Sherry A; Tartaglia, James; Phogat, Sanjay; Pantaleo, Giuseppe; Esteban, Mariano; Gomez, Carmen E; Perdiguero, Beatriz; Jacobs, Bertram; Kibler, Karen; Korber, Bette; Montefiori, David C; Ferrari, Guido; Vandergrift, Nathan; Liao, Hua-Xin; Tomaras, Georgia D; Haynes, Barton F

2018-04-15

A preventive human immunodeficiency virus type 1 (HIV-1) vaccine is an essential part of the strategy to eradicate AIDS. A critical question is whether antibodies that do not neutralize primary isolate (tier 2) HIV-1 strains can protect from infection. In this study, we investigated the ability of an attenuated poxvirus vector (NYVAC) prime-envelope gp120 boost to elicit potentially protective antibody responses in a rhesus macaque model of mucosal simian-human immunodeficiency virus (SHIV) infection. NYVAC vector delivery of a group M consensus envelope, trivalent mosaic envelopes, or a natural clade B isolate B.1059 envelope elicited antibodies that mediated neutralization of tier 1 viruses, cellular cytotoxicity, and phagocytosis. None of the macaques made neutralizing antibodies against the tier 2 SHIV SF162P3 used for mucosal challenge. Significant protection from infection was not observed for the three groups of vaccinated macaques compared to unvaccinated macaques, although binding antibody to HIV-1 Env correlated with decreased viremia after challenge. Thus, NYVAC Env prime-gp120 boost vaccination elicited polyfunctional, nonneutralizing antibody responses with minimal protective activity against tier 2 SHIV mucosal challenge. IMPORTANCE The antibody responses that confer protection against HIV-1 infection remain unknown. Polyfunctional antibody responses correlated with time to infection in previous macaque studies. Determining the ability of vaccines to induce these types of responses is critical for understanding how to improve upon the one efficacious human HIV-1 vaccine trial completed thus far. We characterized the antibody responses induced by a NYVAC-protein vaccine and determined the protective capacity of polyfunctional antibody responses in an R5, tier 2 mucosal SHIV infection model. Copyright © 2018 American Society for Microbiology.
Chronic aquatic effect assessment for the fungicide azoxystrobin.

PubMed

van Wijngaarden, Rene P A; Belgers, Dick J M; Zafar, Mazhar I; Matser, Arrienne M; Boerwinkel, Marie-Claire; Arts, Gertie H P

2014-12-01

The present study examined the ecological effects of a range of chronic exposure concentrations of the fungicide azoxystrobin in freshwater experimental systems (1270-L outdoor microcosms). Intended and environmentally relevant test concentrations of azoxystrobin were 0 µg active ingredient (a.i.)/L, 0.33 µg a.i./L, 1 µg a.i./L, 3.3 µg a.i./L, 10 µg a.i./L, and 33 µg a.i./L, kept at constant values. Responses of freshwater populations and community parameters were studied. During the 42-d experimental period, the time-weighted average concentrations of azoxystrobin ranged from 93.5% to 99.3% of intended values. Zooplankton, especially copepods and the Daphnia longispina group, were the most sensitive groups. At the population level, a consistent no-observed-effect concentration (NOEC) of 1 µg a.i./L was calculated for Copepoda. The NOEC at the zooplankton community level was 10 µg azoxystrobin/L. The principle of the European Union pesticide directive is that lower-tier regulatory acceptable concentrations (RACs) are protective of higher-tier RACs. This was tested for chronic risks from azoxystrobin. With the exception of the microcosm community chronic RAC (highest tier), all other chronic RAC values were similar to each other (0.5-1 µg a.i./L). The new and stricter first-tier species requirements of the European Union pesticide regulation (1107/2009/EC) are not protective for the most sensitive populations in the microcosm study, when based on the higher tier population RAC. In comparison, the Water Framework Directive generates environmental quality standards that are 5 to 10 times lower than the derived chronic RACs. © 2014 SETAC.
Overview of EDSP Tier II Larval Amphibian Growth and Development Assay histopathology and statistics

EPA Science Inventory

These presentations are meant to provide expert pathologists and statisticians with background information on the Tier II LAGDA design. Expert pathologists at this workshop are charged with providing guidance on histopathology considerations unique to the LAGDA. Expert statisti...
Principles for characterizing the potential human health effects from exposure to nanomaterials: elements of a screening strategy

PubMed Central

Oberdörster, Günter; Maynard, Andrew; Donaldson, Ken; Castranova, Vincent; Fitzpatrick, Julie; Ausman, Kevin; Carter, Janet; Karn, Barbara; Kreyling, Wolfgang; Lai, David; Olin, Stephen; Monteiro-Riviere, Nancy; Warheit, David; Yang, Hong

2005-01-01

The rapid proliferation of many different engineered nanomaterials (defined as materials designed and produced to have structural features with at least one dimension of 100 nanometers or less) presents a dilemma to regulators regarding hazard identification. The International Life Sciences Institute Research Foundation/Risk Science Institute convened an expert working group to develop a screening strategy for the hazard identification of engineered nanomaterials. The working group report presents the elements of a screening strategy rather than a detailed testing protocol. Based on an evaluation of the limited data currently available, the report presents a broad data gathering strategy applicable to this early stage in the development of a risk assessment process for nanomaterials. Oral, dermal, inhalation, and injection routes of exposure are included recognizing that, depending on use patterns, exposure to nanomaterials may occur by any of these routes. The three key elements of the toxicity screening strategy are: Physicochemical Characteristics, In Vitro Assays (cellular and non-cellular), and In Vivo Assays. There is a strong likelihood that biological activity of nanoparticles will depend on physicochemical parameters not routinely considered in toxicity screening studies. Physicochemical properties that may be important in understanding the toxic effects of test materials include particle size and size distribution, agglomeration state, shape, crystal structure, chemical composition, surface area, surface chemistry, surface charge, and porosity. In vitro techniques allow specific biological and mechanistic pathways to be isolated and tested under controlled conditions, in ways that are not feasible in in vivo tests. Tests are suggested for portal-of-entry toxicity for lungs, skin, and the mucosal membranes, and target organ toxicity for endothelium, blood, spleen, liver, nervous system, heart, and kidney. Non-cellular assessment of nanoparticle durability, protein interactions, complement activation, and pro-oxidant activity is also considered. Tier 1 in vivo assays are proposed for pulmonary, oral, skin and injection exposures, and Tier 2 evaluations for pulmonary exposures are also proposed. Tier 1 evaluations include markers of inflammation, oxidant stress, and cell proliferation in portal-of-entry and selected remote organs and tissues. Tier 2 evaluations for pulmonary exposures could include deposition, translocation, and toxicokinetics and biopersistence studies; effects of multiple exposures; potential effects on the reproductive system, placenta, and fetus; alternative animal models; and mechanistic studies. PMID:16209704
76 FR 40974 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-12

... Two New Pricing Tiers, Step-Up Tier 1 and Step-Up Tier 2 July 6, 2011. Pursuant to Section 19(b)(1) of... Services (the ``Schedule'') to introduce two new pricing tiers, Step-Up Tier 1 and Step-Up Tier 2. The text... Arca proposes to introduce two new pricing tier levels, Step-Up Tier 1 and Step-Up Tier 2. Step-Up Tier...
What Are the Implications of Tier 4 UK Immigration Rules and Policy for Non-EU Students? The Experiences of Students from Nigeria

ERIC Educational Resources Information Center

Achinewhu-Nworgu, Elizabeth; Nworgu, Queen Chioma; Ayinde, Helen

2015-01-01

Changes introduced in 2010 to the Tier 4 immigration rules that apply to non-EU students wishing to study in the UK have led to a reduction in the overall number of non-EU students gaining entry to the UK. This paper outlines the reasons for these changes to the UK's immigration rules and explores the experiences of one group of non-EU students in…
Achieving Tier 4 Emissions in Biomass Cookstoves

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

Marchese, Anthony; DeFoort, Morgan; Gao, Xinfeng

Previous literature on top-lit updraft (TLUD) gasifier cookstoves suggested that these stoves have the potential to be the lowest emitting biomass cookstove. However, the previous literature also demonstrated a high degree of variability in TLUD emissions and performance, and a lack of general understanding of the TLUD combustion process. The objective of this study was to improve understanding of the combustion process in TLUD cookstoves. In a TLUD, biomass is gasified and the resulting producer gas is burned in a secondary flame located just above the fuel bed. The goal of this project is to enable the design of amore » more robust TLUD that consistently meets Tier 4 performance targets through a better understanding of the underlying combustion physics. The project featured a combined modeling, experimental and product design/development effort comprised of four different activities: Development of a model of the gasification process in the biomass fuel bed; Development of a CFD model of the secondary combustion zone; Experiments with a modular TLUD test bed to provide information on how stove design, fuel properties, and operating mode influence performance and provide data needed to validate the fuel bed model; Planar laser-induced fluorescence (PLIF) experiments with a two-dimensional optical test bed to provide insight into the flame dynamics in the secondary combustion zone and data to validate the CFD model; Design, development and field testing of a market ready TLUD prototype. Over 180 tests of 40 different configurations of the modular TLUD test bed were performed to demonstrate how stove design, fuel properties and operating mode influences performance, and the conditions under which Tier 4 emissions are obtainable. Images of OH and acetone PLIF were collected at 10 kHz with the optical test bed. The modeling and experimental results informed the design of a TLUD prototype that met Tier 3 to Tier 4 specifications in emissions and Tier 2 in efficiency. The final prototype was field tested in India.« less
Effects of Tier 3 Intervention for Students With Persistent Reading Difficulties and Characteristics of Inadequate Responders.

PubMed

Denton, Carolyn A; Tolar, Tammy D; Fletcher, Jack M; Barth, Amy E; Vaughn, Sharon; Francis, David J

2013-08-01

This article describes a randomized controlled trial conducted to evaluate the effects of an intensive, individualized, Tier 3 reading intervention for second grade students who had previously experienced inadequate response to quality first grade classroom reading instruction (Tier 1) and supplemental small-group intervention (Tier 2). Also evaluated were cognitive characteristics of students with inadequate response to intensive Tier 3 intervention. Students were randomized to receive the research intervention ( N = 47) or the instruction and intervention typically provided in their schools ( N = 25). Results indicated that students who received the research intervention made significantly better growth than those who received typical school instruction on measures of word identification, phonemic decoding, and word reading fluency and on a measure of sentence- and paragraph-level reading comprehension. Treatment effects were smaller and not statistically significant on phonemic decoding efficiency, text reading fluency, and reading comprehension in extended text. Effect sizes for all outcomes except oral reading fluency met criteria for substantive importance; however, many of the students in the intervention continued to struggle. An evaluation of cognitive profiles of adequate and inadequate responders was consistent with a continuum of severity (as opposed to qualitative differences), showing greater language and reading impairment prior to the intervention in students who were inadequate responders.

Effects of Tier 3 Intervention for Students With Persistent Reading Difficulties and Characteristics of Inadequate Responders

PubMed Central

Denton, Carolyn A.; Tolar, Tammy D.; Fletcher, Jack M.; Barth, Amy E.; Vaughn, Sharon; Francis, David J.

2013-01-01

This article describes a randomized controlled trial conducted to evaluate the effects of an intensive, individualized, Tier 3 reading intervention for second grade students who had previously experienced inadequate response to quality first grade classroom reading instruction (Tier 1) and supplemental small-group intervention (Tier 2). Also evaluated were cognitive characteristics of students with inadequate response to intensive Tier 3 intervention. Students were randomized to receive the research intervention (N = 47) or the instruction and intervention typically provided in their schools (N = 25). Results indicated that students who received the research intervention made significantly better growth than those who received typical school instruction on measures of word identification, phonemic decoding, and word reading fluency and on a measure of sentence- and paragraph-level reading comprehension. Treatment effects were smaller and not statistically significant on phonemic decoding efficiency, text reading fluency, and reading comprehension in extended text. Effect sizes for all outcomes except oral reading fluency met criteria for substantive importance; however, many of the students in the intervention continued to struggle. An evaluation of cognitive profiles of adequate and inadequate responders was consistent with a continuum of severity (as opposed to qualitative differences), showing greater language and reading impairment prior to the intervention in students who were inadequate responders. PMID:25308995
Technical Adequacy of the SWPBIS Tiered Fidelity Inventory

ERIC Educational Resources Information Center

McIntosh, Kent; Massar, Michelle M.; Algozzine, Robert F.; George, Heather Peshak; Horner, Robert H.; Lewis, Timothy J.; Swain-Bradway, Jessica

2017-01-01

Full and durable implementation of school-based interventions is supported by regular evaluation of fidelity of implementation. Multiple assessments have been developed to evaluate the extent to which schools are applying the core features of school-wide positive behavioral interventions and supports (SWPBIS). The "SWPBIS Tiered Fidelity…
XENOENDOCRINE DISRUPTERS-TIERED SCREENING AND TESTING: FILLING KEY DATA GAPS

EPA Science Inventory

ABSTRACT
The US Environmental Protection Agency (EPA) is developing a screening and testing program for endocrine disrupting chemicals (EDCs). High priority chemicals would be evaluated in the Tier 1 Screening (T1S) battery. Chemicals positive in T1S would then be tested...
Idaho's Three-Tiered System for Speech-Language Paratherapist Training and Utilization.

ERIC Educational Resources Information Center

Longhurst, Thomas M.

1997-01-01

Discusses the development and current implementation of Idaho's three-tiered system of speech-language paratherapists. Support personnel providing speech-language services to learners with special communication needs in educational settings must obtain one of three certification levels: (1) speech-language aide, (2) associate degree…
Tiered Approach to Resilience Assessment.

PubMed

Linkov, Igor; Fox-Lent, Cate; Read, Laura; Allen, Craig R; Arnott, James C; Bellini, Emanuele; Coaffee, Jon; Florin, Marie-Valentine; Hatfield, Kirk; Hyde, Iain; Hynes, William; Jovanovic, Aleksandar; Kasperson, Roger; Katzenberger, John; Keys, Patrick W; Lambert, James H; Moss, Richard; Murdoch, Peter S; Palma-Oliveira, Jose; Pulwarty, Roger S; Sands, Dale; Thomas, Edward A; Tye, Mari R; Woods, David

2018-04-25

Regulatory agencies have long adopted a three-tier framework for risk assessment. We build on this structure to propose a tiered approach for resilience assessment that can be integrated into the existing regulatory processes. Comprehensive approaches to assessing resilience at appropriate and operational scales, reconciling analytical complexity as needed with stakeholder needs and resources available, and ultimately creating actionable recommendations to enhance resilience are still lacking. Our proposed framework consists of tiers by which analysts can select resilience assessment and decision support tools to inform associated management actions relative to the scope and urgency of the risk and the capacity of resource managers to improve system resilience. The resilience management framework proposed is not intended to supplant either risk management or the many existing efforts of resilience quantification method development, but instead provide a guide to selecting tools that are appropriate for the given analytic need. The goal of this tiered approach is to intentionally parallel the tiered approach used in regulatory contexts so that resilience assessment might be more easily and quickly integrated into existing structures and with existing policies. Published 2018. This article is a U.S. government work and is in the public domain in the USA.
The ATLAS Tier-0: Overview and operational experience

NASA Astrophysics Data System (ADS)

Elsing, Markus; Goossens, Luc; Nairz, Armin; Negri, Guido

2010-04-01

Within the ATLAS hierarchical, multi-tier computing infrastructure, the Tier-0 centre at CERN is mainly responsible for prompt processing of the raw data coming from the online DAQ system, to archive the raw and derived data on tape, to register the data with the relevant catalogues and to distribute them to the associated Tier-1 centers. The Tier-0 is already fully functional. It has been successfully participating in all cosmic and commissioning data taking since May 2007, and was ramped up to its foreseen full size, performance and throughput for the cosmic (and short single-beam) run periods between July and October 2008. Data and work flows for collision data taking were exercised in several "Full Dress Rehearsals" (FDRs) in the course of 2008. The transition from an expert to a shifter-based system was successfully established in July 2008. This article will give an overview of the Tier-0 system, its data and work flows, and operations model. It will review the operational experience gained in cosmic, commissioning, and FDR exercises during the past year. And it will give an outlook on planned developments and the evolution of the system towards first collision data taking expected now in late Autumn 2009.
Application of elements of microbiological risk assessment in the food industry via a tiered approach.

PubMed

van Gerwen, Suzanne J C; Gorris, Leon G M

2004-09-01

Food safety control is a matter for concern for all parts of the food supply chain, including governments that develop food safety policy, food industries that must control potential hazards, and consumers who need to keep to the intended use of the food. In the future, food safety policy may be set using the framework of risk analysis, part of which is the development of (inter)national microbiological risk assessment (MRA) studies. MRA studies increase our understanding of the impact of risk management interventions and of the relationships among subsequent parts of food supply chains with regard to the safety of the food when it reaches the consumer. Application of aspects of MRA in the development of new food concepts has potential benefits for the food industry. A tiered approach to applying MRA can best realize these benefits. The tiered MRA approach involves calculation of microbial fate for a product and process design on the basis of experimental data (e.g., monitoring data on prevalence) and predictive microbiological models. Calculations on new product formulations and novel processing technologies provide improved understanding of microbial fate beyond currently known boundaries, which enables identification of new opportunities in process design. The outcome of the tiered approach focuses on developing benchmarks of potential consumer exposure to hazards associated with new products by comparison with exposure associated with products that are already on the market and have a safe history of use. The tiered prototype is a tool to be used by experienced microbiologists as a basis for advice to product developers and can help to make safety assurance for new food concepts transparent to food inspection services.
Assessing the Nutritional Quality of Diets of Canadian Adults Using the 2014 Health Canada Surveillance Tool Tier System

PubMed Central

Jessri, Mahsa; Nishi, Stephanie K.; L’Abbé, Mary R.

2015-01-01

The 2014 Health Canada Surveillance Tool (HCST) was developed to assess adherence of dietary intakes with Canada’s Food Guide. HCST classifies foods into one of four Tiers based on thresholds for sodium, total fat, saturated fat and sugar, with Tier 1 representing the healthiest and Tier 4 foods being the unhealthiest. This study presents the first application of HCST to assess (a) dietary patterns of Canadians; and (b) applicability of this tool as a measure of diet quality among 19,912 adult participants of Canadian Community Health Survey 2.2. Findings indicated that even though most of processed meats and potatoes were Tier 4, the majority of reported foods in general were categorized as Tiers 2 and 3 due to the adjustable lenient criteria used in HCST. Moving from the 1st to the 4th quartile of Tier 4 and “other” foods/beverages, there was a significant trend towards increased calories (1876 kcal vs. 2290 kcal) and “harmful” nutrients (e.g., sodium) as well as decreased “beneficial” nutrients. Compliance with the HCST was not associated with lower body mass index. Future nutrient profiling systems need to incorporate both “positive” and “negative” nutrients, an overall score and a wider range of nutrient thresholds to better capture food product differences. PMID:26703721
Newborn Screening for Vitamin B6 Non-responsive Classical Homocystinuria: Systematical Evaluation of a Two-Tier Strategy.

PubMed

Okun, Jürgen G; Gan-Schreier, Hongying; Ben-Omran, Tawfeq; Schmidt, Kathrin V; Fang-Hoffmann, Junmin; Gramer, Gwendolyn; Abdoh, Ghassan; Shahbeck, Noora; Al Rifai, Hilal; Al Khal, Abdul Latif; Haege, Gisela; Chiang, Chuan-Chi; Kasper, David C; Wilcken, Bridget; Burgard, Peter; Hoffmann, Georg F

2017-01-01

In classical homocystinuria (HCU, MIM# 236200) due to the deficiency of cystathionine β-synthase (EC 4.2.1.22) there is a clear evidence for the success of early treatment. The aim of this study was to develop and evaluate a two-tier strategy for HCU newborn screening. We reevaluated data from our newborn screening programme for Qatar in a total number of 125,047 neonates including 30 confirmed HCU patients. Our hitherto existing screening strategy includes homocysteine (Hcy) measurements in every child, resulting in a unique dataset for evaluation of two-tier strategies. Reevaluation included methionine (Met) levels, Met to phenylalanine (Phe) ratio, and Hcy. Four HCU cases identified after database closure were also included in the evaluation. In addition, dried blood spot samples selected by Met values >P97 in the newborn screening programs in Austria, Australia, the Netherlands, and Taiwan were analyzed for Hcy. Met to Phe ratio was found to be more effective for first sieve than Met, sorting out nearly 90% of normal samples. Only 10% of the samples would have to be processed by second-tier measurement of Hcy in dried blood spots. As no patient with HCU was found neither in the samples investigated for HCU, nor by clinical diagnosis in the other countries, the generalization of our two-tier strategy could only be tested indirectly. The finally derived two-tier algorithm using Met to Phe ratio as first- and Hcy as second-tier requires 10% first-tier positives to be transferred to Hcy measurement, resulting in 100% sensitivity and specificity in HCU newborn screening.
Towards a theory of tiered testing.

PubMed

Hansson, Sven Ove; Rudén, Christina

2007-06-01

Tiered testing is an essential part of any resource-efficient strategy for the toxicity testing of a large number of chemicals, which is required for instance in the risk management of general (industrial) chemicals, In spite of this, no general theory seems to be available for the combination of single tests into efficient tiered testing systems. A first outline of such a theory is developed. It is argued that chemical, toxicological, and decision-theoretical knowledge should be combined in the construction of such a theory. A decision-theoretical approach for the optimization of test systems is introduced. It is based on expected utility maximization with simplified assumptions covering factual and value-related information that is usually missing in the development of test systems.
Investigating a Tier 1 Intervention Focused on Proportional Reasoning: A Follow-Up Study

ERIC Educational Resources Information Center

Jitendra, Asha K.; Harwell, Michael R.; Karl, Stacy R.; Simonson, Gregory R.; Slater, Susan C.

2017-01-01

This randomized controlled study investigated the efficacy of a Tier 1 intervention--schema-based instruction--designed to help students with and without mathematics difficulties (MD) develop proportional reasoning. Twenty seventh-grade teachers/classrooms were randomly assigned to a treatment condition (schema-based instruction) or control…
Technical Criteria and Procedures for Evaluating the Crashworthiness and Occupant Protection Performance of Alternatively Designed Passenger Rail Equipment for Use in Tier I Service

DOT National Transportation Integrated Search

2011-10-01

Criteria and procedures have been developed for assessing crashworthiness and occupant protection performance of alternatively designed trainsets to be used in Tier I (not exceeding 125 mph) passenger service. These criteria and procedures take advan...
Using Tiered Assignments to Engage Learners in Advanced Placement Physics

ERIC Educational Resources Information Center

Geddes, Kimberly A.

2010-01-01

This article presents lesson plans that incorporate tiered objectives and brainstorming techniques as means for differentiating instruction and ensuring that learners are challenged at levels commensurate with their abilities even though they are developing an understanding of the same physics concepts. A listing of materials and resources…
Examining the Efficacy of a Tier 2 Kindergarten Mathematics Intervention

ERIC Educational Resources Information Center

Clarke, Ben; Doabler, Christian T.; Smolkowski, Keith; Baker, Scott K.; Fien, Hank; Cary, Mari Strand

2016-01-01

This study examined the efficacy of a Tier 2 kindergarten mathematics intervention program, ROOTS, focused on developing whole number understanding for students at risk in mathematics. A total of 29 classrooms were randomly assigned to treatment (ROOTS) or control (standard district practices) conditions. Measures of mathematics achievement were…
76 FR 78967 - Second Tier Environmental Impact Statement: Jackson County, MO

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-20

... determine an improvement strategy for the corridor to address the following needs: Improve safety, reduce.... Various concepts were combined to develop 15 initial strategies that were screened down to four first tier strategies. These four strategies included the No-Build Strategy, Improve Key Bottlenecks Strategy, Add...
CTC Sentinel. Volume 1, Issue 7, June 2008. Al-Qa’ida in Iraq: Lessons from the Mosul Security Operation

DTIC Science & Technology

2008-06-01

Mark Hertling, Tier 1 oper- atives are operational leaders who finance operations or provide ideological guidance. Tier 2 operatives are “bat- talion...criminal fundraising to finance insurgent operations long after any popular base for resistance had eroded, with money greasing the wheels of the...Some Elements Received Training in Lebanon - Part III,” Dar al-Hayat, June 13, 2007. 42 Ibid. 43 Ibid. 44 See the “Groupe Islamique Arme (GIA
Development and Application of a Novel Rasch-Based Methodology for Evaluating Multi-Tiered Assessment Instruments: Validation and Utilization of an Undergraduate Diagnostic Test of the Water Cycle

ERIC Educational Resources Information Center

Romine, William L.; Schaffer, Dane L.; Barrow, Lloyd

2015-01-01

We describe the development and validation of a three-tiered diagnostic test of the water cycle (DTWC) and use it to evaluate the impact of prior learning experiences on undergraduates' misconceptions. While most approaches to instrument validation take a positivist perspective using singular criteria such as reliability and fit with a measurement…
A stepped-care model of post-disaster child and adolescent mental health service provision.

PubMed

McDermott, Brett M; Cobham, Vanessa E

2014-01-01

From a global perspective, natural disasters are common events. Published research highlights that a significant minority of exposed children and adolescents develop disaster-related mental health syndromes and associated functional impairment. Consistent with the considerable unmet need of children and adolescents with regard to psychopathology, there is strong evidence that many children and adolescents with post-disaster mental health presentations are not receiving adequate interventions. To critique existing child and adolescent mental health services (CAMHS) models of care and the capacity of such models to deal with any post-disaster surge in clinical demand. Further, to detail an innovative service response; a child and adolescent stepped-care service provision model. A narrative review of traditional CAMHS is presented. Important elements of a disaster response - individual versus community recovery, public health approaches, capacity for promotion and prevention and service reach are discussed and compared with the CAMHS approach. Difficulties with traditional models of care are highlighted across all levels of intervention; from the ability to provide preventative initiatives to the capacity to provide intense specialised posttraumatic stress disorder interventions. In response, our over-arching stepped-care model is advocated. The general response is discussed and details of the three tiers of the model are provided: Tier 1 communication strategy, Tier 2 parent effectiveness and teacher training, and Tier 3 screening linked to trauma-focused cognitive behavioural therapy. In this paper, we argue that traditional CAMHS are not an appropriate model of care to meet the clinical needs of this group in the post-disaster setting. We conclude with suggestions how improved post-disaster child and adolescent mental health outcomes can be achieved by applying an innovative service approach.
Population study of hearing disorders in adults: preliminary communication.

PubMed Central

1981-01-01

The Institute of Hearing Research is embarked upon a study of the prevalence, characteristics and determinants of hearing problems and tinnitus in the adult population of the UK. One of its objectives is to ascertain the size of the problem in terms both of numbers of people affected and the degrees to which they are affected. Such knowledge is highly relevant to any consideration of the services needed for the adult hearing impaired. The overall plan for the study and the results of its pilot study are outlined. In Tier A, a questionnaire on hearing difficulties and tinnitus was sent to 6804 persons living in Cardiff, Glasgow, Nottingham and Southampton. This enabled stratification of respondents by age groups and reported impairments, and thereby permitted appropriate sampling ratios from those strata to be invited to attend the clinics for the Tier B clinical and audiological investigations. Response rates were around 80% at Tier A and 50% at Tier B; domiciliary follow up showed the biases in non-responders and non-attenders to be minimal. About 25% of the sample reported some hearing difficulty, and about 17% reported an experience of tinnitus that was more than transitory or temporary noise-induced. Taking a criterion of over 25 dB hearing level in the better ear, averaged across 0.5, 1, 2 and 4 kHz, a prevalence estimate for the UK population is that 19.9 +/- 4.4% of adults are so affected. About 0.5-1% of adults appear to be severely affected by tinnitus; this amounts to about 200 000 persons in the UK. The scale of the problem has not been fully appreciated before and points to an urgent need to develop further the clinical services and research effort in the field of tinnitus. PMID:7299784
Childhood Obesity Policy Research and Practice Evidence for Policy and Environmental Strategies

PubMed Central

Brennan, Laura K.; Brownson, Ross C.; Orleans, C. Tracy

2016-01-01

Investigators developed a review system to evaluate the growing literature on policy and environmental strategies to prevent childhood obesity. Over 2000 documents published between January 2000 and May 2009 in the scientific and grey literature were identified (2008–2009) and systematically analyzed (2009–2012). These focused on policy or environmental strategies to reduce obesity/overweight, increase physical activity, and/or improve nutrition/diet among youth (aged 3–18 years). Guided by the RE-AIM framework, investigators abstracted studies of 24 intervention strategies and assessed evidence for their effectiveness (i.e., study design, intervention duration, and outcomes) and population impact (i.e., effectiveness and reach – participation or exposure, and representativeness) in 142 evaluation study groupings and 254 associational study groupings (n=396 groupings of 600 peer-reviewed studies). The 24 strategies yielded 25 classifications (school wellness policies yielded nutrition and physical activity classifications): 1st-tier effective (n=5); 2nd-tier effective (n=6); “promising” (n=5); or “emerging” (n=9). Evidence for intervention effectiveness was reported in 56% of the evaluation, and 77% of the associational, study groupings. Among the evaluation study groupings, only 49% reported sufficient data for population impact ratings, and only 22% qualified for a rating of high population impact. Effectiveness and impact ratings were summarized in graphic evidence maps, displaying effects/associations with behavioral and obesity/overweight outcomes. This paper describes the results and products of the review, with recommendations for policy research and practice. PMID:24355679

Specialty Tier-Level Cost Sharing and Biologic Agent Use in the Medicare Part D Initial Coverage Period Among Beneficiaries With Rheumatoid Arthritis.

PubMed

Doshi, Jalpa A; Hu, Tianyan; Li, Pengxiang; Pettit, Amy R; Yu, Xinyan; Blum, Marissa

2016-11-01

To examine associations between specialty tier-level cost sharing and use of biologic agents for rheumatoid arthritis (RA) during Medicare Part D's initial coverage period (ICP). This was a retrospective study using 2007-2010 5% sample Medicare files to examine RA patients with use of a Part D RA biologic agent in the prior year. Patients without low-income subsidies (non-LIS group), who faced specialty tier-level cost sharing, were compared to a control group of low-income subsidy patients (LIS group), who faced nominal out-of-pocket costs in the ICP. Outcomes included use of a Part D or Part B RA biologic agent during the ICP and presence of a ≥30-day continuous gap in treatment among Part D biologic agent users in the ICP. Risk-adjusted outcomes were estimated using logistic regressions, controlling for patient demographic, clinical, and Part D plan characteristics. On average, a 30-day Part D biologic agent supply cost the non-LIS group $484 out of pocket (29.9% cost sharing) versus $5 (0.3% cost sharing) for the LIS group. The non-LIS group was less likely to fill Part D biologic agents (61.2% versus 72.7%, odds ratio [OR] 0.58 [95% confidence interval (95% CI) 0.46-0.72]; P < 0.001), more than twice as likely to receive Part B biologic agents (9.9% versus 4.4%, OR 2.41 [95% CI 1.61-3.60]; P < 0.001), and less likely to use any biologic agent (70.1% versus 76.9%, OR 0.69 [95% CI 0.55-0.88]; P = 0.002). The non-LIS subgroup filling Part D biologic agents had approximately twice the odds of a gap in both Part D biologic agent and any biologic agent availability. Specialty tier-level cost sharing was associated with interruptions in RA biologic agent treatment among Medicare patients. © 2016, American College of Rheumatology.
Agreement of three interpretation systems of intrapartum foetal heart rate monitoring by different levels of physicians.

PubMed

Pruksanusak, Ninlapa; Thongphanang, Putthaporn; Chainarong, Natthicha; Suntharasaj, Thitima; Kor-Anantakul, Ounjai; Suwanrath, Chitkasaem; Petpichetchian, Chusana

2017-11-01

A prospective study was conducted in centre in Southern Thailand, to evaluate agreement in EFM interpretation among various physicians in order to find out the most practical system for daily use. We found strong agreement of very normal FHR tracings among the FIGO, NICHD 3-tier and 5-tier systems. The NICHD 3-tier was more compatible with the FIGO system than 5-tier system. Overall inter-observer agreement was moderate for the NICHD 3-tier system while inter-observer agreement of 5-tier system was fair also the intra-observer agreement was higher in the NICHD 3-tier system. So the 3-tier systems are more suitable than the 5-tier system in general obstetric practice. Impact statement What is already known on this subject: The 3-tier and 5-tier systems were widely used in general obstetrics practice. What the results of this study add: The inter- and intra-observer agreement of NICHD 3-tier system was higher than the 5-tier system. What the implications are of these findings for clinical practice and/or further research: The 3-tier systems were more suitable than the 5-tier systems in general obstetrics practice.
49 CFR 238.15 - Movement of passenger equipment with power brake defects.

Code of Federal Regulations, 2010 CFR

2010-10-01

... brakes; (C) Piston travel that is in excess of the Class I brake test limits required in § 238.313 but... where the necessary repairs can be made. (3) Commuter, short-distance intercity, and short-distance Tier... brakes. Commuter, short-distance intercity, and short-distance Tier II passenger trains which develop...
12 CFR 24.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Definitions. 24.2 Section 24.2 Banks and... ENTITIES, COMMUNITY DEVELOPMENT PROJECTS, AND OTHER PUBLIC WELFARE INVESTMENTS § 24.2 Definitions. For... adequately capitalized in 12 CFR 6.4. (b) Capital and surplus means: (1) A bank's Tier 1 and Tier 2 capital...
78 FR 17946 - Consolidated Tape Association; Notice of Filing and Immediate Effectiveness of the Sixteenth...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-25

... Network A and Network B data feeds. Consistent with current practice, within each of a firm's billable... fee schedules by compressing the current 14-tier Network A device rate schedule into four tiers, by... products, unprecedented levels of trading, internationalization and developments in portfolio analysis and...
22 CFR 208.330 - What requirements must I pass down to persons at lower tiers with whom I intend to do business?

Code of Federal Regulations, 2011 CFR

2011-04-01

... at lower tiers with whom I intend to do business? 208.330 Section 208.330 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Responsibilities of Participants Regarding Transactions Doing Business with Other Persons § 208.330 What...
22 CFR 208.330 - What requirements must I pass down to persons at lower tiers with whom I intend to do business?

Code of Federal Regulations, 2010 CFR

2010-04-01

... at lower tiers with whom I intend to do business? 208.330 Section 208.330 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Responsibilities of Participants Regarding Transactions Doing Business with Other Persons § 208.330 What...
MODELS AND METHODS FOR PETROLEUM HYDROCARBON RISK ASSESSMENT: ONSITE, LUSTRISK, AND HSSM

EPA Science Inventory

U.S. EPA has developed three tiers of models for analysis of fuel releases from underground storage tank (UST) systems: 1) OnSite; 2) LUSTRisk, and 3) the Hydrocarbon Spill Screening Model (HSSM). The tiered approach to modeling allows users to select a model based upon the amoun...
Validation of The Scenarios Designed For The Eu Registration of Pesticides

NASA Astrophysics Data System (ADS)

Piñeros Garcet, J. D.; de Nie, D.; Vanclooster, M.; Tiktak, A.; Klein, M.

As part of recent efforts to harmonise registration procedures for pesticides within the EU, a set of uniform principles were developed, setting out the detailed evaluation and decision making criteria for pesticide registration. The EU directive 91/414/EEC places great importance on the use of validated models to calculate Predicted Envi- ronmental Concentrations (PECs), as a basis for assessing the environmental risks and health effects. To be used in a harmonised registration process, the quality of PEC modelling needs to be assured. Quality assurance of mathematical modelling implies, amongst others, the validation of the environmental modelling scenarios. The FOrum for the CO-ordination of pesticide fate models and their USe (FOCUS), is the cur- rent platform where common modelling methodologies are designed and subjected for approval to the European authorities. In 2000, the FOCUS groundwater scenarios working group defined the procedures for realising tier 1 PEC groundwater calcula- tions for the active substances of plant protection products at the pan-european level. The procedures and guidelines were approved by the Standing Committee on Plant Health, and are now recommended for tier 1 PEC groundwater calculations in the reg-istration dossier. Yet, the working group also identified a range of uncertainties related to the validity of the present leaching scenarios. To mitigate some of these problems,the EU R&D project APECOP was designed and approved for support in the frame-work of the EU-FP5-Quality of Life Programme. One of the objectives of the project is to evaluate the appropriateness of the current Tier 1 groundwater scenarios. In this paper, we summarise the methodology and results of the scenarios validation.
Validation of The Scenarios Designed For The Eu Registration of Pesticides

NASA Astrophysics Data System (ADS)

Piñeros Garcet, J. D.; de Nie, D.; Vanclooster, M.; Tiktak, A.; Klein, M.; Jones, A.

As part of recent efforts to harmonise registration procedures for pesticides within the EU, a set of uniform principles were developed, setting out the detailed evaluation and decision making criteria for pesticide registration. The EU directive 91/414/EEC places great importance on the use of validated models to calculate Predicted Envi- ronmental Concentrations (PECs), as a basis for assessing the environmental risks and health effects. To be used in a harmonised registration process, the quality of PEC modelling needs to be assured. Quality assurance of mathematical modelling implies, amongst others, the validation of the environmental modelling scenarios. The FOrum for the CO-ordination of pesticide fate models and their USe (FOCUS), is the cur- rent platform where common modelling methodologies are designed and subjected for approval to the European authorities. In 2000, the FOCUS groundwater scenarios working group defined the procedures for realising tier 1 PEC groundwater calcula- tions for the active substances of plant protection products at the pan-european level. The procedures and guidelines were approved by the Standing Committee on Plant Health, and are now recommended for tier 1 PEC groundwater calculations in the reg- istration dossier. Yet, the working group also identified a range of uncertainties related to the validity of the present leaching scenarios. To mitigate some of these problems, the EU R&D project APECOP was designed and approved for support in the frame- work of the EU-FP5-Quality of Life Programme. One of the objectives of the project is to evaluate the appropriateness of the current Tier 1 groundwater scenarios. In this paper, we summarise the methodology and results of the scenarios validation.
40 CFR 1033.230 - Grouping locomotives into engine families.

Code of Federal Regulations, 2014 CFR

2014-07-01

... control (electronic or mechanical). (d) You may subdivide a group of locomotives that is identical under...) AIR POLLUTION CONTROLS CONTROL OF EMISSIONS FROM LOCOMOTIVES Certifying Engine Families § 1033.230...) This paragraph (b) applies for all locomotives other than Tier 0 locomotives. Group locomotives in the...
40 CFR 1033.230 - Grouping locomotives into engine families.

Code of Federal Regulations, 2011 CFR

2011-07-01

... control (electronic or mechanical). (d) You may subdivide a group of locomotives that is identical under...) AIR POLLUTION CONTROLS CONTROL OF EMISSIONS FROM LOCOMOTIVES Certifying Engine Families § 1033.230...) This paragraph (b) applies for all locomotives other than Tier 0 locomotives. Group locomotives in the...
40 CFR 1033.230 - Grouping locomotives into engine families.

Code of Federal Regulations, 2010 CFR

2010-07-01

... control (electronic or mechanical). (d) You may subdivide a group of locomotives that is identical under...) AIR POLLUTION CONTROLS CONTROL OF EMISSIONS FROM LOCOMOTIVES Certifying Engine Families § 1033.230...) This paragraph (b) applies for all locomotives other than Tier 0 locomotives. Group locomotives in the...
40 CFR 1033.230 - Grouping locomotives into engine families.

Code of Federal Regulations, 2012 CFR

2012-07-01

... control (electronic or mechanical). (d) You may subdivide a group of locomotives that is identical under...) AIR POLLUTION CONTROLS CONTROL OF EMISSIONS FROM LOCOMOTIVES Certifying Engine Families § 1033.230...) This paragraph (b) applies for all locomotives other than Tier 0 locomotives. Group locomotives in the...
Modeling Market Shares of Competing (e)Care Providers

NASA Astrophysics Data System (ADS)

van Ooteghem, Jan; Tesch, Tom; Verbrugge, Sofie; Ackaert, Ann; Colle, Didier; Pickavet, Mario; Demeester, Piet

In order to address the increasing costs of providing care to the growing group of elderly, efficiency gains through eCare solutions seem an obvious solution. Unfortunately not many techno-economic business models to evaluate the return of these investments are available. The construction of a business case for care for the elderly as they move through different levels of dependency and the effect of introducing an eCare service, is the intended application of the model. The simulation model presented in this paper allows for modeling evolution of market shares of competing care providers. Four tiers are defined, based on the dependency level of the elderly, for which the market shares are determined. The model takes into account available capacity of the different care providers, in- and outflow distribution between tiers and churn between providers within tiers.
Cannabinoids for fibromyalgia.

PubMed

Walitt, Brian; Klose, Petra; Fitzcharles, Mary-Ann; Phillips, Tudor; Häuser, Winfried

2016-07-18

This review is one of a series on drugs used to treat fibromyalgia. Fibromyalgia is a clinically well-defined chronic condition of unknown aetiology characterised by chronic widespread pain that often co-exists with sleep problems and fatigue affecting approximately 2% of the general population. People often report high disability levels and poor health-related quality of life (HRQoL). Drug therapy focuses on reducing key symptoms and disability, and improving HRQoL. Cannabis has been used for millennia to reduce pain and other somatic and psychological symptoms. To assess the efficacy, tolerability and safety of cannabinoids for fibromyalgia symptoms in adults. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE to April 2016, together with reference lists of retrieved papers and reviews, three clinical trial registries, and contact with trial authors. We selected randomised controlled trials of at least four weeks' duration of any formulation of cannabis products used for the treatment of adults with fibromyalgia. Two review authors independently extracted the data of all included studies and assessed risk of bias. We resolved discrepancies by discussion. We performed analysis using three tiers of evidence. First tier evidence was derived from data meeting current best standards and subject to minimal risk of bias (outcome equivalent to substantial pain intensity reduction, intention-to-treat analysis without imputation for drop-outs; at least 200 participants in the comparison, eight to 12 weeks' duration, parallel design), second tier evidence from data that did not meet one or more of these criteria and were considered at some risk of bias but with adequate numbers (i.e. data from at least 200 participants) in the comparison, and third tier evidence from data involving small numbers of participants that were considered very likely to be biased or used outcomes of limited clinical utility, or both. We assessed the evidence using GRADE (Grading of Recommendations Assessment, Development and Evaluation). We included two studies with 72 participants. Overall, the two studies were at moderate risk of bias. The evidence was derived from group mean data and completer analysis (very low quality evidence overall). We rated the quality of all outcomes according to GRADE as very low due to indirectness, imprecision and potential reporting bias.The primary outcomes in our review were participant-reported pain relief of 50% or greater, Patient Global Impression of Change (PGIC) much or very much improved, withdrawal due to adverse events (tolerability) and serious adverse events (safety). Nabilone was compared to placebo and to amitriptyline in one study each. Study sizes were 32 and 40 participants. One study used a cross-over design and one used a parallel group design; study duration was four or six weeks. Both studies used nabilone, a synthetic cannabinoid, with a bedtime dosage of 1 mg/day. No study reported the proportion of participants experiencing at least 30% or 50% pain relief or who were very much improved. No study provided first or second tier (high to moderate quality) evidence for an outcome of efficacy, tolerability and safety. Third tier (very low quality) evidence indicated greater reduction of pain and limitations of HRQoL compared to placebo in one study. There were no significant differences to placebo noted for fatigue and depression (very low quality evidence). Third tier evidence indicated better effects of nabilone on sleep than amitriptyline (very low quality evidence). There were no significant differences between the two drugs noted for pain, mood and HRQoL (very low quality evidence). More participants dropped out due to adverse events in the nabilone groups (4/52 participants) than in the control groups (1/20 in placebo and 0/32 in amitriptyline group). The most frequent adverse events were dizziness, nausea, dry mouth and drowsiness (six participants with nabilone). Neither study reported serious adverse events during the period of both studies. We planned to create a GRADE 'Summary of findings' table, but due to the scarcity of data we were unable to do this. We found no relevant study with herbal cannabis, plant-based cannabinoids or synthetic cannabinoids other than nabilone in fibromyalgia. We found no convincing, unbiased, high quality evidence suggesting that nabilone is of value in treating people with fibromyalgia. The tolerability of nabilone was low in people with fibromyalgia.
The Legnaro-Padova distributed Tier-2: challenges and results

NASA Astrophysics Data System (ADS)

Badoer, Simone; Biasotto, Massimo; Costa, Fulvia; Crescente, Alberto; Fantinel, Sergio; Ferrari, Roberto; Gulmini, Michele; Maron, Gaetano; Michelotto, Michele; Sgaravatto, Massimo; Toniolo, Nicola

2014-06-01

The Legnaro-Padova Tier-2 is a computing facility serving the ALICE and CMS LHC experiments. It also supports other High Energy Physics experiments and other virtual organizations of different disciplines, which can opportunistically harness idle resources if available. The unique characteristic of this Tier-2 is its topology: the computational resources are spread in two different sites, about 15 km apart: the INFN Legnaro National Laboratories and the INFN Padova unit, connected through a 10 Gbps network link (it will be soon updated to 20 Gbps). Nevertheless these resources are seamlessly integrated and are exposed as a single computing facility. Despite this intrinsic complexity, the Legnaro-Padova Tier-2 ranks among the best Grid sites for what concerns reliability and availability. The Tier-2 comprises about 190 worker nodes, providing about 26000 HS06 in total. Such computing nodes are managed by the LSF local resource management system, and are accessible using a Grid-based interface implemented through multiple CREAM CE front-ends. dCache, xrootd and Lustre are the storage systems in use at the Tier-2: about 1.5 PB of disk space is available to users in total, through multiple access protocols. A 10 Gbps network link, planned to be doubled in the next months, connects the Tier-2 to WAN. This link is used for the LHC Open Network Environment (LHCONE) and for other general purpose traffic. In this paper we discuss about the experiences at the Legnaro-Padova Tier-2: the problems that had to be addressed, the lessons learned, the implementation choices. We also present the tools used for the daily management operations. These include DOCET, a Java-based webtool designed, implemented and maintained at the Legnaro-Padova Tier-2, and deployed also in other sites, such as the LHC Italian T1. DOCET provides an uniform interface to manage all the information about the physical resources of a computing center. It is also used as documentation repository available to the Tier-2 operations team. Finally we discuss about the foreseen developments of the existing infrastructure. This includes in particular the evolution from a Grid-based resource towards a Cloud-based computing facility.
Laying hen movement in a commercial aviary: Enclosure to floor and back again.

PubMed

Campbell, D L M; Makagon, M M; Swanson, J C; Siegford, J M

2016-01-01

Many producers in the laying hen industry, including in North America, are phasing out conventional cages in response to consumer demands and sometimes subsequent legislation. Alternative housing systems such as aviaries are being implemented in an attempt to improve hen welfare. Aviaries provide additional space and resources to groups of hens, including a litter area on the floor. However, little is known about hen movement between tiered enclosures and floor litter areas in aviary systems. Diurnal rhythms and social attraction may result in peak times of movement that could lead to overcrowding of areas, or alternatively hen preferences may lead to some areas not being fully utilized. We monitored hen movement between tiered enclosures and litter areas, including movement on and off the outer perch, across the day at peak, mid and end of lay in a commercial aviary. Hens moved onto and off of the open litter area across the day, transitioning between tiered enclosures, outer perches, open litter areas, and litter areas under tiered enclosures. At certain times of day, there were periods of greater hen movement down to the open litter area and between litter areas. For example, more hens were typically observed exiting enclosures, jumping from perches to open litter, and traveling between open litter and litter under tiered enclosures in the morning (all P ≤ 0.001). In all but one instance, more hens were observed on open litter areas in the afternoon than at other times of day (all P ≤ 0.029). However, hen re-entry to tiered enclosures showed less circadian patterning. Hen movement was observed between areas of interest at all sampled time periods, indicating hens use all areas of the system. Further research should examine whether all individual hens do move between areas equally, including within levels of the tiered enclosure, or if crowding occurs on the outer perches or in the litter during times of peak movement. © 2015 Poultry Science Association Inc.
A 3-tier classification of cerebral arteriovenous malformations. Clinical article.

PubMed

Spetzler, Robert F; Ponce, Francisco A

2011-03-01

The authors propose a 3-tier classification for cerebral arteriovenous malformations (AVMs). The classification is based on the original 5-tier Spetzler-Martin grading system, and reflects the treatment paradigm for these lesions. The implications of this modification in the literature are explored. Class A combines Grades I and II AVMs, Class B are Grade III AVMs, and Class C combines Grades IV and V AVMs. Recommended management is surgery for Class A AVMs, multimodality treatment for Class B, and observation for Class C, with exceptions to the latter including recurrent hemorrhages and progressive neurological deficits. To evaluate whether combining grades is warranted from the perspective of surgical outcomes, the 3-tier system was applied to 1476 patients from 7 surgical series in which results were stratified according to Spetzler-Martin grades. Pairwise comparisons of individual Spetzler-Martin grades in the series analyzed showed the fewest significant differences (p < 0.05) in outcomes between Grades I and II AVMs and between Grades IV and V AVMs. In the pooled data analysis, significant differences in outcomes were found between all grades except IV and V (p = 0.38), and the lowest relative risks were found between Grades I and II (1.066) and between Grades IV and V (1.095). Using the pooled data, the predictive accuracies for surgical outcomes of the 5-tier and 3-tier systems were equivalent (receiver operating characteristic curve area 0.711 and 0.713, respectively). Combining Grades I and II AVMs and combining Grades IV and V AVMs is justified in part because the differences in surgical results between these respective pairs are small. The proposed 3-tier classification of AVMs offers simplification of the Spetzler-Martin system, provides a guide to treatment, and is predictive of outcome. The revised classification not only simplifies treatment recommendations; by placing patients into 3 as opposed to 5 groups, statistical power is markedly increased for series comparisons.
Achieving Potent Autologous Neutralizing Antibody Responses against Tier 2 HIV-1 Viruses by Strategic Selection of Envelope Immunogens.

PubMed

Hessell, Ann J; Malherbe, Delphine C; Pissani, Franco; McBurney, Sean; Krebs, Shelly J; Gomes, Michelle; Pandey, Shilpi; Sutton, William F; Burwitz, Benjamin J; Gray, Matthew; Robins, Harlan; Park, Byung S; Sacha, Jonah B; LaBranche, Celia C; Fuller, Deborah H; Montefiori, David C; Stamatatos, Leonidas; Sather, D Noah; Haigwood, Nancy L

2016-04-01

Advancement in immunogen selection and vaccine design that will rapidly elicit a protective Ab response is considered critical for HIV vaccine protective efficacy. Vaccine-elicited Ab responses must therefore have the capacity to prevent infection by neutralization-resistant phenotypes of transmitted/founder (T/F) viruses that establish infection in humans. Most vaccine candidates to date have been ineffective at generating Abs that neutralize T/F or early variants. In this study, we report that coimmunizing rhesus macaques with HIV-1 gp160 DNA and gp140 trimeric protein selected from native envelope gene sequences (envs) induced neutralizing Abs against Tier 2 autologous viruses expressing cognate envelope (Env). The Env immunogens were selected from envs emerging during the earliest stages of neutralization breadth developing within the first 2 years of infection in two clade B-infected human subjects. Moreover, the IgG responses in macaques emulated the targeting to specific regions of Env known to be associated with autologous and heterologous neutralizing Abs developed within the human subjects. Furthermore, we measured increasing affinity of macaque polyclonal IgG responses over the course of the immunization regimen that correlated with Tier 1 neutralization. In addition, we report firm correlations between Tier 2 autologous neutralization and Tier 1 heterologous neutralization, as well as overall TZM-bl breadth scores. Additionally, the activation of Env-specific follicular helper CD4 T cells in lymphocytes isolated from inguinal lymph nodes of vaccinated macaques correlated with Tier 2 autologous neutralization. These results demonstrate the potential for native Env derived from subjects at the time of neutralization broadening as effective HIV vaccine elements. Copyright © 2016 by The American Association of Immunologists, Inc.

Effects of Course Type on Freshman Learning.

ERIC Educational Resources Information Center

Bohr, Louise

This study considers the effects of course types on reading, mathematics, and critical thinking skill gains for college freshmen. Course groups, arranged hierarchically in three tiers from large groupings down to individual courses, are used as units for analysis. Both Hard Applied and Hard Pure Biglan-paradigm course groups contributed to…
Maximizing data holdings and data documentation with a hierarchical system for sample-based geochemical data

NASA Astrophysics Data System (ADS)

Hsu, L.; Lehnert, K. A.; Walker, J. D.; Chan, C.; Ash, J.; Johansson, A. K.; Rivera, T. A.

2011-12-01

Sample-based measurements in geochemistry are highly diverse, due to the large variety of sample types, measured properties, and idiosyncratic analytical procedures. In order to ensure the utility of sample-based data for re-use in research or education they must be associated with a high quality and quantity of descriptive, discipline-specific metadata. Without an adequate level of documentation, it is not possible to reproduce scientific results or have confidence in using the data for new research inquiries. The required detail in data documentation makes it challenging to aggregate large sets of data from different investigators and disciplines. One solution to this challenge is to build data systems with several tiers of intricacy, where the less detailed tiers are geared toward discovery and interoperability, and the more detailed tiers have higher value for data analysis. The Geoinformatics for Geochemistry (GfG) group, which is part of the Integrated Earth Data Applications facility (http://www.iedadata.org), has taken this approach to provide services for the discovery, access, and analysis of sample-based geochemical data for a diverse user community, ranging from the highly informed geochemist to non-domain scientists and undergraduate students. GfG builds and maintains three tiers in the sample based data systems, from a simple data catalog (Geochemical Resource Library), to a substantially richer data model for the EarthChem Portal (EarthChem XML), and finally to detailed discipline-specific data models for petrologic (PetDB), sedimentary (SedDB), hydrothermal spring (VentDB), and geochronological (GeoChron) samples. The data catalog, the lowest level in the hierarchy, contains the sample data values plus metadata only about the dataset itself (Dublin Core metadata such as dataset title and author), and therefore can accommodate the widest diversity of data holdings. The second level includes measured data values from the sample, basic information about the analytical method, and metadata about the samples such as geospatial information and sample type. The third and highest level includes detailed data quality documentation and more specific information about the scientific context of the sample. The three tiers are linked to allow users to quickly navigate to their desired level of metadata detail. Links are based on the use of unique identifiers: (a) DOI at the granularity of datasets, and (b) the International Geo Sample Number IGSN at the granularity of samples. Current developments in the GfG sample-based systems include new registry architecture for the IGSN to advance international implementation, growth and modification of EarthChemXML to include geochemical data for new sample types such as soils and liquids, and the construction of a hydrothermal vent data system. This flexible, tiered, model provides a solution for offering varying levels of detail in order to aggregate a large quantity of data and serve the largest user group of both disciplinary novices and experts.
The Developing Purposes of Low-Income College Students in China's Elite Universities: A Longitudinal Case Study of How Socioeconomic Background and University Culture Interact to Influence the Development and Realization of Low Income College Students' Goals

ERIC Educational Resources Information Center

Zhao, Wanxia

2014-01-01

In the process of China's transformation from a socialist to a post-socialist society, China's entire system of education has experienced breathtaking expansion and reform. In this context, first-tier universities increasingly accept students from more financially well off backgrounds. While second-tier universities are inclined to accept more…
Developing an Educational Computer Game for Migratory Bird Identification Based on a Two-Tier Test Approach

ERIC Educational Resources Information Center

Chu, Hui-Chun; Chang, Shao-Chen

2014-01-01

Although educational computer games have been recognized as being a promising approach, previous studies have indicated that, without supportive models, students might only show temporary interest during the game-based learning process, and their learning performance is often not as good as expected. Therefore, in this paper, a two-tier test…
Using UML Modeling to Facilitate Three-Tier Architecture Projects in Software Engineering Courses

ERIC Educational Resources Information Center

Mitra, Sandeep

2014-01-01

This article presents the use of a model-centric approach to facilitate software development projects conforming to the three-tier architecture in undergraduate software engineering courses. Many instructors intend that such projects create software applications for use by real-world customers. While it is important that the first version of these…
Tiers of Intervention in Kindergarten Through Third Grade

ERIC Educational Resources Information Center

O'Connor, Rollanda E.; Harty, Kristin R.; Fulmer, Deborah

2005-01-01

This study measured the effects of increasing levels of intervention in reading for a cohort of children in Grades K through 3 to determine whether the severity of reading disability (RD) could be significantly reduced in the catchment schools. Tier 1 consisted of professional development for teachers of reading. The focus of this study is on…
Developing a Tiered Response Model for Social-Emotional Learning through Interdisciplinary Collaboration

ERIC Educational Resources Information Center

Maras, Melissa A.; Thompson, Aaron M.; Lewis, Christie; Thornburg, Kathy; Hawks, Jacqueline

2015-01-01

A tiered response model for social-emotional learning (SEL) is needed to address the significant mental health needs of young people in this country. In collaboration with other school mental health professionals, school psychologists have a unique expertise that situates them to be systems change agents in this work. This article describes a…
The Development and Validation of a Two-Tiered Multiple-Choice Instrument to Identify Alternative Conceptions in Earth Science

ERIC Educational Resources Information Center

Mangione, Katherine Anna

2010-01-01

This study was to determine reliability and validity for a two-tiered, multiple- choice instrument designed to identify alternative conceptions in earth science. Additionally, this study sought to identify alternative conceptions in earth science held by preservice teachers, to investigate relationships between self-reported confidence scores and…
Are British Higher Educational Concerns Different from European Higher Educational Concerns?

ERIC Educational Resources Information Center

Mangset, Marte

2008-01-01

British universities are known among the other Bologna countries not to have adjusted fully to the new common three-tier degree structure. Is it the case that British higher educational concerns are different from Continental concerns? A study of recent developments in two British graduate schools of history shows that a three-tier study structure…
The Etiology of Top-Tier Publications in Management: A Status Attainment Perspective on Academic Career Success

ERIC Educational Resources Information Center

Valle, Matthew; Schultz, Kaitlyn

2011-01-01

Purpose: The purpose of this paper is to develop and test a comprehensive model of personal and institutional input variables, composed of elements describing status-based antecedents, job/organizational context antecedents, and individual level antecedents, which may contribute to the production of significant (top-tier) research outputs in the…
An Examination of Treatment Effects of a First Grade Literacy Intervention Using a Regression Discontinuity Design

ERIC Educational Resources Information Center

Chaparro, Erin A.; Smolkowski, Keith; Baker, Scott K.; Fien, Hank; Smith, Jean Louise M.

2012-01-01

Response to Intervention (RTI) is a tiered instructional delivery framework developed to meet the needs of all students and has the potential to improve reading achievement, prevent reading problems, and improve identification accuracy for learning disabilities. Tier 1 typically occurs in the context of the general education classroom and is…
Web-Based Two-Tier Diagnostic Test and Remedial Learning Experiment

ERIC Educational Resources Information Center

Lai, Ah-Fur; Chen, Deng-Jyi

2010-01-01

Offering a series of diagnosis and individual remedial learning activities for a general class by means of web and multimedia technology can overcome the dilemma of conventional diagnosis and remedial instruction. The study proposes a three-layer conceptual framework and adopts a two-tier diagnostic test theory to develop a web-based two-tier…
ATLAS Distributed Computing Experience and Performance During the LHC Run-2

NASA Astrophysics Data System (ADS)

Filipčič, A.; ATLAS Collaboration

2017-10-01

ATLAS Distributed Computing during LHC Run-1 was challenged by steadily increasing computing, storage and network requirements. In addition, the complexity of processing task workflows and their associated data management requirements led to a new paradigm in the ATLAS computing model for Run-2, accompanied by extensive evolution and redesign of the workflow and data management systems. The new systems were put into production at the end of 2014, and gained robustness and maturity during 2015 data taking. ProdSys2, the new request and task interface; JEDI, the dynamic job execution engine developed as an extension to PanDA; and Rucio, the new data management system, form the core of Run-2 ATLAS distributed computing engine. One of the big changes for Run-2 was the adoption of the Derivation Framework, which moves the chaotic CPU and data intensive part of the user analysis into the centrally organized train production, delivering derived AOD datasets to user groups for final analysis. The effectiveness of the new model was demonstrated through the delivery of analysis datasets to users just one week after data taking, by completing the calibration loop, Tier-0 processing and train production steps promptly. The great flexibility of the new system also makes it possible to execute part of the Tier-0 processing on the grid when Tier-0 resources experience a backlog during high data-taking periods. The introduction of the data lifetime model, where each dataset is assigned a finite lifetime (with extensions possible for frequently accessed data), was made possible by Rucio. Thanks to this the storage crises experienced in Run-1 have not reappeared during Run-2. In addition, the distinction between Tier-1 and Tier-2 disk storage, now largely artificial given the quality of Tier-2 resources and their networking, has been removed through the introduction of dynamic ATLAS clouds that group the storage endpoint nucleus and its close-by execution satellite sites. All stable ATLAS sites are now able to store unique or primary copies of the datasets. ATLAS Distributed Computing is further evolving to speed up request processing by introducing network awareness, using machine learning and optimisation of the latencies during the execution of the full chain of tasks. The Event Service, a new workflow and job execution engine, is designed around check-pointing at the level of event processing to use opportunistic resources more efficiently. ATLAS has been extensively exploring possibilities of using computing resources extending beyond conventional grid sites in the WLCG fabric to deliver as many computing cycles as possible and thereby enhance the significance of the Monte-Carlo samples to deliver better physics results. The exploitation of opportunistic resources was at an early stage throughout 2015, at the level of 10% of the total ATLAS computing power, but in the next few years it is expected to deliver much more. In addition, demonstrating the ability to use an opportunistic resource can lead to securing ATLAS allocations on the facility, hence the importance of this work goes beyond merely the initial CPU cycles gained. In this paper, we give an overview and compare the performance, development effort, flexibility and robustness of the various approaches.
Three Tier Unified Process Model for Requirement Negotiations and Stakeholder Collaborations

NASA Astrophysics Data System (ADS)

Niazi, Muhammad Ashraf Khan; Abbas, Muhammad; Shahzad, Muhammad

2012-11-01

This research paper is focused towards carrying out a pragmatic qualitative analysis of various models and approaches of requirements negotiations (a sub process of requirements management plan which is an output of scope managementís collect requirements process) and studies stakeholder collaborations methodologies (i.e. from within communication management knowledge area). Experiential analysis encompass two tiers; first tier refers to the weighted scoring model while second tier focuses on development of SWOT matrices on the basis of findings of weighted scoring model for selecting an appropriate requirements negotiation model. Finally the results are simulated with the help of statistical pie charts. On the basis of simulated results of prevalent models and approaches of negotiations, a unified approach for requirements negotiations and stakeholder collaborations is proposed where the collaboration methodologies are embeded into selected requirements negotiation model as internal parameters of the proposed process alongside some external required parameters like MBTI, opportunity analysis etc.
Final Tier 2 Environmental Impact Statement for International Space Station

NASA Technical Reports Server (NTRS)

1996-01-01

The Final Tier 2 Environmental Impact Statement (EIS) for the International Space Station (ISS) has been prepared by the National Aeronautics and Space Administration (NASA) and follows NASA's Record of Decision on the Final Tier 1 EIS for the Space Station Freedom. The Tier 2 EIS provides an updated evaluation of the environmental impacts associated with the alternatives considered: the Proposed Action and the No-Action alternative. The Proposed Action is to continue U.S. participation in the assembly and operation of ISS. The No-Action alternative would cancel NASA!s participation in the Space Station Program. ISS is an international cooperative venture between NASA, the Canadian Space Agency, the European Space Agency, the Science and Technology Agency of Japan, the Russian Space Agency, and the Italian Space Agency. The purpose of the NASA action would be to further develop human presence in space; to meet scientific, technological, and commercial research needs; and to foster international cooperation.
Draft Tier 2 Environmental Impact Statement for International Space Station

NASA Technical Reports Server (NTRS)

1995-01-01

The Draft Tier 2 Environmental Impact Statement (EIS) for the International Space Station (ISS) has been prepared by the National Aeronautics and Space Administration (NASA) and follows NASA's Record of Decision on the Final Tier 1 EIS for the Space Station Freedom. The Tier 2 EIS provides an updated evaluation of the environmental impacts associated with the alternatives considered: the Proposed Action and the No-Action alternative. The Proposed Action is to continue U.S. participation in the assembly and operation of ISS. The No-Action alternative would cancel NASA's participation in the Space Station Program. ISS is an international cooperative venture between NASA, the Canadian Space Agency, the European Space Agency, the Science and Technology Agency of Japan, the Russian Space Agency, and the Italian Space Agency. The purpose of the NASA action would be to further develop a human presence in space; to meet scientific, technological, and commercial research needs; and to foster international cooperation.
Mobility dynamics of migrant workers and their socio-behavioral parameters related to malaria in Tier II, Artemisinin Resistance Containment Zone, Myanmar.

PubMed

Hlaing, Thaung; Wai, Khin Thet; Oo, Tin; Sint, Nyan; Min, Tun; Myar, Shwe; Lon, Khin Nan; Naing, Myo Myint; Tun, Tet Toe; Maung, Nay Lin Yin; Galappaththy, Gawrie N L; Thimarsan, Krongthong; Wai, Tin Tin; Thaung, Lwin Ni Ni

2015-09-14

Areas with dynamic population movements are likely to be associated with higher levels of drug-resistant malaria. Myanmar Artemisinin Resistance Containment (MARC) Project has been launching since 2012. One of its components includes enhancing strategic approaches for mobile/migrant populations. We aimed to ascertain the estimated population of mobile migrant workers and their families in terms of stability in work setting in townships classified as tier II (areas with significant inflows of people from areas with credible evidence of artemisinin resistance) for Artemisinin resistance; to identify knowledge, attitudes and practices related to prevention and control of malaria and to recommend cost-effective strategies in planning for prevention and control of malaria. A prospective cross-sectional study conducted between June to December 2013 that covered 1,899 migrant groups from 16 tier II townships of Bago Region, and Kayin and Kayah States. Trained data collectors used a pre-tested and subsequently modified questionnaire and interviewed 2,381 respondents. Data of migrant groups were analyzed and compared by category depending upon the stability of their work setting. The estimated population of the 1,899 migrant groups categorized into three on the nature of their work setting was 56,030. Bago region was the commonest reported source of origin of migrant groups as well as their transit. Malaria volunteers were mostly within the reach of category 1 migrant groups (43/66, 65.2 %). Less stable migrant groups in category 3 had limited access to malaria information (14.7 %) and malaria care providers (22.1 %), low level of awareness and use of long-lasting insecticide-treated nets (46.6 and 38.8 %). Also, they had poor knowledge on malaria prevention on confirming suspected malaria and on using artemisinin combined therapy (ACT). Within two weeks prior to the survey, only 16.5 % of respondents in all categories combined reported acute undifferentiated fever. Mobility dynamics of migrant groups was complex and increased their vulnerability to malaria. This phenomenon was accentuated in less stable areas. Even though migrant workers were familiar with rapid diagnostic tests for malaria, ACT still needed wide recognition to improve practices supportive of MARC including the use of appropriate personal protection. High mobility calls for re-designation of tier II townships to optimize ACT resistance containment.
Re-visiting protein-centric two-tier classification of existing DNA-protein complexes

PubMed Central

2012-01-01

Background Precise DNA-protein interactions play most important and vital role in maintaining the normal physiological functioning of the cell, as it controls many high fidelity cellular processes. Detailed study of the nature of these interactions has paved the way for understanding the mechanisms behind the biological processes in which they are involved. Earlier in 2000, a systematic classification of DNA-protein complexes based on the structural analysis of the proteins was proposed at two tiers, namely groups and families. With the advancement in the number and resolution of structures of DNA-protein complexes deposited in the Protein Data Bank, it is important to revisit the existing classification. Results On the basis of the sequence analysis of DNA binding proteins, we have built upon the protein centric, two-tier classification of DNA-protein complexes by adding new members to existing families and making new families and groups. While classifying the new complexes, we also realised the emergence of new groups and families. The new group observed was where β-propeller was seen to interact with DNA. There were 34 SCOP folds which were observed to be present in the complexes of both old and new classifications, whereas 28 folds are present exclusively in the new complexes. Some new families noticed were NarL transcription factor, Z-α DNA binding proteins, Forkhead transcription factor, AP2 protein, Methyl CpG binding protein etc. Conclusions Our results suggest that with the increasing number of availability of DNA-protein complexes in Protein Data Bank, the number of families in the classification increased by approximately three fold. The folds present exclusively in newly classified complexes is suggestive of inclusion of proteins with new function in new classification, the most populated of which are the folds responsible for DNA damage repair. The proposed re-visited classification can be used to perform genome-wide surveys in the genomes of interest for the presence of DNA-binding proteins. Further analysis of these complexes can aid in developing algorithms for identifying DNA-binding proteins and their family members from mere sequence information. PMID:22800292
Re-visiting protein-centric two-tier classification of existing DNA-protein complexes.

PubMed

Malhotra, Sony; Sowdhamini, Ramanathan

2012-07-16

Precise DNA-protein interactions play most important and vital role in maintaining the normal physiological functioning of the cell, as it controls many high fidelity cellular processes. Detailed study of the nature of these interactions has paved the way for understanding the mechanisms behind the biological processes in which they are involved. Earlier in 2000, a systematic classification of DNA-protein complexes based on the structural analysis of the proteins was proposed at two tiers, namely groups and families. With the advancement in the number and resolution of structures of DNA-protein complexes deposited in the Protein Data Bank, it is important to revisit the existing classification. On the basis of the sequence analysis of DNA binding proteins, we have built upon the protein centric, two-tier classification of DNA-protein complexes by adding new members to existing families and making new families and groups. While classifying the new complexes, we also realised the emergence of new groups and families. The new group observed was where β-propeller was seen to interact with DNA. There were 34 SCOP folds which were observed to be present in the complexes of both old and new classifications, whereas 28 folds are present exclusively in the new complexes. Some new families noticed were NarL transcription factor, Z-α DNA binding proteins, Forkhead transcription factor, AP2 protein, Methyl CpG binding protein etc. Our results suggest that with the increasing number of availability of DNA-protein complexes in Protein Data Bank, the number of families in the classification increased by approximately three fold. The folds present exclusively in newly classified complexes is suggestive of inclusion of proteins with new function in new classification, the most populated of which are the folds responsible for DNA damage repair. The proposed re-visited classification can be used to perform genome-wide surveys in the genomes of interest for the presence of DNA-binding proteins. Further analysis of these complexes can aid in developing algorithms for identifying DNA-binding proteins and their family members from mere sequence information.
WMO summit on exchange of weather data may yield to status quo

NASA Astrophysics Data System (ADS)

Wakefield, Julie

A stalemate may seal the stormy debate over the free exchange of weather data at the upcoming Congress of the World Meteorological Organization (WMO) that begins May 26 in Geneva, U.S. officials say. The central conflict is how to maintain open access for academics while allowing government and industry players to have commercialism.European nations are pushing for a vote on a proposal to develop a two-tiered system for the exchange of international meteorological data. The first-tier data—to include mainly synoptic-scale information—would be freely exchanged internationally; distribution of the second-tier data would be regulated by guidelines established by WMO.

Thermoelectric Waste Heat Recovery Program for Passenger Vehicles

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

Jovovic, Vladimir

2015-12-31

Gentherm began work in October 2011 to develop a Thermoelectric Waste Energy Recovery System for passenger vehicle applications. Partners in this program were BMW and Tenneco. Tenneco, in the role of TIER 1 supplier, developed the system-level packaging of the thermoelectric power generator. As the OEM, BMW Group demonstrated the TEG system in their vehicle in the final program phase. Gentherm demonstrated the performance of the TEG in medium duty and heavy duty vehicles. Technology developed and demonstrated in this program showed potential to reduce fuel consumption in medium and heavy duty vehicles. In light duty vehicles it showed moremore » modest potential.« less
A Forecast Skill Comparison between CliPAS One-Tier and Two-Tier Hindcast Experiments

NASA Astrophysics Data System (ADS)

Lee, J.; Wang, B.; Kang, I.

2006-05-01

A 24-year (1981-2004) MME hindcast experimental dataset is produced under the "Climate Prediction and Its Application to Society" (CliPAS) project sponsored by Korean Meteorological Administration (KMA). This dataset consists of 5 one-tier model systems from National Aeronautics and Space Administration (NASA), National Center for Environmental Prediction (NCEP), Frontier Research Center for Global Change (FRCGC), Seoul National University (SNU), and University of Hawaii (UH) and 5 two-tier model systems from Florida State University (FSU), Geophysical Fluid Dynamic Lab (GFDL), SNU, and UH. Multi-model Ensemble (MME) Forecast skills of seasonal precipitation and atmospheric circulation are compared between CliPAS one-tier and two-tier hindcast experiments for seasonal mean precipitation and atmospheric circulation. For winter prediction, two-tier MME has a comparable skill to one-tier MME. However, it is demonstrated that in the Asian-Australian monsoon (A-AM) heavy precipitation regions, one-tier systems are superior to two-tier systems in summer season. The reason is that inclusion of the local warm pool- monsoon interaction in the one-tier system improves the ENSO teleconnection with monsoon regions. Both one-tier and two-tier MME fail to predict Indian monsoon circulation, while they have a significantly good skill for the broad scale monsoon circulation defined by Webster and Yang index. One-tier system has a much better skill to predict the monsoon circulation over the western North pacific where air-sea interaction plays an important role than two-tier system.
Data sharing as a national quality improvement program: reporting on BRCA1 and BRCA2 variant-interpretation comparisons through the Canadian Open Genetics Repository (COGR).

PubMed

Lebo, Matthew S; Zakoor, Kathleen-Rose; Chun, Kathy; Speevak, Marsha D; Waye, John S; McCready, Elizabeth; Parboosingh, Jillian S; Lamont, Ryan E; Feilotter, Harriet; Bosdet, Ian; Tucker, Tracy; Young, Sean; Karsan, Aly; Charames, George S; Agatep, Ronald; Spriggs, Elizabeth L; Chisholm, Caitlin; Vasli, Nasim; Daoud, Hussein; Jarinova, Olga; Tomaszewski, Robert; Hume, Stacey; Taylor, Sherryl; Akbari, Mohammad R; Lerner-Ellis, Jordan

2018-03-01

PurposeThe purpose of this study was to develop a national program for Canadian diagnostic laboratories to compare DNA-variant interpretations and resolve discordant-variant classifications using the BRCA1 and BRCA2 genes as a case study.MethodsBRCA1 and BRCA2 variant data were uploaded and shared through the Canadian Open Genetics Repository (COGR; http://www.opengenetics.ca). A total of 5,554 variant observations were submitted; classification differences were identified and comparison reports were sent to participating laboratories. Each site had the opportunity to reclassify variants. The data were analyzed before and after the comparison report process to track concordant- or discordant-variant classifications by three different models.ResultsVariant-discordance rates varied by classification model: 38.9% of variants were discordant when using a five-tier model, 26.7% with a three-tier model, and 5.0% with a two-tier model. After the comparison report process, the proportion of discordant variants dropped to 30.7% with the five-tier model, to 14.2% with the three-tier model, and to 0.9% using the two-tier model.ConclusionWe present a Canadian interinstitutional quality improvement program for DNA-variant interpretations. Sharing of variant knowledge by clinical diagnostic laboratories will allow clinicians and patients to make more informed decisions and lead to better patient outcomes.
Primary care in a new era: disillusion and dissolution?.

PubMed

Sandy, Lewis G; Schroeder, Steven A

2003-02-04

The current dilemmas in primary care stem from 1) the unintended consequences of forces thought to promote primary care and 2) the "disruptive technologies of care" that attack the very function and concept of primary care itself. This paper suggests that these forces, in combination with "tiering" in the health insurance market, could lead to the dissolution of primary care as a single concept, to be replaced by alignment of clinicians by economic niche. Evidence already exists in the marketplace for both tiering of health insurance benefits and corresponding practice changes within primary care. In the future, primary care for the top tier will cater to the affluent as "full-service brokers" and will be delivered by a wide variety of clinicians. The middle tier will continue to grapple with tensions created by patient demand and bureaucratic systems but will remain most closely aligned to primary care as a concept. The lower tier will become increasingly concerned with community health and social justice. Each primary care specialty will adapt in a unique way to a tiered world, with general internal medicine facing the most challenges. Given this forecast for the future, those concerned about primary care should focus less on workforce issues and more on macro health care financing and organization issues (such as Medicare reform); appropriate training models; and the development of a conception of primary care that emphasizes values and ethos, not just function.
Middle School Students' Responses to Two-Tier Tasks

ERIC Educational Resources Information Center

Haja, Shajahan; Clarke, David

2011-01-01

The structure of two-tier testing is such that the first tier consists of a multiple-choice question and the second tier requires justifications for choices of answers made in the first tier. This study aims to evaluate two-tier tasks in "proportion" in terms of students' capacity to write and select justifications and to examine the effect of…
Understanding the T2 traffic in CMS during Run-1

NASA Astrophysics Data System (ADS)

T, Wildish

2015-12-01

In the run-up to Run-1 CMS was operating its facilities according to the MONARC model, where data-transfers were strictly hierarchical in nature. Direct transfers between Tier-2 nodes was excluded, being perceived as operationally intensive and risky in an era where the network was expected to be a major source of errors. By the end of Run-1 wide-area networks were more capable and stable than originally anticipated. The original data-placement model was relaxed, and traffic was allowed between Tier-2 nodes. Tier-2 to Tier-2 traffic in 2012 already exceeded the amount of Tier-2 to Tier-1 traffic, so it clearly has the potential to become important in the future. Moreover, while Tier-2 to Tier-1 traffic is mostly upload of Monte Carlo data, the Tier-2 to Tier-2 traffic represents data moved in direct response to requests from the physics analysis community. As such, problems or delays there are more likely to have a direct impact on the user community. Tier-2 to Tier-2 traffic may also traverse parts of the WAN that are at the 'edge' of our network, with limited network capacity or reliability compared to, say, the Tier-0 to Tier-1 traffic which goes the over LHCOPN network. CMS is looking to exploit technologies that allow us to interact with the network fabric so that it can manage our traffic better for us, this we hope to achieve before the end of Run-2. Tier-2 to Tier-2 traffic would be the most interesting use-case for such traffic management, precisely because it is close to the users' analysis and far from the 'core' network infrastructure. As such, a better understanding of our Tier-2 to Tier-2 traffic is important. Knowing the characteristics of our data-flows can help us place our data more intelligently. Knowing how widely the data moves can help us anticipate the requirements for network capacity, and inform the dynamic data placement algorithms we expect to have in place for Run-2. This paper presents an analysis of the CMS Tier-2 traffic during Run 1.
Analysis of the Marine Corps Educational Tier System

DTIC Science & Technology

2013-03-01

Accounting Office GED General Educational Development HSDG High School Diploma Graduate HumRRO Human Resources Research Organization JAMERS...Tier III: Non- High School Diploma Graduate (NHSDG) In 1997, research by Laurence, Ramsberger, and Arabian examined yet again the first-term...recruiting and first-term attrition. E. FINAL REMARKS A reoccurring theme in attrition research is that the high school diploma is the most
Evaluating Secondary Students' Scientific Reasoning in Genetics Using a Two-Tier Diagnostic Instrument

ERIC Educational Resources Information Center

Tsui, Chi-Yan; Treagust, David

2010-01-01

While genetics has remained as one key topic in school science, it continues to be conceptually and linguistically difficult for students with the concomitant debates as to what should be taught in the age of biotechnology. This article documents the development and implementation of a two-tier multiple-choice instrument for diagnosing grades 10…
75 FR 68021 - Draft Finding of No Significant Impact on the Tier 1 Ohio 3C Quick Start Passenger Rail Tier-1...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-04

... purpose of the 3C ``Quick Start'' Passenger Rail Project is to reestablish intercity conventional speed... predictable and consistent travel times. It is intended to provide travel options and develop the passenger... through the High Speed Intercity Passenger Rail Program (HSIPR Program) administered by the FRA and funded...
Diagnosing Students' Misconceptions in Number Sense via a Web-Based Two-Tier Test

ERIC Educational Resources Information Center

Lin, Yung-Chi; Yang, Der-Ching; Li, Mao-Neng

2016-01-01

A web-based two-tier test (WTTT-NS) which combined the advantages of traditional written tests and interviews in assessing number sense was developed and applied to assess students' answers and reasons for the questions. In addition, students' major misconceptions can be detected. A total of 1,248 sixth graders in Taiwan were selected to…
Improving On-Task Behavior Using a Functional Assessment-Based Intervention in an Inclusive High School Setting

ERIC Educational Resources Information Center

Majeika, Caitlyn E.; Walder, Jessica P.; Hubbard, Jessica P.; Steeb, Kelly M.; Ferris, Geoffrey J.; Oakes, Wendy P.; Lane, Kathleen Lynne

2011-01-01

A comprehensive, integrated, three-tiered model (CI3T) of prevention is a framework for proactively meeting students' academic, behavioral, and social skills. At the tertiary (Tier 3) level of prevention, functional-assessment based interventions (FABIs) may be used to identify, develop, and implement supports based on the function, or purpose, of…
The JINR Tier1 Site Simulation for Research and Development Purposes

NASA Astrophysics Data System (ADS)

Korenkov, V.; Nechaevskiy, A.; Ososkov, G.; Pryahina, D.; Trofimov, V.; Uzhinskiy, A.; Voytishin, N.

2016-02-01

Distributed complex computing systems for data storage and processing are in common use in the majority of modern scientific centers. The design of such systems is usually based on recommendations obtained via a preliminary simulated model used and executed only once. However big experiments last for years and decades, and the development of their computing system is going on, not only quantitatively but also qualitatively. Even with the substantial efforts invested in the design phase to understand the systems configuration, it would be hard enough to develop a system without additional research of its future evolution. The developers and operators face the problem of the system behaviour predicting after the planned modifications. A system for grid and cloud services simulation is developed at LIT (JINR, Dubna). This simulation system is focused on improving the effciency of the grid/cloud structures development by using the work quality indicators of some real system. The development of such kind of software is very important for making a new grid/cloud infrastructure for such big scientific experiments like the JINR Tier1 site for WLCG. The simulation of some processes of the Tier1 site is considered as an example of our application approach.
50 CFR 86.53 - What are funding tiers?

Code of Federal Regulations, 2013 CFR

2013-10-01

... 50 Wildlife and Fisheries 9 2013-10-01 2013-10-01 false What are funding tiers? 86.53 Section 86... (BIG) PROGRAM How States Apply for Grants § 86.53 What are funding tiers? (a) This grant program will consist of two tiers of funding. (i) You may apply for one or both tiers. (ii) The two tiers will allow...
Strain-Specific V3 and CD4 Binding Site Autologous HIV-1 Neutralizing Antibodies Select Neutralization-Resistant Viruses.

PubMed

Moody, M Anthony; Gao, Feng; Gurley, Thaddeus C; Amos, Joshua D; Kumar, Amit; Hora, Bhavna; Marshall, Dawn J; Whitesides, John F; Xia, Shi-Mao; Parks, Robert; Lloyd, Krissey E; Hwang, Kwan-Ki; Lu, Xiaozhi; Bonsignori, Mattia; Finzi, Andrés; Vandergrift, Nathan A; Alam, S Munir; Ferrari, Guido; Shen, Xiaoying; Tomaras, Georgia D; Kamanga, Gift; Cohen, Myron S; Sam, Noel E; Kapiga, Saidi; Gray, Elin S; Tumba, Nancy L; Morris, Lynn; Zolla-Pazner, Susan; Gorny, Miroslaw K; Mascola, John R; Hahn, Beatrice H; Shaw, George M; Sodroski, Joseph G; Liao, Hua-Xin; Montefiori, David C; Hraber, Peter T; Korber, Bette T; Haynes, Barton F

2015-09-09

The third variable (V3) loop and the CD4 binding site (CD4bs) of the HIV-1 envelope are frequently targeted by neutralizing antibodies (nAbs) in infected individuals. In chronic infection, HIV-1 escape mutants repopulate the plasma, and V3 and CD4bs nAbs emerge that can neutralize heterologous tier 1 easy-to-neutralize but not tier 2 difficult-to-neutralize HIV-1 isolates. However, neutralization sensitivity of autologous plasma viruses to this type of nAb response has not been studied. We describe the development and evolution in vivo of antibodies distinguished by their target specificity for V3 and CD4bs epitopes on autologous tier 2 viruses but not on heterologous tier 2 viruses. A surprisingly high fraction of autologous circulating viruses was sensitive to these antibodies. These findings demonstrate a role for V3 and CD4bs antibodies in constraining the native envelope trimer in vivo to a neutralization-resistant phenotype, explaining why HIV-1 transmission generally occurs by tier 2 neutralization-resistant viruses. Copyright © 2015 Elsevier Inc. All rights reserved.
Web mapping system for complex processing and visualization of environmental geospatial datasets

NASA Astrophysics Data System (ADS)

Titov, Alexander; Gordov, Evgeny; Okladnikov, Igor

2016-04-01

Environmental geospatial datasets (meteorological observations, modeling and reanalysis results, etc.) are used in numerous research applications. Due to a number of objective reasons such as inherent heterogeneity of environmental datasets, big dataset volume, complexity of data models used, syntactic and semantic differences that complicate creation and use of unified terminology, the development of environmental geodata access, processing and visualization services as well as client applications turns out to be quite a sophisticated task. According to general INSPIRE requirements to data visualization geoportal web applications have to provide such standard functionality as data overview, image navigation, scrolling, scaling and graphical overlay, displaying map legends and corresponding metadata information. It should be noted that modern web mapping systems as integrated geoportal applications are developed based on the SOA and might be considered as complexes of interconnected software tools for working with geospatial data. In the report a complex web mapping system including GIS web client and corresponding OGC services for working with geospatial (NetCDF, PostGIS) dataset archive is presented. There are three basic tiers of the GIS web client in it: 1. Tier of geospatial metadata retrieved from central MySQL repository and represented in JSON format 2. Tier of JavaScript objects implementing methods handling: --- NetCDF metadata --- Task XML object for configuring user calculations, input and output formats --- OGC WMS/WFS cartographical services 3. Graphical user interface (GUI) tier representing JavaScript objects realizing web application business logic Metadata tier consists of a number of JSON objects containing technical information describing geospatial datasets (such as spatio-temporal resolution, meteorological parameters, valid processing methods, etc). The middleware tier of JavaScript objects implementing methods for handling geospatial metadata, task XML object, and WMS/WFS cartographical services interconnects metadata and GUI tiers. The methods include such procedures as JSON metadata downloading and update, launching and tracking of the calculation task running on the remote servers as well as working with WMS/WFS cartographical services including: obtaining the list of available layers, visualizing layers on the map, exporting layers in graphical (PNG, JPG, GeoTIFF), vector (KML, GML, Shape) and digital (NetCDF) formats. Graphical user interface tier is based on the bundle of JavaScript libraries (OpenLayers, GeoExt and ExtJS) and represents a set of software components implementing web mapping application business logic (complex menus, toolbars, wizards, event handlers, etc.). GUI provides two basic capabilities for the end user: configuring the task XML object functionality and cartographical information visualizing. The web interface developed is similar to the interface of such popular desktop GIS applications, as uDIG, QuantumGIS etc. Web mapping system developed has shown its effectiveness in the process of solving real climate change research problems and disseminating investigation results in cartographical form. The work is supported by SB RAS Basic Program Projects VIII.80.2.1 and IV.38.1.7.
Single-channel kinetics of BK (Slo1) channels

PubMed Central

Geng, Yanyan; Magleby, Karl L.

2014-01-01

Single-channel kinetics has proven a powerful tool to reveal information about the gating mechanisms that control the opening and closing of ion channels. This introductory review focuses on the gating of large conductance Ca2+- and voltage-activated K+ (BK or Slo1) channels at the single-channel level. It starts with single-channel current records and progresses to presentation and analysis of single-channel data and the development of gating mechanisms in terms of discrete state Markov (DSM) models. The DSM models are formulated in terms of the tetrameric modular structure of BK channels, consisting of a central transmembrane pore-gate domain (PGD) attached to four surrounding transmembrane voltage sensing domains (VSD) and a large intracellular cytosolic domain (CTD), also referred to as the gating ring. The modular structure and data analysis shows that the Ca2+ and voltage dependent gating considered separately can each be approximated by 10-state two-tiered models with five closed states on the upper tier and five open states on the lower tier. The modular structure and joint Ca2+ and voltage dependent gating are consistent with a 50 state two-tiered model with 25 closed states on the upper tier and 25 open states on the lower tier. Adding an additional tier of brief closed (flicker states) to the 10-state or 50-state models improved the description of the gating. For fixed experimental conditions a channel would gate in only a subset of the potential number of states. The detected number of states and the correlations between adjacent interval durations are consistent with the tiered models. The examined models can account for the single-channel kinetics and the bursting behavior of gating. Ca2+ and voltage activate BK channels by predominantly increasing the effective opening rate of the channel with a smaller decrease in the effective closing rate. Ca2+ and depolarization thus activate by mainly destabilizing the closed states. PMID:25653620
Guidance for commissioning NHS England dental conscious sedation services: a framework tool.

PubMed

Howlett, Paul

2014-01-01

Conscious sedation is an integral part of modern day dental care and should be delivered through a high quality, effective and evidence-based approach. Commissioning of NHS dental services in England is currently under review by NHS England and the National Dental Commissioning Group. This group has identified the management of vulnerable people including anxious patients, as one of its priorities. The Society for the Advancement of Anaesthesia in Dentistry (SAAD) believes this provides an opportunity to influence the commissioning of NHS conscious sedation services. With this aim in mind,"Guidance for Commissioning NHS England Dental Conscious Sedation Services: A Framework Tool" was developed. This guidance proposes a common approach to the organisation of NHS dental conscious sedation services in England, advocating the provision of Tier 1 and Tier 2 services in all regions. Its ethos is a"hub and spoke" model of service delivery with patient assessment delivered by experienced and well trained dental sedationists at its core. In line with the recent Francis Report fundamental standards for all aspects of dental conscious sedation practice are outlined, supported by a robust and predictable quality assurance process. This work has been shared with key stakeholders in NHS England including the Chief Dental Officer and the Head of Primary Care Commissioning.
Genomic sequencing in cystic fibrosis newborn screening: what works best, two-tier predefined CFTR mutation panels or second-tier CFTR panel followed by third-tier sequencing?

PubMed

Currier, Robert J; Sciortino, Stan; Liu, Ruiling; Bishop, Tracey; Alikhani Koupaei, Rasoul; Feuchtbaum, Lisa

2017-10-01

PurposeThe purpose of this study was to model the performance of several known two-tier, predefined mutation panels and three-tier algorithms for cystic fibrosis (CF) screening utilizing the ethnically diverse California population.MethodsThe cystic fibrosis transmembrane conductance regulator (CFTR) mutations identified among the 317 CF cases in California screened between 12 August 2008 and 18 December 2012 were used to compare the expected CF detection rates for several two- and three-tier screening approaches, including the current California approach, which consists of a population-specific 40-mutation panel followed by third-tier sequencing when indicated.ResultsThe data show that the strategy of using third-tier sequencing improves CF detection following an initial elevated immunoreactive trypsinogen and detection of only one mutation on a second-tier panel.ConclusionIn a diverse population, the use of a second-tier panel followed by third-tier CFTR gene sequencing provides a better detection rate for CF, compared with the use of a second-tier approach alone, and is an effective way to minimize the referrals of CF carriers for sweat testing. Restricting screening to a second-tier testing to predefined mutation panels, even broad ones, results in some missed CF cases and demonstrates the limited utility of this approach in states that have diverse multiethnic populations.
Development and implementation of the Caribbean Laboratory Quality Management Systems Stepwise Improvement Process (LQMS-SIP) Towards Accreditation.

PubMed

Alemnji, George; Edghill, Lisa; Guevara, Giselle; Wallace-Sankarsingh, Sacha; Albalak, Rachel; Cognat, Sebastien; Nkengasong, John; Gabastou, Jean-Marc

2017-01-01

Implementing quality management systems and accrediting laboratories in the Caribbean has been a challenge. We report the development of a stepwise process for quality systems improvement in the Caribbean Region. The Caribbean Laboratory Stakeholders met under a joint Pan American Health Organization/US Centers for Disease Control and Prevention initiative and developed a user-friendly framework called 'Laboratory Quality Management System - Stepwise Improvement Process (LQMS-SIP) Towards Accreditation' to support countries in strengthening laboratory services through a stepwise approach toward fulfilling the ISO 15189: 2012 requirements. This approach consists of a three-tiered framework. Tier 1 represents the minimum requirements corresponding to the mandatory criteria for obtaining a licence from the Ministry of Health of the participating country. The next two tiers are quality improvement milestones that are achieved through the implementation of specific quality management system requirements. Laboratories that meet the requirements of the three tiers will be encouraged to apply for accreditation. The Caribbean Regional Organisation for Standards and Quality hosts the LQMS-SIP Secretariat and will work with countries, including the Ministry of Health and stakeholders, including laboratory staff, to coordinate and implement LQMS-SIP activities. The Caribbean Public Health Agency will coordinate and advocate for the LQMS-SIP implementation. This article presents the Caribbean LQMS-SIP framework and describes how it will be implemented among various countries in the region to achieve quality improvement.
The “NetBoard”: Network Monitoring Tools Integration for INFN Tier-1 Data Center

NASA Astrophysics Data System (ADS)

De Girolamo, D.; dell'Agnello and, L.; Zani, S.

2012-12-01

The monitoring and alert system is fundamental for the management and the operation of the network in a large data center such as an LHC Tier-1. The network of the INFN Tier-1 at CNAF is a multi-vendor environment: for its management and monitoring several tools have been adopted and different sensors have been developed. In this paper, after an overview on the different aspects to be monitored and the tools used for them (i.e. MRTG, Nagios, Arpwatch, NetFlow, Syslog, etc), we will describe the “NetBoard”, a monitoring toolkit developed at the INFN Tier-1. NetBoard, developed for a multi-vendor network, is able to install and auto-configure all tools needed for its monitoring, either via network devices discovery mechanism or via configuration file or via wizard. In this way, we are also able to activate different types of sensors and Nagios checks according to the equipment vendor specifications. Moreover, when a new device is connected in the LAN, NetBoard can detect where it is plugged. Finally the NetBoard web interface allows to have the overall status of the entire network “at a glance”, both the local and the geographical (including the LHCOPN and the LHCONE) link utilization, health status of network devices (with active alerts) and flow analysis.

The Impact of Income and Taxation in a Price-Tiered Cigarette Market - findings from the ITC Bangladesh Surveys.

PubMed

Huq, Iftekharul; Nargis, Nigar; Lkhagvasuren, Damba; Hussain, Akm Ghulam; Fong, Geoffrey T

2018-04-25

Taxing tobacco is among the most effective measures of tobacco control. However, in a tiered market structure where multiple tiers of taxes coexist, the anticipated impact of tobacco taxes on consumption is complex. This paper investigates changing smoking behaviour in lieu of changing prices and changing income. The objective of the paper is to evaluate the effectiveness of change in prices (through taxes) and change in income in a price-tiered cigarette market. A panel dataset from the International Tobacco Control Bangladesh surveys is used for analysis. For preliminary analysis transition matrices are developed. Next, probit and multinomial logit regression models are used to identify the effects of changes in prices and changes in income along with other control variables. Transition matrices show significant movement of smokers across price tiers from one wave to another. Regression results show that higher income raises the probability to up-trade and decreases the probability to down-trade. Results also show that higher prices raises the probability to up-trade and reduces the probability to down-trade. Although not significant, there exists a negative relationship between the probability to down-trade and the probability to intend to quit. It is evident from the results that a price-tiered market provides smokers more opportunities to accommodate their smoking behaviour when faced with price and income change. Therefore, tiered structure of the tax system should be replaced with uniform taxes. Moreover, overall cigarette taxes need to be raised to an extent so that it off-sets any positive effects of income growth. © 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.
2-tiered antibody testing for early and late Lyme disease using only an immunoglobulin G blot with the addition of a VlsE band as the second-tier test.

PubMed

Branda, John A; Aguero-Rosenfeld, Maria E; Ferraro, Mary Jane; Johnson, Barbara J B; Wormser, Gary P; Steere, Allen C

2010-01-01

Standard 2-tiered immunoglobulin G (IgG) testing has performed well in late Lyme disease (LD), but IgM testing early in the illness has been problematic. IgG VlsE antibody testing, by itself, improves early sensitivity, but may lower specificity. We studied whether elements of the 2 approaches could be combined to produce a second-tier IgG blot that performs well throughout the infection. Separate serum sets from LD patients and control subjects were tested independently at 2 medical centers using whole-cell enzyme immunoassays and IgM and IgG immunoblots, with recombinant VlsE added to the IgG blots. The results from both centers were combined, and a new second-tier IgG algorithm was developed. With standard 2-tiered IgM and IgG testing, 31% of patients with active erythema migrans (stage 1), 63% of those with acute neuroborreliosis or carditis (stage 2), and 100% of those with arthritis or late neurologic involvement (stage 3) had positive results. Using new IgG criteria, in which only the VlsE band was scored as a second-tier test among patients with early LD (stage 1 or 2) and 5 of 11 IgG bands were required in those with stage 3 LD, 34% of patients with stage 1, 96% of those with stage 2, and 100% of those with stage 3 infection had positive responses. Both new and standard testing achieved 100% specificity. Compared with standard IgM and IgG testing, the new IgG algorithm (with VlsE band) eliminates the need for IgM testing; it provides comparable or better sensitivity, and it maintains high specificity.
A win-win solution?: A critical analysis of tiered pricing to improve access to medicines in developing countries.

PubMed

Moon, Suerie; Jambert, Elodie; Childs, Michelle; von Schoen-Angerer, Tido

2011-10-12

Tiered pricing - the concept of selling drugs and vaccines in developing countries at prices systematically lower than in industrialized countries - has received widespread support from industry, policymakers, civil society, and academics as a way to improve access to medicines for the poor. We carried out case studies based on a review of international drug price developments for antiretrovirals, artemisinin combination therapies, drug-resistant tuberculosis medicines, liposomal amphotericin B (for visceral leishmaniasis), and pneumococcal vaccines. We found several critical shortcomings to tiered pricing: it is inferior to competition for achieving the lowest sustainable prices; it often involves arbitrary divisions between markets and/or countries, which can lead to very high prices for middle-income markets; and it leaves a disproportionate amount of decision-making power in the hands of sellers vis-à-vis consumers. In many developing countries, resources are often stretched so tight that affordability can only be approached by selling medicines at or near the cost of production. Policies that "de-link" the financing of R&D from the price of medicines merit further attention, since they can reward innovation while exploiting robust competition in production to generate the lowest sustainable prices. However, in special cases - such as when market volumes are very small or multi-source production capacity is lacking - tiered pricing may offer the only practical option to meet short-term needs for access to a product. In such cases, steps should be taken to ensure affordability and availability in the longer-term. To ensure access to medicines for populations in need, alternate strategies should be explored that harness the power of competition, avoid arbitrary market segmentation, and/or recognize government responsibilities. Competition should generally be the default option for achieving affordability, as it has proven superior to tiered pricing for reliably achieving the lowest sustainable prices.
A win-win solution?: A critical analysis of tiered pricing to improve access to medicines in developing countries

PubMed Central

2011-01-01

Background Tiered pricing - the concept of selling drugs and vaccines in developing countries at prices systematically lower than in industrialized countries - has received widespread support from industry, policymakers, civil society, and academics as a way to improve access to medicines for the poor. We carried out case studies based on a review of international drug price developments for antiretrovirals, artemisinin combination therapies, drug-resistant tuberculosis medicines, liposomal amphotericin B (for visceral leishmaniasis), and pneumococcal vaccines. Discussion We found several critical shortcomings to tiered pricing: it is inferior to competition for achieving the lowest sustainable prices; it often involves arbitrary divisions between markets and/or countries, which can lead to very high prices for middle-income markets; and it leaves a disproportionate amount of decision-making power in the hands of sellers vis-à-vis consumers. In many developing countries, resources are often stretched so tight that affordability can only be approached by selling medicines at or near the cost of production. Policies that "de-link" the financing of R&D from the price of medicines merit further attention, since they can reward innovation while exploiting robust competition in production to generate the lowest sustainable prices. However, in special cases - such as when market volumes are very small or multi-source production capacity is lacking - tiered pricing may offer the only practical option to meet short-term needs for access to a product. In such cases, steps should be taken to ensure affordability and availability in the longer-term. Summary To ensure access to medicines for populations in need, alternate strategies should be explored that harness the power of competition, avoid arbitrary market segmentation, and/or recognize government responsibilities. Competition should generally be the default option for achieving affordability, as it has proven superior to tiered pricing for reliably achieving the lowest sustainable prices. PMID:21992405
The Cambridge Prognostic Groups for improved prediction of disease mortality at diagnosis in primary non-metastatic prostate cancer: a validation study.

PubMed

Gnanapragasam, V J; Bratt, O; Muir, K; Lee, L S; Huang, H H; Stattin, P; Lophatananon, A

2018-02-28

The purpose of this study is to validate a new five-tiered prognostic classification system to better discriminate cancer-specific mortality in men diagnosed with primary non-metastatic prostate cancer. We applied a recently described five-strata model, the Cambridge Prognostic Groups (CPGs 1-5), in two international cohorts and tested prognostic performance against the current standard three-strata classification of low-, intermediate- or high-risk disease. Diagnostic clinico-pathological data for men obtained from the Prostate Cancer data Base Sweden (PCBaSe) and the Singapore Health Study were used. The main outcome measure was prostate cancer mortality (PCM) stratified by age group and treatment modality. The PCBaSe cohort included 72,337 men, of whom 7162 died of prostate cancer. The CPG model successfully classified men with different risks of PCM with competing risk regression confirming significant intergroup distinction (p < 0.0001). The CPGs were significantly better at stratified prediction of PCM compared to the current three-tiered system (concordance index (C-index) 0.81 vs. 0.77, p < 0.0001). This superiority was maintained for every age group division (p < 0.0001). Also in the ethnically different Singapore cohort of 2550 men with 142 prostate cancer deaths, the CPG model outperformed the three strata categories (C-index 0.79 vs. 0.76, p < 0.0001). The model also retained superior prognostic discrimination in the treatment sub-groups: radical prostatectomy (n = 20,586), C-index 0.77 vs. 074; radiotherapy (n = 11,872), C-index 0.73 vs. 0.69; and conservative management (n = 14,950), C-index 0.74 vs. 0.73. The CPG groups that sub-divided the old intermediate-risk (CPG2 vs. CPG3) and high-risk categories (CPG4 vs. CPG5) significantly discriminated PCM outcomes after radical therapy or conservative management (p < 0.0001). This validation study of nearly 75,000 men confirms that the CPG five-tiered prognostic model has superior discrimination compared to the three-tiered model in predicting prostate cancer death across different age and treatment groups. Crucially, it identifies distinct sub-groups of men within the old intermediate-risk and high-risk criteria who have very different prognostic outcomes. We therefore propose adoption of the CPG model as a simple-to-use but more accurate prognostic stratification tool to help guide management for men with newly diagnosed prostate cancer.
Tier 2 Intervention for At-Risk First-Grade Students within a Response-to-Intervention Model of Support

ERIC Educational Resources Information Center

Bryant, Diane Pedrotty

2014-01-01

Clarke et al. (2014) provide a persuasive case for the role of a theory-of-change model to guide the nature of curriculum development work embodying both a theoretical and empirical knowledge foundation. They illuminate the components of their model, which were used to design and test the efficacy of a Tier 2 intervention for students who met…
An Analysis of 16-17-Year-Old Students' Understanding of Solution Chemistry Concepts Using a Two-Tier Diagnostic Instrument

ERIC Educational Resources Information Center

Adadan, Emine; Savasci, Funda

2012-01-01

This study focused on the development of a two-tier multiple-choice diagnostic instrument, which was designed and then progressively modified, and implemented to assess students' understanding of solution chemistry concepts. The results of the study are derived from the responses of 756 Grade 11 students (age 16-17) from 14 different high schools…
The Evaluation of a Three-Tier Model of Positive Behavior Interventions and Supports for Preschoolers in Head Start

ERIC Educational Resources Information Center

Stanton-Chapman, Tina L.; Walker, Virginia L.; Voorhees, Mary D.; Snell, Martha E.

2016-01-01

The purpose of this study was to evaluate the overall effectiveness of a three-tier model of positive behavior interventions and supports (PBIS), which was developed and tested in Head Start (HS) programs. Ten HS classrooms from five HS programs participated in the current study. Results indicated that PBIS was effective in improving classroom…
Using a Multi-Tier Diagnostic Test to Explore the Nature of Students' Alternative Conceptions on Reaction Kinetics

ERIC Educational Resources Information Center

Yan, Yaw Kai; Subramaniam, R.

2018-01-01

This study focused on grade 12 students' understanding of reaction kinetics. A 4-tier diagnostic instrument was developed for this purpose and administered to 137 students in the main study. Findings showed that reaction kinetics is a difficult topic for these students, with a total of 25 alternative conceptions (ACs) being uncovered. Except for…
A specialist, second-tier response to out-of-hospital cardiac arrest: setting up TOPCAT2.

PubMed

Clarke, Scott; Lyon, Richard M; Short, Steven; Crookston, Colin; Clegg, Gareth R

2014-05-01

Out-of-hospital cardiac arrest (OHCA) is the most common, immediately life-threatening, medical emergency faced by ambulance crews. Survival from OHCA is largely dependent on quality of prehospital resuscitation. Non-technical skills, including resuscitation team leadership, communication and clinical decision-making are important in providing high quality prehospital resuscitation. We describe a pilot study (TOPCAT2, TC2) to establish a second tier, expert paramedic response to OHCA in Edinburgh, Scotland. Eight paramedics were selected to undergo advanced training in resuscitation and non-technical skills. Simulation and video feedback was used during training. The designated TC2 paramedic manned a regular ambulance service response car and attended emergency calls in the usual manner. Emergency medical dispatch centre dispatchers were instructed to call the TC2 paramedic directly on receipt of a possible OHCA call. Call and dispatch timings, quality of cardiopulmonary resuscitation and return-of-spontaneous circulation were all measured prospectively. Establishing a specialist, second-tier paramedic response was feasible. There was no overall impact on ambulance response times. From the first 40 activations, the TC2 paramedic was activated in a median of 3.2 min (IQR 1.6-5.8) and on-scene in a median of 10.8 min (8.0-17.9). Bimonthly team debrief, case review and training sessions were successfully established. OHCA attended by TC2 showed an additional trend towards improved outcome with a rate of return of spontaneous circulation of 22.5%, compared with a national average of 16%. Establishing a specialist, second-tier response to OHCA is feasible, without impacting on overall ambulance response times. Improving non-technical skills, including prehospital resuscitation team leadership, has the potential to save lives and further research on the impact of the TOPCAT2 pilot programme is warranted. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Vaccine-Elicited Tier 2 HIV-1 Neutralizing Antibodies Bind to Quaternary Epitopes Involving Glycan-Deficient Patches Proximal to the CD4 Binding Site

PubMed Central

Crooks, Ema T.; Tong, Tommy; Chakrabarti, Bimal; Narayan, Kristin; Georgiev, Ivelin S.; Menis, Sergey; Huang, Xiaoxing; Kulp, Daniel; Osawa, Keiko; Muranaka, Janelle; Stewart-Jones, Guillaume; Destefano, Joanne; O’Dell, Sijy; LaBranche, Celia; Robinson, James E.; Montefiori, David C.; McKee, Krisha; Du, Sean X.; Doria-Rose, Nicole; Kwong, Peter D.; Mascola, John R.; Zhu, Ping; Schief, William R.; Wyatt, Richard T.; Whalen, Robert G.; Binley, James M.

2015-01-01

Eliciting broad tier 2 neutralizing antibodies (nAbs) is a major goal of HIV-1 vaccine research. Here we investigated the ability of native, membrane-expressed JR-FL Env trimers to elicit nAbs. Unusually potent nAb titers developed in 2 of 8 rabbits immunized with virus-like particles (VLPs) expressing trimers (trimer VLP sera) and in 1 of 20 rabbits immunized with DNA expressing native Env trimer, followed by a protein boost (DNA trimer sera). All 3 sera neutralized via quaternary epitopes and exploited natural gaps in the glycan defenses of the second conserved region of JR-FL gp120. Specifically, trimer VLP sera took advantage of the unusual absence of a glycan at residue 197 (present in 98.7% of Envs). Intriguingly, removing the N197 glycan (with no loss of tier 2 phenotype) rendered 50% or 16.7% (n = 18) of clade B tier 2 isolates sensitive to the two trimer VLP sera, showing broad neutralization via the surface masked by the N197 glycan. Neutralizing sera targeted epitopes that overlap with the CD4 binding site, consistent with the role of the N197 glycan in a putative “glycan fence” that limits access to this region. A bioinformatics analysis suggested shared features of one of the trimer VLP sera and monoclonal antibody PG9, consistent with its trimer-dependency. The neutralizing DNA trimer serum took advantage of the absence of a glycan at residue 230, also proximal to the CD4 binding site and suggesting an epitope similar to that of monoclonal antibody 8ANC195, albeit lacking tier 2 breadth. Taken together, our data show for the first time that strain-specific holes in the glycan fence can allow the development of tier 2 neutralizing antibodies to native spikes. Moreover, cross-neutralization can occur in the absence of protecting glycan. Overall, our observations provide new insights that may inform the future development of a neutralizing antibody vaccine. PMID:26023780
Vaccine-Elicited Tier 2 HIV-1 Neutralizing Antibodies Bind to Quaternary Epitopes Involving Glycan-Deficient Patches Proximal to the CD4 Binding Site.

PubMed

Crooks, Ema T; Tong, Tommy; Chakrabarti, Bimal; Narayan, Kristin; Georgiev, Ivelin S; Menis, Sergey; Huang, Xiaoxing; Kulp, Daniel; Osawa, Keiko; Muranaka, Janelle; Stewart-Jones, Guillaume; Destefano, Joanne; O'Dell, Sijy; LaBranche, Celia; Robinson, James E; Montefiori, David C; McKee, Krisha; Du, Sean X; Doria-Rose, Nicole; Kwong, Peter D; Mascola, John R; Zhu, Ping; Schief, William R; Wyatt, Richard T; Whalen, Robert G; Binley, James M

2015-05-01

Eliciting broad tier 2 neutralizing antibodies (nAbs) is a major goal of HIV-1 vaccine research. Here we investigated the ability of native, membrane-expressed JR-FL Env trimers to elicit nAbs. Unusually potent nAb titers developed in 2 of 8 rabbits immunized with virus-like particles (VLPs) expressing trimers (trimer VLP sera) and in 1 of 20 rabbits immunized with DNA expressing native Env trimer, followed by a protein boost (DNA trimer sera). All 3 sera neutralized via quaternary epitopes and exploited natural gaps in the glycan defenses of the second conserved region of JR-FL gp120. Specifically, trimer VLP sera took advantage of the unusual absence of a glycan at residue 197 (present in 98.7% of Envs). Intriguingly, removing the N197 glycan (with no loss of tier 2 phenotype) rendered 50% or 16.7% (n = 18) of clade B tier 2 isolates sensitive to the two trimer VLP sera, showing broad neutralization via the surface masked by the N197 glycan. Neutralizing sera targeted epitopes that overlap with the CD4 binding site, consistent with the role of the N197 glycan in a putative "glycan fence" that limits access to this region. A bioinformatics analysis suggested shared features of one of the trimer VLP sera and monoclonal antibody PG9, consistent with its trimer-dependency. The neutralizing DNA trimer serum took advantage of the absence of a glycan at residue 230, also proximal to the CD4 binding site and suggesting an epitope similar to that of monoclonal antibody 8ANC195, albeit lacking tier 2 breadth. Taken together, our data show for the first time that strain-specific holes in the glycan fence can allow the development of tier 2 neutralizing antibodies to native spikes. Moreover, cross-neutralization can occur in the absence of protecting glycan. Overall, our observations provide new insights that may inform the future development of a neutralizing antibody vaccine.
Planetary Science Educational Materials for Out-of-School Time Educators

NASA Astrophysics Data System (ADS)

Barlow, Nadine G.; Clark, Joelle G.

2017-10-01

Planetary Learning that Advances the Nexus of Engineering, Technology, and Science (PLANETS) is a five-year NASA-funded (NNX16AC53A) interdisciplinary and cross-institutional partnership to develop and disseminate STEM out-of-school time (OST) curricular and professional development units that integrate planetary science, technology, and engineering. The Center for Science Teaching and Learning (CSTL) and Department of Physics and Astronomy (P&A) at Northern Arizona University, the U.S. Geological Survey Astrogeology Science Center (USGS ASC), and the Museum of Science Boston (MoS) are partners in developing, piloting, and researching the impact of three out-of-school time units. Planetary scientists at USGS ASC and P&A have developed two units for middle grades youth and one for upper elementary aged youth. The two middle school units focus on greywater recycling and remote sensing of planetary surfaces while the elementary unit centers on exploring space hazards. All units are designed for small teams of ~4 youth to work together to investigate materials, engineer tools to assist in the explorations, and utilize what they have learned to solve a problem. Youth participate in a final share-out with adults and other youth of what they learned and their solution to the problem. Curriculum pilot testing of the two middle school units has begun with out-of-school time educators. A needs assessment has been conducted nationwide among educators and evaluation of the curriculum units is being conducted by CSTL during the pilot testing. Based on data analysis, the project is developing and testing four tiers of professional support for OST educators. Tier 1 meets the immediate needs of OST educators to teach curriculum and include how-to videos and other direct support materials. Tier 2 provides additional content and pedagogical knowledge and includes short content videos designed to specifically address the content of the curriculum. Tier 3 elaborates on best practices in education and gives guidance on methods, for example, to develop cultural relevancy for underrepresented students. Tier 4 helps make connections to other NASA or educational products that support STEM learning in out of school settings.
An Examination of Multi-Tier Designs for Legacy Data Access

DTIC Science & Technology

1997-12-01

heterogeneous relational database management systems. The first test system incorporates a two-tier architecture design using Java, and the second system...employs a three-tier architecture design using Java and CORBA. Data on replication times for the two-tier and three-tier designs are presented
Nitrogen oxide emission calculation for post-Panamax container ships by using engine operation power probability as weighting factor: A slow-steaming case.

PubMed

Cheng, Chih-Wen; Hua, Jian; Hwang, Daw-Shang

2018-06-01

In this study, the nitrogen oxide (NO x ) emission factors and total NO x emissions of two groups of post-Panamax container ships operating on a long-term slow-steaming basis along Euro-Asian routes were calculated using both the probability density function of engine power levels and the NO x emission function. The main engines of the five sister ships in Group I satisfied the Tier I emission limit stipulated in MARPOL (International Convention for the Prevention of Pollution from Ships) Annex VI, and those in Group II satisfied the Tier II limit. The calculated NO x emission factors of the Group I and Group II ships were 14.73 and 17.85 g/kWhr, respectively. The total NO x emissions of the Group II ships were determined to be 4.4% greater than those of the Group I ships. When the Tier II certification value was used to calculate the average total NO x emissions of Group II engines, the result was lower than the actual value by 21.9%. Although fuel consumption and carbon dioxide (CO 2 ) emissions were increased by 1.76% because of slow steaming, the NO x emissions were markedly reduced by 17.2%. The proposed method is more effective and accurate than the NO x Technical Code 2008. Furthermore, it can be more appropriately applied to determine the NO x emissions of international shipping inventory. The usage of operating power probability density function of diesel engines as the weighting factor and the NO x emission function obtained from test bed for calculating NO x emissions is more accurate and practical. The proposed method is suitable for all types and purposes of diesel engines, irrespective of their operating power level. The method can be used to effectively determine the NO x emissions of international shipping and inventory applications and should be considered in determining the carbon tax to be imposed in the future.
78 FR 38074 - Announcement Regarding a Change in Eligibility for Unemployment Insurance (UI) Claimants in...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-25

...Announcement regarding a change in eligibility for Unemployment Insurance (UI) claimants in Alabama, Alaska, Delaware, Illinois, Louisiana, Michigan, Mississippi, Ohio, the Virgin Islands and Wisconsin in the Emergency Unemployment Compensation (EUC08) program, and the Federal-State Extended Benefits (EB) program. The U.S. Department of Labor (Department) produces trigger notices indicating which states qualify for both EB and EUC08 benefits, and provides the beginning and ending dates of payable periods for each qualifying state. The trigger notices covering state eligibility for these programs can be found at: http://ows.doleta.gov/unemploy/claims-- arch.asp. The following changes have occurred since the publication of the last notice regarding states EUC08 and EB trigger status: Alabama's trigger value had fallen below the 7.0% threshold and has triggered ``off'' Tier 3 of EUC08. Based on data released by the Bureau of Labor Statistics on March 18, 2013, the three month average, seasonally adjusted total unemployment rate (TUR) in Alabama was 6.9%, falling below the 7.0% trigger threshold necessary to remain ``on'' Tier 3 of EUC08. The week ending April 13, 2013, was the last week in which EUC08 claimants in Alabama could exhaust Tier 2 and establish Tier 3 eligibility. Under the phase-out provisions, claimants could receive any remaining entitlement they had for Tier 3 after April 13, 2013. Alaska's insured unemployment rate (IUR) has fallen below the 6.0% trigger threshold and has triggered ``off'' of EB. Based on data from Alaska for the week ending April 13, 2013, the 13 week IUR in Alaska fell below the 6.0% trigger threshold necessary to remain ``on'' EB. The payable period in EB for Alaska ended May 4, 2013. Alaska's IUR has fallen below the 6.0% trigger threshold and has triggered ``off'' Tier 4 of EUC08. Based on data from Alaska for the week ending April 13, 2013, the 13 week IUR in Alaska fell below the 6.0% trigger rate threshold to remain ``on'' Tier 4 of EUC08. The week ending May 4, 2013, was the last week in which EUC08 claimants in Alaska could exhaust Tier 3, and establish Tier 4 eligibility. Under the phase-out provisions, claimants could receive any remaining entitlement they had for Tier 4 after May 4, 2013. Delaware's trigger value exceeds the 7.0% trigger threshold and has triggered ``on'' Tier 3 of EUC08. Based on data released by the Bureau of Labor Statistics on March 18, 2013, the three month average, seasonally adjusted TUR in Delaware was 7.1%, exceeding the 7.0% threshold necessary to trigger ``on'' Tier 3 of EUC08. The week beginning April 7, 2013, was the first week in which EUC08 claimants in Delaware who had exhausted Tier 2, and are otherwise eligible, could establish Tier 3 eligibility. Illinois' trigger value met the 9.0% trigger threshold and has triggered ``on'' Tier 4 of EUC08. Based on data released by the Bureau of Labor Statistics on March 29, 2013, the three month average, seasonally adjusted TUR in Illinois met the 9.0% trigger threshold to trigger ``on'' Tier 4 of EUC08. The week beginning April 14, 2013, was the first week in which EUC08 claimants in Illinois who had exhausted Tier 3, and were otherwise eligible, could establish Tier 4 eligibility. Louisiana's trigger value has fallen below the 6.0% trigger threshold and has triggered ``off'' Tier 2 of EUC08. Based on data released by the Bureau of Labor Statistics on March 18, 2013, the three month average, seasonally adjusted TUR in Louisiana was 5.8%, falling below the 6.0% trigger threshold to remain ``on'' Tier 2 of EUC08. The week ending April 13, 2013, was the last week in which EUC08 claimants in Louisiana could exhaust Tier 1, and establish Tier 2 eligibility. Under the phase-out provisions, claimants could receive any remaining entitlement they had in Tier 2 after April 13, 2013. Michigan's trigger value has fallen below the 9.0% trigger threshold and has triggered ``off'' Tier 4 of EUC08. Based on data released by the Bureau of Labor Statistics on March 18, 2013, the three month average, seasonally adjusted TUR for Michigan was 8.9%, falling below the 9.0% trigger threshold to remain ``on'' Tier 4 of EUC08. The week ending April 13, 2013, was the last week in which EUC08 claimants in Michigan could exhaust Tier 3, and establish Tier 4 eligibility. Under the phase-out provisions, claimants could receive any remaining entitlement they had in Tier 4 after April 13, 2013. Mississippi's trigger value exceeds the 9.0% trigger threshold and has triggered ``on'' Tier 4 of EUC08. Based on data released by the Bureau of Labor Statistics on March 29, 2013, the three month average, seasonally adjusted TUR in Mississippi was 9.3%, exceeding the 9.0% trigger threshold to trigger ``on'' Tier 4 of EUC08. The week beginning April 14, 2013, was the first week in which EUC08 claimants in Mississippi who had exhausted Tier 3, and are otherwise eligible, could establish Tier 4 eligibility. Ohio's trigger value met the 7.0% trigger threshold and has triggered ``on'' Tier 3 of EUC08. Based on data released by the Bureau of Labor Statistics on April 19, 2013, the three month average, seasonally adjusted total unemployment rate in Ohio had met 7.0% trigger threshold to trigger ``on'' in Tier 3 of EUC08. The week beginning May 5, 2013, was the first week in which EUC08 claimants in Ohio who had exhausted Tier 2, and were otherwise eligible, could establish Tier 3 eligibility. The Virgin Islands' estimated trigger rate fell below the 6.0% threshold and has triggered ``off'' both Tier 2 and Tier 3 of EUC08. Based on data released by the Bureau of Labor Statistics on March 8, 2013, the estimated three month average, seasonally adjusted TUR in the Virgin Islands fell below the 6.0% trigger threshold rate to remain ``on'' both Tier 2 and Tier 3 of EUC08. That triggered the Virgin Islands off both Tier 2 and Tier 3 of EUC08. The week ending March, 30 2013, was the last week in which EUC08 claimants in the Virgin Islands could exhaust Tier 1 and establish Tier 2 eligibility, or exhaust Tier 2 and establish Tier 3 eligibility. Wisconsin's trigger value met the 7.0% threshold and has triggered ``on'' Tier 3 of EUC08, however mandatory 13 week ``off'' period delayed effective date. Based on data released by the Bureau of Labor Statistics on April 19, 2013, the three month average, seasonally adjusted TUR for Wisconsin has met the 7.0% trigger rate threshold to trigger ``on'' Tier 3 of EUC08. However, Wisconsin was in a 13 week mandatory ``off'' period that started February 9, 2013, and did not conclude until May 11, 2013. As a result, Wisconsin remained in an ``off'' period for Tier 3 of EUC08 through May 11, 2013, and triggered ``on'' Tier 3 of EUC08 effective May 12, 2013. The week beginning May 12, 2013, was the first week in which EUC08 claimants in Wisconsin who have exhausted Tier 2, and are otherwise eligible, can establish Tier 3 eligibility.
Use of Self-Management with the CW-FIT Group Contingency Program

ERIC Educational Resources Information Center

Kamps, Debra; Conklin, Carl; Wills, Howard

2015-01-01

The purpose of the study was to determine the effects of self-management as a tier two enhancement to the group contingency intervention, Class-Wide Function-related Intervention Teams Program (CW-FIT). Two classrooms, first and fourth grade, and two students in each of the classrooms participated in the intervention. The group contingency…
Effectiveness of a citywide patient immunization navigator program on improving adolescent immunizations and preventive care visit rates.

PubMed

Szilagyi, Peter G; Humiston, Sharon G; Gallivan, Sarah; Albertin, Christina; Sandler, Martha; Blumkin, Aaron

2011-06-01

To assess the impact of a tiered patient immunization navigator intervention (immunization tracking, reminder/recall, and outreach) on improving immunization and preventive care visit rates in urban adolescents. Randomized clinical trial allocating adolescents (aged 11-15 years) to intervention vs standard of care control. Eight primary care practices. Population-based sample of adolescents (N = 7546). Immunization navigators at each practice implemented a tiered protocol: immunization tracking, telephone or mail reminder/recall, and home visits if participants remained unimmunized or behind on preventive care visits. Immunization rates at study end. Secondary outcomes were preventive care visit rates during the previous 12 months and costs. The intervention and control groups were similar at baseline for demographics (mean age, 13.5 years; 63% black, 14% white, and 23% Hispanic adolescents; and 74% receiving Medicaid), immunization rates, and preventive care visit rates. Immunization rates at the end of the study were 44.7% for the intervention group and 32.4% for the control group (adjusted risk ratio, 1.4; 95% confidence interval, 1.3-1.5); preventive care visit rates were 68.0% for the intervention group and 55.2% for the control group (1.2; 1.2-1.3). Findings were similar across practices, sexes, ages, and insurance providers. The number needed to treat for immunizations and preventive care visits was 9. The intervention cost was $3.81 per adolescent per month; the cost per additional adolescent fully vaccinated was $465, and the cost per additional adolescent receiving a preventive care visit was $417. A tiered tracking, reminder/recall, and outreach intervention improved immunization and preventive care visit rates in urban adolescents. clinicaltrials.gov Identifier: NCT00581347.
Identifying the ‘Vulnerables’ in Biomedical Research: the vox populis from the Tuskegee Legacy Project

PubMed Central

Wiley, John

2011-01-01

Objectives This report presents, for the first time, findings on the vox populis as to who constitutes the ‘vulnerables in biomedical research’. Methods The 3-City Tuskegee Legacy Project (TLP) study used the TLP Questionnaire as administered via RDD telephone interviews to 1,162 adult Blacks, non-Hispanic Whites, and two Puerto Rican (PR) Hispanic groups: Mainland U.S. and San Juan (SJ) in 3 cities. The classification schema was based upon respondents’ answers to an open-ended question asking which groups of people were the most vulnerable when participating in biomedical research. Results Subjects provided 749 valid open-ended responses which were grouped into 29 direct response categories, leading to a 4 tier classification schema for vulnerability traits. Tier 1, the summary tier, had five vulnerability categories: 1) Race/ethnicity; 2) Age; 3) SES; 4) Health; and, 5) Gender. Blacks and Mainland U.S. PR Hispanics most frequently identified Race/Ethnicity as a vulnerability trait (42.1% of Blacks and 42.6% of Mainland U.S. PR Hispanics vs. 15.4% of Whites and 16.7% of San Juan R Hispanics) (p<.007), while Whites and SJ PR Hispanics most frequently identified Age (48.3% and 29.2%) as a vulnerability trait. Conclusions The response patterns on ‘who was vulnerable’ were similar for the two minority groups (Blacks and Mainland U.S. PR Hispanics), and notably different from the response patterns of the two majority groups (Whites and SJPR Hispanics). Further, the vox populis definition of vulnerables differed from the current official definitions as used by the U.S. federal government. PMID:21972462
Identifying the "vulnerables" in biomedical research: the vox populis from the Tuskegee Legacy Project.

PubMed

Chiu, Christopher T; Katz, Ralph V

2011-01-01

This report presents, for the first time, findings on the vox populis as to who constitutes the "vulnerables in biomedical research" The 3-City Tuskegee Legacy Project (TLP) study used the TLP questionnaire as administered via random-digit-dial telephone interviews to 1162 adult Black people, non-Hispanic White people, and two Puerto Rican (PR) Hispanic groups: Mainland United States and San Juan (SJ) in three cities. The classification schema was based upon respondents' answers to an open-ended question asking which groups of people were the most vulnerable when participating in biomedical research. Subjects provided 749 valid open-ended responses, which were grouped into 29 direct response categories, leading to a four-tier classification schema for vulnerability traits. Tier 1, the summary tier, had five vulnerability categories: (1) Race/ ethnicity; (2) Age; (3) SES; (4) Health; and, (5) Gender. Black people and Mainland United States PR Hispanics most frequently identified Race/Ethnicity as a vulnerability trait (42.1 percent of Black people and 42.6 percent of Mainland United States. PR Hispanics versus 15.4 percent of White people and 16.7 percent of SJ R Hispanics) (P < 0.007), while White people and SJ PR Hispanics most frequently identified Age (48.3 percent and 29.2 percent) as a vulnerability trait. The response patterns on "who was vulnerable" were similar for the two minority groups (Black people and Mainland US PR Hispanics), and notably different from the response patterns of the two majority groups (White people and SJ PR Hispanics). Further, the vox populis definition of vulnerables differed from the current official definitions as used by the U.S. federal government.

Tiered Pricing: Implications for Library Collections

ERIC Educational Resources Information Center

Hahn, Karla

2005-01-01

In recent years an increasing number of publishers have adopted tiered pricing of journals. The design and implications of tiered-pricing models, however, are poorly understood. Tiered pricing can be modeled using several variables. A survey of current tiered-pricing models documents the range of key variables used. A sensitivity analysis…
Differences in Growth Reading Patterns for at-Risk Spanish-Monolingual Children as a Function of a Tier 2 Intervention.

PubMed

Crespo, Patricia; Jiménez, Juan E; Rodríguez, Cristina; Baker, Doris; Park, Yonghan

2018-03-09

The present study compares the patterns of growth of beginning reading skills (i.e., phonemic awareness, phonics, fluency, vocabulary and comprehension) of Spanish speaking monolingual students who received a Tier 2 reading intervention with students who did not receive the intervention. All the students in grades K-2 were screened at the beginning of the year to confirm their risk status. A quasi-experimental longitudinal design was used: the treatment group received a supplemental program in small groups of 3 to 5 students, for 30 minutes daily from November to June. The control group did not receive it. All students were assessed three times during the academic year. A hierarchical linear growth modeling was conducted and differences on growth rate were found in vocabulary in kindergarten (p < .001; variance explained = 77.0%), phonemic awareness in kindergarten (p < .001; variance explained = 43.7%) and first grade (p < .01; variance explained = 15.2%), and finally we also find significant growth differences for second grade in oral reading fluency (p < .05; variance explained = 15.1%) and retell task (p < .05; variance explained = 14.5%). Children at risk for reading disabilities in Spanish can improve their skills when they receive explicit instruction in the context of Response to Intervention (RtI). Findings are discussed for each skill in the context of implementing a Tier 2 small group intervention within an RtI approach. Implications for practice in the Spanish educational context are also discussed for children who are struggling with reading.
Data visualization, time-series analysis, and mass-balance modeling of hydrologic and water-quality data for the McTier Creek watershed, South Carolina, 2007-2009

USGS Publications Warehouse

Benedict, Stephen T.; Conrads, Paul; Feaster, Toby D.; Journey, Celeste A.; Golden, Heather E.; Knightes, Christopher D.; Davis, Gary M.; Bradley, Paul M.

2012-01-01

The McTier Creek watershed is located in the headwaters of the Edisto River Basin, which is in the Coastal Plain region of South Carolina. The Edisto ecosystem has some of the highest recorded fish-tissue mercury concentrations in the United States. In an effort to advance the understanding of the fate and transport of mercury in stream ecosystems, the U.S. Geological Survey, as part of its National Water-Quality Assessment Program, initiated a field investigation of mercury in the McTier Creek watershed in 2006. The initial efforts of the investigation included the collection of extensive hydrologic and water-quality field data, along with the development of several hydrologic and water-quality models. This series of measured and modeled data forms the primary source of information for this investigation to assess the fate and transport of mercury within the McTier Creek watershed.
Contraceptive use and the role of contraceptive counseling in reproductive-aged women with cancer.

PubMed

Maslow, Bat-Sheva L; Morse, Christopher B; Schanne, Allison; Loren, Alison; Domchek, Susan M; Gracia, Clarisa R

2014-07-01

Few data on contraceptive choices in women with cancer exist. Contraception is challenging for women with cancer, particularly those with breast cancer, who are limited to nonhormonal methods. This study characterized contraceptive use during cancer treatment in a group of reproductive-aged women with a recent cancer diagnosis and assessed the impact of contraceptive counseling on the methods they selected. Cross-sectional, survey study of reproductive-aged women at a large tertiary care health system with a recent cancer diagnosis. A total of 107 women completed the survey. Eighty-two women reported 101 contraceptive choices. Twenty-seven percent (27/101) of all methods selected were Tier I/II, and 35% (35/101) were Tier III/IV. Only 4 used an intrauterine device (IUD). Among women reporting sexual activity after diagnosis, 19 (27%) of 71 reported using Tier I/II methods, 21 (30%) of 71 reported using Tier III/IV methods, 16 (23%) of 71 reported abstinence and 10 (14%) of 71 reported using no method. Factors significantly associated with Tier I/II use in the multivariable model included not having a college degree [odds ratio (OR) 0.21, 95% confidence interval (CI) 0.05-0.92, p=.038], intercourse during treatment (OR 5.92, 95% CI 1.48-23.66, p=.012) and non-breast cancer (OR 3.60, 95% CI 1.03-12.64, p=.046). Report of contraceptive counseling was positively associated with Tier I/II contraceptive use during cancer treatment (OR 6.92, 95% CI 1.14-42.11, p=.036). Reproductive-aged women diagnosed with cancer underutilized Tier I/II contraceptive agents, especially IUDs. Contraceptive counseling by physicians increases contraceptive use, particularly methods most effective at preventing pregnancy. The study uniquely described the contraceptive practices of over 100 women with cancer. The study sample commonly reported abstinence and use of contraceptive methods with high failure rates. Our data suggest that contraceptive counseling from a health care provider may increase use of more effective methods among women with cancer. Copyright © 2014 Elsevier Inc. All rights reserved.
Developing the architecture for the Climate Information Portal for Copernicus

NASA Astrophysics Data System (ADS)

Som de Cerff, Wim; Thijsse, Peter; Plieger, Maarten; Pascoe, Stephen; Jukes, Martin; Leadbetter, Adam; Goosen, Hasse; de Vreede, Ernst

2015-04-01

Climate change is impacting the environment, society and policy decisions. Information about climate change is available from many sources, but not all of them are reliable. The CLIPC project is developing a portal to provide a single point of access for authoritative scientific information on climate change. This ambitious objective is made possible through the Copernicus Earth Observation Programme for Europe, which will deliver a new generation of environmental measurements of climate quality. The data about the physical environment which is used to inform climate change policy and adaptation measures comes from several categories: satellite measurements, terrestrial observing systems, model projections and simulations and from re-analyses (syntheses of all available observations constrained with numerical weather prediction systems). These data categories are managed by different communities: CLIPC will provide a single point of access for the whole range of data. Information on data value and limitations will be provided as part of a knowledge base of authoritative climate information. The impacts of climate change on society will generally reflect a range of different environmental and climate system changes, and different sectors and actors within society will react differently to these changes. The CLIPC portal will provide some a number of indicators showing impacts on specific sectors which have been generated using a range of factors selected through structured expert consultation. It will also, as part of the transformation services, allow users to explore the consequences of using different combinations of driving factors which they consider to be of particular relevance to their work or life. The portal will provide information on the scientific quality and pitfalls of such transformations to prevent misleading usage of the results. The CLIPC project will not be able to process a comprehensive range of climate change impacts on the physical environment and society, but will develop an end to end processing chain (indicator toolkit), from comprehensive information on the climate state through to highly aggregated decision relevant products. This processing chain will be demonstrated within three thematic areas: water, rural and urban. Indicators of climate change and climate change impact will be provided, and a toolkit to update and post process the collection of indicators will be integrated into the portal. For the indicators three levels (Tiers) have been loosely defined: Tier 1: field summarising properties of the climate system; e.g. temperature change; Tier 2: expressed in terms of environmental properties outside the climate system; e.g. flooding change; Tier 3: expressed in social and economic impact. For the architecture, CLIPC has two interlocked themes: 1. Harmonised access to climate datasets derived from models, observations and re-analyses 2. A climate impact toolkit to evaluate, rank and aggregate indicators For development of the CLIPC architecture an Agile 'storyline' approach is taken. The storyline is a real world use case and consists of producing a Tier 3 indicator (Urban Heat Vulnerability) and making it available through the CLIPC infrastructure for a user group. In this way architecture concepts can be directly tested and improved. Also, the produced indicator can be shown to users to refine requirements. Main components of the CLIPC architecture are 1) Data discovery and access, 2) Data processing, 3) Data visualization, 4) Knowledge base and 5) User Management. The Data discovery and access component main challenge is to provide harmonized access to various sources of climate data (ngEO, EMODNET/SeaDataNet, ESGF, MyOcean). The discovery service concept will be provided using a CLIPC data and data product catalogue and via a structured data search on selected infrastructures, using NERC vocabulary services and mappings. Data processing will be provided using OGC WPS services, linking/re-using existing processing services from climate4impact.eu. The processing services will allow users to calculate climate impact indicators (Tier 1, 2 and 3). Processing wizards will guide users in processing indicators. The PyWPS framework will be used. The CLIPC portal will have its own central viewing service, using OGC standards for interoperability. For the WMS server side the ADAGUC framework will be used. For Tier 3 visualizations specific tailored visualisations will be developed. Tier 3 can be complicated to build and require manual work from specialists to provide meaningful results before they can be published as e.g. interactive maps. The CLIPC knowledge base is a set of services that supply explanatory information to the users when working with CLIPC services. It is structured around 1) a catalogue, containing ISO standardized metadata, citations, background information, links to data; 2) Commentary information, e.g. FAQ, annotation URLs , version information, disclaimers; 3) Technical documents, e.g. using vocabularies and mappings 4) Glossaries, adding and using existing glossaries from e.g. EUPORIAS/IS-ENES, IPCC; 5) literature references. CLIPC will have a very light weight user management system, providing as little barriers to the user as possible. We will make use of OpenID, accepting from selected OpenID providers such as Google and ESGF. In the presentation we will show the storyline implementation: the first results of the Tier 3 indicator, the architecture in development and the lessons learned.
A Three-Tier Diagnostic Test to Assess Pre-Service Teachers' Misconceptions about Global Warming, Greenhouse Effect, Ozone Layer Depletion, and Acid Rain

NASA Astrophysics Data System (ADS)

Ozge Arslan, Harika; Cigdemoglu, Ceyhan; Moseley, Christine

2012-07-01

This study describes the development and validation of a three-tier multiple-choice diagnostic test, the atmosphere-related environmental problems diagnostic test (AREPDiT), to reveal common misconceptions of global warming (GW), greenhouse effect (GE), ozone layer depletion (OLD), and acid rain (AR). The development of a two-tier diagnostic test procedure as described by Treagust constitutes the framework for this study. To differentiate a lack of knowledge from a misconception, a certainty response index is added as a third tier to each item. Based on propositional knowledge statements, related literature, and the identified misconceptions gathered initially from 157 pre-service teachers, the AREPDiT was constructed and administered to 256 pre-service teachers. The Cronbach alpha reliability coefficient of the pre-service teachers' scores was estimated to be 0.74. Content and face validations were established by senior experts. A moderate positive correlation between the participants' both-tiers scores and their certainty scores indicated evidence for construct validity. Therefore, the AREPDiT is a reliable and valid instrument not only to identify pre-service teachers' misconceptions about GW, GE, OLD, and AR but also to differentiate these misconceptions from lack of knowledge. The results also reveal that a majority of the respondents demonstrated limited understandings about atmosphere-related environmental problems and held six common misconceptions. Future studies could test the AREPDiT as a tool for assessing the misconceptions held by pre-service teachers from different programs as well as in-service teachers and high school students.
Report from the NOAA workshops to standardize protocols for monitoring toxic Pfiesteria species and associated environmental conditions.

PubMed

Luttenberg, D; Turgeon, D; Higgins, J

2001-10-01

Long-term monitoring of water quality, fish health, and plankton communities in susceptible bodies of water is crucial to identify the environmental factors that contribute to outbreaks of toxic Pfiesteria complex (TPC) species. In the aftermath of the 1997 toxic Pfiesteria outbreaks in North Carolina and Maryland, federal and several state agencies agreed that there was a need to standardize monitoring protocols. The National Oceanic & Atmospheric Administration convened two workshops that brought together state, federal, and academic resource managers and scientific experts to a) seek consensus on responding to and monitoring potential toxic Pfiesteria outbreaks; b) recommend standard parameters and protocols to characterize water quality, fish health, and plankton at historical event sites and potentially susceptible sites; and c) discuss options for integrating monitoring data sets from different states into regional and national assessments. Workshop recommendations included the development of a three-tiered TPC monitoring strategy: Tier 1, rapid event response; Tier 2, comprehensive assessment; and Tier 3, routine monitoring. These tiers correspond to varying levels of water quality, fish health, and plankton monitoring frequency and intensity. Under the strategy, sites are prioritized, depending upon their history and susceptibility to TPC events, and assigned an appropriate level of monitoring activity. Participants also agreed upon a suite of water quality parameters that should be monitored. These recommendations provide guidance to state and federal agencies conducting rapid-response and assessment activities at sites of suspected toxic Pfiesteria outbreaks, as well as to states that are developing such monitoring programs for the first time.
26 CFR 1.1502-33 - Earnings and profits.

Code of Federal Regulations, 2010 CFR

2010-04-01

...-tier members and consolidating the group's earnings and profits in the common parent. References in... tax year beginning on or after January 1, 1995. The statement must be signed by the common parent, and... acquisition of either the assets of the common parent of the terminating group in a reorganization described...
Effects of an Interdependent Group Contingency on Engagement in Physical Education

ERIC Educational Resources Information Center

Hirsch, Shanna Eisner; Healy, Sean; Judge, Joann P.; Lloyd, John Wills

2016-01-01

We examined whether a group contingency increased engagement during elementary school physical education sessions. The intervention employed procedures (explicit instruction, goal setting, and reinforcement) drawn from the first tier of classwide function-related intervention teams (CW-FIT; Wills et al., 2009). Results showed salutary increases in…
Structure of eukaryotic CMG helicase at a replication fork and implications to replisome architecture and origin initiation

PubMed Central

Georgescu, Roxana; Yuan, Zuanning; Bai, Lin; de Luna Almeida Santos, Ruda; Sun, Jingchuan; Zhang, Dan; Yurieva, Olga; Li, Huilin; O’Donnell, Michael E.

2017-01-01

The eukaryotic CMG (Cdc45, Mcm2–7, GINS) helicase consists of the Mcm2–7 hexameric ring along with five accessory factors. The Mcm2–7 heterohexamer, like other hexameric helicases, is shaped like a ring with two tiers, an N-tier ring composed of the N-terminal domains, and a C-tier of C-terminal domains; the C-tier contains the motor. In principle, either tier could translocate ahead of the other during movement on DNA. We have used cryo-EM single-particle 3D reconstruction to solve the structure of CMG in complex with a DNA fork. The duplex stem penetrates into the central channel of the N-tier and the unwound leading single-strand DNA traverses the channel through the N-tier into the C-tier motor, 5′-3′ through CMG. Therefore, the N-tier ring is pushed ahead by the C-tier ring during CMG translocation, opposite the currently accepted polarity. The polarity of the N-tier ahead of the C-tier places the leading Pol ε below CMG and Pol α-primase at the top of CMG at the replication fork. Surprisingly, the new N-tier to C-tier polarity of translocation reveals an unforeseen quality-control mechanism at the origin. Thus, upon assembly of head-to-head CMGs that encircle double-stranded DNA at the origin, the two CMGs must pass one another to leave the origin and both must remodel onto opposite strands of single-stranded DNA to do so. We propose that head-to-head motors may generate energy that underlies initial melting at the origin. PMID:28096349
40 CFR 87.23 - Exhaust emission standards for Tier 6 and Tier 8 engines.

Code of Federal Regulations, 2014 CFR

2014-07-01

... and Tier 8 engines. 87.23 Section 87.23 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF AIR POLLUTION FROM AIRCRAFT AND AIRCRAFT ENGINES Exhaust Emissions (New Aircraft Gas Turbine Engines) § 87.23 Exhaust emission standards for Tier 6 and Tier 8...
40 CFR 87.23 - Exhaust emission standards for Tier 6 and Tier 8 engines.

Code of Federal Regulations, 2013 CFR

2013-07-01

... and Tier 8 engines. 87.23 Section 87.23 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF AIR POLLUTION FROM AIRCRAFT AND AIRCRAFT ENGINES Exhaust Emissions (New Aircraft Gas Turbine Engines) § 87.23 Exhaust emission standards for Tier 6 and Tier 8...
Which Tier? Effects of Linear Assessment and Student Characteristics on GCSE Entry Decisions

ERIC Educational Resources Information Center

Vitello, Sylvia; Crawford, Cara

2018-01-01

In England, students obtain General Certificate of Secondary Education (GCSE) qualifications, typically at age 16. Certain GCSEs are tiered; students take either higher-level (higher tier) or lower-level (foundation tier) exams, which may have different educational, career and psychological consequences. In particular, foundation tier entry, if…
50 CFR 660.211 - Fixed gear fishery-definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... vessel registered to a limited entry fixed gear permit(s) with a Tier 1, Tier 2, and/or Tier 3... fishery or sablefish tier limit fishery means, for the limited entry fixed gear sablefish fishery north of... tier limit and when they are not eligible to fish in the DTL fishery. Sablefish primary season means...
Development, deployment and operations of ATLAS databases

NASA Astrophysics Data System (ADS)

Vaniachine, A. V.; Schmitt, J. G. v. d.

2008-07-01

In preparation for ATLAS data taking, a coordinated shift from development towards operations has occurred in ATLAS database activities. In addition to development and commissioning activities in databases, ATLAS is active in the development and deployment (in collaboration with the WLCG 3D project) of the tools that allow the worldwide distribution and installation of databases and related datasets, as well as the actual operation of this system on ATLAS multi-grid infrastructure. We describe development and commissioning of major ATLAS database applications for online and offline. We present the first scalability test results and ramp-up schedule over the initial LHC years of operations towards the nominal year of ATLAS running, when the database storage volumes are expected to reach 6.1 TB for the Tag DB and 1.0 TB for the Conditions DB. ATLAS database applications require robust operational infrastructure for data replication between online and offline at Tier-0, and for the distribution of the offline data to Tier-1 and Tier-2 computing centers. We describe ATLAS experience with Oracle Streams and other technologies for coordinated replication of databases in the framework of the WLCG 3D services.
A prospective evaluation of whole-exome sequencing as a first-tier molecular test in infants with suspected monogenic disorders.

PubMed

Stark, Zornitza; Tan, Tiong Y; Chong, Belinda; Brett, Gemma R; Yap, Patrick; Walsh, Maie; Yeung, Alison; Peters, Heidi; Mordaunt, Dylan; Cowie, Shannon; Amor, David J; Savarirayan, Ravi; McGillivray, George; Downie, Lilian; Ekert, Paul G; Theda, Christiane; James, Paul A; Yaplito-Lee, Joy; Ryan, Monique M; Leventer, Richard J; Creed, Emma; Macciocca, Ivan; Bell, Katrina M; Oshlack, Alicia; Sadedin, Simon; Georgeson, Peter; Anderson, Charlotte; Thorne, Natalie; Melbourne Genomics Health Alliance; Gaff, Clara; White, Susan M

2016-11-01

To prospectively evaluate the diagnostic and clinical utility of singleton whole-exome sequencing (WES) as a first-tier test in infants with suspected monogenic disease. Singleton WES was performed as a first-tier sequencing test in infants recruited from a single pediatric tertiary center. This occurred in parallel with standard investigations, including single- or multigene panel sequencing when clinically indicated. The diagnosis rate, clinical utility, and impact on management of singleton WES were evaluated. Of 80 enrolled infants, 46 received a molecular genetic diagnosis through singleton WES (57.5%) compared with 11 (13.75%) who underwent standard investigations in the same patient group. Clinical management changed following exome diagnosis in 15 of 46 diagnosed participants (32.6%). Twelve relatives received a genetic diagnosis following cascade testing, and 28 couples were identified as being at high risk of recurrence in future pregnancies. This prospective study provides strong evidence for increased diagnostic and clinical utility of singleton WES as a first-tier sequencing test for infants with a suspected monogenic disorder. Singleton WES outperformed standard care in terms of diagnosis rate and the benefits of a diagnosis, namely, impact on management of the child and clarification of reproductive risks for the extended family in a timely manner.Genet Med 18 11, 1090-1096.
Stability of Special Education Eligibility from Kindergarten to Third Grade: Are There Variables from Fall of Kindergarten That Predict Later Classification Status?

ERIC Educational Resources Information Center

Flynn, Kylie Shawn

2012-01-01

This study examined students' movement in and out of special education and predictors for later special education placement. The sample ( N = 556) came from a response to intervention (RTI) study, specifically, a cluster-randomized control field trial that undertook the development and study of a hybrid Tier 1 (classroom instruction) and Tier 2…
Testing a multi-tiered stress-gradient model for risk assessment using sediment constituents from coral reef environments

USGS Publications Warehouse

Lidz, B.H.; Hallock, P.; ,

2000-01-01

Coral reefs are threatened worldwide by stresses ranging from local to global in extent. One of the major challenges in studies of reef decline is understanding how to distinguish between changes resulting from natural, anthropogenic, local, and global environmental perturbations. As such, a conceptual risk-assessment model is developed that includes tiers for natural stresses, global/regional stresses, and local anthropogenic stresses.
Fostering SMART partnerships to develop an effective continuum of behavioral health services and supports in schools.

PubMed

Bruns, Eric J; Duong, Mylien T; Lyon, Aaron R; Pullmann, Michael D; Cook, Clayton R; Cheney, Douglas; McCauley, Elizabeth

2016-03-01

The education sector offers compelling opportunities to address the shortcomings of traditional mental health delivery systems and to prevent and treat youth mental, emotional, and behavioral (MEB) problems. Recognizing that social and emotional wellness is intrinsically related to academic success, schools are moving to adopt multi-tier frameworks based on the public health model that provide a continuum of services to all children, including services to address both academic and MEB problems. In this article, we review the potential value of multi-tier frameworks in facilitating access to, and increasing the effectiveness of, mental health services in schools, and review the empirical support for school-based mental health interventions by tier. We go on to describe a community-academic partnership between the Seattle Public Schools and the University of Washington School Mental Health Assessment, Research, and Training (SMART) Center that exemplifies how multi-tier educational frameworks, research and evidence, and purposeful collaboration can combine to improve development and implementation of a range of school-based strategies focused on MEB needs of students. Finally, we present a set of 10 recommendations that may help guide other research and practice improvement efforts to address MEB problems in youth through effective school mental health programming. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Fostering SMART Partnerships to Develop an Effective Continuum of Behavioral Health Services and Supports in Schools

PubMed Central

Bruns, Eric J.; Duong, Mylien T.; Lyon, Aaron R.; Pullmann, Michael D.; Cook, Clayton R.; Cheney, Douglas; McCauley, Elizabeth

2015-01-01

The education sector offers compelling opportunities to address the shortcomings of traditional mental health delivery systems and to prevent and treat youth mental, emotional, and behavioral (MEB) problems. Recognizing that social and emotional wellness is intrinsically related to academic success, schools are moving to adopt multi-tier frameworks based on the public health model that provide a continuum of services to all children, including services to address both academic and MEB problems. In this paper, we review the potential value of multi-tier frameworks in facilitating access to, and increasing the effectiveness of, mental health services in schools and review the empirical support for school-based mental health interventions by tier. We go on to describe a community-academic partnership between the Seattle Public Schools and the University of Washington School Mental Health Assessment, Research, and Training (SMART) Center that exemplifies how multi-tier educational frameworks, research and evidence, and purposeful collaboration can combine to improve development and implementation of a range of school-based strategies focused on MEB needs of students. Finally, we present a set of 10 recommendations that may help guide other research and practice improvement efforts to address MEB problems in youth through effective school mental health programming. PMID:26963185

Unsupervised discovery of microbial population structure within metagenomes using nucleotide base composition

PubMed Central

Saeed, Isaam; Tang, Sen-Lin; Halgamuge, Saman K.

2012-01-01

An approach to infer the unknown microbial population structure within a metagenome is to cluster nucleotide sequences based on common patterns in base composition, otherwise referred to as binning. When functional roles are assigned to the identified populations, a deeper understanding of microbial communities can be attained, more so than gene-centric approaches that explore overall functionality. In this study, we propose an unsupervised, model-based binning method with two clustering tiers, which uses a novel transformation of the oligonucleotide frequency-derived error gradient and GC content to generate coarse groups at the first tier of clustering; and tetranucleotide frequency to refine these groups at the secondary clustering tier. The proposed method has a demonstrated improvement over PhyloPythia, S-GSOM, TACOA and TaxSOM on all three benchmarks that were used for evaluation in this study. The proposed method is then applied to a pyrosequenced metagenomic library of mud volcano sediment sampled in southwestern Taiwan, with the inferred population structure validated against complementary sequencing of 16S ribosomal RNA marker genes. Finally, the proposed method was further validated against four publicly available metagenomes, including a highly complex Antarctic whale-fall bone sample, which was previously assumed to be too complex for binning prior to functional analysis. PMID:22180538
How do quality information and cost affect patient choice of provider in a tiered network setting? Results from a survey.

PubMed

Sinaiko, Anna D

2011-04-01

To assess how quality information from multiple sources and financial incentives affect consumer choice of physicians in tiered physician networks. Survey of a stratified random sample of Massachusetts state employees. Respondents were assigned a hypothetical structure with differential copayments for "Tier 1" (preferred) and "Tier 2" (nonpreferred) physicians. Half of respondents were told they needed to select a cardiologist, and half were told they needed to select a dermatologist. Patients were asked whether they would choose a Tier 1 doctor, a Tier 2 doctor, or had no preference in a case where they had no further quality information, a case where a family member or friend recommended a Tier 2 doctor, and a case where their personal physician recommended a Tier 2 doctor. The effects of copayments, recommendations, physician specialty, and patient characteristics on the reported probability of selecting a Tier 1 doctor are analyzed using multinomial logit and logistic regression. Relative to a case where there is no copayment differential between tiers, copayment differences of U.S.$10-U.S.$35 increase the number of respondents indicating they would select a Tier 1 physician by 3.5-11.7 percent. Simulations suggest copayments must exceed U.S.$300 to counteract the recommendation for a lower tiered physician from friends, family, or a referring physician. Sensitivity to the copayments varied with physician specialty. Tiered provider networks with these copayment levels appear to have limited influence on physician choice when contradicted by other trusted sources. Consumers' response likely varies with physician specialty. © Health Research and Educational Trust.
Acute tier-1 and tier-2 effect assessment approaches in the EFSA Aquatic Guidance Document: are they sufficiently protective for insecticides?

PubMed

van Wijngaarden, René P A; Maltby, Lorraine; Brock, Theo C M

2015-08-01

The objective of this paper is to evaluate whether the acute tier-1 and tier-2 methods as proposed by the Aquatic Guidance Document recently published by the European Food Safety Authority (EFSA) are appropriate for deriving regulatory acceptable concentrations (RACs) for insecticides. The tier-1 and tier-2 RACs were compared with RACs based on threshold concentrations from micro/mesocosm studies (ETO-RAC). A lower-tier RAC was considered as sufficiently protective, if less than the corresponding ETO-RAC. ETO-RACs were calculated for repeated (n = 13) and/or single pulsed applications (n = 17) of 26 insecticides to micro/mesocosms, giving a maximum of 30 insecticide × application combinations (i.e. cases) for comparison. Acute tier-1 RACs (for 24 insecticides) were lower than the corresponding ETO-RACs in 27 out of 29 cases, while tier-2 Geom-RACs (for 23 insecticides) were lower in 24 out of 26 cases. The tier-2 SSD-RAC (for 21 insecticides) using HC5 /3 was lower than the ETO-RAC in 23 out of 27 cases, whereas the tier-2 SSD-RAC using HC5 /6 was protective in 25 out of 27 cases. The tier-1 and tier-2 approaches proposed by EFSA for acute effect assessment are sufficiently protective for the majority of insecticides evaluated. Further evaluation may be needed for insecticides with more novel chemistries (neonicotinoids, biopesticides) and compounds that show delayed effects (insect growth regulators). © 2014 Society of Chemical Industry.
A framework for integration of scientific applications into the OpenTopography workflow

NASA Astrophysics Data System (ADS)

Nandigam, V.; Crosby, C.; Baru, C.

2012-12-01

The NSF-funded OpenTopography facility provides online access to Earth science-oriented high-resolution LIDAR topography data, online processing tools, and derivative products. The underlying cyberinfrastructure employs a multi-tier service oriented architecture that is comprised of an infrastructure tier, a processing services tier, and an application tier. The infrastructure tier consists of storage, compute resources as well as supporting databases. The services tier consists of the set of processing routines each deployed as a Web service. The applications tier provides client interfaces to the system. (e.g. Portal). We propose a "pluggable" infrastructure design that will allow new scientific algorithms and processing routines developed and maintained by the community to be integrated into the OpenTopography system so that the wider earth science community can benefit from its availability. All core components in OpenTopography are available as Web services using a customized open-source Opal toolkit. The Opal toolkit provides mechanisms to manage and track job submissions, with the help of a back-end database. It allows monitoring of job and system status by providing charting tools. All core components in OpenTopography have been developed, maintained and wrapped as Web services using Opal by OpenTopography developers. However, as the scientific community develops new processing and analysis approaches this integration approach is not scalable efficiently. Most of the new scientific applications will have their own active development teams performing regular updates, maintenance and other improvements. It would be optimal to have the application co-located where its developers can continue to actively work on it while still making it accessible within the OpenTopography workflow for processing capabilities. We will utilize a software framework for remote integration of these scientific applications into the OpenTopography system. This will be accomplished by virtually extending the OpenTopography service over the various infrastructures running these scientific applications and processing routines. This involves packaging and distributing a customized instance of the Opal toolkit that will wrap the software application as an OPAL-based web service and integrate it into the OpenTopography framework. We plan to make this as automated as possible. A structured specification of service inputs and outputs along with metadata annotations encoded in XML can be utilized to automate the generation of user interfaces, with appropriate tools tips and user help features, and generation of other internal software. The OpenTopography Opal toolkit will also include the customizations that will enable security authentication, authorization and the ability to write application usage and job statistics back to the OpenTopography databases. This usage information could then be reported to the original service providers and used for auditing and performance improvements. This pluggable framework will enable the application developers to continue to work on enhancing their application while making the latest iteration available in a timely manner to the earth sciences community. This will also help us establish an overall framework that other scientific application providers will also be able to use going forward.
A systems relations model for Tier 2 early intervention child mental health services with schools: an exploratory study.

PubMed

van Roosmalen, Marc; Gardner-Elahi, Catherine; Day, Crispin

2013-01-01

Over the last 15 years, policy initiatives have aimed at the provision of more comprehensive Child and Adolescent Mental Health care. These presented a series of new challenges in organising and delivering Tier 2 child mental health services, particularly in schools. This exploratory study aimed to examine and clarify the service model underpinning a Tier 2 child mental health service offering school-based mental health work. Using semi-structured interviews, clinician descriptions of operational experiences were gathered. These were analysed using grounded theory methods. Analysis was validated by respondents at two stages. A pathway for casework emerged that included a systemic consultative function, as part of an overall three-function service model, which required: (1) activity as a member of the multi-agency system; (2) activity to improve the system working around a particular child; and (3) activity to universally develop a Tier 1 workforce confident in supporting children at risk of or experiencing mental health problems. The study challenged the perception of such a service serving solely a Tier 2 function, the requisite workforce to deliver the service model, and could give service providers a rationale for negotiating service models that include an explicit focus on improving the children's environments.
Java RMI Software Technology for the Payload Planning System of the International Space Station

NASA Technical Reports Server (NTRS)

Bryant, Barrett R.

1999-01-01

The Payload Planning System is for experiment planning on the International Space Station. The planning process has a number of different aspects which need to be stored in a database which is then used to generate reports on the planning process in a variety of formats. This process is currently structured as a 3-tier client/server software architecture comprised of a Java applet at the front end, a Java server in the middle, and an Oracle database in the third tier. This system presently uses CGI, the Common Gateway Interface, to communicate between the user-interface and server tiers and Active Data Objects (ADO) to communicate between the server and database tiers. This project investigated other methods and tools for performing the communications between the three tiers of the current system so that both the system performance and software development time could be improved. We specifically found that for the hardware and software platforms that PPS is required to run on, the best solution is to use Java Remote Method Invocation (RMI) for communication between the client and server and SQLJ (Structured Query Language for Java) for server interaction with the database. Prototype implementations showed that RMI combined with SQLJ significantly improved performance and also greatly facilitated construction of the communication software.
Planning for complementarity : an examination of the role and opportunities of first-tier and second-tier cities along the high-speed rail network in California.

DOT National Transportation Integrated Search

2012-03-01

The coming of California High-Speed Rail (HSR) offers opportunities for positive urban transformations in both first-tier and second-tier cities. The research in this report explores the different but complementary roles that first-tier and second-ti...
50 CFR 86.53 - What are funding tiers?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false What are funding tiers? 86.53 Section 86... project merits. (d) We describe the two tiers as follows: (1) Tier One Projects. (i) You may submit a... $100,000 of Federal funds for any given fiscal year. (ii) Tier One projects must meet the eligibility...
Effects of a Tier 3 Self-Management Intervention Implemented with and without Treatment Integrity

ERIC Educational Resources Information Center

Lower, Ashley; Young, K. Richard; Christensen, Lynnette; Caldarella, Paul; Williams, Leslie; Wills, Howard

2016-01-01

This study investigated the effects of a Tier 3 peer-matching self-management intervention on two elementary school students who had previously been less responsive to Tier 1 and Tier 2 interventions. The Tier 3 self-management intervention, which was implemented in the general education classrooms, included daily electronic communication between…
Tier 2 Interventions in Positive Behavior Support: A Survey of School Implementation

ERIC Educational Resources Information Center

Rodriguez, Billie Jo; Loman, Sheldon L.; Borgmeier, Christopher

2016-01-01

As increasing numbers of schools implement Multi-Tiered Systems of Support (MTSS), schools are looking for and implementing evidence-based practices for students whose needs are not fully met by Tier 1 supports. Although there is relative consistency and clarity in what constitutes Tier 1 behavior support within MTSS, Tier 2 supports may be more…
Principles of health infrastructure planning in less developed countries.

PubMed

Unger, J P; Criel, B

1995-01-01

This article proposes a number of key principles for health infrastructure planning, based on a literature review on the one hand, and on a process of internal deduction on the other. The principles discussed are the following: an integrated health system; a thrifty planning of tiers within that health system; a specificity of tiers; a homogeneity of the tiers' structures; a minimum package of activities; a territorial responsibility and/or an explicit and discrete responsibility for a well-defined population; a necessary and sufficient population basis; a partial separation of administrative and public health planning bases; and, finally, rules for a geographical division and integration of non-governmental organizations. The definition of two strategies, primary health care and district health systems, is also revisited.
Examining the Efficacy of a Tier 2 Kindergarten Mathematics Intervention.

PubMed

Clarke, Ben; Doabler, Christian T; Smolkowski, Keith; Baker, Scott K; Fien, Hank; Strand Cary, Mari

2016-01-01

This study examined the efficacy of a Tier 2 kindergarten mathematics intervention program, ROOTS, focused on developing whole number understanding for students at risk in mathematics. A total of 29 classrooms were randomly assigned to treatment (ROOTS) or control (standard district practices) conditions. Measures of mathematics achievement were collected at pretest and posttest. Treatment and control students did not differ on mathematics assessments at pretest. Gain scores of at-risk intervention students were significantly greater than those of control peers, and the gains of at-risk treatment students were greater than the gains of peers not at risk, effectively reducing the achievement gap. Implications for Tier 2 mathematics instruction in a response to intervention (RtI) model are discussed. © Hammill Institute on Disabilities 2014.
Estimating implementation and operational costs of an integrated tiered CD4 service including laboratory and point of care testing in a remote health district in South Africa.

PubMed

Cassim, Naseem; Coetzee, Lindi M; Schnippel, Kathryn; Glencross, Deborah K

2014-01-01

An integrated tiered service delivery model (ITSDM) has been proposed to provide 'full-coverage' of CD4 services throughout South Africa. Five tiers are described, defined by testing volumes and number of referring health-facilities. These include: (1) Tier-1/decentralized point-of-care service (POC) in a single site; Tier-2/POC-hub servicing processing < 30-40 samples from 8-10 health-clinics; Tier-3/Community laboratories servicing ∼ 50 health-clinics, processing < 150 samples/day; high-volume centralized laboratories (Tier-4 and Tier-5) processing < 300 or > 600 samples/day and serving > 100 or > 200 health-clinics, respectively. The objective of this study was to establish costs of existing and ITSDM-tiers 1, 2 and 3 in a remote, under-serviced district in South Africa. Historical health-facility workload volumes from the Pixley-ka-Seme district, and the total volumes of CD4 tests performed by the adjacent district referral CD4 laboratories, linked to locations of all referring clinics and related laboratory-to-result turn-around time (LTR-TAT) data, were extracted from the NHLS Corporate-Data-Warehouse for the period April-2012 to March-2013. Tiers were costed separately (as a cost-per-result) including equipment, staffing, reagents and test consumable costs. A one-way sensitivity analyses provided for changes in reagent price, test volumes and personnel time. The lowest cost-per-result was noted for the existing laboratory-based Tiers- 4 and 5 ($6.24 and $5.37 respectively), but with related increased LTR-TAT of > 24-48 hours. Full service coverage with TAT < 6-hours could be achieved with placement of twenty-seven Tier-1/POC or eight Tier-2/POC-hubs, at a cost-per-result of $32.32 and $15.88 respectively. A single district Tier-3 laboratory also ensured 'full service coverage' and < 24 hour LTR-TAT for the district at $7.42 per-test. Implementing a single Tier-3/community laboratory to extend and improve delivery of services in Pixley-ka-Seme, with an estimated local ∼ 12-24-hour LTR-TAT, is ∼ $2 more than existing referred services per-test, but 2-4 fold cheaper than implementing eight Tier-2/POC-hubs or providing twenty-seven Tier-1/POCT CD4 services.
Request for Naval Reactors Comment on Proposed Prometheus Space Flight Nuclear Reactor High Tier Reactor Safety Requirements and for Naval Reactors Approval to Transmit These Requirements to JPL

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

D. Kokkinos

2005-04-28

The purpose of this letter is to request Naval Reactors comments on the nuclear reactor high tier requirements for the PROMETHEUS space flight reactor design, pre-launch operations, launch, ascent, operation, and disposal, and to request Naval Reactors approval to transmit these requirements to Jet Propulsion Laboratory to ensure consistency between the reactor safety requirements and the spacecraft safety requirements. The proposed PROMETHEUS nuclear reactor high tier safety requirements are consistent with the long standing safety culture of the Naval Reactors Program and its commitment to protecting the health and safety of the public and the environment. In addition, the philosophymore » on which these requirements are based is consistent with the Nuclear Safety Policy Working Group recommendations on space nuclear propulsion safety (Reference 1), DOE Nuclear Safety Criteria and Specifications for Space Nuclear Reactors (Reference 2), the Nuclear Space Power Safety and Facility Guidelines Study of the Applied Physics Laboratory.« less
Meta-Analyses of the Effects of Tier 2 Type Reading Interventions in Grades K-3.

PubMed

Wanzek, Jeanne; Vaughn, Sharon; Scammacca, Nancy; Gatlin, Brandy; Walker, Melodee A; Capin, Philip

2016-09-01

This meta-analysis extends previous work on extensive Tier 3 type reading interventions (Wanzek & Vaughn, 2007; Wanzek et al., 2013) to Tier 2 type interventions by examining a non-overlapping set of studies addressing the effects of less extensive reading interventions for students with or at risk for reading difficulties in Grades K-3. We examined the overall effects of these interventions on students' foundational skills, language, and comprehension as well as the intervention features that may be associated with improved outcomes. We conducted four meta-analyses on 72 studies to examine effects on (1) standardized foundational skill measures (mean ES = 0.54), (2) not-standardized foundational skill measures (mean ES = 0.62), (3) standardized language/comprehension measures (mean ES = 0.36), and (4) not-standardized language/comprehension measures (mean ES = 1.02). There were no differences in effects related to intervention type, instructional group size, grade level, intervention implementer, or the number of intervention hours.
The impact of nonreferral outpatient co-payment on medical care utilization and expenditures in Taiwan.

PubMed

Chen, Li-Chia; Schafheutle, Ellen I; Noyce, Peter R

2009-09-01

Taiwan's National Health Insurance's (NHI) generous coverage and patients' freedom to access different tiers of medical facilities have resulted in accelerating outpatient care utilization and costs. To deter nonessential visits and encourage initial contact in primary care (physician clinics), a differential co-payment was introduced on 15th July 2005. Under this, patients pay more for outpatient consultations at "higher tiers" of medical facilities (local community hospitals, regional hospitals, medical centers), particularly if accessed without referral. This study explored the impact of this policy on outpatient medical activities and expenditures, different co-payment groups, and tiers of medical facilities. A segmented time-series analysis on regional weekly outpatient medical claims (January 2004 to July 2006) was conducted. Outcome variables (number of visits, number of outpatients, total cost of outpatient care) and variables for cost structure were stratified by tiers of medical facilities and co-payment groups. Analysis used the auto-regressive integrated moving-average model in STATA 9.0. The overall number of outpatient visits significantly decreased after policy implementation due to a reduction in the number of patients using outpatient facilities, but total costs of care remained unchanged. The policy had its greatest impact on the number of visits to regional and local community hospitals but had no influence on those to the medical centers. Medical utilization in physician clinics decreased due to an audit of reimbursement declarations. Overall, the policy failed to encourage referrals from primary care to higher tiers because there was no obvious shifting of medical utilization and costs reversely. Differential co-payment policy decreased total medication utilization but not costs to NHI. The results suggest that the increased level of co-payment charge and the strategy of a single cost-sharing policy are not sufficient to promote referrals within the system. To achieve an effective co-payment policy, further research is needed to explore how patients' out-of-pocket payment affects medical utilization and which forces (not susceptible to co-payment) act in tertiary facilities.
On Statistical Approaches for Demonstrating Analytical Similarity in the Presence of Correlation.

PubMed

Yang, Harry; Novick, Steven; Burdick, Richard K

Analytical similarity is the foundation for demonstration of biosimilarity between a proposed product and a reference product. For this assessment, currently the U.S. Food and Drug Administration (FDA) recommends a tiered system in which quality attributes are categorized into three tiers commensurate with their risk and approaches of varying statistical rigor are subsequently used for the three-tier quality attributes. Key to the analyses of Tiers 1 and 2 quality attributes is the establishment of equivalence acceptance criterion and quality range. For particular licensure applications, the FDA has provided advice on statistical methods for demonstration of analytical similarity. For example, for Tier 1 assessment, an equivalence test can be used based on an equivalence margin of 1.5 σ R , where σ R is the reference product variability estimated by the sample standard deviation S R from a sample of reference lots. The quality range for demonstrating Tier 2 analytical similarity is of the form X̄ R ± K × σ R where the constant K is appropriately justified. To demonstrate Tier 2 analytical similarity, a large percentage (e.g., 90%) of test product must fall in the quality range. In this paper, through both theoretical derivations and simulations, we show that when the reference drug product lots are correlated, the sample standard deviation S R underestimates the true reference product variability σ R As a result, substituting S R for σ R in the Tier 1 equivalence acceptance criterion and the Tier 2 quality range inappropriately reduces the statistical power and the ability to declare analytical similarity. Also explored is the impact of correlation among drug product lots on Type I error rate and power. Three methods based on generalized pivotal quantities are introduced, and their performance is compared against a two-one-sided tests (TOST) approach. Finally, strategies to mitigate risk of correlation among the reference products lots are discussed. A biosimilar is a generic version of the original biological drug product. A key component of a biosimilar development is the demonstration of analytical similarity between the biosimilar and the reference product. Such demonstration relies on application of statistical methods to establish a similarity margin and appropriate test for equivalence between the two products. This paper discusses statistical issues with demonstration of analytical similarity and provides alternate approaches to potentially mitigate these problems. © PDA, Inc. 2016.
77 FR 56683 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-13

... the Tape A Step Up Tier, Modify the Remaining Tape Step Up Tiers and Introduce an Alternative Method... and Charges for Exchange Services (``Fee Schedule'') to (i) eliminate the Tape A Step Up Tier; (ii) modify the remaining Tape Step Up Tiers to exclude ETP Holders that qualify for the Cross-Asset Tier or...
Effects of Tier 2 and Tier 3 Mathematics Interventions for Second Graders with Mathematics Difficulties

ERIC Educational Resources Information Center

Dennis, Minyi Shih

2015-01-01

Two studies were conducted to examine the effects of Tier 2 and Tier 3 mathematics interventions on students with mathematics learning difficulties. In the first study, the work of Bryant et al. was replicated and expanded upon by documenting the sustained effects of a Tier 2 mathematics intervention on mathematics performance by second graders.…
Building Tier 3 Intervention for Long-Term Slow Growers in Grades 3-4: A Pilot Study

ERIC Educational Resources Information Center

Sanchez, Victoria; O'Connor, Rollanda E.

2015-01-01

Tier 3 interventions are necessary for students who fail to respond adequately to Tier 1 general education instruction and Tier 2 supplemental reading intervention instruction. We identified 8 students in 3rd and 4th grade who had demonstrated a slow response to Tier 2 reading interventions for three years. Students participated in a…

40 CFR 1033.102 - Transition to the standards of this part.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Tier 0 and Tier 1 standards of § 1033.101 apply for new locomotives beginning January 1, 2010, except as specified in § 1033.150(a). The Tier 0 and Tier 1 standards of 40 CFR part 92 apply for earlier... locomotives beginning January 1, 2013. The Tier 2 standards of 40 CFR part 92 apply for earlier model years...
Development and implementation of the Caribbean Laboratory Quality Management Systems Stepwise Improvement Process (LQMS-SIP) Towards Accreditation

PubMed Central

Alemnji, George; Edghill, Lisa; Wallace-Sankarsingh, Sacha; Albalak, Rachel; Cognat, Sebastien; Nkengasong, John; Gabastou, Jean-Marc

2017-01-01

Background Implementing quality management systems and accrediting laboratories in the Caribbean has been a challenge. Objectives We report the development of a stepwise process for quality systems improvement in the Caribbean Region. Methods The Caribbean Laboratory Stakeholders met under a joint Pan American Health Organization/US Centers for Disease Control and Prevention initiative and developed a user-friendly framework called ‘Laboratory Quality Management System – Stepwise Improvement Process (LQMS-SIP) Towards Accreditation’ to support countries in strengthening laboratory services through a stepwise approach toward fulfilling the ISO 15189: 2012 requirements. Results This approach consists of a three-tiered framework. Tier 1 represents the minimum requirements corresponding to the mandatory criteria for obtaining a licence from the Ministry of Health of the participating country. The next two tiers are quality improvement milestones that are achieved through the implementation of specific quality management system requirements. Laboratories that meet the requirements of the three tiers will be encouraged to apply for accreditation. The Caribbean Regional Organisation for Standards and Quality hosts the LQMS-SIP Secretariat and will work with countries, including the Ministry of Health and stakeholders, including laboratory staff, to coordinate and implement LQMS-SIP activities. The Caribbean Public Health Agency will coordinate and advocate for the LQMS-SIP implementation. Conclusion This article presents the Caribbean LQMS-SIP framework and describes how it will be implemented among various countries in the region to achieve quality improvement. PMID:28879149
A Two-Tier Multiple Choice Questions to Diagnose Thermodynamic Misconception of Thai and Laos Students

NASA Astrophysics Data System (ADS)

Kamcharean, Chanwit; Wattanakasiwich, Pornrat

The objective of this study was to diagnose misconceptions of Thai and Lao students in thermodynamics by using a two-tier multiple-choice test. Two-tier multiple choice questions consist of the first tier, a content-based question and the second tier, a reasoning-based question. Data of student understanding was collected by using 10 two-tier multiple-choice questions. Thai participants were the first-year students (N = 57) taking a fundamental physics course at Chiang Mai University in 2012. Lao participants were high school students in Grade 11 (N = 57) and Grade 12 (N = 83) at Muengnern high school in Xayaboury province, Lao PDR. As results, most students answered content-tier questions correctly but chose incorrect answers for reason-tier questions. When further investigating their incorrect reasons, we found similar misconceptions as reported in previous studies such as incorrectly relating pressure with temperature when presenting with multiple variables.
Tier II Interventions within the Framework of School-Wide Positive Behavior Support: Essential Features for Design, Implementation, and Maintenance.

PubMed

Anderson, Cynthia M; Borgmeier, Chris

2010-01-01

To meet the complex social behavioral and academic needs of all students, schools benefit from having available multiple evidence-based interventions of varying intensity. School-wide positive behavior support provides a framework within which a continuum of evidence-based interventions can be implemented in a school. This framework includes three levels or tiers of intervention; Tier I (primary or universal), Tier II (secondary or targeted), and Tier III (tertiary or individualized) supports. In this paper we review the logic behind school-wide positive behavior support and then focus on Tier II interventions, as this level of support has received the least attention in the literature. We delineate the key features of Tier II interventions as implemented within school-wide positive behavior support, provide guidelines for matching Tier II interventions to school and student needs, and describe how schools plan for implementation and maintenance of selected interventions.
Extending access to essential services against constraints: the three-tier health service delivery system in rural China (1949-1980).

PubMed

Feng, Xing Lin; Martinez-Alvarez, Melisa; Zhong, Jun; Xu, Jin; Yuan, Beibei; Meng, Qingyue; Balabanova, Dina

2017-05-23

China has made remarkable progress in scaling up essential services during the last six decades, making health care increasingly available in rural areas. This was partly achieved through the building of a three-tier health system in the 1950s, established as a linked network with health service facilities at county, township and village level, to extend services to the whole population. We developed a Theory of Change to chart the policy context, contents and mechanisms that may have facilitated the establishment of the three-tier health service delivery system in rural China. We systematically synthesized the best available evidence on how China achieved universal access to essential services in resource-scarce rural settings, with a particular emphasis on the experiences learned before the 1980s, when the country suffered a particularly acute lack of resources. The search identified only three peered-reviewed articles that fit our criteria for scientific rigor. We therefore drew extensively on government policy documents, and triangulated them with other publications and key informant interviews. We found that China's three-tier health service delivery system was established in response to acute health challenges, including high fertility and mortality rates. Health system resources were extremely low in view of the needs and insufficient to extend access to even basic care. With strong political commitment to rural health and a "health-for-all" policy vision underlying implementation, a three-tier health service delivery model connecting villages, townships and counties was quickly established. We identified several factors that contributed to the success of the three-tier system in China: a realistic health human resource development strategy, use of mass campaigns as a vehicle to increase demand, an innovative financing mechanisms, public-private partnership models in the early stages of scale up, and an integrated approach to service delivery. An implementation process involving gradual adaptation and incorporation of the lessons learnt was also essential. China's 60 year experience in establishing a de-professionalized, community-based, health service delivery model that is economically feasible, institutionally and culturally appropriate mechanism can be useful to other low- and middle-income countries (LMICs) seeking to extend essential services. Lessons can be drawn from both reform content and from its implementation pathway, identifying the political, institutional and contextual factors shaping the three-tier delivery model over time.
Differential Effectiveness of Interdependent and Dependent Group Contingencies in Reducing Disruptive Classroom Behavior

ERIC Educational Resources Information Center

Hartman, Kelsey; Gresham, Frank

2016-01-01

Disruptive behavior in the classroom negatively affects all students' academic engagement, achievement, and behavior. Group contingencies have been proven effective in reducing disruptive behavior as part of behavior interventions in the classroom. The Good Behavior Game is a Tier 1 classwide intervention that utilizes an interdependent group…
40 CFR 1043.50 - Approval of methods to meet Tier 1 retrofit NOX standards.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Approval of methods to meet Tier 1... SUBJECT TO THE MARPOL PROTOCOL § 1043.50 Approval of methods to meet Tier 1 retrofit NOX standards... enable Pre-Tier 1 engines to meet the Tier 1 NOX standard of regulation 13 of Annex VI. Any person may...
40 CFR 92.305 - Credit generation and use calculation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... and Tier 1 PM line-haul credits; Std=0.59 g/kW-hr, for Tier 0 and Tier 1 PM switch credits; and Std.... For Tier 1 and Tier 2 engine families, the FEL may not exceed the limit established in § 92.304(k) for...). Consistent units are to be used throughout the calculation. (1) When useful life is expressed in terms of...
Building Tier 3 Intervention for Long-Term Slow Growers in Grades 3-4: A Pilot Study

ERIC Educational Resources Information Center

Sanchez, Victoria M.; O'Connor, Rollanda E.

2015-01-01

Tier 3 interventions are necessary for improving the reading performance of students who fail to respond adequately to Tier 1 general education instruction and Tier 2 supplemental reading intervention. In this pilot study, we identified 8 students in 3rd and 4th grade who had demonstrated slow response to Tier 2 reading interventions for three…
Tier-specific evolution of match performance characteristics in the English Premier League: it's getting tougher at the top.

PubMed

Bradley, Paul S; Archer, David T; Hogg, Bob; Schuth, Gabor; Bush, Michael; Carling, Chris; Barnes, Chris

2016-01-01

This study investigated the evolution of physical and technical performances in the English Premier League (EPL), with special reference to league ranking. Match performance observations (n = 14,700) were collected using a multiple-camera computerised tracking system across seven consecutive EPL seasons (2006-07 to 2012-13). Final league rankings were classified into Tiers: (A) 1st-4th ranking (n = 2519), (B) 5th-8th ranking (n = 2965), (C) 9th-14th ranking (n = 4448) and (D) 15th-20th ranking (n = 4768). Teams in Tier B demonstrated moderate increases in high-intensity running distance while in ball possession from the 2006-07 to 2012-13 season (P < 0.001; effect size [ES]: 0.68), with Tiers A, C and D producing less pronounced increases across the same period (P < 0.005; ES: 0.26, 0.41 and 0.33, respectively). Large increases in sprint distance were observed from the 2006-07 to 2012-13 season for Tier B (P < 0.001; ES: 1.21), while only moderate increases were evident for Tiers A, C and D (P < 0.001; ES: 0.75, 0.97 and 0.84, respectively). Tier B demonstrated large increases in the number of passes performed and received in 2012-13 compared to 2006-07 (P < 0.001; ES: 1.32-1.53) with small-to-moderate increases in Tier A (P < 0.001; ES: 0.30-0.38), Tier C (P < 0.001; ES: 0.46-0.54) and Tier D (P < 0.001; ES: 0.69-0.87). The demarcation line between 4th (bottom of Tier A) and 5th ranking (top of Tier B) in the 2006-07 season was 8 points, but this decreased to just a single point in the 2012-13 season. The data demonstrate that physical and technical performances have evolved more in Tier B than any other Tier in the EPL and could indicate a narrowing of the performance gap between the top two Tiers.
Prospective Environmental Risk Assessment for Sediment-Bound Organic Chemicals: A Proposal for Tiered Effect Assessment.

PubMed

Diepens, Noël J; Koelmans, Albert A; Baveco, Hans; van den Brink, Paul J; van den Heuvel-Greve, Martine J; Brock, Theo C M

A broadly accepted framework for prospective environmental risk assessment (ERA) of sediment-bound organic chemicals is currently lacking. Such a framework requires clear protection goals, evidence-based concepts that link exposure to effects and a transparent tiered-effect assessment. In this paper, we provide a tiered prospective sediment ERA procedure for organic chemicals in sediment, with a focus on the applicable European regulations and the underlying data requirements. Using the ecosystem services concept, we derived specific protection goals for ecosystem service providing units: microorganisms, benthic algae, sediment-rooted macrophytes, benthic invertebrates and benthic vertebrates. Triggers for sediment toxicity testing are discussed.We recommend a tiered approach (Tier 0 through Tier 3). Tier-0 is a cost-effective screening based on chronic water-exposure toxicity data for pelagic species and equilibrium partitioning. Tier-1 is based on spiked sediment laboratory toxicity tests with standard benthic test species and standardised test methods. If comparable chronic toxicity data for both standard and additional benthic test species are available, the Species Sensitivity Distribution (SSD) approach is a more viable Tier-2 option than the geometric mean approach. This paper includes criteria for accepting results of sediment-spiked single species toxicity tests in prospective ERA, and for the application of the SSD approach. We propose micro/mesocosm experiments with spiked sediment, to study colonisation success by benthic organisms, as a Tier-3 option. Ecological effect models can be used to supplement the experimental tiers. A strategy for unifying information from various tiers by experimental work and exposure-and effect modelling is provided.
Novel tradable instruments in the conservation of coral reefs, based on the coral gardening concept for reef restoration.

PubMed

Rinkevich, Baruch

2015-10-01

Nearly all coral reefs bordering nations have experienced net losses in reef biodiversity, goods and services, even without considering the ever-developing global change impacts. In response, this overview wishes to reveal through prospects of active reef-restoration, the currently non-marketed or poorly marketed reef services, focusing on a single coral species (Stylophora pistillata). It is implied that the integration of equity capitals and other commodification with reef-restoration practices will improve total reef services. Two tiers of market-related activities are defined, the traditional first-tier instruments (valuating costs/gains for extracting tradable goods and services) and novel second-tier instruments (new/expanded monetary tools developed as by-products of reef restoration measures). The emerging new suite of economic mechanisms based on restoration methodologies could be served as an incentive for ecosystem conservation, enhancing the sum values of all services generated by coral reefs, where the same stocks of farmed/transplanted coral colonies will be used as market instruments. I found that active restoration measures disclose 12 classes of second-tier goods and services, which may partly/wholly finance restoration acts, bringing to light reef capitalizations that allow the expansion of markets with products that have not been considered before. The degree to which the second tier of market-related services could buffer coral-reef degradation is still unclear and would vary with different reef types and in various reef restoration scenarios; however, reducing the uncertainty associated with restoration. It is expected that the expansion of markets with the new products and the enhancement of those already existing will be materialized even if reef ecosystems will recover into different statuses. Copyright © 2015 Elsevier Ltd. All rights reserved.
A component-based, distributed object services architecture for a clinical workstation.

PubMed

Chueh, H C; Raila, W F; Pappas, J J; Ford, M; Zatsman, P; Tu, J; Barnett, G O

1996-01-01

Attention to an architectural framework in the development of clinical applications can promote reusability of both legacy systems as well as newly designed software. We describe one approach to an architecture for a clinical workstation application which is based on a critical middle tier of distributed object-oriented services. This tier of network-based services provides flexibility in the creation of both the user interface and the database tiers. We developed a clinical workstation for ambulatory care using this architecture, defining a number of core services including those for vocabulary, patient index, documents, charting, security, and encounter management. These services can be implemented through proprietary or more standard distributed object interfaces such as CORBA and OLE. Services are accessed over the network by a collection of user interface components which can be mixed and matched to form a variety of interface styles. These services have also been reused with several applications based on World Wide Web browser interfaces.
A component-based, distributed object services architecture for a clinical workstation.

PubMed Central

Chueh, H. C.; Raila, W. F.; Pappas, J. J.; Ford, M.; Zatsman, P.; Tu, J.; Barnett, G. O.

1996-01-01

Attention to an architectural framework in the development of clinical applications can promote reusability of both legacy systems as well as newly designed software. We describe one approach to an architecture for a clinical workstation application which is based on a critical middle tier of distributed object-oriented services. This tier of network-based services provides flexibility in the creation of both the user interface and the database tiers. We developed a clinical workstation for ambulatory care using this architecture, defining a number of core services including those for vocabulary, patient index, documents, charting, security, and encounter management. These services can be implemented through proprietary or more standard distributed object interfaces such as CORBA and OLE. Services are accessed over the network by a collection of user interface components which can be mixed and matched to form a variety of interface styles. These services have also been reused with several applications based on World Wide Web browser interfaces. PMID:8947744
Positive youth development programs for adolescents with greater psychosocial needs: evaluation based on program implementers.

PubMed

Shek, Daniel T L; Ng, Catalina S M; Law, Moon Y M

2017-02-01

As program implementers' views are seldom included in program evaluation and there are few related studies in different Chinese communities, this study examined the perceptions of the program implementers who implemented the Tier 2 Program of the P.A.T.H.S. Program in Hong Kong. The Tier 2 Program was designed to promote the development of adolescents with greater psychosocial needs. In the community-based P.A.T.H.S. Project, 400 program implementers completed a subjective outcome evaluation form (Form D) for program implementers. Consistent with the previous findings, program implementers generally held positive views towards the program, implementers, and program effectiveness and their views towards these three domains did not differ across grades. In line with the hypotheses, perceived program quality and perceived implementer quality predicted program effectiveness. The present findings provided an alternative perspective showing that the Tier 2 Program was well received by the program implementers and they regarded the program to be beneficial to the program participants.
Single-tier city logistics model for single product

NASA Astrophysics Data System (ADS)

Saragih, N. I.; Nur Bahagia, S.; Suprayogi; Syabri, I.

2017-11-01

This research develops single-tier city logistics model which consists of suppliers, UCCs, and retailers. The problem that will be answered in this research is how to determine the location of UCCs, to allocate retailers to opened UCCs, to assign suppliers to opened UCCs, to control inventory in the three entities involved, and to determine the route of the vehicles from opened UCCs to retailers. This model has never been developed before. All the decisions will be simultaneously optimized. Characteristic of the demand is probabilistic following a normal distribution, and the number of product is single.
Estimating Implementation and Operational Costs of an Integrated Tiered CD4 Service including Laboratory and Point of Care Testing in a Remote Health District in South Africa

PubMed Central

Cassim, Naseem; Coetzee, Lindi M.; Schnippel, Kathryn; Glencross, Deborah K.

2014-01-01

Background An integrated tiered service delivery model (ITSDM) has been proposed to provide ‘full-coverage’ of CD4 services throughout South Africa. Five tiers are described, defined by testing volumes and number of referring health-facilities. These include: (1) Tier-1/decentralized point-of-care service (POC) in a single site; Tier-2/POC-hub servicing processing <30–40 samples from 8–10 health-clinics; Tier-3/Community laboratories servicing ∼50 health-clinics, processing <150 samples/day; high-volume centralized laboratories (Tier-4 and Tier-5) processing <300 or >600 samples/day and serving >100 or >200 health-clinics, respectively. The objective of this study was to establish costs of existing and ITSDM-tiers 1, 2 and 3 in a remote, under-serviced district in South Africa. Methods Historical health-facility workload volumes from the Pixley-ka-Seme district, and the total volumes of CD4 tests performed by the adjacent district referral CD4 laboratories, linked to locations of all referring clinics and related laboratory-to-result turn-around time (LTR-TAT) data, were extracted from the NHLS Corporate-Data-Warehouse for the period April-2012 to March-2013. Tiers were costed separately (as a cost-per-result) including equipment, staffing, reagents and test consumable costs. A one-way sensitivity analyses provided for changes in reagent price, test volumes and personnel time. Results The lowest cost-per-result was noted for the existing laboratory-based Tiers- 4 and 5 ($6.24 and $5.37 respectively), but with related increased LTR-TAT of >24–48 hours. Full service coverage with TAT <6-hours could be achieved with placement of twenty-seven Tier-1/POC or eight Tier-2/POC-hubs, at a cost-per-result of $32.32 and $15.88 respectively. A single district Tier-3 laboratory also ensured ‘full service coverage’ and <24 hour LTR-TAT for the district at $7.42 per-test. Conclusion Implementing a single Tier-3/community laboratory to extend and improve delivery of services in Pixley-ka-Seme, with an estimated local ∼12–24-hour LTR-TAT, is ∼$2 more than existing referred services per-test, but 2–4 fold cheaper than implementing eight Tier-2/POC-hubs or providing twenty-seven Tier-1/POCT CD4 services. PMID:25517412
76 FR 11381 - Magnuson-Stevens Act Provisions; Fisheries Off West Coast States; Pacific Coast Groundfish...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-02

... calculate the fixed gear primary sablefish fishery tier limits for 2011 at a level that will reduce concerns..., 2011, NMFS is implementing the following decrease in the annual tier limits for sablefish for 2011 and beyond: From Tier 1 at 56,081-lb (25,437 kg), Tier 2 at 25,492-lb (11,562 kg), and Tier 3 at 14,567-lb (6...
Identifying Students for Secondary and Tertiary Prevention Efforts: How Do We Determine Which Students Have Tier 2 and Tier 3 Needs?

ERIC Educational Resources Information Center

Lane, Kathleen Lynne; Oakes, Wendy Peia; Ennis, Robin Parks; Hirsch, Shanna Eisner

2014-01-01

In comprehensive, integrated, three-tiered models, it is essential to have a systematic method for identifying students who need supports at Tier 2 or Tier 3. This article provides explicit information on how to use multiple sources of data to determine which students might benefit from these supports. First, the authors provide an overview of how…
Cleavage-Independent HIV-1 Trimers From CHO Cell Lines Elicit Robust Autologous Tier 2 Neutralizing Antibodies

PubMed Central

Bale, Shridhar; Martiné, Alexandra; Wilson, Richard; Behrens, Anna-Janina; Le Fourn, Valérie; de Val, Natalia; Sharma, Shailendra K.; Tran, Karen; Torres, Jonathan L.; Girod, Pierre-Alain; Ward, Andrew B.; Crispin, Max; Wyatt, Richard T.

2018-01-01

Native flexibly linked (NFL) HIV-1 envelope glycoprotein (Env) trimers are cleavage-independent and display a native-like, well-folded conformation that preferentially displays broadly neutralizing determinants. The NFL platform simplifies large-scale production of Env by eliminating the need to co-transfect the precursor-cleaving protease, furin that is required by the cleavage-dependent SOSIP trimers. Here, we report the development of a CHO-M cell line that expressed BG505 NFL trimers at a high level of homogeneity and yields of ~1.8 g/l. BG505 NFL trimers purified by single-step lectin-affinity chromatography displayed a native-like closed structure, efficient recognition by trimer-preferring bNAbs, no recognition by non-neutralizing CD4 binding site-directed and V3-directed antibodies, long-term stability, and proper N-glycan processing. Following negative-selection, formulation in ISCOMATRIX adjuvant and inoculation into rabbits, the trimers rapidly elicited potent autologous tier 2 neutralizing antibodies. These antibodies targeted the N-glycan “hole” naturally present on the BG505 Env proximal to residues at positions 230, 241, and 289. The BG505 NFL trimers that did not expose V3 in vitro, elicited low-to-no tier 1 virus neutralization in vivo, indicating that they remained intact during the immunization process, not exposing V3. In addition, BG505 NFL and BG505 SOSIP trimers expressed from 293F cells, when formulated in Adjuplex adjuvant, elicited equivalent BG505 tier 2 autologous neutralizing titers. These titers were lower in potency when compared to the titers elicited by CHO-M cell derived trimers. In addition, increased neutralization of tier 1 viruses was detected. Taken together, these data indicate that both adjuvant and cell-type expression can affect the elicitation of tier 2 and tier 1 neutralizing responses in vivo.

Ensuring Safety of Navigation: A Three-Tiered Approach

NASA Astrophysics Data System (ADS)

Johnson, S. D.; Thompson, M.; Brazier, D.

2014-12-01

The primary responsibility of the Hydrographic Department at the Naval Oceanographic Office (NAVOCEANO) is to support US Navy surface and sub-surface Safety of Navigation (SoN) requirements. These requirements are interpreted, surveys are conducted, and accurate products are compiled and archived for future exploitation. For a number of years NAVOCEANO has employed a two-tiered data-basing structure to support SoN. The first tier (Data Warehouse, or DWH) provides access to the full-resolution sonar and lidar data. DWH preserves the original data such that any scale product can be built. The second tier (Digital Bathymetric Database - Variable resolution, or DBDB-V) served as the final archive for SoN chart scale, gridded products compiled from source bathymetry. DBDB-V has been incorporated into numerous DoD tactical decision aids and serves as the foundation bathymetry for ocean modeling. With the evolution of higher density survey systems and the addition of high-resolution gridded bathymetry product requirements, a two-tiered model did not provide an efficient solution for SoN. The two-tiered approach required scientists to exploit full-resolution data in order to build any higher resolution product. A new perspective on the archival and exploitation of source data was required. This new perspective has taken the form of a third tier, the Navigation Surface Database (NSDB). NSDB is an SQLite relational database populated with International Hydrographic Organization (IHO), S-102 compliant Bathymetric Attributed Grids (BAGs). BAGs archived within NSDB are developed at the highest resolution that the collection sensor system can support and contain nodal estimates for depth, uncertainty, separation values and metadata. Gridded surface analysis efforts culminate in the generation of the source resolution BAG files and their storage within NSDB. Exploitation of these resources eliminates the time and effort needed to re-grid and re-analyze native source file formats.
Strain-Specific V3 and CD4 Binding Site Autologous HIV-1 Neutralizing Antibodies Select Neutralization-Resistant Viruses

DOE PAGES

Moody, M. Anthony; Gao, Feng; Gurley, Thaddeus C.; ...

2015-09-09

The third variable (V3) loop and the CD4 binding site (CD4bs) of the viral envelope are frequently targeted by neutralizing antibodies (nAbs) in HIV-1-infected individuals. In chronic infection, virus escape mutants repopulate the plasma and V3 and CD4bs nAbs emerge that can neutralize heterologous tier 1 easy-to-neutralize, but not tier 2 difficult-to-neutralize HIV-1 isolates. However, neutralization sensitivity of autologous plasma viruses to this type of nAb response has not been studied. We describe the development and evolution in vivo of antibodies distinguished by their target specificity for V3and CD4bs epitopes on autologous tier 2 viruses but not on heterologous tiermore » 2 viruses. A surprisingly high fraction of autologous circulating viruses was sensitive to these antibodies. These findings demonstrate a role for V3 and CD4bs antibodies in constraining the native envelope trimer in vivo to a neutralization-resistant phenotype, explaining why HIV-1 transmission generally occurs by tier 2 neutralization-resistant viruses.« less
Strain-Specific V3 and CD4 Binding Site Autologous HIV-1 Neutralizing Antibodies Select Neutralization-Resistant Viruses

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

Moody, M. Anthony; Gao, Feng; Gurley, Thaddeus C.

The third variable (V3) loop and the CD4 binding site (CD4bs) of the viral envelope are frequently targeted by neutralizing antibodies (nAbs) in HIV-1-infected individuals. In chronic infection, virus escape mutants repopulate the plasma and V3 and CD4bs nAbs emerge that can neutralize heterologous tier 1 easy-to-neutralize, but not tier 2 difficult-to-neutralize HIV-1 isolates. However, neutralization sensitivity of autologous plasma viruses to this type of nAb response has not been studied. We describe the development and evolution in vivo of antibodies distinguished by their target specificity for V3and CD4bs epitopes on autologous tier 2 viruses but not on heterologous tiermore » 2 viruses. A surprisingly high fraction of autologous circulating viruses was sensitive to these antibodies. These findings demonstrate a role for V3 and CD4bs antibodies in constraining the native envelope trimer in vivo to a neutralization-resistant phenotype, explaining why HIV-1 transmission generally occurs by tier 2 neutralization-resistant viruses.« less
Collusion-aware privacy-preserving range query in tiered wireless sensor networks.

PubMed

Zhang, Xiaoying; Dong, Lei; Peng, Hui; Chen, Hong; Zhao, Suyun; Li, Cuiping

2014-12-11

Wireless sensor networks (WSNs) are indispensable building blocks for the Internet of Things (IoT). With the development of WSNs, privacy issues have drawn more attention. Existing work on the privacy-preserving range query mainly focuses on privacy preservation and integrity verification in two-tiered WSNs in the case of compromisedmaster nodes, but neglects the damage of node collusion. In this paper, we propose a series of collusion-aware privacy-preserving range query protocols in two-tiered WSNs. To the best of our knowledge, this paper is the first to consider collusion attacks for a range query in tiered WSNs while fulfilling the preservation of privacy and integrity. To preserve the privacy of data and queries, we propose a novel encoding scheme to conceal sensitive information. To preserve the integrity of the results, we present a verification scheme using the correlation among data. In addition, two schemes are further presented to improve result accuracy and reduce communication cost. Finally, theoretical analysis and experimental results confirm the efficiency, accuracy and privacy of our proposals.
Collusion-Aware Privacy-Preserving Range Query in Tiered Wireless Sensor Networks†

PubMed Central

Zhang, Xiaoying; Dong, Lei; Peng, Hui; Chen, Hong; Zhao, Suyun; Li, Cuiping

2014-01-01

Wireless sensor networks (WSNs) are indispensable building blocks for the Internet of Things (IoT). With the development of WSNs, privacy issues have drawn more attention. Existing work on the privacy-preserving range query mainly focuses on privacy preservation and integrity verification in two-tiered WSNs in the case of compromised master nodes, but neglects the damage of node collusion. In this paper, we propose a series of collusion-aware privacy-preserving range query protocols in two-tiered WSNs. To the best of our knowledge, this paper is the first to consider collusion attacks for a range query in tiered WSNs while fulfilling the preservation of privacy and integrity. To preserve the privacy of data and queries, we propose a novel encoding scheme to conceal sensitive information. To preserve the integrity of the results, we present a verification scheme using the correlation among data. In addition, two schemes are further presented to improve result accuracy and reduce communication cost. Finally, theoretical analysis and experimental results confirm the efficiency, accuracy and privacy of our proposals. PMID:25615731
A Carbon Monitoring System Approach to US Coastal Wetland Carbon Fluxes: Progress Towards a Tier II Accounting Method with Uncertainty Quantification

NASA Astrophysics Data System (ADS)

Windham-Myers, L.; Holmquist, J. R.; Bergamaschi, B. A.; Byrd, K. B.; Callaway, J.; Crooks, S.; Drexler, J. Z.; Feagin, R. A.; Ferner, M. C.; Gonneea, M. E.; Kroeger, K. D.; Megonigal, P.; Morris, J. T.; Schile, L. M.; Simard, M.; Sutton-Grier, A.; Takekawa, J.; Troxler, T.; Weller, D.; Woo, I.

2015-12-01

Despite their high rates of long-term carbon (C) sequestration when compared to upland ecosystems, coastal C accounting is only recently receiving the attention of policy makers and carbon markets. Assessing accuracy and uncertainty in net C flux estimates requires both direct and derived measurements based on both short and long term dynamics in key drivers, particularly soil accretion rates and soil organic content. We are testing the ability of remote sensing products and national scale datasets to estimate biomass and soil stocks and fluxes over a wide range of spatial and temporal scales. For example, the 2013 Wetlands Supplement to the 2006 IPCC GHG national inventory reporting guidelines requests information on development of Tier I-III reporting, which express increasing levels of detail. We report progress toward development of a Carbon Monitoring System for "blue carbon" that may be useful for IPCC reporting guidelines at Tier II levels. Our project uses a current dataset of publically available and contributed field-based measurements to validate models of changing soil C stocks, across a broad range of U.S. tidal wetland types and landuse conversions. Additionally, development of biomass algorithms for both radar and spectral datasets will be tested and used to determine the "price of precision" of different satellite products. We discuss progress in calculating Tier II estimates focusing on variation introduced by the different input datasets. These include the USFWS National Wetlands Inventory, NOAA Coastal Change Analysis Program, and combinations to calculate tidal wetland area. We also assess the use of different attributes and depths from the USDA-SSURGO database to map soil C density. Finally, we examine the relative benefit of radar, spectral and hybrid approaches to biomass mapping in tidal marshes and mangroves. While the US currently plans to report GHG emissions at a Tier I level, we argue that a Tier II analysis is possible due to national maps of wetland area and soil carbon, as well as sediment accretion and sea-level rise correlations and wetland area change data. The uncertainty analyses performed nationally and in six regionally-representative "sentinel sites" will be an important guide for future efforts towards more accurate and complete wetland C inventories.
Design of the Resources and Environment Monitoring Website in Kashgar

NASA Astrophysics Data System (ADS)

Huang, Z.; Lin, Q. Z.; Wang, Q. J.

2014-03-01

Despite the development of the web geographical information system (web GIS), many useful spatial analysis functions are ignored in the system implementation. As Kashgar is rich in natural resources, it is of great significance to monitor the ample natural resource and environment situation in the region. Therefore, with multiple uses of spatial analysis, resources and environment monitoring website of Kashgar was built. Functions of water, vegetation, ice and snow extraction, task management, change assessment as well as thematic mapping and reports based on TM remote sensing images were implemented in the website. The design of the website was presented based on database management tier, the business logic tier and the top-level presentation tier. The vital operations of the website were introduced and the general performance was evaluated.
Genetically modified crops and aquatic ecosystems: considerations for environmental risk assessment and non-target organism testing.

PubMed

Carstens, Keri; Anderson, Jennifer; Bachman, Pamela; De Schrijver, Adinda; Dively, Galen; Federici, Brian; Hamer, Mick; Gielkens, Marco; Jensen, Peter; Lamp, William; Rauschen, Stefan; Ridley, Geoff; Romeis, Jörg; Waggoner, Annabel

2012-08-01

Environmental risk assessments (ERA) support regulatory decisions for the commercial cultivation of genetically modified (GM) crops. The ERA for terrestrial agroecosystems is well-developed, whereas guidance for ERA of GM crops in aquatic ecosystems is not as well-defined. The purpose of this document is to demonstrate how comprehensive problem formulation can be used to develop a conceptual model and to identify potential exposure pathways, using Bacillus thuringiensis (Bt) maize as a case study. Within problem formulation, the insecticidal trait, the crop, the receiving environment, and protection goals were characterized, and a conceptual model was developed to identify routes through which aquatic organisms may be exposed to insecticidal proteins in maize tissue. Following a tiered approach for exposure assessment, worst-case exposures were estimated using standardized models, and factors mitigating exposure were described. Based on exposure estimates, shredders were identified as the functional group most likely to be exposed to insecticidal proteins. However, even using worst-case assumptions, the exposure of shredders to Bt maize was low and studies supporting the current risk assessments were deemed adequate. Determining if early tier toxicity studies are necessary to inform the risk assessment for a specific GM crop should be done on a case by case basis, and should be guided by thorough problem formulation and exposure assessment. The processes used to develop the Bt maize case study are intended to serve as a model for performing risk assessments on future traits and crops.
A Tiered Mentoring Model of Exposing and Engaging Students with Research Throughout the Undergraduate Curriculum

NASA Astrophysics Data System (ADS)

Guerard, J.; Hayes, S. M.

2015-12-01

Incorporating research into undergraduate curricula has been linked to improved critical thinking, intellectual independence, and student retention, resulting in a graduating population more ready for the workforce or graduate school. We have designed a three-tier model of undergraduate chemistry courses that enable first-year students with no previous research experience to gain the skills needed to develop, fund and execute independent research projects by the close of their undergraduate studies. First-year students are provided with context through a broadly focused introductory class that exposes them to current faculty research activities, and also gives them direct experience with the research process through peer mentored research teams as they participate in faculty-directed projects. Mid-career undergraduate students receive exposure and support in two formats: illustrative examples from current faculty research are incorporated into lessons in core classes, and courses specially designed to foster research independence. This is done by providing content and process mentoring as students develop independent projects, write proposals, and build relationships with faculty and graduate students in research groups. Advanced undergraduates further develop their research independence performing student-designed projects with faculty collaboration that frequently result in tangible research products. Further, graduate students gain experience in mentoring though formal training, as well as through actively mentoring mid-career undergraduates. This novel, integrated approach enables faculty to directly incorporate their research into all levels of the undergraduate curriculum while fostering undergraduates in developing and executing independent projects and empowering mentoring relationships.
Atmospheric River Tracking Method Intercomparison Project (ARTMIP): Science Goals and Preliminary Analysis

NASA Astrophysics Data System (ADS)

Shields, C. A.; Rutz, J. J.; Wehner, M. F.; Ralph, F. M.; Leung, L. R.

2017-12-01

The Atmospheric River Tracking Method Intercomparison Project (ARTMIP) is a community effort whose purpose is to quantify uncertainties in atmospheric river (AR) research solely due to different identification and tracking techniques. Atmospheric rivers transport significant amounts of moisture in long, narrow filamentary bands, typically travelling from the subtropics to the mid-latitudes. They are an important source of regional precipitation impacting local hydroclimate, and in extreme cases, cause severe flooding and infrastructure damage in local communities. Our understanding of ARs, from forecast skill to future climate projections, all hinge on how we define ARs. By comparing a diverse set of detection algorithms, the uncertainty in our definition of ARs, (including statistics and climatology), and the implications of those uncertainties, can be analyzed and quantified. ARTMIP is divided into two broad phases that aim to answer science questions impacted by choice of detection algorithm. How robust are AR metrics such as climatology, storm duration, and relationship to extreme precipitation? How are the AR metrics in future climate projections impacted by choice of algorithm? Some algorithms rely on threshold values for water vapor. In a warmer world, the background state, by definition, is moister due to the Clausius-Clapeyron relationship, and could potentially skew results. Can uncertainty bounds be accurately placed on each metric? Tier 1 participants will apply their algorithms to a high resolution common dataset (MERRA2) and provide the greater group AR metrics (frequency, location, duration, etc). Tier 2 research will encompass sensitivity studies regarding resolution, reanalysis choice, and future climate change scenarios. ARTMIP is currently in the Tier 1 Phase and will begin Tier 2 in 2018. Preliminary metrics and analysis from Tier 1 will be presented.
A Five-Tier System for Improving the Categorization of Transplant Program Performance.

PubMed

Wey, Andrew; Salkowski, Nicholas; Kasiske, Bertram L; Israni, Ajay K; Snyder, Jon J

2018-06-01

To better inform health care consumers by better identifying differences in transplant program performance. Adult kidney transplants performed in the United States, January 1, 2012-June 30, 2014. In December 2016, the Scientific Registry of Transplant Recipients instituted a five-tier system for reporting transplant program performance. We compare the differentiation of program performance and the simulated misclassification rate of the five-tier system with the previous three-tier system based on the 95 percent credible interval. Scientific Registry of Transplant Recipients database. The five-tier system improved differentiation and maintained a low misclassification rate of less than 22 percent for programs differing by two tiers. The five-tier system will better inform health care consumers of transplant program performance. © Health Research and Educational Trust.
A Multi-Tiered Approach for Building Capacity in Hydrologic Modeling for Water Resource Management in Developing Regions

NASA Astrophysics Data System (ADS)

Markert, K. N.; Limaye, A. S.; Rushi, B. R.; Adams, E. C.; Anderson, E.; Ellenburg, W. L.; Mithieu, F.; Griffin, R.

2017-12-01

Water resource management is the process by which governments, businesses and/or individuals reach and implement decisions that are intended to address the future quantity and/or quality of water for societal benefit. The implementation of water resource management typically requires the understanding of the quantity and/or timing of a variety of hydrologic variables (e.g. discharge, soil moisture and evapotranspiration). Often times these variables for management are simulated using hydrologic models particularly in data sparse regions. However, there are several large barriers to entry in learning how to use models, applying best practices during the modeling process, and selecting and understanding the most appropriate model for diverse applications. This presentation focuses on a multi-tiered approach to bring the state-of-the-art hydrologic modeling capabilities and methods to developing regions through the SERVIR program, a joint NASA and USAID initiative that builds capacity of regional partners and their end users on the use of Earth observations for environmental decision making. The first tier is a series of trainings on the use of multiple hydrologic models, including the Variable Infiltration Capacity (VIC) and Ensemble Framework For Flash Flood Forecasting (EF5), which focus on model concepts and steps to successfully implement the models. We present a case study for this in a pilot area, the Nyando Basin in Kenya. The second tier is focused on building a community of practice on applied hydrology modeling aimed at creating a support network for hydrologists in SERVIR regions and promoting best practices. The third tier is a hydrologic inter-comparison project under development in the SERVIR regions. The objective of this step is to understand model performance under specific decision-making scenarios, and to share knowledge among hydrologists in SERVIR regions. The results of these efforts include computer programs, training materials, and new scientific understanding, all of which are shared in an open and collaborative environment for transparency and subsequent capacity building in SERVIR regions and beyond. The outcome of this work is increased awareness and capacity on the use of hydrologic models in developing regions to support water resource management and water security.
Evaluation of bioMérieux's Dissociated Vidas Lyme IgM II and IgG II as a First-Tier Diagnostic Assay for Lyme Disease

PubMed Central

Delorey, Mark J.; Replogle, Adam; Sexton, Christopher; Schriefer, Martin E.

2017-01-01

ABSTRACT The recommended laboratory diagnostic approach for Lyme disease is a standard two-tiered testing (STTT) algorithm where the first tier is typically an enzyme immunoassay (EIA) that if positive or equivocal is reflexed to Western immunoblotting as the second tier. bioMérieux manufactures one of the most commonly used first-tier EIAs in the United States, the combined IgM/IgG Vidas test (LYT). Recently, bioMérieux launched its dissociated first-tier tests, the Vidas Lyme IgM II (LYM) and IgG II (LYG) EIAs, which use purified recombinant test antigens and a different algorithm than STTT. The dissociated LYM/LYG EIAs were evaluated against the combined LYT EIA using samples from 471 well-characterized Lyme patients and controls. Statistical analyses were conducted to assess the performance of these EIAs as first-tier tests and when used in two-tiered algorithms, including a modified two-tiered testing (MTTT) approach where the second-tier test was a C6 EIA. Similar sensitivities and specificities were obtained for the two testing strategies (LYT versus LYM/LYG) when used as first-tier tests (sensitivity, 83 to 85%; specificity, 85 to 88%) with an observed agreement of 80%. Sensitivities of 68 to 69% and 76 to 77% and specificities of 97% and 98 to 99% resulted when the two EIA strategies were followed by Western immunoblotting and when used in an MTTT, respectively. The MTTT approach resulted in significantly higher sensitivities than did STTT. Overall, the LYM/LYG EIAs performed equivalently to the LYT EIA in test-to-test comparisons or as first-tier assays in STTT or MTTT with few exceptions. PMID:28330884
A cloud medication safety support system using QR code and Web services for elderly outpatients.

PubMed

Tseng, Ming-Hseng; Wu, Hui-Ching

2014-01-01

Drug is an important part of disease treatment, but medication errors happen frequently and have significant clinical and financial consequences. The prevalence of prescription medication use among the ambulatory adult population increases with advancing age. Because of the global aging society, outpatients need to improve medication safety more than inpatients. The elderly with multiple chronic conditions face the complex task of medication management. To reduce the medication errors for the elder outpatients with chronic diseases, a cloud medication safety supporting system is designed, demonstrated and evaluated. The proposed system is composed of a three-tier architecture: the front-end tier, the mobile tier and the cloud tier. The mobile tier will host the personalized medication safety supporting application on Android platforms that provides some primary functions including reminders for medication, assistance with pill-dispensing, recording of medications, position of medications and notices of forgotten medications for elderly outpatients. Finally, the hybrid technology acceptance model is employed to understand the intention and satisfaction level of the potential users to use this mobile medication safety support application system. The result of the system acceptance testing indicates that this developed system, implementing patient-centered services, is highly accepted by the elderly. This proposed M-health system could assist elderly outpatients' homecare in preventing medication errors and improving their medication safety.
Progress and Challenges in Developing Tiered Quality Rating and Improvement Systems (TQRIS) in the Round 1 Race to the Top-Early Learning Challenge (RTT-ELC) States. NCEE 2018-4003

ERIC Educational Resources Information Center

Kirby, Gretchen; Caronongan, Pia; Esposito, Andrea Mraz; Murphy, Lauren; Shoji, Megan; Del Grosso, Patricia; Kiambuthi, Wamaitha; Clark, Melissa; Dragoset, Lisa

2017-01-01

This report focuses on the progress made and challenges faced by the nine states in achieving the first three objectives for which they were held accountable for use of their Race to the Top Early Learning Challenge (RTTELC) funds. It discusses discrete findings related to these objectives in relevant chapters of the report: Tiered Quality Rating…
47 CFR 76.901 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... principal headend. (d) New Product Tier. A new product tier (“NPT”) is a cable programming service tier... CABLE TELEVISION SERVICE Cable Rate Regulation § 76.901 Definitions. (a) Basic service. The basic service tier shall, at a minimum, include all signals of domestic television broadcast stations provided...
47 CFR 76.901 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... principal headend. (d) New Product Tier. A new product tier (“NPT”) is a cable programming service tier... CABLE TELEVISION SERVICE Cable Rate Regulation § 76.901 Definitions. (a) Basic service. The basic service tier shall, at a minimum, include all signals of domestic television broadcast stations provided...
47 CFR 76.901 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... principal headend. (d) New Product Tier. A new product tier (“NPT”) is a cable programming service tier... CABLE TELEVISION SERVICE Cable Rate Regulation § 76.901 Definitions. (a) Basic service. The basic service tier shall, at a minimum, include all signals of domestic television broadcast stations provided...
Retrospective analysis supports algorithm as efficient diagnostic approach to treatable intellectual developmental disabilities.

PubMed

Sayson, Bryan; Popurs, Marioara Angela Moisa; Lafek, Mirafe; Berkow, Ruth; Stockler-Ipsiroglu, Sylvia; van Karnebeek, Clara D M

2015-05-01

Intellectual developmental disorders (IDD(1)), characterized by a significant impairment in cognitive function and behavior, affect 2.5% of the population and are associated with considerable morbidity and healthcare costs. Inborn errors of metabolism (IEM) currently constitute the largest group of genetic defects presenting with IDD, which are amenable to causal therapy. Recently, we created an evidence-based 2-tiered diagnostic protocol (TIDE protocol); the first tier is a 'screening step' applied in all patients, comprising routinely performed, wide available metabolic tests in blood and urine, while second-tier tests are more specific and based on the patient's phenotype. The protocol is supported by an app (www.treatable-ID.org). To retrospectively examine the cost- and time-effectiveness of the TIDE protocol in patients identified with a treatable IEM at the British Columbia Children's Hospital. We searched the database for all IDD patients diagnosed with a treatable IEM, during the period 2000-2009 in our academic institution. Data regarding the patient's clinical phenotype, IEM, diagnostic tests and interval were collected. Total costs and time intervals associated with all testing and physician consultations actually performed were calculated and compared to the model of the TIDE protocol. Thirty-one patients (16 males) were diagnosed with treatable IDD during the period 2000-2009. For those identifiable via the 1st tier (n=20), the average cost savings would have been $311.17 CAD, and for those diagnosed via a second-tier test (n=11) $340.14 CAD. Significant diagnostic delay (mean 9 months; range 1-29 months) could have been avoided in 9 patients with first-tier diagnoses, had the TIDE protocol been used. For those with second-tier treatable IDD, diagnoses could have been more rapidly achieved with the use of the Treatable IDD app allowing for specific searches based on signs and symptoms. The TIDE protocol for treatable forms of IDD appears effective reducing diagnostic delay and unnecessary costs. Larger prospective studies, currently underway, are needed to prove that standard screening for treatable conditions in patients with IDD is time- and cost-effective, and most importantly will preserve brain function by timely diagnosis enabling initiation of causal therapy. Copyright © 2015 Elsevier Inc. All rights reserved.
6 CFR 27.220 - Tiering.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 6 Domestic Security 1 2010-01-01 2010-01-01 false Tiering. 27.220 Section 27.220 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY CHEMICAL FACILITY ANTI-TERRORISM STANDARDS Chemical Facility Security Program § 27.220 Tiering. (a) Preliminary Determination of Risk-Based Tiering. Based on...

75 FR 73166 - Publication of the Tier 2 Tax Rates

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-29

... DEPARTMENT OF THE TREASURY Internal Revenue Service Publication of the Tier 2 Tax Rates AGENCY: Internal Revenue Service, Treasury. ACTION: Notice. SUMMARY: Publication of the tier 2 tax rates for...). Tier 2 taxes on railroad employees, employers, and employee representatives are one source of funding...
75 FR 61639 - Fisheries of the Exclusive Economic Zone Off Alaska; Skate Management in the Groundfish Fisheries...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-06

... and GOA sharks, sculpins, and octopuses, and GOA squids as a group for purposes of prohibited species.../npfmc/default.htm . One alternative previously adopted for a Tier 6 stock (squid and octopus in the GOA... groups (sharks, skates, sculpins, octopus, or squid) approaches overfishing. Response: See the response...
78 FR 24241 - John Hancock Exchange-Traded Fund Trust, et al.; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-24

...\\ and Investing Fund's Sub-Advisory Group,\\28\\ to control a Single-Tier Fund within the meaning of... trusts outside of the same group of investment companies as the series to acquire Shares; and (f) certain... an entity controlling, controlled by or under common control with the Adviser and (b) comply with the...
75 FR 6033 - Agency Information Collection Request; 60-Day Public Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-05

... Initial Telephone Screen........ Active Control 2400 1 20 minutes 800 hours Group (ACG)/ Experimental Group (EG) In-person interview EG 1200 1 1.25 hours 1,500 hours Jump start phone call EG 1200 1 30... care insurance who are age 75 and over using a multi- tiered random experimental research design to...
75 FR 19976 - Agency Information Collection Request; 30-Day Public Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-16

...) hours Initial Telephone Screen...... Experimental 240 1 20/60 80 Group. In-person interview 240 1 80/60... Telephone Screen...... Active Control 240 1 20/60 80 Group. Quarterly phone calls......... 240 4 10/60 160... private long-term care insurance who are age 75 and over using a multi- tiered random experimental...
Response to Intervention for Middle School Students with Reading Difficulties: Effects of a Primary and Secondary Intervention

ERIC Educational Resources Information Center

Vaughn, Sharon; Cirino, Paul T.; Wanzek, Jeanne; Wexler, Jade; Fletcher, Jack M.; Denton, Carolyn D.; Barth, Amy; Romain, Melissa; Francis, David J.

2010-01-01

This study examined the effectiveness of a yearlong, researcher-provided, Tier 2 (secondary) intervention with a group of sixth-graders. The intervention emphasized word recognition, vocabulary, fluency, and comprehension. Participants scored below a proficiency level on their state accountability test and were compared to a similar group of…
Curriculum for neurogastroenterology and motility training: A report from the joint ANMS-ESNM task force.

PubMed

Gyawali, C P; Savarino, E; Lazarescu, A; Bor, S; Patel, A; Dickman, R; Pressman, A; Drewes, A M; Rosen, J; Drug, V; Saps, M; Novais, L; Vazquez-Roque, M; Pohl, D; van Tilburg, M A L; Smout, A; Yoon, S; Pandolfino, J; Farrugia, G; Barbara, G; Roman, S

2018-03-25

Although neurogastroenterology and motility (NGM) disorders are some of the most frequent disorders encountered by practicing gastroenterologists, a structured competency-based training curriculum developed by NGM experts is lacking. The American Neurogastroenterology and Motility Society (ANMS) and the European Society of Neurogastroenterology and Motility (ESNM) jointly evaluated the components of NGM training in North America and Europe. Eleven training domains were identified within NGM, consisting of functional gastrointestinal disorders, visceral hypersensitivity and pain pathways, motor disorders within anatomic areas (esophagus, stomach, small bowel and colon, anorectum), mucosal disorders (gastro-esophageal reflux disease, other mucosal disorders), consequences of systemic disease, consequences of therapy (surgery, endoscopic intervention, medications, other therapy), and transition of pediatric patients into adult practice. A 3-tiered training curriculum covering these domains is proposed here and endorsed by all NGM societies. Tier 1 NGM knowledge and training is expected of all gastroenterology trainees and practicing gastroenterologists. Tier 2 knowledge and training is appropriate for trainees who anticipate NGM disorder management and NGM function test interpretation being an important part of their careers, which may require competency assessment and credentialing of test interpretation skills. Tier 3 knowledge and training is undertaken by trainees interested in a dedicated NGM career and may be restricted to specific domains within the broad NGM field. The joint ANMS and ESNM task force anticipates that the NGM curriculum will streamline NGM training in North America and Europe and will lead to better identification of centers of excellence where Tier 2 and Tier 3 training can be accomplished. © 2018 The Authors. Neurogastroenterology & Motility Published by John Wiley & Sons, Ltd.
Methane emission estimation from landfills in Korea (1978-2004): quantitative assessment of a new approach.

PubMed

Kim, Hyun-Sun; Yi, Seung-Muk

2009-01-01

Quantifying methane emission from landfills is important to evaluating measures for reduction of greenhouse gas (GHG) emissions. To quantify GHG emissions and identify sensitive parameters for their measurement, a new assessment approach consisting of six different scenarios was developed using Tier 1 (mass balance method) and Tier 2 (the first-order decay method) methodologies for GHG estimation from landfills, suggested by the Intergovernmental Panel on Climate Change (IPCC). Methane emissions using Tier 1 correspond to trends in disposed waste amount, whereas emissions from Tier 2 gradually increase as disposed waste decomposes over time. The results indicate that the amount of disposed waste and the decay rate for anaerobic decomposition were decisive parameters for emission estimation using Tier 1 and Tier 2. As for the different scenarios, methane emissions were highest under Scope 1 (scenarios I and II), in which all landfills in Korea were regarded as one landfill. Methane emissions under scenarios III, IV, and V, which separated the dissimilated fraction of degradable organic carbon (DOC(F)) by waste type and/or revised the methane correction factor (MCF) by waste layer, were underestimated compared with scenarios II and III. This indicates that the methodology of scenario I, which has been used in most previous studies, may lead to an overestimation of methane emissions. Additionally, separate DOC(F) and revised MCF were shown to be important parameters for methane emission estimation from landfills, and revised MCF by waste layer played an important role in emission variations. Therefore, more precise information on each landfill and careful determination of parameter values and characteristics of disposed waste in Korea should be used to accurately estimate methane emissions from landfills.
The Clinician-Educator Pathway in Radiology: An Analysis of Institutional Promotion Criteria.

PubMed

Jhala, Khushboo; Kim, Jisoo; Chetlen, Alison; Nickerson, Joshua P; Lewis, Petra J

2017-12-01

To provide radiology departmental promotional committees and vice chairs of education with a more global perspective on the types of academic activity valued by institutions to aid in their faculty mentoring and standardizing of the Clinician-Educator (ClinEd) pathway. Ninety-two research schools were ranked into three tiers. Ranking was correlated with the presence of a ClinEd track. Thirty promotion documents (ten from each tier) were analyzed to identify common criteria. Differences in guidelines between tiers were assessed by the frequency distribution of criteria. Tier 1 had a significantly greater proportion of schools with a ClinEd track than tier 2 (73% versus 44%, p < 0.05). Thirty-nine criteria were identified and organized into four categories teaching (13), scholarship (12), service/clinical excellence (7), and research (7). The top five included meeting presentations, trainee evaluations, leadership in committees, development of teaching methodologies and materials, and publication of book chapters. First and second tier schools were most similar in frequency distribution. The criteria for the ClinEd promotion track still vary across institutions, though many commonalities exist. A handful of innovative criteria reflect the changing structure of modern health care systems, such as incorporation of online teaching modules and quality improvement efforts. As health care changes, guidelines and incentive structures for faculty should change as well. The information gathered may provide promotion committees with a more global perspective on the types of academic activity valued by modern-day institutions to aid in the national standardization of this pathway and to assist in faculty mentoring. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.
Establishing causality in the decline and deformity of amphibians: The amphibian research and monitoring initiative model

USGS Publications Warehouse

Little, E.E.; Bridges, C.M.; Linder, G.; Boone, M.; ,

2003-01-01

Research to date has indicated that a range of environmental variables such as disease, parasitism, predation, competition, environmental contamination, solar ultraviolet radiation, climate change, or habitat alteration may be responsible for declining amphibian populations and the appearance of deformed organisms, yet in many cases no definitive environmental variable stands out as a causal factor. Multiple Stressors are often present in the habitat, and interactions among these can magnify injury to biota. This raises the possibility that the additive or synergistic impact of these Stressors may be the underlying cause of amphibian declines. Effective management for the restoration of amphibian populations requires the identification of causal factors contributing to their declines. A systematic approach to determine causality is especially important because initial impressions may be misleading or ambiguous. In addition, the evaluation of amphibian populations requires consideration of a broader spatial scale than commonly used in regulatory monitoring. We describe a systematic three-tiered approach to determine causality in amphibian declines and deformities. Tier 1 includes an evaluation of historic databases and extant data and would involve a desktop synopsis of the status of various stressors as well as site visits. Tier 2 studies are iterative, hypothesis driven studies beginning with general tests and continuing with analyses of increasing complexity as certain stressors are identified for further investigation. Tier 3 applies information developed in Tier 2 as predictive indicators of habitats and species at risk over broad landscape scales and provides decision support for the adaptive management of amphibian recovery. This comprehensive, tiered program could provide a mechanistic approach to identifying and addressing specific stressors responsible for amphibian declines across various landscapes.
Analytical Study on Multi-Tier 5G Heterogeneous Small Cell Networks: Coverage Performance and Energy Efficiency.

PubMed

Xiao, Zhu; Liu, Hongjing; Havyarimana, Vincent; Li, Tong; Wang, Dong

2016-11-04

In this paper, we investigate the coverage performance and energy efficiency of multi-tier heterogeneous cellular networks (HetNets) which are composed of macrocells and different types of small cells, i.e., picocells and femtocells. By virtue of stochastic geometry tools, we model the multi-tier HetNets based on a Poisson point process (PPP) and analyze the Signal to Interference Ratio (SIR) via studying the cumulative interference from pico-tier and femto-tier. We then derive the analytical expressions of coverage probabilities in order to evaluate coverage performance in different tiers and investigate how it varies with the small cells' deployment density. By taking the fairness and user experience into consideration, we propose a disjoint channel allocation scheme and derive the system channel throughput for various tiers. Further, we formulate the energy efficiency optimization problem for multi-tier HetNets in terms of throughput performance and resource allocation fairness. To solve this problem, we devise a linear programming based approach to obtain the available area of the feasible solutions. System-level simulations demonstrate that the small cells' deployment density has a significant effect on the coverage performance and energy efficiency. Simulation results also reveal that there exits an optimal small cell base station (SBS) density ratio between pico-tier and femto-tier which can be applied to maximize the energy efficiency and at the same time enhance the system performance. Our findings provide guidance for the design of multi-tier HetNets for improving the coverage performance as well as the energy efficiency.
Analytical Study on Multi-Tier 5G Heterogeneous Small Cell Networks: Coverage Performance and Energy Efficiency

PubMed Central

Xiao, Zhu; Liu, Hongjing; Havyarimana, Vincent; Li, Tong; Wang, Dong

2016-01-01

In this paper, we investigate the coverage performance and energy efficiency of multi-tier heterogeneous cellular networks (HetNets) which are composed of macrocells and different types of small cells, i.e., picocells and femtocells. By virtue of stochastic geometry tools, we model the multi-tier HetNets based on a Poisson point process (PPP) and analyze the Signal to Interference Ratio (SIR) via studying the cumulative interference from pico-tier and femto-tier. We then derive the analytical expressions of coverage probabilities in order to evaluate coverage performance in different tiers and investigate how it varies with the small cells’ deployment density. By taking the fairness and user experience into consideration, we propose a disjoint channel allocation scheme and derive the system channel throughput for various tiers. Further, we formulate the energy efficiency optimization problem for multi-tier HetNets in terms of throughput performance and resource allocation fairness. To solve this problem, we devise a linear programming based approach to obtain the available area of the feasible solutions. System-level simulations demonstrate that the small cells’ deployment density has a significant effect on the coverage performance and energy efficiency. Simulation results also reveal that there exits an optimal small cell base station (SBS) density ratio between pico-tier and femto-tier which can be applied to maximize the energy efficiency and at the same time enhance the system performance. Our findings provide guidance for the design of multi-tier HetNets for improving the coverage performance as well as the energy efficiency. PMID:27827917
26 CFR 1.1446-5 - Tiered partnership structures.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 12 2010-04-01 2010-04-01 false Tiered partnership structures. 1.1446-5 Section...-Free Covenant Bonds § 1.1446-5 Tiered partnership structures. (a) In general. The rules of this section... prescribes rules applicable to a publicly traded partnership in a tiered partnership structure. Paragraph (e...
26 CFR 1.1503-2 - Dual consolidated loss.

Code of Federal Regulations, 2010 CFR

2010-04-01

... tiers of separate units. If a separate unit of a domestic corporation is owned indirectly through... upper-tier separate unit were a subsidiary of the domestic corporation and the lower-tier separate unit were a lower-tier subsidiary. (4) Examples. The following examples illustrate the application of this...
76 FR 71623 - Publication of the Tier 2 Tax Rates

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-18

... DEPARTMENT OF THE TREASURY Internal Revenue Service Publication of the Tier 2 Tax Rates AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice. SUMMARY: Publication of the tier 2 tax rates for...). Tier 2 taxes on railroad employees, employers, and employee representatives are one source of funding...
38 CFR 36.4318 - Servicer tier ranking-temporary procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Servicer tier ranking... § 36.4318 Servicer tier ranking—temporary procedures. (a) The Secretary shall assign to each servicer a “Tier Ranking” based upon the servicer's performance in servicing guaranteed loans. There shall be four...
47 CFR 76.922 - Rates for the basic service tier and cable programming services tiers.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 4 2010-10-01 2010-10-01 false Rates for the basic service tier and cable programming services tiers. 76.922 Section 76.922 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Cable Rate Regulation...
Systematic Implementation of a Tier 2 Behavior Intervention

ERIC Educational Resources Information Center

Carter, Deborah Russell; Carter, Gabriel M.; Johnson, Evelyn S.; Pool, Juli L.

2013-01-01

Schools are increasingly adopting tiered models of prevention to meet the needs of diverse populations of students. This article outlines the steps involved in designing and implementing a systematic Tier 2 behavior intervention within a tiered service delivery model. An elementary school example is provided to outline the identification,…
A New Approach to Ballistic Missile Defense for Countering Antiaccess/Area-Denial Threats from Precision-Guided Weapons

DTIC Science & Technology

2013-04-01

performance esti- mates. Four notional developments of the PAA surrogate were mod- eled , with burnout velocities of 5 km/second and 6 km/second (40...his weapon on the intended target. Interceptor Models The notional baseline surface-launch interceptor was modeled with 3.5 km/second burnout ...agility. The AWL upper-tier interceptor was modeled, based on employment from an F-35A.11 In general the upper-tier interceptor has a burnout
Sub-Saharan Africa; Report No. 2844.

DTIC Science & Technology

1983-09-15

by legislative instrument, specify a group of persons either by description or occupational groups, except companies, which would pay a fixed...National Party of South West Africa, which controls the white second-tier Legislative Assembly and which also dominates AKTUR, the alliance of...groups, and also a unitary state in the Westminister pattern, both of which appear to be the meaning of the wording of Resolution 435." AKTUR further

Pharmacy benefit forecast for a new interferon Beta-1a for the treatment of multiple sclerosis: development of a first-line decision tool for pharmacy-budget planning using administrative claims data.

PubMed

Meyer, Christina M; Phipps, Robert; Cooper, Deborah; Wright, Alan

2003-01-01

To estimate the incremental change in pharmacy per-member-permonth (PMPM) costs, according to various formulary designs, for a new interferon beta-1a product (IB1a2) using administrative claims data. Cross-sectional sex- and age-specific disease prevalence and treatment rates for relapsing, remitting multiple sclerosis (RRMS) patients were measured using integrated medical and pharmacy claims data from a 500,000- member employer group in the southern United States. Migration to IB1a2 from other drugs in the class was based on market-share data for new and existing RRMS patients. Duration of therapy was estimated by analyzing claims for current RRMS therapies. Daily therapy cost was provided by the manufacturer of IB1a2, adjusted for migration from other therapies, and multiplied by estimated volume to predict incremental and total PMPM cost impact. Market-share estimates were used to develop a PMPM cost forecast for the next 2 years. PMPM cost estimates were calculated for preferred (copayment tier 2) and nonpreferred (copayment tier 3) formulary designs with and without prior authorization (PA). One-way sensitivity analysis was performed to assess the influence of product pricing, duration of therapy, and other market factors. Annual incremental PMPM change was $0.047 for the scenario of third copayment tier with PA. The incremental change was greatest for those aged 55 to 65 years ($0.056 PMPM) and did not vary greatly by benefit design. Duration of therapy had the greatest impact on the PMPM estimate across benefit designs. IB1a2 will not cause a significant change in managed care pharmacy budgets under a variety of formulary conditions, according to this crosssectional analysis of current care-seeking behavior by RRMS patients. Economic impact may differ if IB1a2 expands RRMS patients. treatment-seeking behavior.
NASA Center for Astronomy Education: Building a Community of Practice

NASA Astrophysics Data System (ADS)

Brissenden, Gina; Prather, E. E.; Slater, T. F.; Greene, W. M.; Thaller, M.; Alvidrez, R.

2007-12-01

The NASA Center for Astronomy Education (CAE) is devoted to the professional development of introductory college astronomy instructors teaching at community colleges. The primary goal is building a "community of practice." Evaluation results suggest this community of practice model is effective at improving instructional practices, particularly in settings where instructors feel isolated from their peers. For community college faculty this isolation can be quite real. Many are the only astronomer, if not the only scientist, at their institution. In addition, they may be adjunct instructors who have no office, no institutional email address, nor appear in the campus directory. CAE works to prevent this sense of isolation by building both actual and virtual communities for these instructors, as well as provide actual and virtual professional development opportunities. CAE's major effort is providing multi-tiered "Teaching Excellence Workshops" offered at national and regional venues. Recently added to our workshop offerings is a Tier II, or advanced, workshop for instructors who have attended a previous Teaching Excellence Workshop. The focus of the Tier II workshops is on implementation issues. In addition, we are now also offering a workshop exclusively for post-docs, graduates, and undergraduate students. Ongoing support is offered through the CAE website. Instructors can learn about, and register for, upcoming workshops. They can engage in discussions about educational issues and share best practices with peers using the moderated discussion group Astrolrner@CAE. CAE also provides an updated article "This Month's Teaching Strategy” which is a reflection on teaching strategies discussed in the workshops. Instructors can also find their peers through the online map of US community colleges offering introductory astronomy courses. Lastly, CAE Regional Teaching Exchanges facilitate local, and sustained, community building. CAE is supported by the NASA/JPL Navigator Public Engagement Program and the Spitzer Space Telescope Education and Public Outreach Program.
Bimanual Psychomotor Performance in Neurosurgical Resident Applicants Assessed Using NeuroTouch, a Virtual Reality Simulator.

PubMed

Winkler-Schwartz, Alexander; Bajunaid, Khalid; Mullah, Muhammad A S; Marwa, Ibrahim; Alotaibi, Fahad E; Fares, Jawad; Baggiani, Marta; Azarnoush, Hamed; Zharni, Gmaan Al; Christie, Sommer; Sabbagh, Abdulrahman J; Werthner, Penny; Del Maestro, Rolando F

Current selection methods for neurosurgical residents fail to include objective measurements of bimanual psychomotor performance. Advancements in computer-based simulation provide opportunities to assess cognitive and psychomotor skills in surgically naive populations during complex simulated neurosurgical tasks in risk-free environments. This pilot study was designed to answer 3 questions: (1) What are the differences in bimanual psychomotor performance among neurosurgical residency applicants using NeuroTouch? (2) Are there exceptionally skilled medical students in the applicant cohort? and (3) Is there an influence of previous surgical exposure on surgical performance? Participants were instructed to remove 3 simulated brain tumors with identical visual appearance, stiffness, and random bleeding points. Validated tier 1, tier 2, and advanced tier 2 metrics were used to assess bimanual psychomotor performance. Demographic data included weeks of neurosurgical elective and prior operative exposure. This pilot study was carried out at the McGill Neurosurgical Simulation Research and Training Center immediately following neurosurgical residency interviews at McGill University, Montreal, Canada. All 17 medical students interviewed were asked to participate, of which 16 agreed. Performances were clustered in definable top, middle, and bottom groups with significant differences for all metrics. Increased time spent playing music, increased applicant self-evaluated technical skills, high self-ratings of confidence, and increased skin closures statistically influenced performance on univariate analysis. A trend for both self-rated increased operating room confidence and increased weeks of neurosurgical exposure to increased blood loss was seen in multivariate analysis. Simulation technology identifies neurosurgical residency applicants with differing levels of technical ability. These results provide information for studies being developed for longitudinal studies on the acquisition, development, and maintenance of psychomotor skills. Technical abilities customized training programs that maximize individual resident bimanual psychomotor training dependant on continuously updated and validated metrics from virtual reality simulation studies should be explored. Copyright Â© 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
Cautionary Notes on a Global Tiered Pricing Framework for Medicines

PubMed Central

Williams, Owain D.; Ooms, Gorik

2015-01-01

Recently, there has been a policy momentum toward creating a global tiered pricing framework, which would provide differentiated prices for medicines globally, based on each country’s capacity to pay. We studied the most influential proposals for a tiered pricing framework since the 1995 World Trade Organization’s Agreement on Trade-Related Aspects of Intellectual Property Rights. We synthesized 6 critical questions to be addressed for a global framework to function and explored the many challenges of implementation. Although we acknowledge that there is the potential for an exceptional global commitment that would benefit both producers and those in developing countries in need of wider access to medicines, our greatest concern is to ensure that a global framework does not price out the poor from pharmaceutical markets nor threaten current flexibilities within the international patent regime. PMID:25973806
40 CFR 87.23 - Exhaust emission standards for Tier 6 and Tier 8 engines.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 21 2012-07-01 2012-07-01 false Exhaust emission standards for Tier 6 and Tier 8 engines. 87.23 Section 87.23 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) Definitions. Exhaust Emissions (New Aircraft Gas Turbine Engines) § 87...
A Systematic Review of the Empirical Support for Check-in Check-Out

ERIC Educational Resources Information Center

Wolfe, Katie; Pyle, Daniel; Charlton, Cade T.; Sabey, Christian V.; Lund, Emily M.; Ross, Scott W.

2016-01-01

Tier 2 interventions play an important role within the Positive Behavioral Interventions and Supports framework, bridging the gap between schoolwide Tier 1 interventions and individualized Tier 3 supports. Check-in Check-out (CICO) is a promising Tier 2 intervention for addressing mild problem behavior and potentially preventing the need for more…
76 FR 24872 - California State Nonroad Engine and Vehicle Pollution Control Standards; Authorization of Tier II...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-03

... Pollution Control Standards; Authorization of Tier II Marine Inboard/Sterndrive Spark Ignition Engine... for its second tier (``Tier II'') of emission standards for new marine inboard/sterndrive spark... record of this Marine Engine Authorization Request docket. Although a part of the official docket, the...
75 FR 38566 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-02

...- Demutualization Trading Permits, Tier Appointment and Bandwidth Packets June 25, 2010. Pursuant to Section 19(b)(1...-demutualization Trading Permits, tier appointment and bandwidth packets. The text of the proposed rule change is..., tier appointment and bandwidth packets. These post-demutualization Trading Permits, tier appointment...
76 FR 65307 - Self-Regulatory Organizations; Financial Industry Regulatory Authority, Inc.; Notice of Filing of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-20

... Equity Security would fall into one of six tiers rather than nine tiers. Specifically, for OTC Equity... proposing changes to the minimum quotation sizes to, among other things, simplify the tier structure... quotations in this lower- priced tier should result in more substantive dollar-value commitments to the...
SWPBIS Tiered Fidelity Inventory. Version 2.1

ERIC Educational Resources Information Center

Algozzine, B.; Barrett, S.; Eber, L.; George, H.; Horner, R.; Lewis, T.; Putnam, B.; Swain-Bradway, J.; McIntosh, K.; Sugai, G.

2014-01-01

The purpose of the SWPBIS Tiered Fidelity Inventory (TFI) is to provide a valid, reliable, and efficient measure of the extent to which school personnel are applying the core features of school-wide positive behavioral interventions and supports (SWPBIS). The TFI is divided into three sections (Tier I: Universal SWPBIS Features; Tier II: Targeted…
20 CFR 225.21 - Survivor Tier I PIA.

Code of Federal Regulations, 2010 CFR

2010-04-01

... INSURANCE AMOUNT DETERMINATIONS PIA's Used in Computing Survivor Annuities and the Amount of the Residual Lump-Sum Payable § 225.21 Survivor Tier I PIA. The Survivor Tier I PIA is used in computing the tier I... Security Act using the deceased employee's combined railroad and social security earnings after 1950 (or...
30 CFR 57.5067 - Engines.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) light duty truck 0.1 g/mile. 40 CFR 86.094-11(a)(1)(iv)(B) heavy duty highway engine 0.1 g/bhp-hr. 40... g/bhp-hr). tier 1 8≤kWbhp-hr). tier 1 19≤kWbhp-hr). tier 2 37≤kWbhp-hr). tier 2 75≤kW<130...
40 CFR 1033.135 - Labeling.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Tier 1 and later locomotives. The label on the engine is replaced each time the locomotive is... 0 and Tier 1 locomotives, the label may be made up of more than one piece, as long as all pieces are... to Tier 1+ locomotives.” (4) “This locomotive conforms to U.S. EPA regulations applicable to Tier 2...
Psychology Degrees: Employment, Wage, and Career Trajectory Consequences.

PubMed

Rajecki, D W; Borden, Victor M H

2011-07-01

Psychology is a very popular undergraduate major. Examining wage data from a range of degree holders reveals much about the expected career trajectories of those with psychology degrees. First, regarding baccalaureates, psychology and other liberal arts graduates-compared with those from certain preprofessional and technical undergraduate programs-generally fall in relatively low tiers of salary levels at both starting and later career points. Salary levels among baccalaureate alumni groups correlate with averaged measures of salary satisfaction, repeated job seeking, and perceptions of underemployment. These patterns seem to stem from the specific occupational categories (job titles) entered by graduates in psychology compared with other graduates, calling into question the employability advantage of so-called generic liberal arts skills. Second, psychology master's degree holders also generally fall in a low tier of salary among their science, engineering, and health counterparts. Third, psychology college faculty (including instructors) fall in low tiers of salary compared with their colleagues from other academic fields. Such broadly based indications of the relative economic disadvantages of psychology degrees have implications for career counseling in the field. © The Author(s) 2011.
Expanding clarity or confusion? Volatility of the 5-tier ratings assessing quality of transplant centers in the United States.

PubMed

Schold, Jesse D; Andreoni, Kenneth A; Chandraker, Anil K; Gaston, Robert S; Locke, Jayme E; Mathur, Amit K; Pruett, Timothy L; Rana, Abbas; Ratner, Lloyd E; Buccini, Laura D

2018-06-01

Outcomes of patients receiving solid organ transplants in the United States are systematically aggregated into bi-annual Program-Specific Reports (PSRs) detailing risk-adjusted survival by transplant center. Recently, the Scientific Registry of Transplant Recipients (SRTR) issued 5-tier ratings evaluating centers based on risk-adjusted 1-year graft survival. Our primary aim was to examine the reliability of 5-tier ratings over time. Using 10 consecutive PSRs for adult kidney transplant centers from June 2012 to December 2016 (n = 208), we applied 5-tier ratings to center outcomes and evaluated ratings over time. From the baseline period (June 2012), 47% of centers had at least a 1-unit tier change within 6 months, 66% by 1 year, and 94% by 3 years. Similarly, 46% of centers had at least a 2-unit tier change by 3 years. In comparison, 15% of centers had a change in the traditional 3-tier rating at 3 years. The 5-tier ratings at 4 years had minimal association with baseline rating (Kappa 0.07, 95% confidence interval [CI] -0.002 to 0.158). Centers had a median of 3 different 5-tier ratings over the period (q1 = 2, q3 = 4). Findings were consistent for center volume, transplant rate, and baseline 5-tier rating. Cumulatively, results suggest that 5-tier ratings are highly volatile, limiting their utility for informing potential stakeholders, particularly transplant candidates given expected waiting times between wait listing and transplantation. © 2018 The American Society of Transplantation and the American Society of Transplant Surgeons.
7 CFR 1416.302 - Eligible crops and producers.

Code of Federal Regulations, 2010 CFR

2010-01-01

... determine payment rates are as follows: Tier I—75 percent or greater crop loss and associated tree damage. Tier II—50 to 74 percent crop loss and associated tree damage/loss. Tier III—35 to 49 percent crop loss and associated tree damage/loss. Tier IV —15 percent and greater associated tree damage only. (2...
Implementation Challenges for Tier One and Tier Two School-Based Programs for Early Adolescents

ERIC Educational Resources Information Center

LaRusso, Maria D.; Donovan, Suzanne; Snow, Catherine

2016-01-01

This mixed-method study examined the implementation and the challenges to implementation for participants in randomized controlled trials of two school-based programs for early adolescents: the Tier One Word Generation (WG) program, and the Tier Two Strategic Adolescent Reading Intervention (STARI). Levels of implementation for WG and STARI varied…
25 CFR 542.30 - What is a Tier B gaming operation?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 2 2010-04-01 2010-04-01 false What is a Tier B gaming operation? 542.30 Section 542.30 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE INTERIOR HUMAN SERVICES MINIMUM INTERNAL CONTROL STANDARDS § 542.30 What is a Tier B gaming operation? A Tier B gaming operation is one with gross...
25 CFR 542.40 - What is a Tier C gaming operation?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 2 2010-04-01 2010-04-01 false What is a Tier C gaming operation? 542.40 Section 542.40 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE INTERIOR HUMAN SERVICES MINIMUM INTERNAL CONTROL STANDARDS § 542.40 What is a Tier C gaming operation? A Tier C gaming operation is one with annual...
25 CFR 542.20 - What is a Tier A gaming operation?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 2 2010-04-01 2010-04-01 false What is a Tier A gaming operation? 542.20 Section 542.20 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE INTERIOR HUMAN SERVICES MINIMUM INTERNAL CONTROL STANDARDS § 542.20 What is a Tier A gaming operation? A Tier A gaming operation is one with annual...

76 FR 35896 - Agency Information Collection Activities; Proposed Collection; Comment Request; Guidance for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-20

... information by August 19, 2011. ADDRESSES: Submit electronic comments on the collection of information to http... Estimate: Based on the number of requests for tier one and tier two DRs received by FDA since the guidance... requests for tier one and tier two DRs. FDA estimates the burden of this collection of information as...
76 FR 3184 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-19

...); (ii) establish a VIX Tier Appointment; (iii) amend the monthly fee for Floor Broker Trading Permits... demutualization, CBOE amended its Fees Schedule to establish Trading Permit, tier appointment and bandwidth packet... permit ($) 1 permit 10 permits 6,000 Tier 1 11 permits 20 permits 4,800 Tier 2 21 or more permits...
Use of Self-Monitoring to Maintain Program Fidelity of Multi-Tiered Interventions

ERIC Educational Resources Information Center

Nelson, J. Ron; Oliver, Regina M.; Hebert, Michael A.; Bohaty, Janet

2015-01-01

Multi-tiered system of supports represents one of the most significant advancements in improving the outcomes of students for whom typical instruction is not effective. While many practices need to be in place to make multi-tiered systems of support effective, accurate implementation of evidence-based practices by individuals at all tiers is…
Combining Tier 2 and Tier 3 Supports for Students with Disabilities in General Education Settings

ERIC Educational Resources Information Center

MacLeod, K. Sandra; Hawken, Leanne S.; O'Neill, Robert E.; Bundock, Kaitlin

2016-01-01

Secondary level or Tier 2 interventions such as the Check-in Check-out (CICO) intervention effectively reduce problem behaviors of students who are non-responsive to school-wide interventions. However, some students will not be successful with Tier 2 interventions. This study investigated the effects of adding individualized function-based support…
Effects of a Tier 3 Phonological Awareness Intervention on Preschoolers' Emergent Literacy

ERIC Educational Resources Information Center

Noe, Sean; Spencer, Trina D.; Kruse, Lydia; Goldstein, Howard

2014-01-01

This multiple baseline design study examined the effects of a Tier 3 early literacy intervention on low-income preschool children's phonological awareness (PA). Seven preschool children who did not make progress on identifying first sounds in words during a previous Tier 2 intervention participated in a more intensive Tier 3 intervention. Children…
Tier identification (TID) for tiered memory characteristics

DOEpatents

Chang, Jichuan; Lim, Kevin T; Ranganathan, Parthasarathy

2014-03-25

A tier identification (TID) is to indicate a characteristic of a memory region associated with a virtual address in a tiered memory system. A thread may be serviced according to a first path based on the TID indicating a first characteristic. The thread may be serviced according to a second path based on the TID indicating a second characteristic.
77 FR 9277 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-16

... Change Amending the NYSE Arca Equities Fee Schedule Increasing the Indication of Interest Tier 1 Credit and the Tracking Order Tier 1 Credit for ETP Holders and Market Makers February 10, 2012. Pursuant to... Schedule'') to increase the indication of interest (``IOI'') Tier 1 credit and the Tracking Order Tier 1...
12 CFR 325.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Report.” (m) Leverage ratio means the ratio of Tier 1 capital to total assets, as calculated under this... assets may be included in calculating the bank's Tier 1 capital. (v) Tier 1 capital or core capital means... in excess of the limit set forth in § 325.5(g), minus identified losses (to the extent that Tier 1...
Tier 3 Toxicity Value White Paper

EPA Pesticide Factsheets

The purpose of this white paper is to articulate the issues pertaining to Tier 3 toxicity values and provide recommendations on processes that will improve the transparency and consistency of identifying, evaluating, selecting, and documenting Tier 3 toxicity values for use in the Superfund and Resource Conservation and Recovery Act (RCRA) programs. This white paper will be used to assist regional risk assessors in selecting Tier 3 toxicity values as well as provide the foundation for future regional and national efforts to improve guidance and policy on Tier 3 toxicity values.
Proposed Tier 2 Screening Criteria and Tier 3 Field Procedures for Evaluation of Vapor Intrusion (ESTCP Cost and Performance Report)

DTIC Science & Technology

2012-08-01

Interstate Technology & Regulatory Council, Washington, DC, Copyright 2007. McHugh T.E., D.E. Hammond, T. Nickels , and B. Hartman. 2008. Use of...based corrective action have realized significant cost savings for their corrective action programs (Connor and McHugh , 2002). As described above...Groundwater (Tier 2) VOCs USEPA 8260B 40 mL VOA vial HCl 14 days Vapor (Tier 2 and Tier 3) Radon McHugh et al., 2008 500 mL Tedlar bag None 14
40 CFR Appendix I to Part 1042 - Summary of Previous Emission Standards

Code of Federal Regulations, 2010 CFR

2010-07-01

...: (a) Engines below 37 kW. Tier 1 and Tier 2 standards for engines below 37 kW apply as specified in 40... Engines Below 37 kW (g/kW-hr) Rated power (kW) Tier Model year NMHC + NOX CO PM kWTier 1 2000 10.5 8.0 1.0 Tier 2 2005 7.5 8.0 0.80 8≤kWTier 1 2000 9.5 6.6 0.80 Tier 2 2005 7.5 6.6 0.80 19≤kWTier...
LHCNet: Wide Area Networking and Collaborative Systems for HEP

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

Newman, H.B,

2007-08-20

This proposal presents the status and progress in 2006-7, and the technical and financial plans for 2008-2010 for the US LHCNet transatlantic network supporting U.S. participation in the LHC physics program. US LHCNet provides transatlantic connections of the Tier1 computing facilities at Fermilab and Brookhaven with the Tier0 and Tier1 facilities at CERN as well as Tier1s elsewhere in Europe and Asia. Together with ESnet, Internet2, the GEANT pan-European network, and NSF’s UltraLight project, US LHCNet also supports connections between the Tier2 centers (where most of the analysis of the data will take place, starting this year) and the Tier1smore » as needed.See report« less
Contingent approach to Internet-based supply network integration

NASA Astrophysics Data System (ADS)

Ho, Jessica; Boughton, Nick; Kehoe, Dennis; Michaelides, Zenon

2001-10-01

The Internet is playing an increasingly important role in enhancing the operations of supply networks as many organizations begin to recognize the benefits of Internet- enabled supply arrangements. However, the developments and applications to-date do not extend significantly beyond the dyadic model, whereas the real advantages are to be made with the external and network models to support a coordinated and collaborative based approach. The DOMAIN research group at the University of Liverpool is currently defining new Internet- enabled approaches to enable greater collaboration across supply chains. Different e-business models and tools are focusing on different applications. Using inappropriate e- business models, tools or techniques will bring negative results instead of benefits to all the tiers in the supply network. Thus there are a number of issues to be considered before addressing Internet based supply network integration, in particular an understanding of supply chain management, the emergent business models and evaluating the effects of deploying e-business to the supply network or a particular tier. It is important to utilize a contingent approach to selecting the right e-business model to meet the specific supply chain requirements. This paper addresses the issues and provides a case study on the indirect materials supply networks.
Contingency Contractor Optimization Phase 3 Sustainment Cost by JCA Implementation Guide

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

Durfee, Justin David; Frazier, Christopher Rawls; Arguello, Bryan

This document provides implementation guidance for implementing personnel group FTE costs by JCA Tier 1 or 2 categories in the Contingency Contractor Optimization Tool – Engineering Prototype (CCOT-P). CCOT-P currently only allows FTE costs by personnel group to differ by mission. Changes will need to be made to the user interface inputs pages and the database
Effects of Automated Tier 2 Storybook Intervention on Vocabulary and Comprehension Learning in Preschool Children with Limited Oral Language Skills

ERIC Educational Resources Information Center

Kelley, Elizabeth Spencer; Goldstein, Howard; Spencer, Trina D.; Sherman, Amber

2015-01-01

This early efficacy study examined the effects of an automated storybook intervention designed to promote school readiness among at-risk prekindergarten children. Story Friends is a small-group intervention in which vocabulary and question-answering lessons are embedded in a series of storybooks.A randomized group design with an embedded…
Prenatal chromosomal microarray analysis in fetuses with congenital heart disease: a prospective cohort study.

PubMed

Wang, Yan; Cao, Li; Liang, Dong; Meng, Lulu; Wu, Yun; Qiao, Fengchang; Ji, Xiuqing; Luo, Chunyu; Zhang, Jingjing; Xu, Tianhui; Yu, Bin; Wang, Leilei; Wang, Ting; Pan, Qiong; Ma, Dingyuan; Hu, Ping; Xu, Zhengfeng

2018-02-01

Currently, chromosomal microarray analysis is considered the first-tier test in pediatric care and prenatal diagnosis. However, the diagnostic yield of chromosomal microarray analysis for prenatal diagnosis of congenital heart disease has not been evaluated based on a large cohort. Our aim was to evaluate the clinical utility of chromosomal microarray as the first-tier test for chromosomal abnormalities in fetuses with congenital heart disease. In this prospective study, 602 prenatal cases of congenital heart disease were investigated using single nucleotide polymorphism array over a 5-year period. Overall, pathogenic chromosomal abnormalities were identified in 125 (20.8%) of 602 prenatal cases of congenital heart disease, with 52.0% of them being numerical chromosomal abnormalities. The detection rates of likely pathogenic copy number variations and variants of uncertain significance were 1.3% and 6.0%, respectively. The detection rate of pathogenic chromosomal abnormalities in congenital heart disease plus additional structural anomalies (48.9% vs 14.3%, P < .0001) or intrauterine growth retardation group (50.0% vs 14.3%, P = .044) was significantly higher than that in isolated congenital heart disease group. Additionally, the detection rate in congenital heart disease with additional structural anomalies group was significantly higher than that in congenital heart disease with soft markers group (48.9% vs 19.8%, P < .0001). No significant difference was observed in the detection rates between congenital heart disease with additional structural anomalies and congenital heart disease with intrauterine growth retardation groups (48.9% vs 50.0%), congenital heart disease with soft markers and congenital heart disease with intrauterine growth retardation groups (19.8% vs 50.0%), or congenital heart disease with soft markers and isolated congenital heart disease groups (19.8% vs 14.3%). The detection rate in fetuses with congenital heart disease plus mild ventriculomegaly was significantly higher than in those with other types of soft markers (50.0% vs 15.6%, P < .05). Our study suggests chromosomal microarray analysis is a reliable and high-resolution technology and should be used as the first-tier test for prenatal diagnosis of congenital heart disease in clinical practice. Copyright © 2017 Elsevier Inc. All rights reserved.
Small groups, big gains: efficacy of a tier 2 phonological awareness intervention with preschoolers with early literacy deficits.

PubMed

Kruse, Lydia G; Spencer, Trina D; Olszewski, Arnold; Goldstein, Howard

2015-05-01

The purpose of the present study was to evaluate the efficacy of a phonological awareness (PA) intervention, designed for Tier 2 instruction in a Response to Intervention (RTI) model, delivered to small groups of preschoolers. A multiple-baseline design across participants was used to evaluate the efficacy of the intervention on low-income preschool children's PA skills. A trained interventionist delivered small group sessions 3 to 4 days a week and ensured children received frequent opportunities to respond and contingent feedback. Participants received 28 to 36 lessons that lasted about 10 min each and focused on PA and alphabet knowledge. Initiation of intervention was staggered across 3 triads, and 7 children completed the study. The intervention produced consistent gains on weekly progress monitoring assessments of the primary outcome measure for first sound identification (First Sound Fluency). Most children also demonstrated gains on other measures of PA and alphabet knowledge. Results provide support for the application of a small group intervention consistent with an RTI framework and document the potential benefits of the intervention to learners who need early literacy instruction beyond the core curriculum.
A cluster randomized trial to evaluate external support for the implementation of positive behavioral interventions and supports by school personnel

PubMed Central

2014-01-01

Background Urban schools lag behind non-urban schools in attending to the behavioral health needs of their students. This is especially evident with regard to the level of use of evidence-based interventions with school children. Increased used of evidence-based interventions in urban schools would contribute to reducing mental health services disparities in low-income communities. School-wide positive behavioral interventions and supports (SWPBIS) is a service delivery framework that can be used to deliver universal preventive interventions and evidence-based behavioral health treatments, such as group cognitive behavioral therapy. In this article, we describe our ongoing research on creating internal capacity for program implementation. We also examine the cost-effectiveness and resulting school climate when two different levels of external support are provided to personnel as they implement a two-tier SWPBIS program. Methods/Design The study follows six K – 8 schools in the School District of Philadelphia randomly assigned to consultation support or consultation-plus-coaching support. Participants are: approximately 48 leadership team members, 180 school staff and 3,900 students in Tier 1, and 12 counselors, and 306 child participants in Tier 2. Children who meet inclusion criteria for Tier 2 will participate in group cognitive behavioral therapy for externalizing or anxiety disorders. The study has three phases, baseline/training, implementation, and sustainability. We will measure implementation outcomes, service outcomes, child outcomes, and cost. Discussion Findings from this study will provide evidence as to the appropriateness of school-wide prevention and treatment service delivery models for addressing services disparities in schools. The effectiveness and cost-effectiveness analyses of the two levels of training and consultation should help urban school districts and policymakers with the planning and deployment of cost-effective strategies for the implementation of evidence-based interventions for some of the most common behavioral health problems in school children. Trial registration ClinicalTrials.gov identifier: NCT01941069 PMID:24428904
A cluster randomized trial to evaluate external support for the implementation of positive behavioral interventions and supports by school personnel.

PubMed

Eiraldi, Ricardo; McCurdy, Barry; Khanna, Muniya; Mautone, Jennifer; Jawad, Abbas F; Power, Thomas; Cidav, Zuleyha; Cacia, Jaclyn; Sugai, George

2014-01-15

Urban schools lag behind non-urban schools in attending to the behavioral health needs of their students. This is especially evident with regard to the level of use of evidence-based interventions with school children. Increased used of evidence-based interventions in urban schools would contribute to reducing mental health services disparities in low-income communities. School-wide positive behavioral interventions and supports (SWPBIS) is a service delivery framework that can be used to deliver universal preventive interventions and evidence-based behavioral health treatments, such as group cognitive behavioral therapy. In this article, we describe our ongoing research on creating internal capacity for program implementation. We also examine the cost-effectiveness and resulting school climate when two different levels of external support are provided to personnel as they implement a two-tier SWPBIS program. The study follows six K - 8 schools in the School District of Philadelphia randomly assigned to consultation support or consultation-plus-coaching support. Participants are: approximately 48 leadership team members, 180 school staff and 3,900 students in Tier 1, and 12 counselors, and 306 child participants in Tier 2. Children who meet inclusion criteria for Tier 2 will participate in group cognitive behavioral therapy for externalizing or anxiety disorders. The study has three phases, baseline/training, implementation, and sustainability. We will measure implementation outcomes, service outcomes, child outcomes, and cost. Findings from this study will provide evidence as to the appropriateness of school-wide prevention and treatment service delivery models for addressing services disparities in schools. The effectiveness and cost-effectiveness analyses of the two levels of training and consultation should help urban school districts and policymakers with the planning and deployment of cost-effective strategies for the implementation of evidence-based interventions for some of the most common behavioral health problems in school children. ClinicalTrials.gov identifier: NCT01941069.
Elicitation of Robust Tier 2 Neutralizing Antibody Responses in Nonhuman Primates by HIV Envelope Trimer Immunization Using Optimized Approaches.

PubMed

Pauthner, Matthias; Havenar-Daughton, Colin; Sok, Devin; Nkolola, Joseph P; Bastidas, Raiza; Boopathy, Archana V; Carnathan, Diane G; Chandrashekar, Abishek; Cirelli, Kimberly M; Cottrell, Christopher A; Eroshkin, Alexey M; Guenaga, Javier; Kaushik, Kirti; Kulp, Daniel W; Liu, Jinyan; McCoy, Laura E; Oom, Aaron L; Ozorowski, Gabriel; Post, Kai W; Sharma, Shailendra K; Steichen, Jon M; de Taeye, Steven W; Tokatlian, Talar; Torrents de la Peña, Alba; Butera, Salvatore T; LaBranche, Celia C; Montefiori, David C; Silvestri, Guido; Wilson, Ian A; Irvine, Darrell J; Sanders, Rogier W; Schief, William R; Ward, Andrew B; Wyatt, Richard T; Barouch, Dan H; Crotty, Shane; Burton, Dennis R

2017-06-20

The development of stabilized recombinant HIV envelope trimers that mimic the virion surface molecule has increased enthusiasm for a neutralizing antibody (nAb)-based HIV vaccine. However, there is limited experience with recombinant trimers as immunogens in nonhuman primates, which are typically used as a model for humans. Here, we tested multiple immunogens and immunization strategies head-to-head to determine their impact on the quantity, quality, and kinetics of autologous tier 2 nAb development. A bilateral, adjuvanted, subcutaneous immunization protocol induced reproducible tier 2 nAb responses after only two immunizations 8 weeks apart, and these were further enhanced by a third immunization with BG505 SOSIP trimer. We identified immunogens that minimized non-neutralizing V3 responses and demonstrated that continuous immunogen delivery could enhance nAb responses. nAb responses were strongly associated with germinal center reactions, as assessed by lymph node fine needle aspiration. This study provides a framework for preclinical and clinical vaccine studies targeting nAb elicitation. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Redesigning Radiotherapy Quality Assurance: Opportunities to Develop an Efficient, Evidence-Based System to Support Clinical Trials-Report of the National Cancer Institute Work Group on Radiotherapy Quality Assurance

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

Bekelman, Justin E., E-mail: bekelman@uphs.upenn.edu; Deye, James A.; Vikram, Bhadrasain

2012-07-01

Purpose: In the context of national calls for reorganizing cancer clinical trials, the National Cancer Institute sponsored a 2-day workshop to examine challenges and opportunities for optimizing radiotherapy quality assurance (QA) in clinical trial design. Methods and Materials: Participants reviewed the current processes of clinical trial QA and noted the QA challenges presented by advanced technologies. The lessons learned from the radiotherapy QA programs of recent trials were discussed in detail. Four potential opportunities for optimizing radiotherapy QA were explored, including the use of normal tissue toxicity and tumor control metrics, biomarkers of radiation toxicity, new radiotherapy modalities such asmore » proton beam therapy, and the international harmonization of clinical trial QA. Results: Four recommendations were made: (1) to develop a tiered (and more efficient) system for radiotherapy QA and tailor the intensity of QA to the clinical trial objectives (tiers include general credentialing, trial-specific credentialing, and individual case review); (2) to establish a case QA repository; (3) to develop an evidence base for clinical trial QA and introduce innovative prospective trial designs to evaluate radiotherapy QA in clinical trials; and (4) to explore the feasibility of consolidating clinical trial QA in the United States. Conclusion: Radiotherapy QA can affect clinical trial accrual, cost, outcomes, and generalizability. To achieve maximum benefit, QA programs must become more efficient and evidence-based.« less
Redesigning radiotherapy quality assurance: opportunities to develop an efficient, evidence-based system to support clinical trials--report of the National Cancer Institute Work Group on Radiotherapy Quality Assurance.

PubMed

Bekelman, Justin E; Deye, James A; Vikram, Bhadrasain; Bentzen, Soren M; Bruner, Deborah; Curran, Walter J; Dignam, James; Efstathiou, Jason A; FitzGerald, T J; Hurkmans, Coen; Ibbott, Geoffrey S; Lee, J Jack; Merchant, Thomas E; Michalski, Jeff; Palta, Jatinder R; Simon, Richard; Ten Haken, Randal K; Timmerman, Robert; Tunis, Sean; Coleman, C Norman; Purdy, James

2012-07-01

In the context of national calls for reorganizing cancer clinical trials, the National Cancer Institute sponsored a 2-day workshop to examine challenges and opportunities for optimizing radiotherapy quality assurance (QA) in clinical trial design. Participants reviewed the current processes of clinical trial QA and noted the QA challenges presented by advanced technologies. The lessons learned from the radiotherapy QA programs of recent trials were discussed in detail. Four potential opportunities for optimizing radiotherapy QA were explored, including the use of normal tissue toxicity and tumor control metrics, biomarkers of radiation toxicity, new radiotherapy modalities such as proton beam therapy, and the international harmonization of clinical trial QA. Four recommendations were made: (1) to develop a tiered (and more efficient) system for radiotherapy QA and tailor the intensity of QA to the clinical trial objectives (tiers include general credentialing, trial-specific credentialing, and individual case review); (2) to establish a case QA repository; (3) to develop an evidence base for clinical trial QA and introduce innovative prospective trial designs to evaluate radiotherapy QA in clinical trials; and (4) to explore the feasibility of consolidating clinical trial QA in the United States. Radiotherapy QA can affect clinical trial accrual, cost, outcomes, and generalizability. To achieve maximum benefit, QA programs must become more efficient and evidence-based. Copyright © 2012 Elsevier Inc. All rights reserved.
Application of a three-tier framework to assess ecological condition of Gulf of Mexico coastal wetlands.

PubMed

Nestlerode, Janet A; Hansen, Virginia D; Teague, Aarin; Harwell, Matthew C

2014-06-01

A multi-level coastal wetland assessment strategy was applied to wetlands in the northern Gulf of Mexico (GOM) to evaluate the feasibility of this approach for a broad national scale wetland condition assessment (US Environmental Protection Agency's National Wetlands Condition Assessment). Landscape-scale assessment indicators (tier 1) were developed and applied at the sub-watershed (12-digit hydrologic unit code (HUC)) level within the GOM coastal wetland sample frame with scores calculated using land-use maps and geographic information system. Rapid assessment protocols (tier 2), using a combination of data analysis and field work, evaluated metrics associated with landscape context, hydrology, physical structure, and biological structure. Intensive site monitoring (tier 3) included measures of soil chemistry and composition, water column and pore-water chemistry, and dominant macrophyte community composition and tissue chemistry. Relationships within and among assessment levels were evaluated using multivariate analyses with few significant correlations found. More detailed measures of hydrology, soils, and macrophyte species composition from sites across a known condition gradient, in conjunction with validation of standardized rapid assessment method, may be necessary to fully characterize coastal wetlands across the region.
Low Emissions Aftertreatment and Diesel Emissions Reduction

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

None

2005-05-27

Detroit Diesel Corporation (DDC) has successfully completed a five-year Low Emissions Aftertreatment and Diesel Emissions Reduction (LEADER) program under a DOE project entitled: ''Research and Development for Compression-Ignition Direct-Injection Engines (CIDI) and Aftertreatment Sub-Systems''. The objectives of the LEADER Program were to: Demonstrate technologies that will achieve future federal Tier 2 emissions targets; and Demonstrate production-viable technical targets for engine out emissions, efficiency, power density, noise, durability, production cost, aftertreatment volume and weight. These objectives were successfully met during the course of the LEADER program The most noteworthy achievements in this program are listed below: (1) Demonstrated Tier 2 Binmore » 3 emissions target over the FTP75 cycle on a PNGV-mule Neon passenger car, utilizing a CSF + SCR system These aggressive emissions were obtained with no ammonia (NH{sub 3}) slip and a combined fuel economy of 63 miles per gallon, integrating FTP75 and highway fuel economy transient cycle test results. Demonstrated feasibility to achieve Tier 2 Bin 8 emissions levels without active NOx aftertreatment. (2) Demonstrated Tier 2 Bin 3 emissions target over the FTP75 cycle on a light-duty truck utilizing a CSF + SCR system, synergizing efforts with the DOE-DDC DELTA program. This aggressive reduction in tailpipe out emissions was achieved with no ammonia slip and a 41% fuel economy improvement, compared to the equivalent gasoline engine-equipped vehicle. (3) Demonstrated Tier 2 near-Bin 9 emissions compliance on a light-duty truck, without active NOx aftertreatment devices, in synergy with the DOE-DDC DELTA program. (4) Developed and applied advanced combustion technologies such as ''CLEAN Combustion{copyright}'', which yields simultaneous reduction in engine out NOx and PM emissions while also improving engine and aftertreatment integration by providing favorable exhaust species and temperature characteristics. These favorable emissions characteristics were obtained while maintaining performance and fuel economy. These aggressive emissions and performance results were achieved by applying a robust systems technology development methodology. This systems approach benefits substantially from an integrated experimental and analytical approach to technology development, which is one of DDCs core competencies Also, DDC is uniquely positioned to undertake such a systems technology development approach, given its vertically integrated commercial structure within the DaimlerChrysler organization. State-of-the-art analytical tools were developed targeting specific LEADER program objectives and were applied to guide system enhancements and to provide testing directions, resulting in a shortened and efficient development cycle. Application examples include ammonia/NO{sub x} distribution improvement and urea injection controls development, and were key contributors to significantly reduce engine out as well as tailpipe out emissions. Successful cooperation between DDC and Engelhard Corporation, the major subcontractor for the LEADER program and provider of state-of-the-art technologies on various catalysts, was another contributing factor to ensure that both passenger car and LD truck applications achieved Tier 2 Bin 3 emissions levels. Significant technical challenges, which highlight barriers of commercialization of diesel technology for passenger cars and LD truck applications, are presented at the end of this report.« less
Processes and outcomes of the veterans health administration safe patient handling program: study protocol.

PubMed

Rugs, Deborah; Toyinbo, Peter; Patel, Nitin; Powell-Cope, Gail; Hahm, Bridget; Elnitsky, Christine; Besterman-Dahan, Karen; Campbell, Robert; Sutton, Bryce

2013-11-18

Health care workers, such as nurses, nursing aides, orderlies, and attendants, who manually move patients, are consistently listed in the top professions for musculoskeletal injuries (MSIs) by the Bureau of Labor Statistics. These MSIs are typically caused by high-risk patient caregiving activities. In 2008, a safe patient handling (SPH) program was implemented in all 153 Veterans Administration Medical Centers (VAMCs) throughout the United States to reduce patient handling injuries. The goal of the present study is to evaluate the effects associated with the national implementation of a comprehensive SPH program. The primary objectives of the research were to determine the effectiveness of the SPH program in improving direct care nursing outcomes and to provide a context for understanding variations in program results across sites over time. Secondary objectives of the present research were to evaluate the effectiveness of the program in reducing direct and indirect costs associated with patient handling, to explore the potential mediating and moderating mechanisms, and to identify unintended consequences of implementing the program. This 3-year longitudinal study used mixed methods of data collection at 6- to 9-month intervals. The analyses will include data from surveys, administrative databases, individual and focus group interviews, and nonparticipant observations. For this study, a 3-tiered measurement plan was used. For Tier 1, the unit of analysis was the facility, the data source was the facility coordinator or administrative data, and all 153 VAMCs participated. For Tier 2, frontline caregivers and program peer leaders at 17 facilities each completed different surveys. For Tier 3, six facilities completed qualitative site visits, which included individual interviews, focus groups, and nonparticipant observations. Multiple regression models were proposed to test the effects of SPH components on nursing outcomes related to patient handling. Content analysis and constant comparative analysis were proposed for qualitative data analysis to understand the context of implementation and to triangulate quantitative data. All three tiers of data for this study have been collected. We are now in the analyses and writing phase of the project, with the possibility for extraction of additional administrative data. The focus of this paper is to describe the SPH program, its evaluation study design, and its data collection procedures. This study evaluates the effects associated with the national implementation of a comprehensive SPH program that was implemented in all 153 VAMCs throughout the United States to reduce patient handling injuries. To our knowledge, this is the largest evaluation of an SPH program in the United States. A major strength of this observational study design is that all VAMCs implemented the program and were included in Tier 1 of the study; therefore, population sampling bias is not a concern. Although the design lacks a comparison group for testing program effects, this longitudinal field study design allows for capturing program dose-response effects within a naturalistic context. Implementation of the VA-wide SPH program afforded the opportunity for rigorous evaluation in a naturalistic context. Findings will guide VA operations for policy and decision making about resources, and will be useful for health care, in general, outside of the VA, in implementation and impact of an SPH program.
Single-Tier Testing with the C6 Peptide ELISA Kit Compared with Two-Tier Testing for Lyme Disease

PubMed Central

Wormser, Gary P.; Schriefer, Martin; Aguero-Rosenfeld, Maria E.; Levin, Andrew; Steere, Allen C.; Nadelman, Robert B.; Nowakowski, John; Marques, Adriana; Johnson, Barbara J. B.; Dumler, J. Stephen

2014-01-01

Background The two-tier serologic testing protocol for Lyme disease has a number of shortcomings including low sensitivity in early disease; increased cost, time and labor; and subjectivity in the interpretation of immunoblots. Methods The diagnostic accuracy of a single-tier commercial C6 ELISA kit was compared with two-tier testing. Results The C6 ELISA was significantly more sensitive than two-tier testing with sensitivities of 66.5% (95% C.I.:61.7-71.1) and 35.2% (95%C.I.:30.6-40.1), respectively (p<0.001) in 403 sera from patients with erythema migrans. The C6 ELISA had sensitivity statistically comparable to two-tier testing in sera from Lyme disease patients with early neurological manifestations (88.6% vs. 77.3%, p=0.13) or arthritis (98.3% vs. 95.6%, p= 0.38). Te specificities of C6 ELISA and two-tier testing in over 2200 blood donors, patients with other conditions, and Lyme disease vaccine recipients were found to be 98.9% and 99.5%, respectively (p<0.05, 95% C.I. surrounding the 0.6 percentage point difference of 0.04 to 1.15). Conclusions Using a reference standard of two-tier testing, the C6 ELISA as a single step serodiagnostic test provided increased sensitivity in early Lyme disease with comparable sensitivity in later manifestations of Lyme disease. The C6 ELISA had slightly decreased specificity. Future studies should evaluate the performance of the C6 ELISA compared with two-tier testing in routine clinical practice. PMID:23062467
Neutralization tiers of HIV-1

PubMed Central

Montefiori, David C.; Roederer, Mario; Morris, Lynn; Seaman, Michael S.

2018-01-01

Purpose of review HIV-1 isolates are often classified on the basis of neutralization ‘tier’ phenotype. Tier classification has important implications for the monitoring and interpretation of vaccine-elicited neutralizing antibody responses. The molecular basis that distinguishes the multiple neutralization phenotypes of HIV-1 has been unclear. We present a model based on the dynamic nature of the HIV-1 envelope glycoproteins and its impact on epitope exposure. We also describe a new approach for ranking HIV-1 vaccine-elicited neutralizing antibody responses. Recent findings The unliganded trimeric HIV-1 envelope glycoprotein spike spontaneously transitions through at least three conformations. Neutralization tier phenotypes correspond to the frequency by which the trimer exists in a closed (tiers 2 and 3), open (tier 1A), or intermediate (tier 1B) conformation. An increasing number of epitopes become exposed as the trimer opens, making the virus more sensitive to neutralization by certain antibodies. The closed conformation is stabilized by many broadly neutralizing antibodies. Summary The tier 2 neutralization phenotype is typical of most circulating strains and is associated with a predominantly closed Env trimer configuration that is a high priority to target with vaccines. Assays with tier 1A viruses should be interpreted with caution and with the understanding that they detect many antibody specificities that do not neutralize tier 2 viruses and do not protect against HIV-1 infection. PMID:29266013
75 FR 20413 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing and Immediate Effectiveness of a...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-19

... volume levels in non-Premium Tier Penny Pilot issues. This new tiered pricing structure will replace the.... The Exchange also proposes to introduce a Premium Tier for electronic transactions in certain Penny..., UNG, FAZ, DIA, GDX, and USO will qualify for the Premium Tier, and will receive an additional $.05 per...
76 FR 56248 - Self-Regulatory Organizations; Chicago Stock Exchange, Inc.; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-12

... this tiered schedule, there were three volume-based Tiers and the rate of applicable take fees and provide credits varied based upon the Tier into which a Participant falls. \\5\\ Through its filing on....0026/share to $0.0025/share for the lowest Tier of activity, from $0.0028/share to $0.0027/share in the...
49 CFR 393.118 - What are the rules for securing dressed lumber or similar building products?

Code of Federal Regulations, 2010 CFR

2010-10-01

... Shifting and Falling Cargo Specific Securement Requirements by Commodity Type § 393.118 What are the rules... transported using no more than one tier. Bundles carried on one tier must be secured in accordance with the... one tier. Bundles carried in more than one tier must be either: (1) Blocked against lateral movement...
75 FR 39301 - Self-Regulatory Organizations; Notice of Filing and Immediate Effectiveness of Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-08

...,000 contracts. Payments would be made at the stated rate for each tier for those contracts that fall... increasing the per contract rate on the Tier II and Tier III levels. The Exchange still continues to afford the members [sic] organizations who transact volume in Tier I a benefit as well. Amending the...
26 CFR 1.1248-7 - Taxpayer to establish earnings and profits and foreign taxes.

Code of Federal Regulations, 2010 CFR

2010-04-01

... shall also show for the first tier corporation, and for each lower tier corporation as to which...) of § 1.1248-2, and (iv) If the amount of earnings and profits of a lower tier corporation... lower tier corporation which the taxpayer owns within the meaning of section 958(a)(2)(b) the total...
EDSP Tier 2 test (T2T) guidances and protocols are delivered, including web-based guidance for diagnosing and scoring, and evaluating EDC-induced pathology in fish and amphibian

EPA Science Inventory

The Agency’s Endocrine Disruptor Screening Program (EDSP) consists of two tiers. The first tier provides information regarding whether a chemical may have endocrine disruption properties. Tier 2 tests provide confirmation of ED effects and dose-response information to be us...
29 CFR Appendix D to Part 510 - Municipalities Eligible for Minimum Wage Phase-In

Code of Federal Regulations, 2010 CFR

2010-07-01

... other employees are subject to Tier 3. Municipalities which did not submit data are subject to Tier 1... June 1, 1990. If upon review it is determined that the municipality should have been subject to Tier 1... Minimum Wage Phase-In This appendix contains a listing of the municipalities in Puerto Rico and the tier...
A Two-Tiered Model for Analyzing Library Web Site Usage Statistics, Part 1: Web Server Logs.

ERIC Educational Resources Information Center

Cohen, Laura B.

2003-01-01

Proposes a two-tiered model for analyzing web site usage statistics for academic libraries: one tier for library administrators that analyzes measures indicating library use, and a second tier for web site managers that analyzes measures aiding in server maintenance and site design. Discusses the technology of web site usage statistics, and…
Enhanced risk prediction model for emergency department use and hospitalizations in patients in a primary care medical home.

PubMed

Takahashi, Paul Y; Heien, Herbert C; Sangaralingham, Lindsey R; Shah, Nilay D; Naessens, James M

2016-07-01

With the advent of healthcare payment reform, identifying high-risk populations has become more important to providers. Existing risk-prediction models often focus on chronic conditions. This study sought to better understand other factors to improve identification of the highest risk population. A retrospective cohort study of a paneled primary care population utilizing 2010 data to calibrate a risk prediction model of hospital and emergency department (ED) use in 2011. Data were randomly split into development and validation data sets. We compared the enhanced model containing the additional risk predictors with the Minnesota medical tiering model. The study was conducted in the primary care practice of an integrated delivery system at an academic medical center in Rochester, Minnesota. The study focus was primary care medical home patients in 2010 and 2011 (n = 84,752), with the primary outcome of subsequent hospitalization or ED visit. A total of 42,384 individuals derived the enhanced risk-prediction model and 42,368 individuals validated the model. Predictors included Adjusted Clinical Groups-based Minnesota medical tiering, patient demographics, insurance status, and prior year healthcare utilization. Additional variables included specific mental and medical conditions, use of high-risk medications, and body mass index. The area under the curve in the enhanced model was 0.705 (95% CI, 0.698-0.712) compared with 0.662 (95% CI, 0.656-0.669) in the Minnesota medical tiering-only model. New high-risk patients in the enhanced model were more likely to have lack of health insurance, presence of Medicaid, diagnosed depression, and prior ED utilization. An enhanced model including additional healthcare-related factors improved the prediction of risk of hospitalization or ED visit.
From the CMS Computing Experience in the WLCG STEP'09 Challenge to the First Data Taking of the LHC Era

NASA Astrophysics Data System (ADS)

Bonacorsi, D.; Gutsche, O.

The Worldwide LHC Computing Grid (WLCG) project decided in March 2009 to perform scale tests of parts of its overall Grid infrastructure before the start of the LHC data taking. The "Scale Test for the Experiment Program" (STEP'09) was performed mainly in June 2009 -with more selected tests in September- October 2009 -and emphasized the simultaneous test of the computing systems of all 4 LHC experiments. CMS tested its Tier-0 tape writing and processing capabilities. The Tier-1 tape systems were stress tested using the complete range of Tier-1 work-flows: transfer from Tier-0 and custody of data on tape, processing and subsequent archival, redistribution of datasets amongst all Tier-1 sites as well as burst transfers of datasets to Tier-2 sites. The Tier-2 analysis capacity was tested using bulk analysis job submissions to backfill normal user activity. In this talk, we will report on the different performed tests and present their post-mortem analysis.
A simplified regimen of targeted antifungal prophylaxis in liver transplant recipients: A single-center experience.

PubMed

Lavezzo, B; Patrono, D; Tandoi, F; Martini, S; Fop, F; Ballerini, V; Stratta, C; Skurzak, S; Lupo, F; Strignano, P; Donadio, P P; Salizzoni, M; Romagnoli, R; De Rosa, F G

2018-04-01

Invasive fungal infection (IFI) is a severe complication of liver transplantation burdened by high mortality. Guidelines recommend targeted rather than universal antifungal prophylaxis based on tiers of risk. We aimed to evaluate IFI incidence, risk factors, and outcome after implementation of a simplified two-tiered targeted prophylaxis regimen based on a single broad-spectrum antifungal drug (amphotericin B). Patients presenting 1 or more risk factors according to literature were administered prophylaxis. Prospectively collected data on all adult patients transplanted in Turin from January 2011 to December 2015 were reviewed. Patients re-transplanted before postoperative day 7 were considered once, yielding a study cohort of 581 cases. Prophylaxis was administered to 299 (51.4%) patients; adherence to protocol was 94.1%. Sixteen patients developed 18 IFIs for an overall rate of 2.8%. All IFI cases were in targeted prophylaxis group; none of the non-prophylaxis group developed IFI. Most cases (81.3%) presented within 30 days after transplantation during prophylaxis; predominant pathogens were molds (94.4%). Only 1 case of candidemia was observed. One-year mortality in IFI patients was 33.3% vs 6.4% in patients without IFI (P = .001); IFI attributable mortality was 6.3%. At multivariate analysis, significant risk factors for IFI were renal replacement therapy (OR = 8.1) and re-operation (OR = 5.2). The implementation of a simplified targeted prophylaxis regimen appeared to be safe and applicable and was associated with low IFI incidence and mortality. Association of IFI with re-operation and renal replacement therapy calls for further studies to identify optimal prophylaxis in this subset of patients. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Summary of the development the US Environmental Protection Agency's Medaka Extended One Generation Reproduction Test (MEOGRT) using data from 9 multigenerational medaka tests.

PubMed

Flynn, Kevin; Lothenbach, Doug; Whiteman, Frank; Hammermeister, Dean; Touart, Leslie W; Swintek, Joe; Tatarazako, Norihisa; Onishi, Yuta; Iguchi, Taisen; Johnson, Rodney

2017-12-01

In response to various legislative mandates, the US Environmental Protection Agency (USEPA) formed its Endocrine Disruptor Screening Program (EDSP), which in turn, formed the basis of a tiered testing strategy to determine the potential of pesticides, commercial chemicals, and environmental contaminants to disrupt the endocrine system. The first tier of tests is intended to detect the potential for endocrine disruption mediated through estrogen, androgen, or thyroid pathways, whereas the second tier is intended to further characterize the effects on these pathways and to establish a dose-response relationship for adverse effects. One of these tier 2 tests, the Medaka Extended One Generation Reproduction Test (MEOGRT), was developed by the USEPA for the EDSP and, in collaboration with the Japanese Ministry of the Environment, for the Guidelines for the Testing of Chemicals of the Organisation for Economic Co-operation and Development (OECD). The MEOGRT protocol was iteratively modified based on knowledge gained after the successful completion of 9 tests with variations in test protocols. The present study describes both the final MEOGRT protocol that has been published by the USEPA and the OECD, and the iterations that provided valuable insights into nuances of the protocol. The various tests include exposure to 17β-estradiol, 4-t-octylphenol, o,p'- dichlorodiphenyltrichloroethane, 4-chloro-3-methylphenol, tamoxifen, 17β-trenbolone, vinclozolin, and prochloraz. Environ Toxicol Chem 2017;36:3387-3403. Published 2017 Wiley Periodicals Inc. on behalf of SETAC. This article is a US government work and, as such, is in the public domain in the United States of America. Published 2017 Wiley Periodicals Inc. on behalf of SETAC. This article is a US government work and, as such, is in the public domain in the United States of America.
Rhabdom evolution in butterflies: insights from the uniquely tiered and heterogeneous ommatidia of the Glacial Apollo butterfly, Parnassius glacialis.

PubMed

Matsushita, Atsuko; Awata, Hiroko; Wakakuwa, Motohiro; Takemura, Shin-ya; Arikawa, Kentaro

2012-09-07

The eye of the Glacial Apollo butterfly, Parnassius glacialis, a 'living fossil' species of the family Papilionidae, contains three types of spectrally heterogeneous ommatidia. Electron microscopy reveals that the Apollo rhabdom is tiered. The distal tier is composed exclusively of photoreceptors expressing opsins of ultraviolet or blue-absorbing visual pigments, and the proximal tier consists of photoreceptors expressing opsins of green or red-absorbing visual pigments. This organization is unique because the distal tier of other known butterflies contains two green-sensitive photoreceptors, which probably function in improving spatial and/or motion vision. Interspecific comparison suggests that the Apollo rhabdom retains an ancestral tiered pattern with some modification to enhance its colour vision towards the long-wavelength region of the spectrum.

Case studies putting the decision-making framework for the grouping and testing of nanomaterials (DF4nanoGrouping) into practice.

PubMed

Arts, Josje H E; Irfan, Muhammad-Adeel; Keene, Athena M; Kreiling, Reinhard; Lyon, Delina; Maier, Monika; Michel, Karin; Neubauer, Nicole; Petry, Thomas; Sauer, Ursula G; Warheit, David; Wiench, Karin; Wohlleben, Wendel; Landsiedel, Robert

2016-04-01

Case studies covering carbonaceous nanomaterials, metal oxide and metal sulphate nanomaterials, amorphous silica and organic pigments were performed to assess the Decision-making framework for the grouping and testing of nanomaterials (DF4nanoGrouping). The usefulness of the DF4nanoGrouping for nanomaterial hazard assessment was confirmed. In two tiers that rely exclusively on non-animal test methods followed by a third tier, if necessary, in which data from rat short-term inhalation studies are evaluated, nanomaterials are assigned to one of four main groups (MGs). The DF4nanoGrouping proved efficient in sorting out nanomaterials that could undergo hazard assessment without further testing. These are soluble nanomaterials (MG1) whose further hazard assessment should rely on read-across to the dissolved materials, high aspect-ratio nanomaterials (MG2) which could be assessed according to their potential fibre toxicity and passive nanomaterials (MG3) that only elicit effects under pulmonary overload conditions. Thereby, the DF4nanoGrouping allows identifying active nanomaterials (MG4) that merit in-depth investigations, and it provides a solid rationale for their sub-grouping to specify the further information needs. Finally, the evaluated case study materials may be used as source nanomaterials in future read-across applications. Overall, the DF4nanoGrouping is a hazard assessment strategy that strictly uses animals as a last resort. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.
Impact of a Value-Based Formulary on Medication Utilization, Health Services Utilization, and Expenditures

PubMed Central

Yeung, Kai; Basu, Anirban; Hansen, Ryan N.; Watkins, John B.; Sullivan, Sean D.

2016-01-01

Background Value-based benefit design has been suggested as an effective approach to managing the high cost of pharmaceuticals in health insurance markets. Premera Blue Cross, a large regional health plan, implemented a Value-Based Formulary (VBF) for pharmaceuticals in 2010 that explicitly used cost-effectiveness analysis (CEA) to inform medication copayments. Objective To determine the impact of the VBF. Design Interrupted time-series of employer-sponsored plans from 2006 to 2013. Subjects Intervention group: 5,235 beneficiaries exposed to the VBF. Control group: 11,171 beneficiaries in plans without any changes in pharmacy benefits. Intervention The VBF assigned medications with lower value (estimated by CEA) to higher copayment tiers and assigned medications with higher value to lower copayment tiers. Measures Primary outcome was medication expenditures from member, health plan, and member plus health plan perspectives. Secondary outcomes were medication utilization, emergency department visits, hospitalizations, office visits, and non-medication expenditures. Results In the intervention group after VBF implementation, member medication expenditures increased by $2 per member per month (PMPM) (95% CI, $1 to $3) or 9%, while health plan medication expenditures decreased by $10 PMPM (CI, $18 to $2) or 16%, resulting in a net decrease of $8 PMPM (CI, $15 to $2) or 10%, which translates to a net savings of $1.1 million. Utilization of medications moved into lower copayment tiers increased by 1.95 days’ supply (CI, 1.29 to 2.62) or 17%. Total medication utilization, health services utilization and non-medication expenditures did not change. Conclusions Cost-sharing informed by CEA reduced overall medication expenditures without negatively impacting medication utilization, health services utilization or non-medication expenditures. PMID:27579915
Vibrational energy transport in acetylbenzonitrile described by an ab initio-based quantum tier model

NASA Astrophysics Data System (ADS)

Fujisaki, Hiroshi; Yagi, Kiyoshi; Kikuchi, Hiroto; Takami, Toshiya; Stock, Gerhard

2017-01-01

Performing comprehensive quantum-chemical calculations, a vibrational Hamiltonian of acetylbenzonitrile is constructed, on the basis of which a quantum-mechanical "tier model" is developed that describes the vibrational dynamics following excitation of the CN stretch mode. Taking into account 36 vibrational modes and cubic and quartic anharmonic couplings between up to three different modes, the tier model calculations are shown to qualitatively reproduce the main findings of the experiments of Rubtsov and coworkers (2011), including the energy relaxation of the initially excited CN mode and the structure-dependent vibrational transport. Moreover, the calculations suggest that the experimentally measured cross-peak among the CN and CO modes does not correspond to direct excitation of the CO normal mode but rather reflects excited low-frequency vibrations that anharmonically couple to the CO mode. Complementary quasiclassical trajectory calculations are found to be in good overall agreement with the quantum calculations.
Off-Highway Heavy Vehicle Diesel Efficiency Improvement and Emissions Reduction

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

Jennifer Rumsey

2005-12-31

Cummins Inc. is a world leader in the development and production of diesel engines for on-highway vehicles, off-highway industrial machines, and power generation units. Cummins Inc. diesel products cover a 50-3000 HP range. The power range for this project includes 174-750 HP to achieve EPA's Tier 3 emission levels of 4.0 NOx+NMHC gm/kW-hr and 0.2 PM gm/kWhr and Tier 4 Interim emission levels of 2.0 gm/kW-hr NOx and 0.02 gm/kW-hr PM. Cummins' anticipated product offerings for Tier 4 in this range include the following: QSB6.7, QSC8.3, QSL9, QSM11, QSX15, QSK19. (For reference, numerical values indicate engine displacement in liters, themore » letter designation ns indicate the product model). A summary of the EPA's mobile off-highway emissions requirements is given in Figure 1.« less
40 CFR 86.1711-99 - Limitations on sale of Tier 1 vehicles and TLEVs.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 19 2011-07-01 2011-07-01 false Limitations on sale of Tier 1 vehicles... Vehicles and Light-Duty Trucks § 86.1711-99 Limitations on sale of Tier 1 vehicles and TLEVs. (a) In the 2001 and subsequent model years, manufacturers may sell Tier 1 vehicles and TLEVs in the NTR only if...
40 CFR 86.1711-99 - Limitations on sale of Tier 1 vehicles and TLEVs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 19 2010-07-01 2010-07-01 false Limitations on sale of Tier 1 vehicles... Vehicles and Light-Duty Trucks § 86.1711-99 Limitations on sale of Tier 1 vehicles and TLEVs. (a) In the 2001 and subsequent model years, manufacturers may sell Tier 1 vehicles and TLEVs in the NTR only if...
26 CFR 1.902-3 - Credit for domestic corporate shareholder of a foreign corporation for foreign income taxes paid...

Code of Federal Regulations, 2010 CFR

2010-04-01

... the United States. (3) Second-tier corporation. (i) In the case of dividends paid to a first-tier... shareholder ending after that date, the foreign corporation is a “second-tier corporation” if at least 10... corporation by a foreign corporation before January 13, 1971, the foreign corporation is a “second-tier...
40 CFR 86.1861-04 - How do the Tier 2 and interim non-Tier 2 NOX averaging, banking and trading programs work?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 2 NOX averaging, banking and trading programs work? 86.1861-04 Section 86.1861-04 Protection of... work? (a) General provisions for Tier 2 credits and debits. (1) A manufacturer whose Tier 2 fleet... to a full useful life of 100,000 miles, provided that the credits are prorated by a multiplicative...
Technology Innovations to Improve Biomass Cookstoves to Meet Tier 4 Standards

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

Still, Dean K; Hatfield, Micheal S

Technology Innovations to Improve Biomass Cookstoves to Meet Tier 4 Standards. Protecting public health has become a major motivation for investigating how improved cook stoves might function as a viable intervention. Currently, the great majority of cookstoves for sale in the developing world were not designed for this purpose but instead success was based on criteria such as reduced fuel use, affordability, and ease of use. With DOE funding Aprovecho Research Center spent three years creating stoves using an iterative development and modeling approach resulting in four stoves that in lab tests met the World Health Organization (2014) intermediate ratemore » vented targets for PM2.5 and for CO.« less
Immunologic response among HIV-infected patients enrolled in a graduated cost-recovery programme of antiretroviral therapy delivery in Chennai, India.

PubMed

Solomon, Sunil Suhas; Ganesh, Aylur K; Mehta, Shruti H; Yepthomi, Tokugha; Balaji, Kavitha; Anand, Santhanam; Gallant, Joel E; Solomon, Suniti

2013-06-01

Sustainability of free antiretroviral therapy (ART) roll out programmes in resource-limited settings is challenging given the need for lifelong therapy and lack of effective vaccine. This study was undertaken to compare treatment outcomes among HIV-infected patients enrolled in a graduated cost-recovery programme of ART delivery in Chennai, India. Financial status of patients accessing care at a tertiary care centre, YRGCARE, Chennai, was assessed using an economic survey; patients were distributed into tiers 1- 4 requiring them to pay 0, 50, 75 or 100 per cent of their medication costs, respectively. A total of 1754 participants (ART naοve = 244) were enrolled from February 2005-January 2008 with the following distribution: tier 1=371; tier 2=338; tier 3=693; tier 4=352. Linear regression models with generalized estimating equations were used to examine immunological response among patients across the four tiers. Median age was 34; 73 per cent were male, and the majority were on nevirapine-based regimens. Median follow up was 11.1 months. The mean increase in CD4 cell count within the 1 st three months of HAART was 50.3 cells/μl per month in tier 1. Compared to those in tier 1, persons in tiers 2, 3 and 4 had comparable increases (49.7, 57.0, and 50.9 cells/μl per month, respectively). Increases in subsequent periods (3-18 and >18 months) were also comparable across tiers. No differential CD4 gains across tiers were observed when the analysis was restricted to patients initiating ART under the GCR programme. This ART delivery model was associated with significant CD4 gains with no observable difference by how much patients paid. Importantly, gains were comparable to those in other free rollout programmes. Additional cost-effectiveness analyses and mathematical modelling would be needed to determine whether such a delivery programme is a sustainable alternative to free ART programmes.
The effect of cigarette prices on brand-switching in China: a longitudinal analysis of data from the ITC China Survey

PubMed Central

White, Justin S; Li, Jing; Hu, Teh-wei; Fong, Geoffrey T; Jiang, Yuan

2014-01-01

Background Recent studies have found that Chinese smokers are relatively unresponsive to cigarette prices. As the Chinese government contemplates higher tobacco taxes, it is important to understand the reasons for this low response. One possible explanation is that smokers buffer themselves from rising cigarette prices by switching to cheaper cigarette brands. Objective This study examines how cigarette prices influence consumers’ choices of cigarette brands in China. Methods This study uses panel data from the first three waves of the International Tobacco Control China Survey, drawn from six large cities in China and collected between 2006 and 2009. The study sample includes 3477 smokers who are present in at least two waves (8552 person-years). Cigarette brands are sorted by price into four tiers, using excise tax categories to determine the cut-off for each tier. The analysis relies on a conditional logit model to identify the relationship between price and brand choice. Findings Overall, 38% of smokers switched price tiers from one wave to the next. A ¥1 change in the price of cigarettes alters the tier choice of 4–7% of smokers. Restricting the sample to those who chose each given tier at baseline, a ¥1 increase in price in a given tier would decrease the share choosing that tier by 4% for Tier 1 and 1–2% for Tiers 2 and 3. Conclusions China's large price spread across cigarette brands appears to alter the brand selection of some consumers, especially smokers of cheaper brands. Tobacco pricing and tax policy can influence consumers’ incentives to switch brands. In particular, whereas ad valorem taxes in a tiered pricing system like China's encourage trading down, specific excise taxes discourage the practice. PMID:23697645
Single-tier testing with the C6 peptide ELISA kit compared with two-tier testing for Lyme disease.

PubMed

Wormser, Gary P; Schriefer, Martin; Aguero-Rosenfeld, Maria E; Levin, Andrew; Steere, Allen C; Nadelman, Robert B; Nowakowski, John; Marques, Adriana; Johnson, Barbara J B; Dumler, J Stephen

2013-01-01

For the diagnosis of Lyme disease, the 2-tier serologic testing protocol for Lyme disease has a number of shortcomings including low sensitivity in early disease; increased cost, time, and labor; and subjectivity in the interpretation of immunoblots. In this study, the diagnostic accuracy of a single-tier commercial C6 ELISA kit was compared with 2-tier testing. The results showed that the C6 ELISA was significantly more sensitive than 2-tier testing with sensitivities of 66.5% (95% confidence interval [CI] 61.7-71.1) and 35.2% (95% CI 30.6-40.1), respectively (P < 0.001) in 403 sera from patients with erythema migrans. The C6 ELISA had sensitivity statistically comparable to 2-tier testing in sera from Lyme disease patients with early neurologic manifestations (88.6% versus 77.3%, P = 0.13) or arthritis (98.3% versus 95.6%, P = 0.38). The specificities of C6 ELISA and 2-tier testing in over 2200 blood donors, patients with other conditions, and Lyme disease vaccine recipients were found to be 98.9% and 99.5%, respectively (P < 0.05, 95% CI surrounding the 0.6 percentage point difference of 0.04 to 1.15). In conclusion, using a reference standard of 2-tier testing, the C6 ELISA as a single-step serodiagnostic test provided increased sensitivity in early Lyme disease with comparable sensitivity in later manifestations of Lyme disease. The C6 ELISA had slightly decreased specificity. Future studies should evaluate the performance of the C6 ELISA compared with 2-tier testing in routine clinical practice. Copyright © 2013 Elsevier Inc. All rights reserved.
Modeling individual exposures to ambient PM2.5 in the diabetes and the environment panel study (DEPS).

PubMed

Breen, Michael; Xu, Yadong; Schneider, Alexandra; Williams, Ronald; Devlin, Robert

2018-06-01

Air pollution epidemiology studies of ambient fine particulate matter (PM 2.5 ) often use outdoor concentrations as exposure surrogates, which can induce exposure error. The goal of this study was to improve ambient PM 2.5 exposure assessments for a repeated measurements study with 22 diabetic individuals in central North Carolina called the Diabetes and Environment Panel Study (DEPS) by applying the Exposure Model for Individuals (EMI), which predicts five tiers of individual-level exposure metrics for ambient PM 2.5 using outdoor concentrations, questionnaires, weather, and time-location information. Using EMI, we linked a mechanistic air exchange rate (AER) model to a mass-balance PM 2.5 infiltration model to predict residential AER (Tier 1), infiltration factors (F inf_home , Tier 2), indoor concentrations (C in , Tier 3), personal exposure factors (F pex , Tier 4), and personal exposures (E, Tier 5) for ambient PM 2.5 . We applied EMI to predict daily PM 2.5 exposure metrics (Tiers 1-5) for 174 participant-days across the 13 months of DEPS. Individual model predictions were compared to a subset of daily measurements of F pex and E (Tiers 4-5) from the DEPS participants. Model-predicted F pex and E corresponded well to daily measurements with a median difference of 14% and 23%; respectively. Daily model predictions for all 174 days showed considerable temporal and house-to-house variability of AER, F inf_home , and C in (Tiers 1-3), and person-to-person variability of F pex and E (Tiers 4-5). Our study demonstrates the capability of predicting individual-level ambient PM 2.5 exposure metrics for an epidemiological study, in support of improving risk estimation. Copyright © 2018. Published by Elsevier B.V.
Lessons learned from evaluating launch-site processing problems of Space Shuttle payloads

NASA Technical Reports Server (NTRS)

Flores, Carlos A.; Heuser, Robert E.; Sales, Johnny R.; Smith, Anthony M.

1992-01-01

The authors discuss a trend analysis program that is being conducted on the problem reports written during the processing of Space Shuttle payloads at Kennedy Space Center. The program is aimed at developing lessons learned that can both improve the effectiveness of the current payload processing cycles as well as help to guide the processing strategies for Space Station Freedom. The payload processing reports from STS 26R and STS 41 are used. A two-tier evaluation activity is described, and some typical results from the tier one analyses are presented.
DSCOVR_EPIC_L2_AER_01

Atmospheric Science Data Center

2018-04-23

DSCOVR_EPIC_L2_AER_01 The Aerosol UV product provides aerosol and UV products in three tiers. Tier 1 products include Absorbing Aerosol Index (AAI) and above-cloud-aerosol optical depth (ACAOD). Tier 2 ...
CMS tier structure and operation of the experiment-specific tasks in Germany

NASA Astrophysics Data System (ADS)

Nowack, A.

2008-07-01

In Germany, several university institutes and research centres take part in the CMS experiment. Concerning the data analysis, a couple of computing centres at different Tier levels, ranging from Tier 1 to Tier 3, exists at these places. The German Tier 1 centre GridKa at the research centre at Karlsruhe serves all four LHC experiments as well as four non-LHC experiments. With respect to the CMS experiment, GridKa is mainly involved in central tasks. The Tier 2 centre in Germany consists of two sites, one at the research centre DESY at Hamburg and one at RWTH Aachen University, forming a federated Tier 2 centre. Both parts cover different aspects of a Tier 2 centre. The German Tier 3 centres are located at the research centre DESY at Hamburg, at RWTH Aachen University, and at the University of Karlsruhe. Furthermore the building of a German user analysis facility is planned. Since the CMS community in German is rather small, a good cooperation between the different sites is essential. This cooperation includes physical topics as well as technical and operational issues. All available communication channels such as email, phone, monthly video conferences, and regular personal meetings are used. For example, the distribution of data sets is coordinated globally within Germany. Also the CMS-specific services such as the data transfer tool PhEDEx or the Monte Carlo production are operated by people from different sites in order to spread the knowledge widely and increase the redundancy in terms of operators.
Hypoglycemia education needs.

PubMed

Sutton, Leslie; Chapman-Novakofski, Karen

2011-09-01

Because more than half of those participating in a community-based diabetes session expressed experience with hypoglycemia, we sought additional information by conducting focus groups before developing programs or materials for educational support. The objectives of these focus groups were to determine how and to what extent hypoglycemia affected people, and what, if any, methods were used to prevent or treat the condition, to better target education in the future. Four focus groups were held using a tiered discussion script with a moderator and comoderator. Discussions were audiotaped, transcribed, and analyzed by content by independent researchers. Five themes emerged from the discussions: friends, family, and neighbors need hypoglycemia education as well as individuals themselves; leaving home is a concern if you experience hypoglycemia; overeating occurs when treating hypoglycemia; routine is important; and hypoglycemia is a limitation. We found that hypoglycemia had a significant impact on the participants' quality of life.
Bridging the bonding gap: the transition from primates to humans.

PubMed

Dunbar, R I M

2012-07-05

Primate societies are characterized by bonded social relationships of a kind that are rare in other mammal taxa. These bonded relationships, which provide the basis for coalitions, are underpinned by an endorphin mechanism mediated by social grooming. However, bonded relationships of this kind impose constraints on the size of social groups that are possible. When ecological pressures have demanded larger groups, primates have had to evolve new mechanisms to facilitate bonding. This has involved increasing the size of vocal and visual communication repertoires, increasing the time devoted to social interaction and developing a capacity to manage two-tier social relationships (strong and weak ties). I consider the implications of these constraints for the evolution of human social communities and argue that laughter was an early evolutionary innovation that helped bridge the bonding gap between the group sizes characteristic of chimpanzees and australopithecines and those in later hominins.
Examining the Effects and Feasibility of a Teacher-Implemented Tier 1 and Tier 2 Intervention in Word Reading, Fluency, and Comprehension

ERIC Educational Resources Information Center

Solari, Emily J.; Denton, Carolyn A.; Petscher, Yaacov; Haring, Christa

2018-01-01

This study investigates the effects and feasibility of an intervention for first-grade students at risk for reading difficulties or disabilities (RD). The intervention was provided by general education classroom teachers and consisted of 15 min whole-class comprehension lessons (Tier 1) and 30 min Tier 2 intervention sessions in word reading,…
76 FR 74079 - Self-Regulatory Organizations; BATS Exchange, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-30

... applicable Exchange listing tier into which such products fall. \\3\\ 15 U.S.C. 78f(b). \\4\\ 15 U.S.C. 78f(b)(5... on the Exchange pursuant to Rule 14.11 as Tier I securities. Exchange Rule 14.11 sets forth the... the Exchange's current rules, ETPs are not designated as either Tier I or Tier II securities. The...

Mathematics Intervention for First- and Second-Grade Students with Mathematics Difficulties: The Effects of Tier 2 Intervention Delivered as Booster Lessons

ERIC Educational Resources Information Center

Bryant, Diane Pedrotty; Bryant, Brian R.; Gersten, Russell; Scammacca, Nancy; Chavez, Melissa M.

2008-01-01

This study sought to examine the effects of Tier 2 intervention in a multitiered model on the performance of first- and second-grade students who were identified as having mathematics difficulties. A regression discontinuity design was utilized. Participants included 126 (Tier 2, n = 26) first graders and 140 (Tier 2, n = 25) second graders. Tier…
To Wait in Tier 1 or Intervene Immediately: A Randomized Experiment Examining First Grade Response to Intervention (RTI) in Reading

ERIC Educational Resources Information Center

Al Otaiba, Stephanie; Connor, Carol M.; Folsom, Jessica S.; Wanzek, Jeanne; Greulich, Luana; Schatschneider, Christopher; Wagner, Richard K.

2015-01-01

This randomized control study compares the efficacy of two response-to-intervention (RTI) models: (1) Dynamic RTI, which immediately refers grade 1 students with the weakest skills to the most intensive intervention supports (Tier 2 or Tier 3); and (2) Typical RTI, which starts all students in Tier 1 and after 8 weeks, decides whether students who…
The Influence Of Team Rating On Running Performance In Elite Gaelic Football.

PubMed

Mangan, Shane; Malone, Shane; Ryan, Martin; Gahan, Jason Mc; Warne, Joe; Martin, Denise; O'Neill, Cian; Burns, Con; Collins, Kieran

2017-11-06

It is currently unknown how team rating influences running performance in Gaelic football. GPS technologies were used to quantify match-running performance within 5 elite Gaelic football teams over a period of 5 years (2012-2016). In total 780 player data sets were collected over 95 matches. Running performance variables included total distance, high-speed distance (≥17 km h) and the percentage of high-speed distance. Team ratings were determined objectively using the Elo Ratings System for Gaelic football. Reference team rating had trivial effects on total distance (p = 0.011, partial η2 = 0.008) and high-speed distance (p = 0.011, partial η2 = 0.008). Opposition team rating had small effects on total distance (p = 0.005, partial η2 = 0.016) and high-speed distance (p = 0.001, partial η2 = 0.020). Top tier teams cover greater total distances and high-speed distance than lower tier teams. Players cover considerably less total distance and high-speed distance against tier 3 and tier 4 teams. Tier 1 players ran a significantly higher percentage of distance at high-speed, than players who played for tier 2 teams (p = 0.020). The competitive advantage of top tier Gaelic football teams is closely linked with their ability to demonstrate a higher physical intensity than lower tier teams.
Prospective Study of Serologic Tests for Lyme Disease

PubMed Central

Steere, Allen C.; McHugh, Gail; Damle, Nitin; Sikand, Vijay K.

2017-01-01

Background Tests to determine serum antibody levels—the 2-tier sonicate immunoglobulin M (IgM) and immunoglobulin G (IgG) enzyme-linked immunosorbent assay (ELISA) and Western blot method or the IgG of the variable major protein-like sequence-expressed (VlsE) sixth invariant region (C6) peptide ELISA method—are the major tests available for support of the diagnosis of Lyme disease. However, these tests have not been assessed prospectively. Methods We used these tests prospectively to determine serologic responses in 134 patients with various manifestations of Lyme disease, 89 patients with other illnesses (with or without a history of Lyme disease), and 136 healthy subjects from areas of endemicity and areas in which the infection was not endemic. Results With 2-tier tests and the C6 peptide ELISA, only approximately one-third of 76 patients with erythema migrans had results that were positive for IgM or IgG seroreactivity with Borrelia burgdorferi in acute-phase samples. During convalescence, 3–4 weeks later, almost two-thirds of patients had seroreactivity with the spirochete B. burgdorferi. The frequencies of seroreactivity were significantly greater among patients with spirochetal dissemination than they were among those who lacked evidence of disseminated disease. Of the 44 patients with Lyme disease who had neurologic, heart, or joint involvement, all had positive C6 peptide ELISA results, 42 had IgG responses with 2-tier tests, and 2 patients with facial palsy had only IgM responses. However, among the control groups, the IgG Western blot was slightly more specific than the C6 peptide ELISA. The differences between the 2 test systems (2-tier testing and C6 peptide ELISA) with respect to sensitivity and specificity were not statistically significant. Conclusions Except in patients with erythema migrans, both test systems were sensitive for support of the diagnosis of Lyme disease. However, with current methods, 2-tier testing was associated with slightly better specificity. PMID:18532885
JPEG 2000 Encoding with Perceptual Distortion Control

NASA Technical Reports Server (NTRS)

Watson, Andrew B.; Liu, Zhen; Karam, Lina J.

2008-01-01

An alternative approach has been devised for encoding image data in compliance with JPEG 2000, the most recent still-image data-compression standard of the Joint Photographic Experts Group. Heretofore, JPEG 2000 encoding has been implemented by several related schemes classified as rate-based distortion-minimization encoding. In each of these schemes, the end user specifies a desired bit rate and the encoding algorithm strives to attain that rate while minimizing a mean squared error (MSE). While rate-based distortion minimization is appropriate for transmitting data over a limited-bandwidth channel, it is not the best approach for applications in which the perceptual quality of reconstructed images is a major consideration. A better approach for such applications is the present alternative one, denoted perceptual distortion control, in which the encoding algorithm strives to compress data to the lowest bit rate that yields at least a specified level of perceptual image quality. Some additional background information on JPEG 2000 is prerequisite to a meaningful summary of JPEG encoding with perceptual distortion control. The JPEG 2000 encoding process includes two subprocesses known as tier-1 and tier-2 coding. In order to minimize the MSE for the desired bit rate, a rate-distortion- optimization subprocess is introduced between the tier-1 and tier-2 subprocesses. In tier-1 coding, each coding block is independently bit-plane coded from the most-significant-bit (MSB) plane to the least-significant-bit (LSB) plane, using three coding passes (except for the MSB plane, which is coded using only one "clean up" coding pass). For M bit planes, this subprocess involves a total number of (3M - 2) coding passes. An embedded bit stream is then generated for each coding block. Information on the reduction in distortion and the increase in the bit rate associated with each coding pass is collected. This information is then used in a rate-control procedure to determine the contribution of each coding block to the output compressed bit stream.
20 CFR 226.11 - Employee tier II.

Code of Federal Regulations, 2011 CFR

2011-04-01

.... The tier II of an employee annuity is based only on railroad service. For annuities awarded after... of the tier II benefit for age. The result cannot be less than zero. (c) If the railroad retirement...
20 CFR 228.2 - Tier I and tier II annuity components.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Social Security Act if all of the employee's earnings after 1936 under both the railroad retirement system and the social security system had been creditable under the Social Security Act. (b) Tier II...
76 FR 45742 - Fisheries of the Northeastern United States; Atlantic Mackerel, Squid, and Butterfish Fisheries...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-01

... vessel must have landed at least 400,000 lb (181.44 mt) in any one year 1997-2005 to qualify for a Tier 1... Tier 2 permit; or at least 1,000 lb (0.45 mt) in any one year March 1, 1994--December 31, 2005, to qualify for a Tier 3 permit, with Tier 3 allocated up to 7 percent of the commercial quota, through the...
Three-tier rough superhydrophobic surfaces

NASA Astrophysics Data System (ADS)

Cao, Yuanzhi; Yuan, Longyan; Hu, Bin; Zhou, Jun

2015-08-01

A three-tier rough superhydrophobic surface was fabricated by growing hydrophobic modified (fluorinated silane) zinc oxide (ZnO)/copper oxide (CuO) hetero-hierarchical structures on silicon (Si) micro-pillar arrays. Compared with the other three control samples with a less rough tier, the three-tier surface exhibits the best water repellency with the largest contact angle 161° and the lowest sliding angle 0.5°. It also shows a robust Cassie state which enables the water to flow with a speed over 2 m s-1. In addition, it could prevent itself from being wetted by the droplet with low surface tension (mixed water and ethanol 1:1 in volume) which reveals a flow speed of 0.6 m s-1 (dropped from the height of 2 cm). All these features prove that adding another rough tier on a two-tier rough surface could futher improve its water-repellent properties.
Three-tier rough superhydrophobic surfaces.

PubMed

Cao, Yuanzhi; Yuan, Longyan; Hu, Bin; Zhou, Jun

2015-08-07

A three-tier rough superhydrophobic surface was fabricated by growing hydrophobic modified (fluorinated silane) zinc oxide (ZnO)/copper oxide (CuO) hetero-hierarchical structures on silicon (Si) micro-pillar arrays. Compared with the other three control samples with a less rough tier, the three-tier surface exhibits the best water repellency with the largest contact angle 161° and the lowest sliding angle 0.5°. It also shows a robust Cassie state which enables the water to flow with a speed over 2 m s(-1). In addition, it could prevent itself from being wetted by the droplet with low surface tension (mixed water and ethanol 1:1 in volume) which reveals a flow speed of 0.6 m s(-1) (dropped from the height of 2 cm). All these features prove that adding another rough tier on a two-tier rough surface could futher improve its water-repellent properties.
Methods and apparatus for constructing and implementing a universal extension module for processing objects in a database

NASA Technical Reports Server (NTRS)

Li, Chung-Sheng (Inventor); Smith, John R. (Inventor); Chang, Yuan-Chi (Inventor); Jhingran, Anant D. (Inventor); Padmanabhan, Sriram K. (Inventor); Hsiao, Hui-I (Inventor); Choy, David Mun-Hien (Inventor); Lin, Jy-Jine James (Inventor); Fuh, Gene Y. C. (Inventor); Williams, Robin (Inventor)

2004-01-01

Methods and apparatus for providing a multi-tier object-relational database architecture are disclosed. In one illustrative embodiment of the present invention, a multi-tier database architecture comprises an object-relational database engine as a top tier, one or more domain-specific extension modules as a bottom tier, and one or more universal extension modules as a middle tier. The individual extension modules of the bottom tier operationally connect with the one or more universal extension modules which, themselves, operationally connect with the database engine. The domain-specific extension modules preferably provide such functions as search, index, and retrieval services of images, video, audio, time series, web pages, text, XML, spatial data, etc. The domain-specific extension modules may include one or more IBM DB2 extenders, Oracle data cartridges and/or Informix datablades, although other domain-specific extension modules may be used.
Feature Selection Using Information Gain for Improved Structural-Based Alert Correlation

PubMed Central

Siraj, Maheyzah Md; Zainal, Anazida; Elshoush, Huwaida Tagelsir; Elhaj, Fatin

2016-01-01

Grouping and clustering alerts for intrusion detection based on the similarity of features is referred to as structurally base alert correlation and can discover a list of attack steps. Previous researchers selected different features and data sources manually based on their knowledge and experience, which lead to the less accurate identification of attack steps and inconsistent performance of clustering accuracy. Furthermore, the existing alert correlation systems deal with a huge amount of data that contains null values, incomplete information, and irrelevant features causing the analysis of the alerts to be tedious, time-consuming and error-prone. Therefore, this paper focuses on selecting accurate and significant features of alerts that are appropriate to represent the attack steps, thus, enhancing the structural-based alert correlation model. A two-tier feature selection method is proposed to obtain the significant features. The first tier aims at ranking the subset of features based on high information gain entropy in decreasing order. The‏ second tier extends additional features with a better discriminative ability than the initially ranked features. Performance analysis results show the significance of the selected features in terms of the clustering accuracy using 2000 DARPA intrusion detection scenario-specific dataset. PMID:27893821
MADGE: scalable distributed data management software for cDNA microarrays.

PubMed

McIndoe, Richard A; Lanzen, Aaron; Hurtz, Kimberly

2003-01-01

The human genome project and the development of new high-throughput technologies have created unparalleled opportunities to study the mechanism of diseases, monitor the disease progression and evaluate effective therapies. Gene expression profiling is a critical tool to accomplish these goals. The use of nucleic acid microarrays to assess the gene expression of thousands of genes simultaneously has seen phenomenal growth over the past five years. Although commercial sources of microarrays exist, investigators wanting more flexibility in the genes represented on the array will turn to in-house production. The creation and use of cDNA microarrays is a complicated process that generates an enormous amount of information. Effective data management of this information is essential to efficiently access, analyze, troubleshoot and evaluate the microarray experiments. We have developed a distributable software package designed to track and store the various pieces of data generated by a cDNA microarray facility. This includes the clone collection storage data, annotation data, workflow queues, microarray data, data repositories, sample submission information, and project/investigator information. This application was designed using a 3-tier client server model. The data access layer (1st tier) contains the relational database system tuned to support a large number of transactions. The data services layer (2nd tier) is a distributed COM server with full database transaction support. The application layer (3rd tier) is an internet based user interface that contains both client and server side code for dynamic interactions with the user. This software is freely available to academic institutions and non-profit organizations at http://www.genomics.mcg.edu/niddkbtc.
Integration of Novel Low-Cost Colorimetric, Laser Photometric, and Visual Fluorescent Techniques for Rapid Identification of Falsified Medicines in Resource-Poor Areas: Application to Artemether–Lumefantrine

PubMed Central

Green, Michael D.; Hostetler, Dana M.; Nettey, Henry; Swamidoss, Isabel; Ranieri, Nicola; Newton, Paul N.

2015-01-01

The availability of falsified antimalarial drugs can be reduced with effective drug regulatory agencies and proper enforcement. Fundamental to these agencies taking action, rapid identification must be made as soon as they appear in the market place. Since falsified antimalarials occur mostly in developing countries, performing drug analysis presents itself with unique challenges. A fundamental factor in choosing a useful technique is affordability and simplicity. Therefore, we suggest a three-tiered drug evaluation strategy for identifying a falsified drug in resource-poor areas. Tier I is a simple comparison of a tablet's weight and dimensions with official specifications. Tier II uses inexpensive photometric devices (laser and fluorescence) to evaluate a tablet. Suspicious samples from Tier I and II assessments are then subjected to a colorimetric assay for active ingredients identification and quantification. In this article, we evaluate a novel colorimetric assay for the simultaneous assessment of both lumefantrine and artemether in co-formulated Coartem™ tablets, and integrate the method with two novel, low-cost, fluorescence and laser photometric devices. Image analysis software is used for the assessments. Although artemether–lumefantrine is used as an example, the strategy may be adapted to other medicines. PMID:25897066
Constructing and Implementing a Four Tier Test about Static Electricity to Diagnose Pre-service Elementary School Teacher’ Misconceptions

NASA Astrophysics Data System (ADS)

Hermita, N.; Suhandi, A.; Syaodih, E.; Samsudin, A.; Isjoni; Johan, H.; Rosa, F.; Setyaningsih, R.; Sapriadil; Safitri, D.

2017-09-01

We have already constructed and implemented the diagnostic test formed in the four tier test to diagnose pre-service elementary teachers’ misconceptions about static electricity. The method which is utilized in this study is 3D-1I (Define, Design, Develop and Implementation) conducted to the pre-service elementary school teachers. The number of respondents involved in the study is 78 students of PGSD FKIP Universitas Riau. The data was collected by administering diagnostic test items in the form of four tier test. The result indicates that there are several misconceptions related to static electricity concept, these include: 1) Electrostatic objects cannot attract neutral objects, 2) A neutral object is an object that does not contain an electrical charge, and 3) the magnitude of the tensile force between two charged objects depends on the size of the charge. Moreover, the research’s results establish that the diagnostic test is able to analyse number of misconceptions and classify level of understanding pre-service elementary school teachers that is scientific knowledge, misconception, lack knowledge, and error. In conclusion, the diagnostic test item in the form of four tier test has already been constructed and implemented to diagnose students’ conceptions on static electricity.
Cross-species extrapolation of toxicity information using the ...

EPA Pesticide Factsheets

In the United States, the Endocrine Disruptor Screening Program (EDSP) was established to identify chemicals that may lead to adverse effects via perturbation of the endocrine system (i.e., estrogen, androgen, and thyroid hormone systems). In the mid-1990s the EDSP adopted a two tiered approach for screening chemicals that applied standardized in vitro and in vivo toxicity tests. The Tier 1 screening assays were designed to identify substances that have the potential of interacting with the endocrine system and Tier 2 testing was developed to identify adverse effects caused by the chemical, with documentation of dose-response relationships. While this tiered approach was effective in identifying possible endocrine disrupting chemicals, the cost and time to screen a single chemical was significant. Therefore, in 2012 the EDSP proposed a transition to make greater use of computational approaches (in silico) and high-throughput screening (HTS; in vitro) assays to more rapidly and cost-efficiently screen chemicals for endocrine activity. This transition from resource intensive, primarily in vivo, screening methods to more pathway-based approaches aligns with the simultaneously occurring transformation in toxicity testing termed “Toxicity Testing in the 21st Century” which shifts the focus to the disturbance of the biological pathway predictive of the observable toxic effects. An example of such screening tools include the US Environmental Protection Agency’s
Evaluation of protein safety in the context of agricultural biotechnology.

PubMed

Delaney, Bryan; Astwood, James D; Cunny, Helen; Conn, Robin Eichen; Herouet-Guicheney, Corinne; Macintosh, Susan; Meyer, Linda S; Privalle, Laura; Gao, Yong; Mattsson, Joel; Levine, Marci

2008-05-01

One component of the safety assessment of agricultural products produced through biotechnology is evaluation of the safety of newly expressed proteins. The ILSI International Food Biotechnology Committee has developed a scientifically based two-tiered, weight-of-evidence strategy to assess the safety of novel proteins used in the context of agricultural biotechnology. Recommendations draw upon knowledge of the biological and chemical characteristics of proteins and testing methods for evaluating potential intrinsic hazards of chemicals. Tier I (potential hazard identification) includes an assessment of the biological function or mode of action and intended application of the protein, history of safe use, comparison of the amino acid sequence of the protein to other proteins, as well as the biochemical and physico-chemical properties of the proteins. Studies outlined in Tier II (hazard characterization) are conducted when the results from Tier I are not sufficient to allow a determination of safety (reasonable certainty of no harm) on a case-by-case basis. These studies may include acute and repeated dose toxicology studies and hypothesis-based testing. The application of these guidelines is presented using examples of transgenic proteins applied for agricultural input and output traits in genetically modified crops along with recommendations for future research considerations related to protein safety assessment.
Integration of novel low-cost colorimetric, laser photometric, and visual fluorescent techniques for rapid identification of falsified medicines in resource-poor areas: application to artemether-lumefantrine.

PubMed

Green, Michael D; Hostetler, Dana M; Nettey, Henry; Swamidoss, Isabel; Ranieri, Nicola; Newton, Paul N

2015-06-01

The availability of falsified antimalarial drugs can be reduced with effective drug regulatory agencies and proper enforcement. Fundamental to these agencies taking action, rapid identification must be made as soon as they appear in the market place. Since falsified antimalarials occur mostly in developing countries, performing drug analysis presents itself with unique challenges. A fundamental factor in choosing a useful technique is affordability and simplicity. Therefore, we suggest a three-tiered drug evaluation strategy for identifying a falsified drug in resource-poor areas. Tier I is a simple comparison of a tablet's weight and dimensions with official specifications. Tier II uses inexpensive photometric devices (laser and fluorescence) to evaluate a tablet. Suspicious samples from Tier I and II assessments are then subjected to a colorimetric assay for active ingredients identification and quantification. In this article, we evaluate a novel colorimetric assay for the simultaneous assessment of both lumefantrine and artemether in co-formulated Coartem™ tablets, and integrate the method with two novel, low-cost, fluorescence and laser photometric devices. Image analysis software is used for the assessments. Although artemether-lumefantrine is used as an example, the strategy may be adapted to other medicines. © The American Society of Tropical Medicine and Hygiene.
An introduction to indigenous health and culture: the first tier of the Three Tiered Plan.

PubMed

Sinnott, M J; Wittmann, B

2001-06-01

The objective of the present study was to prepare new doctors with an awareness of cultural and health issues to facilitate positive experiences with indigenous patients. The study incorporated the 1998 intern orientation programs in Queensland public hospitals. The study method included tier one of the Three Tiered Plan, which was implemented and audited. Indigenous liaison officers, directors of clinical training and medical education officers were surveyed prior to this implementation to determine whether any or similar initiatives had been carried out in previous years and/or were planned. Post-implementation feedback from interns was obtained by using questionnaires. Follow-up telephone interviews with the directors of clinical training, medical education officers and indigenous hospital liaison officers detailed the format and content of tier one at each hospital. The results indicate that this active intervention improved the implementation rate of tier one from nine of 19 (47%) Queensland public hospitals in 1997 to 17 (90%) in 1998. The 14 indigenous hospital liaison officers (100%) involved in the intervention perceived it as beneficial. Forty-three (67%) of interns who responded to the survey indicated they had encountered an indigenous patient within the last 2-4 months. The level of knowledge of indigenous health and culture self-reported by interns was between the categories 'enough to get by' and 'inadequate'. In conclusion, it appears that tier one has been successful and is to be a formal component of intern orientations in Queensland public hospitals. Further initiatives in indigenous health and culture targeting medical staff (i.e. tier two and tier three), are needed.
12 CFR 222.72 - General requirements for risk-based pricing notices.

Code of Federal Regulations, 2011 CFR

2011-01-01

... provided to a consumer by placing the consumer within one of a discrete number of pricing tiers for a... lowest-priced tier). For example, a person that uses a tiered pricing structure with annual percentage...

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