The Reliability of a 5km Run Test on a Motorized Treadmill

ERIC Educational Resources Information Center

Driller, Matthew; Brophy-Williams, Ned; Walker, Anthony

2017-01-01

The purpose of the present study was to determine the reliability of a 5km run test on a motorized treadmill. Over three consecutive weeks, 12 well-trained runners completed three 5km time trials on a treadmill following a standardized warm-up. Runners were partially-blinded to their running speed and distance covered. Total time to complete the…

"Surgery interrupted": The effect of multitasking on cognitive and technical tasks in medical students.

PubMed

Evans, C H; Schneider, E; Shostrom, V; Schenarts, P J

2017-02-01

Today's medical learners are Millennials, and reportedly, multitasking pros. We aim to evaluate effect of multitasking on cognitive and technical skills. 16 medical students completed a mock page and laceration closure separately on day 1 and day 13, and in parallel on day 14. Suturing was graded using GRS and mock pages scored. Total time, suturing and loading times, and percent correct on mock page were compared. Percent correct on mock page improved from days 1-13 and 14 (p < 0.01 and 0.04). GRS improved from days 1-13 and 14 (p = 0.04 and <0.01). Total time suturing was similar on all days. However, time suturing during the mock page on day 14 was prolonged compared to before mock page (p = 0.01). Medical students can complete cognitive and technical tasks in parallel, without compromising acceptability. However, multitasking results in longer times to complete the complex component of the technical task. Copyright © 2016 Elsevier Inc. All rights reserved.

Effects of interest-major congruence, motivation, and academic performance on timely degree attainment.

PubMed

Allen, Jeff; Robbins, Steve

2010-01-01

Using longitudinal student data from 15 four-year (n = 3,072) and 13 (n = 788) two-year postsecondary institutions, the authors tested the effects of interest-major congruence, motivation, and 1st-year academic performance on timely degree completion. Findings suggest that interest-major congruence has a direct effect on timely degree completion at both institutional settings and that motivation has indirect effects (via 1st-year academic performance). The total effects of both interest-major congruence and motivation on timely degree completion underscore the importance of both constructs in understanding student adjustment and postsecondary success. Implications for theory and counseling practice are discussed.

Dichotomous scoring of Trails B in patients referred for a dementia evaluation.

PubMed

Schmitt, Andrew L; Livingston, Ronald B; Smernoff, Eric N; Waits, Bethany L; Harris, James B; Davis, Kent M

2010-04-01

The Trail Making Test is a popular neuropsychological test and its interpretation has traditionally used time-based scores. This study examined an alternative approach to scoring that is simply based on the examinees' ability to complete the test. If an examinee is able to complete Trails B successfully, they are coded as "completers"; if not, they are coded as "noncompleters." To assess this approach to scoring Trails B, the performance of 97 diagnostically heterogeneous individuals referred for a dementia evaluation was examined. In this sample, 55 individuals successfully completed Trails B and 42 individuals were unable to complete it. Point-biserial correlations indicated a moderate-to-strong association (r(pb)=.73) between the Trails B completion variable and the Total Scale score of the Repeatable Battery for the Assessment of Neurological Status (RBANS), which was larger than the correlation between the Trails B time-based score and the RBANS Total Scale score (r(pb)=.60). As a screen for dementia status, Trails B completion showed a sensitivity of 69% and a specificity of 100% in this sample. These results suggest that dichotomous scoring of Trails B might provide a brief and clinically useful measure of dementia status.

Temporary bypass for superior vena cava reconstruction with Anthron bypass tubeTM

PubMed Central

Yamasaki, Naoya; Tsuchiya, Tomoshi; Miyazaki, Takuro; Kamohara, Ryotaro; Hatachi, Go; Nagayasu, Takeshi

2017-01-01

Total superior vena cava (SVC) clamping for SVC replacement or repair can be used in thoracic surgery. A bypass technique is an option to avoid hemodynamic instability and cerebral venous hypertension and hypoperfusion. The present report describes a venous bypass technique using Anthron bypass tubeTM for total SVC clamping. Indications for this procedure include the need for a temporary bypass between the brachiocephalic vein and atrium for complete tumor resection. This procedure allows the surgeons sufficient time to complete replacement of SVC or partial resection of SVC without adverse effects. Further, it is a relatively simple procedure requiring minimal time. PMID:28840027

Patterns of long-term and short-term responses in adult patients with attention-deficit/hyperactivity disorder in a completer cohort of 12 weeks or more with atomoxetine.

PubMed

Sobanski, E; Leppämäki, S; Bushe, C; Berggren, L; Casillas, M; Deberdt, W

2015-11-01

Atomoxetine is a well-established pharmacotherapy for adult ADHD. Long-term studies show incremental reductions in symptoms over time. However, clinical experience suggests that patients differ in their response patterns. From 13 Eli Lilly-sponsored studies, we pooled and analyzed data for adults with ADHD who completed atomoxetine treatment at long-term (24 weeks; n=1443) and/or short-term (12 weeks; n=2830) time-points, and had CAARS-Inv:SV total and CGI-S data up to or after these time-points and at Week 0 (i.e. at baseline, when patients first received atomoxetine). The goal was to identify and describe distinct trajectories of response to atomoxetine using hierarchical clustering methods and linear mixed modelling. Based on the homogeneity of changes in CAARS-Inv:SV total scores, 5 response clusters were identified for patients who completed long-term (24 weeks) treatment with atomoxetine, and 4 clusters were identified for patients who completed short-term (12 weeks) treatment. Four of the 5 long-term clusters (comprising 95% of completer patients) showed positive trajectories: 2 faster responding clusters (L1 and L2), and 2 more gradually responding clusters (L3 and L4). Responses (i.e.≥30% reduction in CAARS-Inv:SV total score, and CGI-S score≤3) were observed at 8 and 24 weeks in 80% and 95% of completers in Cluster L1, versus 5% and 48% in Cluster L4. While many adults with ADHD responded relatively rapidly to atomoxetine, others responded more gradually without a clear plateau at 24 weeks. Longer-term treatment may be associated with greater numbers of responders. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

A cost/benefit analysis of commercial fusion-fission hybrid reactor development

NASA Astrophysics Data System (ADS)

Kostoff, Ronald N.

1983-04-01

A simple algorithm was developed that allows rapid computation of the ratio, R, of present worth of benefits to present worth of hybrid R&D program costs as a function of potential hybrid unit electricity cost savings, discount rate, electricity demand growth rate, total hybrid R&D program cost, and time to complete a demonstration reactor. In the sensitivity study, these variables were assigned nominal values (unit electricity cost savings of 4 mills/kW-hr, discount rate of 4%/year, growth rate of 2.25%/year, total R&D program cost of 20 billion, and time to complete a demonstration reactor of 30 years), and the variable of interest was varied about its nominal value. Results show that R increases with decreasing discount rate and increasing unit electricity savings and ranges from 4 to 94 as discount rate ranges from 5 to 3%/year and unit electricity savings range from 2 to 6 mills/kW-hr. R increases with increasing growth rate and ranges from 3 to 187 as growth rate ranges from 1 to 3.5%/year and unit electricity cost savings range from 2 to 6 mills/kW-hr. R attains a maximum value when plotted against time to complete a demonstration reactor. The location of this maximum value occurs at shorter completion times as discount rate increases, and this optimal completion time ranges from 20 years for a discount rate of 4%/year to 45 years for a discount rate of 3%/year.

Minimizing the Sum of Completion Times with Resource Dependant Times

NASA Astrophysics Data System (ADS)

Yedidsion, Liron; Shabtay, Dvir; Kaspi, Moshe

2008-10-01

We extend the classical minimization sum of completion times problem to the case where the processing times are controllable by allocating a nonrenewable resource. The quality of a solution is measured by two different criteria. The first criterion is the sum of completion times and the second is the total weighted resource consumption. We consider four different problem variations for treating the two criteria. We prove that this problem is NP-hard for three of the four variations even if all resource consumption weights are equal. However, somewhat surprisingly, the variation of minimizing the integrated objective function is solvable in polynomial time. Although the sum of completion times is arguably the most important scheduling criteria, the complexity of this problem, up to this paper, was an open question for three of the four variations. The results of this research have various implementations, including efficient battery usage on mobile devices such as mobile computer, phones and GPS devices in order to prolong their battery duration.

Some single-machine scheduling problems with learning effects and two competing agents.

PubMed

Li, Hongjie; Li, Zeyuan; Yin, Yunqiang

2014-01-01

This study considers a scheduling environment in which there are two agents and a set of jobs, each of which belongs to one of the two agents and its actual processing time is defined as a decreasing linear function of its starting time. Each of the two agents competes to process its respective jobs on a single machine and has its own scheduling objective to optimize. The objective is to assign the jobs so that the resulting schedule performs well with respect to the objectives of both agents. The objective functions addressed in this study include the maximum cost, the total weighted completion time, and the discounted total weighted completion time. We investigate three problems arising from different combinations of the objectives of the two agents. The computational complexity of the problems is discussed and solution algorithms where possible are presented.

Psychosocial quality of life in patients after total laryngectomy.

PubMed

Babin, E; Beynier, D; Le Gall, D; Hitier, M

2009-01-01

To examine Psychosocial Quality-of Life (PSQL) changes occurring over time among patients treated for laryngeal carcinoma by total laryngectomy. A retrospective, observational transversal study was performed on PSQL changes over time in laryngeal carcinoma patients having undergone total laryngectomy. Patients were interviewed using a questionnaire developed by two sociologists and a head and neck surgeon. Changes over time were assessed according to information with regards to smoking, alcohol consumption, psychological well-being, social life, family support, occupation and medical and demographic data regarding age, gender, verbal communication and patient appearance. 150 patients completed the questionnaire. All were aged over 50 years at the time of surgery (total laryngectomy). Eighty-five percent of patients were smokers and 81% drinkers. On average, the questionnaires were completed by patients 6 years after surgery. Before and after total laryngectomy, no statistical differences were noted for marital status (p = 1.000), frequency of dining at home with friends (p = 0.175), frequency of weekend outings (p = 0.092) or frequency of holidays (p = 0.565). A significant decrease was noted for smoking and drinking (p < 0.001), frequency of going to a café (p < 0.001), frequency of dinner outings at friends' homes (p = 0.032) and frequency of going out to a restaurant (p < 0.001). A significant increase was observed in: owning a pet (p = 0.02) and time spent watching television (p < 0.001). The two latter results are indicative of feelings of solitude among total laryngectomees. Tracheostoma and voice deprivation are limiting factors in social relationships, hence pushing individuals into withdrawal.

Five Weeks of Sprint and High-Intensity Interval Training Improves Paddling Performance in Adolescent Surfers.

PubMed

Farley, Oliver R L; Secomb, Josh L; Parsonage, Joanna R; Lundgren, Lina E; Abbiss, Chris R; Sheppard, Jeremy M

2016-09-01

Farley, ORL, Secomb, JL, Parsonage, JR, Lundgren, LE, Abbiss, CR, and Sheppard, JM. Five weeks of sprint and high-intensity interval training improves paddling performance in adolescent surfers. J Strength Cond Res 30(9): 2446-2452, 2016-The purpose of our study was to examine the effects of sprint interval training (SIT; 10 seconds) and high-intensity interval training (HIT; 30 seconds) on surfing athletes paddling performance (400-m time trial and repeat-sprint paddle performance). Twenty-four competitive adolescent surfers (19 male, 5 female; age = 14.4 ± 1.3 years, mass: 50.1 ± 10.7 kg, and stature: 159.9 ± 10.3 cm) were assigned to perform either 5 weeks of SIT and HIT. Participants completed a repeated-sprint paddle ability test (RSPT, 15-m surfboard sprint paddle initiated every 40 seconds × 10 bouts) and 400-m endurance surfboard paddle time trial before and after training. High-intensity interval training decreased the total time to complete the 400 m by 15.8 ± 16.1 seconds (p = 0.03), and SIT decreased the total time to complete the RSPT by 6.5 ± 4.3 seconds (p = 0.02). Fatigue index during the RSPT (first-slowest effort) was lower after HIT and SIT (p ≤ 0.001 and p = 0.02, respectively). There were no significant differences in performance changes in the 400 m (total time) and RSPT (total time, fastest 15 m time, and peak velocity) between HIT and SIT. Our study indicates that HIT and SIT may be implemented to the training program of surfers to improve aerobic and repeat-sprint paddle ability, both of which are identified as key aspects of the sport. In addition, these findings indicate that 400-m paddle and RSPT can discriminate between aerobic and anaerobic training adaptations, with aerobic gains likely from HIT and anaerobic gains from SIT.

Factors affecting medication-order processing time.

PubMed

Beaman, M A; Kotzan, J A

1982-11-01

The factors affecting medication-order processing time at one hospital were studied. The order processing time was determined by directly observing the time to process randomly selected new drug orders on all three work shifts during two one-week periods. An order could list more than one drug for an individual patient. The observer recorded the nature, location, and cost of the drugs ordered, as well as the time to process the order. The time and type of interruptions also were noted. The time to process a drug order was classified as six dependent variables: (1) total time, (2) work time, (3) check time, (4) waiting time I--time from arrival on the dumbwaiter until work was initiated, (5) waiting time II--time between completion of the work and initiation of checking, and (6) waiting time III--time after the check was completed until the order left on the dumbwaiter. The significant predictors of each of the six dependent variables were determined using stepwise multiple regression. The total time to process a prescription order was 58.33 +/- 48.72 minutes; the urgency status of the order was the only significant determinant of total time. Urgency status also significantly predicted the three waiting-time variables. Interruptions and the number of drugs on the order were significant determinants of work time and check time. Each telephone interruption increased the work time by 1.72 minutes. While the results of this study cannot be generalized to other institutions, pharmacy managers can use the method of determining factors that affect medication-order processing time to identify problem areas in their institutions.

Glossary Defense Acquisition Acronyms and Terms

DTIC Science & Technology

1991-09-01

of work to complete a job or part of a project . Actual Cost A cost sustained in fact, on the basis of costs incurred, as... of a project which shows the activities to be completed and the time to complete them is represented by horizontal lines drawn in proportion to the ...recorded for the total estimated obligations for a program or project in the initial year of funding. (For distinction, see Full

Completely staple-free hand-sewn laparoscopic anastomosis in colorectal surgery.

PubMed

Lipski, David; Dapri, Giovanni; Himpens, Jacques

2008-04-01

Colonic continuity following a laparoscopic left hemicolectomy is usually performed by using a circular stapler to achieve end-to-end colorectal anastomosis. However, not much consideration is given to the costs of this technique and the long-term risk of stenosis. In this paper, we report the first case of a completely staple-free hand-sewn laparoscopic colonic anastomosis (CSHLCA) following a laparoscopic left hemicolectomy for cancer. Total operative time was 170 minutes, and the time to perform the anastomosis was 38 minutes. The postoperative stay was uneventful, with a total hospital stay of 6 days. CSHLCA is feasible and can lower the cost of the laparoscopic procedure. It may be considered in countries with limited access to mechanical staplers.

Personal best times in an Olympic distance triathlon and in a marathon predict Ironman race time in recreational male triathletes.

PubMed

Rüst, Christoph Alexander; Knechtle, Beat; Knechtle, Patrizia; Rosemann, Thomas; Lepers, Romuald

2011-01-01

The purpose of this study was to define predictor variables for recreational male Ironman triathletes, using age and basic measurements of anthropometry, training, and previous performance to establish an equation for the prediction of an Ironman race time for future recreational male Ironman triathletes. Age and anthropometry, training, and previous experience variables were related to Ironman race time using bivariate and multivariate analysis. A total of 184 recreational male triathletes, of mean age 40.9 ± 8.4 years, height 1.80 ± 0.06 m, and weight 76.3 ± 8.4 kg completed the Ironman within 691 ± 83 minutes. They spent 13.9 ± 5.0 hours per week in training, covering 6.3 ± 3.1 km of swimming, 194.4 ± 76.6 km of cycling, and 45.0 ± 15.9 km of running. In total, 149 triathletes had completed at least one marathon, and 150 athletes had finished at least one Olympic distance triathlon. They had a personal best time of 130.4 ± 44.2 minutes in an Olympic distance triathlon and of 193.9 ± 31.9 minutes in marathon running. In total, 126 finishers had completed both an Olympic distance triathlon and a marathon. After multivariate analysis, both a personal best time in a marathon (P < 0.0001) and in an Olympic distance triathlon (P < 0.0001) were the best variables related to Ironman race time. Ironman race time (minutes) might be partially predicted by the following equation: (r (2) = 0.65, standard error of estimate = 56.8) = 152.1 + 1.332 × (personal best time in a marathon, minutes) + 1.964 × (personal best time in an Olympic distance triathlon, minutes). These results suggest that, in contrast with anthropometric and training characteristics, both the personal best time in an Olympic distance triathlon and in a marathon predict Ironman race time in recreational male Ironman triathletes.

Personal best times in an Olympic distance triathlon and in a marathon predict Ironman race time in recreational male triathletes

PubMed Central

Rüst, Christoph Alexander; Knechtle, Beat; Knechtle, Patrizia; Rosemann, Thomas; Lepers, Romuald

2011-01-01

Background The purpose of this study was to define predictor variables for recreational male Ironman triathletes, using age and basic measurements of anthropometry, training, and previous performance to establish an equation for the prediction of an Ironman race time for future recreational male Ironman triathletes. Methods Age and anthropometry, training, and previous experience variables were related to Ironman race time using bivariate and multivariate analysis. Results A total of 184 recreational male triathletes, of mean age 40.9 ± 8.4 years, height 1.80 ± 0.06 m, and weight 76.3 ± 8.4 kg completed the Ironman within 691 ± 83 minutes. They spent 13.9 ± 5.0 hours per week in training, covering 6.3 ± 3.1 km of swimming, 194.4 ± 76.6 km of cycling, and 45.0 ± 15.9 km of running. In total, 149 triathletes had completed at least one marathon, and 150 athletes had finished at least one Olympic distance triathlon. They had a personal best time of 130.4 ± 44.2 minutes in an Olympic distance triathlon and of 193.9 ± 31.9 minutes in marathon running. In total, 126 finishers had completed both an Olympic distance triathlon and a marathon. After multivariate analysis, both a personal best time in a marathon (P < 0.0001) and in an Olympic distance triathlon (P < 0.0001) were the best variables related to Ironman race time. Ironman race time (minutes) might be partially predicted by the following equation: (r2 = 0.65, standard error of estimate = 56.8) = 152.1 + 1.332 × (personal best time in a marathon, minutes) + 1.964 × (personal best time in an Olympic distance triathlon, minutes). Conclusion These results suggest that, in contrast with anthropometric and training characteristics, both the personal best time in an Olympic distance triathlon and in a marathon predict Ironman race time in recreational male Ironman triathletes. PMID:24198578

Time and Performance on the California Critical Thinking Skills Test.

ERIC Educational Resources Information Center

Frisby, Craig L.; Traffanstedt, Bobby K.

2003-01-01

Investigates the relationship between total scores on the California Critical Thinking Skills Test (CCTST) and the time taken to complete it. Finds that slower test takers obtained significantly higher scores. Discusses implications of these findings for college instruction. (SG)

Computerized Maze Navigation and On-Road Performance by Drivers With Dementia

PubMed Central

Ott, Brian R.; Festa, Elena K.; Amick, Melissa M.; Grace, Janet; Davis, Jennifer D.; Heindel, William C.

2012-01-01

This study examined the ability of computerized maze test performance to predict the road test performance of cognitively impaired and normal older drivers. The authors examined 133 older drivers, including 65 with probable Alzheimer disease, 23 with possible Alzheimer disease, and 45 control subjects without cognitive impairment. Subjects completed 5 computerized maze tasks employing a touch screen and pointer as well as a battery of standard neuropsychological tests. Parameters measured for mazes included errors, planning time, drawing time, and total time. Within 2 weeks, subjects were examined by a professional driving instructor on a standardized road test modeled after the Washington University Road Test. Road test total score was significantly correlated with total time across the 5 mazes. This maze score was significant for both Alzheimer disease subjects and control subjects. One maze in particular, requiring less than 2 minutes to complete, was highly correlated with driving performance. For the standard neuropsychological tests, highest correlations were seen with Trail Making A (TrailsA) and the Hopkins Verbal Learning Tests Trial 1 (HVLT1). Multiple regression models for road test score using stepwise subtraction of maze and neuropsychological test variables revealed significant independent contributions for total maze time, HVLT1, and TrailsA for the entire group; total maze time and HVLT1 for Alzheimer disease subjects; and TrailsA for normal subjects. As a visual analog of driving, a brief computerized test of maze navigation time compares well to standard neuropsychological tests of psychomotor speed, scanning, attention, and working memory as a predictor of driving performance by persons with early Alzheimer disease and normal elders. Measurement of maze task performance appears to be useful in the assessment of older drivers at risk for hazardous driving. PMID:18287166

Relationship Between Reported and Measured Sleep Times

PubMed Central

Silva, Graciela E.; Goodwin, James L.; Sherrill, Duane L.; Arnold, Jean L.; Bootzin, Richard R.; Smith, Terry; Walsleben, Joyce A.; Baldwin, Carol M.; Quan, Stuart F.

2007-01-01

Study Objective: Subjective and objective assessments of sleep may be discrepant due to sleep misperception and measurement effects, the latter of which may change the quality and quantity of a person's usual sleep. This study compared sleep times from polysomnography (PSG) with self-reports of habitual sleep and sleep estimated on the morning after a PSG in adults. Design: Total sleep time and sleep onset latency obtained from unattended home PSGs were compared to sleep times obtained from a questionnaire completed before the PSG and a Morning Survey completed the morning after the PSG. Participants: A total of 2,113 subjects who were ≥ 40 years of age were included in this analysis. Measures and Results: Subjects were 53% female, 75% Caucasian, and 38% obese. The mean habitual sleep time (HABTST), morning estimated sleep time (AMTST), and PSG total sleep times (PSGTST) were 422 min, 379 min, and 363 min, respectively. The mean habitual sleep onset latency, morning estimated sleep onset latency, and PSG sleep onset latency were 17.0 min, 21.8 min, and 16.9 min, respectively. Models adjusting for related demographic factors showed that HABTST and AMTST differ significantly from PSGTST by 61 and 18 minutes, respectively. Obese and higher educated people reported less sleep time than their counterparts. Similarly, small but significant differences were seen for sleep latency. Conclusions: In a community population, self-reported total sleep times and sleep latencies are overestimated even on the morning following overnight PSG. Citation: Silva GE; Goodwin JL; Sherrill DL; Arnold JL; Bootzin RR; Smith T; Walsleben JA; Baldwin CM; Quan SF. Relationship between reported and measured sleep times: the sleep heart health study (SHHS). J Clin Sleep Med 2007;3(6):622-630. PMID:17993045

Diet Quality Scores of Australian Adults Who Have Completed the Healthy Eating Quiz.

PubMed

Williams, Rebecca L; Rollo, Megan E; Schumacher, Tracy; Collins, Clare E

2017-08-15

Higher scores obtained using diet quality and variety indices are indicators of more optimal food and nutrient intakes and lower chronic disease risk. The aim of this paper is to describe the overall diet quality and variety in a sample of Australian adults who completed an online diet quality self-assessment tool, the Healthy Eating Quiz. The Healthy Eating Quiz takes approximately five minutes to complete online and computes user responses into a total diet quality score (out of a maximum of 73 points) and then categorizes them into the following groups: 'needs work' (<33), 'getting there' (33-38), 'excellent' (39-46), or 'outstanding' (47+). There was a total of 93,252 first-time respondents, of which 76% were female. Over 80% of respondents were between 16-44 years of age. The mean total score was 34.1 ± 9.7 points. Females had a higher total score than males ( p < 0.001) and vegetarians had higher total scores than non-vegetarians ( p < 0.001). Healthy eating quiz scores were higher in those aged 45-75 years compared to 16-44 years ( p < 0.001). When comparing Socioeconomic Indices for Areas deciles, those most disadvantaged had a lower total score than those least disadvantaged ( p < 0.001). Repeat measures showed that those who scored lowest (needs work) in their first completion increased their total score by 3.2 ± 7.4 at their second completion ( p < 0.001). While the Healthy Eating Quiz data indicates that individuals receiving feedback on how to improve their score can improve their diet quality, there is a need for further nutrition promotion interventions in Australian adults.

First passage times in homogeneous nucleation: Dependence on the total number of particles

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

Yvinec, Romain; Bernard, Samuel; Pujo-Menjouet, Laurent

2016-01-21

Motivated by nucleation and molecular aggregation in physical, chemical, and biological settings, we present an extension to a thorough analysis of the stochastic self-assembly of a fixed number of identical particles in a finite volume. We study the statistics of times required for maximal clusters to be completed, starting from a pure-monomeric particle configuration. For finite volumes, we extend previous analytical approaches to the case of arbitrary size-dependent aggregation and fragmentation kinetic rates. For larger volumes, we develop a scaling framework to study the first assembly time behavior as a function of the total quantity of particles. We find thatmore » the mean time to first completion of a maximum-sized cluster may have a surprisingly weak dependence on the total number of particles. We highlight how higher statistics (variance, distribution) of the first passage time may nevertheless help to infer key parameters, such as the size of the maximum cluster. Finally, we present a framework to quantify formation of macroscopic sized clusters, which are (asymptotically) very unlikely and occur as a large deviation phenomenon from the mean-field limit. We argue that this framework is suitable to describe phase transition phenomena, as inherent infrequent stochastic processes, in contrast to classical nucleation theory.« less

First passage times in homogeneous nucleation: Dependence on the total number of particles

NASA Astrophysics Data System (ADS)

Yvinec, Romain; Bernard, Samuel; Hingant, Erwan; Pujo-Menjouet, Laurent

2016-01-01

Motivated by nucleation and molecular aggregation in physical, chemical, and biological settings, we present an extension to a thorough analysis of the stochastic self-assembly of a fixed number of identical particles in a finite volume. We study the statistics of times required for maximal clusters to be completed, starting from a pure-monomeric particle configuration. For finite volumes, we extend previous analytical approaches to the case of arbitrary size-dependent aggregation and fragmentation kinetic rates. For larger volumes, we develop a scaling framework to study the first assembly time behavior as a function of the total quantity of particles. We find that the mean time to first completion of a maximum-sized cluster may have a surprisingly weak dependence on the total number of particles. We highlight how higher statistics (variance, distribution) of the first passage time may nevertheless help to infer key parameters, such as the size of the maximum cluster. Finally, we present a framework to quantify formation of macroscopic sized clusters, which are (asymptotically) very unlikely and occur as a large deviation phenomenon from the mean-field limit. We argue that this framework is suitable to describe phase transition phenomena, as inherent infrequent stochastic processes, in contrast to classical nucleation theory.

Iterated greedy algorithms to minimize the total family flow time for job-shop scheduling with job families and sequence-dependent set-ups

NASA Astrophysics Data System (ADS)

Kim, Ji-Su; Park, Jung-Hyeon; Lee, Dong-Ho

2017-10-01

This study addresses a variant of job-shop scheduling in which jobs are grouped into job families, but they are processed individually. The problem can be found in various industrial systems, especially in reprocessing shops of remanufacturing systems. If the reprocessing shop is a job-shop type and has the component-matching requirements, it can be regarded as a job shop with job families since the components of a product constitute a job family. In particular, sequence-dependent set-ups in which set-up time depends on the job just completed and the next job to be processed are also considered. The objective is to minimize the total family flow time, i.e. the maximum among the completion times of the jobs within a job family. A mixed-integer programming model is developed and two iterated greedy algorithms with different local search methods are proposed. Computational experiments were conducted on modified benchmark instances and the results are reported.

Complete tooth loss as status passage.

PubMed

Gibson, Barry John; Sussex, Philip V; Fitzgerald, Ruth P; Thomson, William Murray

2017-03-01

The aim of this article is to add to the literature on the sociology of oral health and dentistry by presenting the relevance of status passage to the study of complete tooth loss. The article reports on an analysis of data taken from participants residing in the Nelson region of New Zealand. In total the data include interviews from 20 participants, all of whom had their remaining natural teeth removed before 1960. In total, 12 women and eight men were interviewed. All were from a European background with an age range of 71 to 101 years. Following a narrative approach, participants were interviewed on the nature of the social factors that resulted in complete tooth loss by starting with their family history and then focusing on the factors and events leading up to their total tooth loss. Data were analysed using the methods and techniques of grounded theory. This article provides an outline of the importance of scheduling, prescribing, social factors, 'compound awareness contexts' and reversibility to the status passage into complete tooth loss. We conclude by arguing that the theory of status passage may enable a detailed analysis of the 'time-space extensionality' of trajectories into complete tooth loss. © 2016 Foundation for the Sociology of Health & Illness.

Opioid Abuse after Traumatic Brain Injury: Evaluation Using Rodent Models

DTIC Science & Technology

2015-09-01

depending on the aspect of SA being assessed. This includes time for acclimation to the laboratory and handling, catheterization surgery and recovery, brain...across the three years / total number to be completed by project end. Total # subjects entered into protocol =50 Total number catheterized = 0...and acclimation before intravenous catheterization or pump implantation was performed (see below). Subjects to be used in the warm water tail

G-III Aircraft from NASA Armstrong Provides Live TV Coverage of Solar Eclipse Across America

NASA Image and Video Library

2017-08-13

For the first time in 99 years, a total solar eclipse will cross the entire nation Monday, Aug. 21. A total solar eclipse occurs when the sun is completely obscured by the moon. The lunar shadow enters the United States near Lincoln City, Oregon, at 9:05 a.m. PDT. Totality, where the moon completely covers the sun, begins in Lincoln City around 10:16 a.m. PDT. During totality, there will be up to two and a half minutes of darkness. The G-III aircraft was modified with upgraded windows and communications equipment to enable high-definition video to be streamed to NASA TV during the eclipse enabling citizen science. The aircraft will be flying at 25,000 feet over the coast of Oregon, near Lincoln City during the eclipse on August 21, 2017.

Inter-session reliability and sex-related differences in hamstrings total reaction time, pre-motor time and motor time during eccentric isokinetic contractions in recreational athlete.

PubMed

Ayala, Francisco; De Ste Croix, Mark; Sainz de Baranda, Pilar; Santonja, Fernando

2014-04-01

The purposes were twofold: (a) to ascertain the inter-session reliability of hamstrings total reaction time, pre-motor time and motor time; and (b) to examine sex-related differences in the hamstrings reaction times profile. Twenty-four men and 24 women completed the study. Biceps femoris and semitendinosus total reaction time, pre-motor time and motor time measured during eccentric isokinetic contractions were recorded on three different occasions. Inter-session reliability was examined through typical percentage error (CVTE), percentage change in the mean (CM) and intraclass correlations (ICC). For both biceps femoris and semitendinosus, total reaction time, pre-motor time and motor time measures demonstrated moderate inter-session reliability (CVTE<10%; CM<3%; ICC>0.7). The results also indicated that, although not statistically significant, women reported consistently longer hamstrings total reaction time (23.5ms), pre-motor time (12.7ms) and motor time (7.5ms) values than men. Therefore, an observed change larger than 5%, 9% and 8% for total reaction time, pre-motor time and motor time respectively from baseline scores after performing a training program would indicate that a real change was likely. Furthermore, while not statistically significant, sex differences were noted in the hamstrings reaction time profile which may play a role in the greater incidence of ACL injuries in women. Copyright © 2013 Elsevier Ltd. All rights reserved.

Dynamic approach to description of entrance channel effects in angular distributions of fission fragments

NASA Astrophysics Data System (ADS)

Eremenko, D. O.; Drozdov, V. A.; Fotina, O. V.; Platonov, S. Yu.; Yuminov, O. A.

2016-07-01

Background: It is well known that the anomalous behavior of angular anisotropies of fission fragments at sub- and near-barrier energies is associated with a memory of conditions in the entrance channel of the heavy-ion reactions, particularly, deformations and spins of colliding nuclei that determine the initial distributions for the components of the total angular momentum over the symmetry axis of the fissioning system and the beam axis. Purpose: We develop a new dynamic approach, which allows the description of the memory effects in the fission fragment angular distributions and provides new information on fusion and fission dynamics. Methods: The approach is based on the dynamic model of the fission fragment angular distributions which takes into account stochastic aspects of nuclear fission and thermal fluctuations for the tilting mode that is characterized by the projection of the total angular momentum onto the symmetry axis of the fissioning system. Another base of our approach is the quantum mechanical method to calculate the initial distributions over the components of the total angular momentum of the nuclear system immediately following complete fusion. Results: A method is suggested for calculating the initial distributions of the total angular momentum projection onto the symmetry axis for the nuclear systems formed in the reactions of complete fusion of deformed nuclei with spins. The angular distributions of fission fragments for the 16O+232Th,12C+235,236,238, and 13C+235U reactions have been analyzed within the dynamic approach over a range of sub- and above-barrier energies. The analysis allowed us to determine the relaxation time for the tilting mode and the fraction of fission events occurring in times not larger than the relaxation time for the tilting mode. Conclusions: It is shown that the memory effects play an important role in the formation of the angular distributions of fission fragments for the reactions induced by heavy ions. The approach developed for analysis of the effects is a suitable tool to get insight into the complete fusion-fission dynamics, in particular, to investigate the mechanism of the complete fusion and fission time scale.

Complete mitochondrial genome sequence of the heart failure model of cardiomyopathic Syrian hamster (Mesocricetus auratus).

PubMed

Hu, Bo; Liu, Dong-Xing; Zhang, Yu-Qing; Song, Jian-Tao; Ji, Xian-Fei; Hou, Zhi-Qiang; Zhang, Zhen-Hai

2016-05-01

In this study we sequenced the complete mitochondrial genome sequencing of a heart failure model of cardiomyopathic Syrian hamster (Mesocricetus auratus) for the first time. The total length of the mitogenome was 16,267 bp. It harbored 13 protein-coding genes, 2 ribosomal RNA genes, 22 transfer RNA genes and 1 non-coding control region.

Factors Related to Taiwanese Adolescents' Academic Procrastination, Time Management, and Perfectionism

ERIC Educational Resources Information Center

Shih, Shu-Shen

2017-01-01

There is a shortage of studies that explore adolescents' academic procrastination. The author hence attempted to examine the mechanisms determining Taiwanese adolescent students' perfectionistic tendencies, time management, and academic procrastination. A total of 405 eighth-grade Taiwanese students completed a self-reported survey assessing their…

77 FR 21577 - Agency Information Collection Activities: Lien Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-10

... technology; and (e) the annual cost burden to respondents or record keepers from the collection of... with a change to the burden hours as a result of changing the estimated response time for completing... Number of Annual Responses per Respondent: 1. Estimated Time per Response: 15 minutes. Estimated Total...

Surgical Safety Checklist compliance: a job done poorly!

PubMed

Sparks, Eric A; Wehbe-Janek, Hania; Johnson, Rebecca L; Smythe, W Roy; Papaconstantinou, Harry T

2013-11-01

The Surgical Safety Checklist (SSC) has been introduced as an effective tool for reducing perioperative mortality and complications. Although reported completion rates are high, objective compliance is not well defined. The purpose of this retrospective analysis is to determine SSC compliance as measured by accuracy and completion, and factors that can affect compliance. In September 2010, our institution implemented an adaptation of the World Health Organization's SSC in an effort to improve patient safety and outcomes. A tool was developed for objective evaluation of overall compliance (maximum score 40) that was an aggregate score of completion and accuracy (20 each). Random samples of SSCs were analyzed at specific, predefined, time points throughout the first year after implementation. Procedure start time, operative time, and case complexity were assessed to determine association with compliance. A total of 671 SSCs were analyzed. The participation rate improved from 33% (95 of 285) at week 1 to 94% (249 of 265) at 1 year (p < 0.0001, chi-square test). Mean overall compliance score was 27.7 (± 5.4 SD) of 40 possible points (69.3% ± 13.5% of total possible score; n = 671) and did not change over time. Although completion scores were high (16.9 ± 2.7 out of 20 [84.5% ± 13.6%]), accuracy was poor (10.8 ± 3.4 out of 20 [54.1% ± 16.9%]). Overall compliance score was significantly associated with case start-time (p < 0.05), and operative time and case complexity showed no association. Our data indicate that although implementation of an SSC results in a high level of overall participation and completion, accuracy remained poor. Identification of barriers to effective use is needed, as improper checklist use can adversely affect patient safety. Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Assessing and comparing the usability of Chinese EHRs used in two Peking University hospitals to EHRs used in the US: A method of RUA.

PubMed

Xu, Lufei; Wen, Dong; Zhang, Xingting; Lei, Jianbo

2016-05-01

The objective of this study was to investigate the usability level of Chinese hospital Electronic Health Records (EHRs) by assessing the completion times of EHRs for seven "meaningful use (MU)" relevant tasks conducted at two Chinese tertiary hospitals and comparing the results to those of relevant research conducted in US EHRs. Using Rapid Usability Assessment (RUA) developed by the National Center for Cognitive Informatics and Decision Making (NCCD), the usability of EHRs from two Peking University hospitals was assessed using a three-step Keystroke Level Model (KLM) in a laboratory environment. (1) The total EHR task completion time for 7 MU relevant test tasks showed no significant differences between the two Chinese EHRs and their US counterparts, in which the time for thinking was relatively large and comprised 35.6% of the total time. The time for the electronic physician order was the largest. (2) For specific tasks, the mean completion times of the 2 hospital EHR systems spent on recording, modifying and searching (RMS) the medication orders were similar to those for the RMS radioactive tests; the mean time spent on the RMS laboratory test orders were much less. (3) There were 85 usability problems identified in the 2 hospital EHR systems. In Chinese EHRs, a substantial amount of time is required to complete tasks relevant to MU targets and many preventable usability problems can be discovered. The task completion time of the 2 Chinese EHR systems was a little shorter than in the 5 reported US EHR systems, while the differences in smoking status and CPOE tasks were obvious; one main reason for these differences was the use of structured data entry. The efficiency of Chinese and US EHRs was not significantly different. The key to improving the efficiency of both systems lies in expediting the Computerized physician order entry (CPOE) task. Many usability problems can be identified using heuristic assessments and improved by corresponding actions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Correlation of shoulder range of motion limitations at discharge with limitations in activities and participation one year later in persons with spinal cord injury.

PubMed

Eriks-Hoogland, Inge E; de Groot, Sonja; Post, Marcel W M; van der Woude, Lucas H V

2011-02-01

To study the correlation between limited shoulder range of motion in persons with spinal cord injury at discharge and the performance of activities, wheeling performance, transfers and participation one year later. Multicentre prospective cohort study. A total of 146 newly injured subjects with spinal cord injury. Shoulder range of motion was measured at discharge. One year later, Functional Independence Measure (FIM), transfer ability, wheelchair circuit and Physical Activity Scale for Individuals with Physical Disabilities (PASIPD) were assessed. Corrections were made for possible confounding factors (age, gender, level and completeness of injury, time since injury and shoulder pain). All subjects with limited shoulder range of motion at discharge had a lower FIM motor score and were less likely (total group 5 times, and subjects with tetraplegia 10 times less likely) to be able to perform an independent transfer one year later. Subjects with limited shoulder range of motion in the total group needed more time to complete the wheelchair circuit. No significant associations with the PASIPD were found in either group. Persons with spinal cord injury and limited shoulder range of motion at discharge are more limited in their activities one year later than those without limited shoulder range of motion.

Powerful lineup

NASA Image and Video Library

2012-10-11

Two J-2X engines and a powerpack, developed for NASA by Pratt and Whitney Rocketdyne, sit side-by-side Oct. 11 at Stennis Space Center as work continues on the Space Launch System. Engine 10001 (far left) has been removed from the A-2 Test Stand after being hot-fire tested 21 times, for a total of 2,697 seconds. The engine is now undergoing a series of post-test inspections. A J-2X powerpack (center) has been removed from the A-1 Test Stand to receive additional instrumentation. So far, the powerpack been hot-fire tested 10 times, for a total of 4,162 seconds. Meanwhile, assembly on the second J-2X engine, known as Engine 10002 and located to the far right, has begun in earnest, with engine completion scheduled for this November. Engine 10002 is about 15 percent complete.

Effectiveness of balance exercises in the acute post-operative phase following total hip and knee arthroplasty: A randomized clinical trial

PubMed Central

Overend, Tom J; Spaulding, Sandi J; Zecevic, Aleksandra; Kramer, John F

2015-01-01

Objectives: To determine the effectiveness of balance exercises in the acute post-operative phase following total hip arthroplasty or total knee arthroplasty. Methods: Patients who had total hip arthroplasty (n = 30) or total knee arthroplasty (n = 33) were seen in their residence 1–2 times per week for 5 weeks. At the first post-operative home visit, patients were randomly assigned to either typical (TE, n = 33) or typical plus balance (TE + B, n = 30) exercise groups. The TE group completed seven typical surgery-specific joint range-of-motion and muscle strengthening exercises, while the TE + B group completed the typical exercises plus three balance exercises. Patients were assessed before and 5 weeks after administering the rehabilitation program using four outcome measures: (1) the Berg Balance Scale, (2) the Timed Up and Go test, (3) the Western Ontario McMaster Universities Osteoarthritis Index, and (4) the Activities-specific Balance Confidence Scale. Results: Post-intervention scores for all four outcome measures were significantly improved (p < 0.01) over baseline scores. Patients who participated in the TE + B group demonstrated significantly greater improvement on the Berg Balance Scale and the Timed Up and Go tests (p < 0.01). Conclusion: Balance exercises added to a typical rehabilitation program resulted in significantly greater improvements in balance and functional mobility compared to typical exercises alone. PMID:26770765

New technique of transanal proctectomy with completely robotic total mesorrectal excision for rectal cancer.

PubMed

Gómez Ruiz, Marcos; Palazuelos, Carlos Manuel; Martín Parra, José Ignacio; Alonso Martín, Joaquín; Cagigas Fernández, Carmen; del Castillo Diego, Julio; Gómez Fleitas, Manuel

2014-05-01

Anterior resection with total mesorectal excision is the standard method of rectal cancer resection. However, this procedure remains technically difficult in mid and low rectal cancer. A robotic transanal proctectomy with total mesorectal excision and laparoscopic assistance is reported in a 57 year old male with BMI 32 kg/m2 and rectal adenocarcinoma T2N1M0 at 5 cm from the dentate line. Operating time was 420 min. Postoperative hospital stay was 6 days and no complications were observed. Pathological report showed a 33 cm specimen with ypT2N0 adenocarcinoma at 2 cm from the distal margin, complete TME and non affected circumferential resection margin. Robotic technology might reduce some technical difficulties associated with TEM/TEO or SILS platforms in transanal total mesorectal excision. Further clinical trials will be necessary to assess this technique. Copyright © 2013 AEC. Published by Elsevier Espana. All rights reserved.

Survey of Part-Time Faculty at Ferris State College.

ERIC Educational Resources Information Center

Snyder, Chryl A.; Terzin, Margaret A.

The status of part-time faculty at Ferris State College during the 1984 fall quarter was investigated. A total of 53 part-timers completed the survey, which was based on the concerns of members of the Ferris Professional Women's organization. It was found that part-time faculty members were likely to be female, 36-50 years old, married, with a…

The complete mitochondrial genome of a chronic hepatitis associated liver cancer LEC rat strain.

PubMed

Zhang, Sihao; Jiang, Zhaoming; Zhang, Shuai; Xia, Mingfeng; Tian, Fang; Tian, Hu

2016-05-01

We sequenced a complete mitochondrial genome sequencing of a chronic hepatitis-associated liver cancer disease LEC rat strain for the first time. The total length of the mitogenome was 16,316 bp with 13 protein-coding genes, two ribosomal RNA genes and 22 transfer RNA genes. This mitochondrial genome sequence will provide new genetic resource into liver cancer disease.

Examination Phase of the Master's Thesis: A Plausible Cause of Delayed Completion of Graduate Studies at Makerere University, Uganda

ERIC Educational Resources Information Center

Oonyu, Joseph C.; Wamala, Robert

2012-01-01

This paper investigates the influence of the examination stage of student theses on the completion time of graduate studies at Makerere University, Uganda. The assessment is based on the administrative data of 504 Master's degree students in the 2000 to 2008 enrollment cohorts at the School of Education, Makerere University. The total elapsed time…

Eclipses across the Curriculum

ERIC Educational Resources Information Center

Fulco, Charles

2017-01-01

On Monday, August 21, 2017 there will be a Total Solar Eclipse. This will be the first time the Moon's umbra has touched the continental United States since 1979 and the first totality to span the country coast-to-coast since 1918. From within parts of Oregon and through 14 states to South Carolina, the Moon will completely hide the Sun for a few…

Corn or sorghum wet distiller's grains with solubles in combination with steam-flaked corn: Feedlot cattle performance, carcass characteristics, and apparent total tract digestibility

USDA-ARS?s Scientific Manuscript database

Two studies were conducted to evaluate corn (CDG) and sorghum (SDG) wet distiller's grains with solubles on feedlot cattle performance, carcass characteristics, apparent total tract digestion of nutrients, and marker retention time. In Experiment 1, 224 steers were used in a randomized complete bloc...

Introduction of a new laboratory test: an econometric approach with the use of neural network analysis.

PubMed

Jabor, A; Vlk, T; Boril, P

1996-04-15

We designed a simulation model for the assessment of the financial risks involved when a new diagnostic test is introduced in the laboratory. The model is based on a neural network consisting of ten neurons and assumes that input entities can have assigned appropriate uncertainty. Simulations are done on a 1-day interval basis. Risk analysis completes the model and the financial effects are evaluated for a selected time period. The basic output of the simulation consists of total expenses and income during the simulation time, net present value of the project at the end of simulation, total number of control samples during simulation, total number of patients evaluated and total number of used kits.

Transplant options for patients undergoing total pancreatectomy for chronic pancreatitis.

PubMed

Gruessner, Rainer W G; Sutherland, David E R; Dunn, David L; Najarian, John S; Jie, Tun; Hering, Bernhard J; Gruessner, Angelika C

2004-04-01

Total pancreatectomy to treat chronic pancreatitis is associated with severe diabetic control problems in 15% to 75% of patients, causing up to 50% of deaths late postoperatively. We report our experience with islet autotransplants at the time of, or with pancreas allotransplants after, total pancreatectomy. Between February 1, 1977, and June 30, 2003, we performed 112 islet autotransplants at the time of total pancreatectomy; we also performed 20 pancreas allotransplants in 13 patients who had already undergone total pancreatectomy months to years earlier. Islet autotransplants at the time of total pancreatectomy in patients who had not had previous operations on the body and tail of the pancreas were associated with a high islet yield (>2,500 islet equivalents/kg body weight), and >70% of the recipients achieved complete insulin independence. In contrast, a previous distal pancreatectomy or a Puestow drainage procedure was associated with a low islet yield in 75% of them and with complete insulin independence in <20%. A pancreas allotransplant after total pancreatectomy was not associated with any transplant-related mortality at 1 and 3 years posttransplant. The pancreas graft survival rate at 1 year posttransplant was 77% with tacrolimus-based immunosuppression (versus 67% with cyclosporine). Enteric (over bladder) drainage was preferred to manage exocrine graft secretions, to cure pancreatectomy-induced endocrine and exocrine insufficiency. Our series shows that pancreas allotransplants can be performed without transplant-related mortality and, when tacrolimus-based immunosuppression is used, with 1-year pancreas graft survival rates >75%. In contrast to a simultaneous islet autotransplant, a pancreas allotransplant has the disadvantage of requiring lifelong immunosuppression, but the advantage of not only curing endocrine but also exocrine insufficiency. Both transplant options, if successful, improve the recipient's quality of life.

Total dissolved gas and water temperature in the lower Columbia River, Oregon and Washington, water year 2011: Quality-assurance data and comparison to water-quality standards

USGS Publications Warehouse

Tanner, Dwight Q.; Bragg, Heather M.; Johnston, Matthew W.

2012-01-01

For the eight monitoring stations in water year 2011, a total of 93.5 percent of the TDG data were received in real time and were within 1-percent saturation of the expected value on the basis of calibration data, replicate quality-control measurements in the river, and comparison to ambient river conditions at adjacent sites. Data received from the Cascade Island site were only 34.9% complete because the equipment was destroyed by high water. The other stations ranged from 99.6 to 100 percent complete.

Total dissolved gas and water temperature in the lower Columbia River, Oregon and Washington, water year 2012: Quality-assurance data and comparison to water-quality standards

USGS Publications Warehouse

Tanner, Dwight Q.; Bragg, Heather M.; Johnston, Matthew W.

2013-01-01

For the eight monitoring stations in water year 2012, a total of 97.0 percent of the TDG data were received in real time and were within 1-percent saturation of the expected value on the ba-sis of calibration data, replicate quality-control measurements in the river, and comparison to ambient river conditions at adjacent sites. Data received from the Cascade Island site were only 77.8 percent complete because the equipment was destroyed by high water. The other stations ranged from 98.9 to 100.0 percent complete.

The Prediction of Achievement and Time Spent in Instruction in a Self-Paced Individualized Course.

ERIC Educational Resources Information Center

Franklin, Thomas E.

Multiple linear regressions were employed to determine the relative contributions of cognitive and affective variables accounting for variance in college students' achievement and amount of time taken to complete a self-paced, individualized course. Study habits and attitudes (SSHA) made greater relative contributions to explaining total course…

75 FR 68381 - Gear Certification Standard; Extension of the Office of Management and Budget's (OMB) Approval of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-05

... prospective accredited agency to complete the form. Total Burden Hours: 190. Estimated Cost (Operation and...)). This program ensures that information is in the desired format, reporting burden (time and costs) is...; The accuracy of OSHA's estimate of the burden (time and costs) of the information collection...

Differences in Military Obstacle Course Performance Between Three Energy-Storing and Shock-Adapting Prosthetic Feet in High-Functioning Transtibial Amputees: A Double-Blind, Randomized Control Trial.

PubMed

Highsmith, M Jason; Kahle, Jason T; Miro, Rebecca M; Lura, Derek J; Carey, Stephanie L; Wernke, Matthew M; Kim, Seok Hun; Quillen, William S

2016-11-01

Approximately 683 persons engaged in military service experienced transtibial amputation (TTA) related to recent war in Iraq and Afghanistan. Military TTAs function at a level beyond basic ambulation. No empirical data demonstrate which higher functioning prosthetic feet maximize injured service personnel's ability to continue performing at a level commensurate with return to duty. This study's purpose was to determine which of three high-functioning, energy-storing prosthetic feet maximize performance and preference in a field obstacle course (OC) and to quantify physical performance differences between TTAs and high-functioning nonamputees. A randomized, double-blind, repeated measures experimental design compared three prosthetic feet (Ossur Variflex, Endolite Elite Blade, and Ossur Re-Flex Rotate) during performance on a field OC. TTAs accommodated with study feet and the OC before assessment. 14 TTAs and 14 nonamputee controls completed the course. Subjective and objective performance differences were compared across feet conditions and between groups. Total OC completion times were similar between prosthetic feet: Elite-Blade (419 seconds ± 130), Variflex (425 seconds ± 144), and Re-Flex Rotate (444 seconds ± 220). Controls' OC completion time (287.2 seconds ± 58) was less (p ≤ 0.05) than TTA times. In total, controls had faster completion times (p ≤ 0.05) compared to all prosthetic feet conditions in 13/17 obstacles. Re-Flex Rotate had 2 additional obstacles different (p ≤ 0.05) than controls and required more time to complete. Median RPE values were lower (p ≤ 0.05) for controls than TTA regardless of foot. Regarding foot preference for OC completion, 7/14 (50%) preferred Elite Blade, 5/14 (36%) preferred Re-Flex Rotate, and the remaining 2/14 (14%) preferred Variflex. Controls completed the OC faster and with less effort than TTAs regardless of prosthetic foot. No clear differences in prosthetic feet emerged during OC completion; however, individual task performance, perceived effort, and preference resulted in trends of slight performance improvement with and preference for Elite Blade, a dual function energy-storing and return foot combined with vertical shock absorption. Understanding how to maximally improve performance in such functional tasks may allow service members to best sustain physical fitness, return to their military occupational specialty and possibly in-theater duty. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Barriers to Participation in Parenting Programs: The Relationship between Parenting Stress, Perceived Barriers, and Program Completion.

PubMed

Rostad, Whitney L; Moreland, Angela D; Valle, Linda Anne; Chaffin, Mark J

2018-04-01

Families experiencing child maltreatment or risk factors for child maltreatment often receive referrals to interventions focused on changing parenting practices. Compliance with specific parenting programs can be challenging as many of the stressors that place families at-risk may also interfere with program participation. Because families may receive limited benefit from programs they do not fully receive, it is critical to understand the relationship between parenting stress and barriers to program completion. We used structural equation modeling to examine the relationship among parenting stress, perceived barriers to program participation, and program completion in two datasets involving low-income parents. Data were collected at two time points from a sample of parents involved with child welfare services and a sample of parents considered at-risk of future involvement (total study n = 803). Direct paths from parenting stress at time 1 to barriers to participation and parenting stress at time 2, and from parenting stress at time 2 to program completion were significant. Interestingly, increased barriers to participation were related to increased parenting stress at time 2, and greater parenting stress was related to increased program completion. Results suggest that with increasing levels of parenting stress, parents have an increased likelihood of completing the program. Assessing and addressing the influence of perceived barriers and parenting stress on program participation may decrease the likelihood of treatment attrition.

Use of papain gel in disabled patients.

PubMed

Carrillo, C M; Tanaka, M H; Cesar, M F; Camargo, M A F; Juliano, Y; Novo, N F

2008-01-01

This study's purpose was to evaluate complete caries removal time (CCR) and patient acceptance of the chemomechanical caries removal agent and papain gel Papacárie in disabled patients. Fifty-one consecutive patients entered a prospective, controlled, randomized, open study. Patients were divided into 2 groups: (1) group 1=28 children 3 to 10 years old with or without visual or hearing impairments, motor disability on upper limbs, and inability to respond to simple orders; and (2) group 2=23 children, without visual or hearing impairments, with motor disability on the upper limbs and the ability to respond to simple orders. CCR time was measured in both groups. Patients' acceptance was assessed only in group 2 by using the visual analogy of face scale. The visual scale was presented in phase A--after the radiography with the child sitting on the dental chair before the beginning of the treatment, phase B--during the treatment, after total removal of the carious tissue and phase C--after the restoration was complete (treatment was finished). The total CCR average time was 8 minutes for each tooth when groups 1 and 2 were considered. Group 2 patients' acceptance in the first treatment was not statistically significant in all stages. Papacárie gel had a completed caries removal time of 8 minutes per tooth and is well accepted by the patients in all phases and in the first and subsequent visits.

The complete mitochondrial genome of eastern lowland gorilla, Gorilla beringei graueri, and comparative mitochondrial genomics of Gorilla species.

PubMed

Hu, Xiao-di; Gao, Li-zhi

2016-01-01

In this study, we determined the complete mitochondrial (mt) genome of eastern lowland gorilla, Gorilla beringei graueri for the first time. The total genome was 16,416 bp in length. It contained a total of 13 protein-coding genes, 22 transfer RNA genes, 2 ribosomal RNA genes and 1 control region (D-loop region). The base composition was A (30.88%), G (13.10%), C (30.89%) and T (25.13%), indicating that the percentage of A+T (56.01%) was higher than G+C (43.99%). Comparisons with the other publicly available Gorilla mitogenome showed the conservation of gene order and base compositions but a bunch of nucleotide diversity. This complete mitochondrial genome sequence will provide valuable genetic information for further studies on conservation genetics of eastern lowland gorilla.

Validation of a Formula for Assigning Continuing Education Credit to Printed Home Study Courses

PubMed Central

Hanson, Alan L.

2007-01-01

Objectives To reevaluate and validate the use of a formula for calculating the amount of continuing education credit to be awarded for printed home study courses. Methods Ten home study courses were selected for inclusion in a study to validate the formula, which is based on the number of words, number of final examination questions, and estimated difficulty level of the course. The amount of estimated credit calculated using the a priori formula was compared to the average amount of time required to complete each article based on pharmacists' self-reporting. Results A strong positive relationship between the amount of time required to complete the home study courses based on the a priori calculation and the times reported by pharmacists completing the 10 courses was found (p < 0.001). The correlation accounted for 86.2% of the total variability in the average pharmacist reported completion times (p < 0.001). Conclusions The formula offers an efficient and accurate means of determining the amount of continuing education credit that should be assigned to printed home study courses. PMID:19503705

Robotic Telesurgery Research

DTIC Science & Technology

2010-10-01

Miniature In Vivo Robotic System for the Surgical Treatment of Diverticular Disease Source of Support: National Institute of Health (NIH) Total...completion time   • Suturing   • Gastrotomy   • Partial colon resection   • Completion of a fully closed procedure - the robot was inserted...repositioned over the sigmoid colon in the left pelvis of the swine and was used, with one grasper hand and one cautery hand, to dissect out the mesentery of

Induction graphitizing furnace acceptance test report

NASA Technical Reports Server (NTRS)

1972-01-01

The induction furnace was designed to provide the controlled temperature and environment required for the post-cure, carbonization and graphitization processes for the fabrication of a fibrous graphite NERVA nozzle extension. The acceptance testing required six tests and a total operating time of 298 hrs. Low temperature mode operations, 120 to 850 C, were completed in one test run. High temperature mode operations, 120 to 2750 C, were completed during five tests.

Wastewater disinfection alternatives: chlorine, ozone, peracetic acid, and UV light.

PubMed

Mezzanotte, V; Antonelli, M; Citterio, S; Nurizzo, C

2007-11-01

Disinfection tests were carried out at pilot scale to compare the disinfection efficiency of ozone, sodium hypochlorite (NaOCl), peracetic acid (PAA), and UV irradiation. Total coliforms, fecal coliforms, and Escherichia coli were monitored as reference microorganisms. Total heterotrophic bacteria (THB) were also enumerated by cytometry. At similar doses, NaOCl was more effective than PAA, and its action was less affected by contact time. The results obtained by ozonation were comparable for total coliforms, fecal coliforms, and E. coli. On the contrary, some differences among the three indicators were observed for NaOCl, PAA, and UV. Differences increased with increasing values of the disinfectant concentration times contact time (C x t) and were probably the result of different initial counts, as total coliforms include fecal coliforms, which include E. coli. The UV irradiation lead to complete E. coli removals, even at low doses (10 to 20 mJ/cm2). Total heterotrophic bacteria appeared to be too wide a group to be a good disinfection indicator; no correlation was found among THB inactivation, dose, and contact time.

The cost of family-oriented communication before air medical interfacility transport.

PubMed

Macnab, A J; Gagnon, F; George, S; Sun, C

2001-01-01

Family-oriented communication with parents by transport teams eases the stress associated with transferring children to tertiary care. This study was conducted to determine the duration of family-oriented visits and whether the visit contributed significant cost to the mission. Data collection was prospective and double-blind; questions were incorporated into another study. Subjects were infants or children requiring assisted ventilation and air transport to tertiary care. Time from completion of stabilization to departure and reasons for any delay were recorded. Cost of contact time longer than 20 minutes (total acceptable time for family visit and transfer to vehicle) was calculated at paramedic overtime at $0.82/minute and aircraft wait time at $200/hour if incurred. Forty-six patients were enrolled. In 16 cases (35%), time between completing stabilization and hospital departure exceeded 20 minutes, with "family visit" listed as the explanation. Nine of these visits incurred overtime, and two incurred aircraft wait costs. Total costs for providing communication visits more than 10 minutes long were $607 or approximately $13 per patient. The costs for visit time longer than 10 minutes are small compared with the documented benefits of family-oriented communication. However, transport personnel must be mindful of the potential to incur additional cost through overtime, aircraft wait time, or pilot replacement.

Delayed versus immediate pushing in second stage of labor.

PubMed

Kelly, Mary; Johnson, Eileen; Lee, Vickie; Massey, Liz; Purser, Debbie; Ring, Karen; Sanderson, Stephanye; Styles, Juanita; Wood, Deb

2010-01-01

Comparison of two different methods for management of second stage of labor: immediate pushing at complete cervical dilation of 10 cm and delayed pushing 90 minutes after complete cervical dilation. This study was a randomized clinical trial in a labor and delivery unit of a not-for-profit community hospital. A sample of 44 nulliparous mothers with continuous epidural anesthesia were studied after random assignment to treatment groups. Subjects were managed with either immediate or delayed pushing during the second stage of labor at the time cervical dilation was complete. The primary outcome measure was the length of pushing during second stage of labor. Secondary outcomes included length of second stage of labor, maternal fatigue and perineal injuries, and fetal heart rate decelerations. Two-tailed, unpaired Student's t-tests and Chi-square analysis were used for data analysis. Level of significance was set at p < .01 following a Bonferroni correction for multiple t-tests. A total of 44 subjects received the study intervention (N = 28 immediate pushing; N = 16 delayed pushing). The delayed pushing group had significantly shorter amount of time spent in pushing compared with the immediate pushing group (38.9 +/- 6.9 vs. 78.7 +/- 7.9 minutes, respectively, p = .002). Maternal fatigue scores, perineal injuries, and fetal heart rate decelerations were similar for both groups. Delaying pushing for up to 90 minutes after complete cervical dilation resulted in a significant decrease in the time mothers spent pushing without a significant increase in total time in second stage of labor.In clinical practice, healthcare providers sometimes resist delaying the onset of pushing after second stage of labor has begun because of a belief it will increase labor time. This study's finding of a 51% reduction in pushing time when mothers delay pushing for up to 90 minutes, with no significant increase in overall time for second stage of labor, disputes that concern.

Single-port plus an additional port robotic complete mesocolic excision and intracorporeal anastomosis using a robotic stapler for right-sided colon cancer

PubMed Central

Bae, Sung Uk; Jeong, Woon Kyung

2016-01-01

The concept of complete mesocolic excision and central vascular ligation for colonic cancer has been recently introduced. The paper describes a technique of right-sided complete mesocolic excision and intracorporeal anastomosis by using a single-port robotic approach with an additional conventional robotic port. We performed a single-port plus an additional port robotic surgery using the Da Vinci Single-Site platform via the Pfannenstiel incision and the wristed robotic instruments via an additional robotic port in the left lower quadrant. The total operative and docking times were 280 and 25 minutes, respectively. The total number of lymph nodes harvested was 36 and the proximal and distal resection margins were 31 and 50 cm, respectively. Single-port plus an additional port robotic surgery for right-sided complete mesocolic excision and intracorporeal anastomosis appears to be feasible and safe. This system can overcome certain limitations of the previous robotic systems and conventional single-port laparoscopic surgery. PMID:27757400

Single-port plus an additional port robotic complete mesocolic excision and intracorporeal anastomosis using a robotic stapler for right-sided colon cancer.

PubMed

Bae, Sung Uk; Jeong, Woon Kyung; Baek, Seong Kyu

2016-10-01

The concept of complete mesocolic excision and central vascular ligation for colonic cancer has been recently introduced. The paper describes a technique of right-sided complete mesocolic excision and intracorporeal anastomosis by using a single-port robotic approach with an additional conventional robotic port. We performed a single-port plus an additional port robotic surgery using the Da Vinci Single-Site platform via the Pfannenstiel incision and the wristed robotic instruments via an additional robotic port in the left lower quadrant. The total operative and docking times were 280 and 25 minutes, respectively. The total number of lymph nodes harvested was 36 and the proximal and distal resection margins were 31 and 50 cm, respectively. Single-port plus an additional port robotic surgery for right-sided complete mesocolic excision and intracorporeal anastomosis appears to be feasible and safe. This system can overcome certain limitations of the previous robotic systems and conventional single-port laparoscopic surgery.

Effects of Improvements in Interval Timing on the Mathematics Achievement of Elementary School Students

ERIC Educational Resources Information Center

Taub, Gordon E.; McGrew, Kevin S.; Keith, Timothy Z.

2015-01-01

This article examines the effect of improvements in timing/rhythmicity on mathematics achievement. A total of 86 participants attending 1st through 4th grades completed pre- and posttest measures of mathematics achievement from the Woodcock-Johnson III Tests of Achievement. Students in the experimental group participated in a 4-week intervention…

Women's experiences of participating in the early external cephalic version 2 trial.

PubMed

Murray-Davis, Beth; Marion, Anya; Malott, Anne; Reitsma, Angela; Hutton, Eileen K

2012-03-01

The international, multicenter External Cephalic Version 2 (ECV2) Trial compared early external cephalic version at 34(0/7) to 35(6/7) weeks with that at greater than 37 weeks. A total of 1,543 women were randomized from 68 centers in 21 countries. The goal of this component of the trial was to understand women's views about participation in a research trial and timing of external cephalic version. A postpartum questionnaire was completed containing a 5-point Likert scale examining contact and availability of staff, choice of timing of external cephalic version, preference of randomization, convenience of participating, and overall satisfaction. Participants also completed two open-ended questions related to timing of external cephalic version and satisfaction with the trial. Descriptive statistics and content analysis were used to analyze data. A total of 1,458 women completed the questionnaire, of whom 86 percent said "yes"-they would participate in the trial again. Themes influencing decisions about participating were perceptions of the external cephalic version experience, preferred mode of delivery, preferred timing of external cephalic version, and perceptions of the effectiveness of external cephalic version and of the trial environment. Many participants preferred the early timing of the procedure offered through the trial because of perceived advantages of a smaller baby being easier to turn and the opportunity for repeat procedures. Women were positive about their participation in the trial. Early external cephalic version was preferred over the traditional timing as it was perceived to afford both physiologic and practical advantages. © 2012, Copyright the Authors. Journal compilation © 2012, Wiley Periodicals, Inc.

Totally laparoscopic aortic surgery: comparison of the apron and retrocolic techniques in a porcine model.

PubMed

Huynh, Hai; Elkouri, Stephane; Beaudoin, Nathalie; Bruneau, Luc; Guimond, Cathie; Daniel, Véronique; Blair, Jean-François

2007-01-01

This study evaluated the learning curve for a second-year general surgery resident and compared 2 totally laparoscopic aortic surgery techniques in 10 pigs: the transretroperitoneal apron approach and the transperitoneal retrocolic approach. Five end points were compared: success rate, percentage of conversion, time required, laparoscopic anastomosis quality, and learning curve. The first 3 interventions required an open conversion. The last 7 were done without complications. Mean dissection time was significantly higher with the apron approach compared with the retrocolic approach. The total times for operation, clamping, and arteriotomy time were similar. All laparoscopic anastomoses were patent and without stenosis. The initial learning curve for laparoscopic anastomosis was relatively short for a second-year surgery resident. Both techniques resulted in satisfactory exposure of the aorta and similar mean operative and clamping time. Training on an ex vivo laparoscopic box trainer and on an animal model seems to be complementary to decrease laparoscopic anastomosis completion time.

Quality and Quantity of Sorghum Hydroponic Fodder from Different Varieties and Harvest Time

NASA Astrophysics Data System (ADS)

Chrisdiana, R.

2018-02-01

This experiment was designed to compare different varieties and harvest time of sorghum hydroponic fodder based on nutrient content and biomass production. Experimental design for fodder productivity was completely randomized design with 2 x 3 factorial, i.e., sorghum varieties (KD 4 and Super-1) and time of harvesting the sorghum hydroponic fodder (8,12 and 16 d). Total biomass and DM production, were affected significantly (p<0.05) on harvest time. Total biomass and nutrient content were increased in longer harvest time. The nutrient content were increased with decreasing total value of DM. Super-1 varieties produce larger biomass and nutrient content higher than KD4 (p<0.05). Based on sorghum hidroponic fodder quality and quantity, sorghum hidroponic fodder with Super-1 varieties harvested at 12 d had a good quality of fodder and it can be alternative of technology providing quality forage and land saving with a short time planting period and continous production.

The validity of birth and pregnancy histories in rural Bangladesh.

PubMed

Espeut, Donna; Becker, Stan

2015-08-28

Maternity histories provide a means of estimating fertility and mortality from surveys. The present analysis compares two types of maternity histories-birth histories and pregnancy histories-in three respects: (1) completeness of live birth and infant death reporting; (2) accuracy of the time placement of live births and infant deaths; and (3) the degree to which reported versus actual total fertility measures differ. The analysis covers a 15-year time span and is based on two data sources from Matlab, Bangladesh: the 1994 Matlab Demographic and Health Survey and, as gold standard, the vital events data from Matlab's Demographic Surveillance System. Both histories are near perfect in live-birth completeness; however, pregnancy histories do better in the completeness and time accuracy of deaths during the first year of life. Birth or pregnancy histories can be used for fertility estimation, but pregnancy histories are advised for estimating infant mortality.

Relationship Factors Contributing to the Progression of Combat Related PTSD and Suicidality Over Time

DTIC Science & Technology

2017-05-01

for military couples. This study consisted of confidential online surveys , which were completed by active duty Army males post deployment, along...with their significant romantic partner. The study consisted of a total of 5 surveys each for the service members and their female partners. Final...participation rates are as follows: 1430 individuals (i.e., 715 couples) passed screening and were invited to complete Survey 1 and 1242 individuals (576

The Use and Management of Secondary Teachers' Time after the Education Reform Act 1988.

ERIC Educational Resources Information Center

Campbell, R. J.; Neill, S. R. St. J.

A sample of 348 secondary teachers in England and Wales kept a week's record of their work and completed a questionnaire on time usage. The survey indicated that the total mean time spent on work and work-related activities was 54.4 hours per week. Of this, teachers spent 16.9 hours on teaching, 12.9 hours on preparation, 18.1 hours in…

Timing of Re-Transfusion Drain Removal Following Total Knee Replacement

PubMed Central

Leeman, MF; Costa, ML; Costello, E; Edwards, D

2006-01-01

INTRODUCTION The use of postoperative drains following total knee replacement (TKR) has recently been modified by the use of re-transfusion drains. The aim of our study was to investigate the optimal time for removal of re-transfusion drains following TKR. PATIENTS AND METHODS The medical records of 66 patients who had a TKR performed between October 2003 and October 2004 were reviewed; blood drained before 6 h and the total volume of blood drained was recorded. RESULTS A total of 56 patients had complete records of postoperative drainage. The mean volume of blood collected in the drain in the first 6 h was 442 ml. The mean total volume of blood in the drain was 595 ml. Therefore, of the blood drained, 78% was available for transfusion. CONCLUSION Re-transfusion drains should be removed after 6 h, when no further re-transfusion is permissible. PMID:16551400

Impact of Music in Reducing Patient Anxiety During Pediatric Ultrasound

PubMed Central

Kesselman, Andrew; Bergen, Michael; Stefanov, Dimitre; Goldfisher, Rachelle; Amodio, John

2016-01-01

The use of noninvasive ultrasound examinations can potentially result in significant anxiety in the pediatric population. The purpose of this study was to assess the influence of music during pediatric ultrasound examinations to reduce anxiety measured by heart rate. A total of 44 patients were recruited; 21 controls and 23 experimental. Each participant was randomized to either music or no music (control) after parental consent was obtained. Pulse oximeters were used to monitor heart rate at 15 second intervals for a total of 1 minute, with mean values calculated prior to entering the procedure room, during the middle of the procedure, and after the procedure was completed. The total scan time was determined from the initial image acquisition until the last image recorded by the ultrasound technologist. At the completion of each procedure, the ultrasound technologist scored the ease of performance for the scan on a subjective scale of 1-10 based on prior experience. When utilizing music during pediatric ultrasounds examinations, our study demonstrated significantly decreased heart rate variability from pre-procedural to post-procedural periods. There was no statistical significant difference in total scan time or ultrasound technologist scoring between the two groups. This study demonstrates that music is an inexpensive and effective means of reducing anxiety during pediatric ultrasound as indicated by heart rate. PMID:27114817

Complete major amputation of the upper extremity: Early results and initial treatment algorithm.

PubMed

Märdian, Sven; Krapohl, Björn D; Roffeis, Jana; Disch, Alexander C; Schaser, Klaus-Dieter; Schwabe, Philipp

2015-03-01

Traumatic major amputations of the upper extremity are devastating injuries. These injuries have a profound impact on patient's quality of life and pose a burden on social economy. The aims of the current study were to report about the initial management of isolated traumatic major upper limb amputation from the time of admission to definitive soft tissue closure and to establish a distinct initial management algorithm. We recorded data concerning the initial management of the patient and the amputated body part in the emergency department (ED) (time from admission to the operation, Injury Severity Score [ISS], cold ischemia time from injury to ED, and total cold ischemia time). The duration, amount of surgical procedures, the time to definitive soft tissue coverage, and the choice of flap were part of the documentation. All intraoperative and postoperative complications were recorded. All patients were successfully replanted (time from injury to ED, 59 ± 4 minutes; ISS16; time from admission to operating room 57 ± 10 minutes; total cold ischemia time 203 ± 20 minutes; total number of procedures 7.3 ± 2.5); definitive soft tissue coverage could be achieved 23 ± 14 days after injury. Two thromboembolic complications occurred, which could be treated by embolectomy during revision surgery, and we saw one early infection, which could be successfully managed by serial debridements in our series. The management of complete major amputations of the upper extremity should be reserved for large trauma centers with enough resources concerning technical, structural, and personnel infrastructure to meet the demands of surgical reconstruction as well as the postoperative care. Following a distinct treatment algorithm is mandatory to increase the rate of successful major replantations, thus laying the foundation for promising secondary functional reconstructive efforts. Therapeutic study, level V.

Visuospatial and Attentional Abilities Predict Driving Simulator Performance Among Older HIV-infected Adults

PubMed Central

Foley, J. M.; Gooding, A. L.; Thames, A. D.; Ettenhofer, M. L.; Kim, M. S.; Castellon, S. A.; Marcotte, T. D.; Sadek, J. R.; Heaton, R. K.; van Gorp, W. G.; Hinkin, C. H.

2013-01-01

Objectives To examine the effects of aging and neuropsychological (NP) impairment on driving simulator performance within a human immunodeficiency virus (HIV)-infected cohort. Methods Participants included 79 HIV-infected adults (n = 58 > age 50, n = 21 ≤ 40) who completed a NP battery and a personnel computer-based driving simulator task. Outcome variables included total completion time (time) and number of city blocks to complete the task (blocks). Results Compared to the younger group, the older group was less efficient in their route finding (blocks over optimum: 25.9 [20.1] vs 14.4 [16.9]; P = .02) and took longer to complete the task (time: 1297.6 [577.6] vs 804.4 [458.5] seconds; P = .001). Regression models within the older adult group indicated that visuospatial abilities (blocks: b = –0.40, P < .001; time: b = –0.40, P = .001) and attention (blocks: b = –0.49, P = .001; time: b = –0.42, P = .006) independently predicted simulator performance. The NP-impaired group performed more poorly on both time and blocks, compared to the NP normal group. Conclusions Older HIV-infected adults may be at risk of driving-related functional compromise secondary to HIV-associated neurocognitive decline. PMID:23314403

Does intentional support of degree programs in general surgery residency affect research productivity or pursuit of academic surgery?

PubMed

Joshua Smith, Jesse; Patel, Ravi K; Chen, Xi; Tarpley, Margaret J; Terhune, Kyla P

2014-01-01

Many residents supplement general surgery training with years of dedicated research, and an increasing number at our institution pursue additional degrees. We sought to determine whether it was worth the financial cost for residency programs to support degrees. We reviewed graduating chief residents (n = 69) in general surgery at Vanderbilt University from 2001 to 2010 and collected the data including research time and additional degrees obtained. We then compared this information with the following parameters: (1) total papers, (2) first-author papers, (3) Journal Citation Reports impact factors of journals in which papers were published, and (4) first job after residency or fellowship training. The general surgery resident training program at Vanderbilt University is an academic program, approved to finish training 7 chief residents yearly during the time period studied. Chief residents in general surgery at Vanderbilt who finished their training 2001 through 2010. We found that completion of a degree during residency was significantly associated with more total and first-author publications as compared with those by residents with only dedicated research time (p = 0.001 and p = 0.017). Residents completing a degree also produced publications of a higher caliber and level of authorship as determined by an adjusted resident impact factor score as compared with those by residents with laboratory research time only (p = 0.005). Degree completion also was significantly correlated with a first job in academia if compared to those with dedicated research time only (p = 0.046). Our data support the utility of degree completion when economically feasible and use of dedicated research time as an effective way to significantly increase research productivity and retain graduates in academic surgery. Aggregating data from other academic surgery programs would allow us to further determine association of funding of additional degrees as a means to encourage academic productivity and retention. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Allowing Physicians to Choose the Value of Compensation for Participation in a Web-Based Survey: Randomized Controlled Trial.

PubMed

Turnbull, Alison E; O'Connor, Cristi L; Lau, Bryan; Halpern, Scott D; Needham, Dale M

2015-07-29

Survey response rates among physicians are declining, and determining an appropriate level of compensation to motivate participation poses a major challenge. To estimate the effect of permitting intensive care physicians to select their preferred level of compensation for completing a short Web-based survey on physician (1) response rate, (2) survey completion rate, (3) time to response, and (4) time spent completing the survey. A total of 1850 US intensivists from an existing database were randomized to receive a survey invitation email with or without an Amazon.com incentive available to the first 100 respondents. The incentive could be instantly redeemed for an amount chosen by the respondent, up to a maximum of US $50. The overall response rate was 35.90% (630/1755). Among the 35.4% (111/314) of eligible participants choosing the incentive, 80.2% (89/111) selected the maximum value. Among intensivists offered an incentive, the response was 6.0% higher (95% CI 1.5-10.5, P=.01), survey completion was marginally greater (807/859, 94.0% vs 892/991, 90.0%; P=.06), and the median number of days to survey response was shorter (0.8, interquartile range [IQR] 0.2-14.4 vs 6.6, IQR 0.3-22.3; P=.001), with no difference in time spent completing the survey. Permitting intensive care physicians to determine compensation level for completing a short Web-based survey modestly increased response rate and substantially decreased response time without decreasing the time spent on survey completion.

Allowing Physicians to Choose the Value of Compensation for Participation in a Web-Based Survey: Randomized Controlled Trial

PubMed Central

O'Connor, Cristi L; Lau, Bryan; Halpern, Scott D; Needham, Dale M

2015-01-01

Background Survey response rates among physicians are declining, and determining an appropriate level of compensation to motivate participation poses a major challenge. Objective To estimate the effect of permitting intensive care physicians to select their preferred level of compensation for completing a short Web-based survey on physician (1) response rate, (2) survey completion rate, (3) time to response, and (4) time spent completing the survey. Methods A total of 1850 US intensivists from an existing database were randomized to receive a survey invitation email with or without an Amazon.com incentive available to the first 100 respondents. The incentive could be instantly redeemed for an amount chosen by the respondent, up to a maximum of US $50. Results The overall response rate was 35.90% (630/1755). Among the 35.4% (111/314) of eligible participants choosing the incentive, 80.2% (89/111) selected the maximum value. Among intensivists offered an incentive, the response was 6.0% higher (95% CI 1.5-10.5, P=.01), survey completion was marginally greater (807/859, 94.0% vs 892/991, 90.0%; P=.06), and the median number of days to survey response was shorter (0.8, interquartile range [IQR] 0.2-14.4 vs 6.6, IQR 0.3-22.3; P=.001), with no difference in time spent completing the survey. Conclusions Permitting intensive care physicians to determine compensation level for completing a short Web-based survey modestly increased response rate and substantially decreased response time without decreasing the time spent on survey completion. PMID:26223821

Descriptive epidemiology of screen and non-screen sedentary time in adolescents: a cross sectional study

PubMed Central

2010-01-01

Background Much attention has been paid to adolescents' screen time, however very few studies have examined non-screen sedentary time (NSST). This study aimed to (1) describe the magnitude and composition of screen sedentary time (SST) and NSST in Australian adolescents, (2) describe the socio-demographic correlates of SST and NSST, and (3) determine whether screen time is an adequate surrogate for total sedentary behaviour in this population. Methods 2200 9-16 year old Australians provided detailed use of time data for four days. Non-screen sedentary time (NSST) included time spent participating in activities expected to elicit <3 METs whilst seated or lying down (other than sleeping), excluding screen-based activities (television, playing videogames or using computers). Total sedentary time was the sum of screen time and NSST. Results Adolescents spent a mean (SD) of 345 (105) minutes/day in NSST, which constituted 60% of total sedentary time. School activities contributed 42% of NSST, socialising 19%, self-care (mainly eating) 16%, and passive transport 15%. Screen time and NSST showed opposite patterns in relation to key socio-demographic characteristics, including sex, age, weight status, household income, parental education and day type. Because screen time was negatively correlated with NSST (r = -0.58), and exhibited a moderate correlation (r = 0.53) with total sedentary time, screen time was only a moderately effective surrogate for total sedentary time. Conclusions To capture a complete picture of young people's sedentary time, studies should endeavour to measure both screen time and NSST. PMID:21194427

A statistical analysis of flank eruptions on Etna volcano

NASA Astrophysics Data System (ADS)

Mulargia, Francesco; Tinti, Stefano; Boschi, Enzo

1985-02-01

A singularly complete record exists for the eruptive activity of Etna volcano. The time series of occurrence of flank eruptions in the period 1600-1980, in which the record is presumably complete, is found to follow a stationary Poisson process. A revision of the available data shows that eruption durations are rather well correlated with the estimates of the volume of lava flows. This implies that the magnitude of an eruption can be defined directly by its duration. Extreme value statistics are then applied to the time series, using duration as a dependent variable. The probability of occurrence of a very long (300 days) eruption is greater than 50% only in time intervals of the order of 50 years. The correlation found between duration and total output also allows estimation of the probability of occurrence of a major event which exceeds a given duration and total flow of lava. The composite probabilities do not differ considerably from the pure ones. Paralleling a well established application to seismic events, extreme value theory can be profitably used in volcanic risk estimates, provided that appropriate account is also taken of all other variables.

In vitro and in vivo testing of a totally implantable left ventricular assist system.

PubMed

Jassawalla, J S; Daniel, M A; Chen, H; Lee, J; LaForge, D; Billich, J; Ramasamy, N; Miller, P J; Oyer, P E; Portner, P M

1988-01-01

The totally implantable Novacor LVAS is being tested under NIH auspices to demonstrate safety and efficacy before clinical trials. Twelve complete systems (submerged in saline at 37 degrees C) are being tested, with an NIH goal of demonstrating 80% reliability for 2 year operation with a 60% confidence level. The systems, which are continuously monitored, are diurnally cycled between two output levels by automatically varying preload and afterload. Currently, 14.3 years of failure-free operation have been accumulated, with a mean duration of 14 months. Using an exponential failure distribution model, the mean time to failure (MTTF) is greater than 8.8 years, corresponding to a demonstrated reliability (for a 2 year mission time) of 80% (80% confidence level). Recent ovine experiments with VAS subsystems include a 767 day volume compensator implant, a 279 day pump/drive unit implant and a 1,448 day BST implant. The last 12 chronic pump/drive unit experiments had a mean duration of 153 days (excluding early postoperative complications). This compares favorably with the NIH goals for complete systems (5 month mean duration). Complete system experiments are currently underway.

Total transverse rupture of the duodenum after blunt abdominal trauma.

PubMed

Pirozzi, Cesare; Di Marco, Carluccio; Loponte, Margherita; Savino, Grazia

2014-05-11

Complete transverse rupture of the duodenum as an isolated lesion in blunt trauma can be considered as exceptional. The aim of this report is to discuss diagnostic procedures and surgical options in such an infrequent presentation. We report on a 37 year old man who had a total transverse rupture of the duodenum after blunt abdominal trauma. Diagnosis was suspected after contrast enhanced CT scan and confirmed at laparotomy; duodenal rupture was repaired by an end to end duodenal-duodenal anastomosis, after Kocher maneuver. The patient had fast and complete recovery. A high index of suspicion is necessary for timely diagnosis. Multi detector contrast enhanced CT scan is the gold standard for that aim. Surgical management must be tailored on an individual basis, since many techniques are available for both reconstruction and duodenum decompression. Kocher maneuver is essential for complete inspection of the pancreatic duodenal block and for appropriate reconstruction. Management of isolated duodenal rupture can be difficult. Contrast enhanced TC scans is essential for timely diagnosis. Primary repair can be achieved by an end to end duodenum anastomosis after Kocher maneuver, although alternative techniques are available for tailored solutions. Complex duodenum decompression techniques are not mandatory.

Time Burden of Standardized Hip Questionnaires.

PubMed

Chughtai, Morad; Khlopas, Anton; Mistry, Jaydev B; Gwam, Chukwuweike U; Elmallah, Randa K; Mont, Michael A

2016-04-01

Many standardized scales and questionnaires have been developed to assess outcomes of patients undergoing total hip arthroplasty (THA). However, these surveys can be a burden to both patients and orthopaedists as some are time-inefficient. In addition, there is a paucity of reports assessing the time it takes to complete them. In this study we aimed to: (1) assess how long it takes to complete the most common standardized hip questionnaires; (2) determine the presence of variation in completion time; and (3) evaluate the effects of age, gender, and level of education on completion time. Based on a previous study, we selected the seven most commonly used hip scoring systems-Western Ontario and McMaster Universities Hip Outcome Assessment (WOMAC), Harris Hip Score (HHS), Hip Disability and Osteoarthritis Outcome Score (HOOS), Larson Score, Short-form 36 (SF-36), modified Merle d'Aubigne and Postel Score (MDA), and Lower Extremity Functional Scale (LEFS). The standardized scales and questionnaires were randomly administered to 70 subjects. The subjects were unaware that they were being timed during completion of the questionnaire. We obtained the coefficients of variation of time for each questionnaire. The mean time to complete the questionnaire was then stratified and compared based on age, gender, and level of education. The mean time to complete each of the systems is listed in ascending order: Modified Merle d'Aubigne and Postel Score (MDA), Lower Extremity Functional Scale (LEFS), Western Ontario and McMaster Universities Hip Outcome Assessment (WOMAC), Harris Hip Score (HHS), Larson Score, Hip Disability and Osteoarthritis Outcome Score (HOOS), and Short-form 36 (SF-36). The WOMAC and Larson Score coefficients of variation were the largest, and the HOOS and MDA were the smallest. There was a significantly higher mean time to completion in those who were above or equal to the age of 55 years as compared to those who were below the age of 55 (227 vs. 166 seconds). There was no significant association found in time of completion between gender or education level. Standardized scales and questionnaire which assess THA patients can be burdensome and time-inefficient, which may lead to task-induced fatigue. This may result in inaccurate THA patient assessments, which do not reflect the patient's true state. Future studies should aim to create an encompassing questionnaire that is time efficient and can replace all currently used validated systems.

Congenital hypothyroidism from complete iodide transport defect: long-term evolution with iodide treatment.

PubMed Central

Albero, R.; Cerdan, A.; Sanchez Franco, F.

1987-01-01

Hypothyroidism from iodide transport deficiency is a rare disease, especially when found in two affected siblings. Treatment with high doses of iodide has been recommended, but no long term results have been reported. Two siblings with congenital hypothyroidism due to total failure to transport iodide have been followed up during twelve and a half years of treatment with oral potassium iodide. Iodine doses varied between 10.3 and 22 mg/day, and serum total iodine concentrations between 100 and 210 micrograms/dl. Total triiodothyronine (T3), thyroxine (T4) and free T4 were in the normal range during the time of study. Basal thyroid stimulating hormones (TSH) and maximum TSH response to thyrotrophin releasing hormone (TRH) were also in the range of normal values. These data along with clinical findings confirmed the potential usefulness of iodine in hypothyroidism due to complete iodide transport defect. PMID:3451231

Treatment of synthetic refinery wastewater in anoxic-aerobic sequential moving bed reactors and sulphur recovery.

PubMed

Mallick, Subrat Kumar; Chakraborty, Saswati

2017-11-10

Objective of the present study was to simultaneously biodegrade synthetic petroleum refinery wastewater containing phenol (750 mg/L), sulphide (750 mg/L), hydrocarbon (as emulsified diesel of 300 mg/L), ammonia-nitrogen (350 mg/L) at pH >9 in anoxic-aerobic sequential moving bed reactors. The optimum mixing speed of anoxic reactor was observed at 20 rpm and beyond that, removal rate remained constant. In anoxic reactor the minimum hydraulic retention time was observed to be 2 days for complete removal of sulphide, 40-50% removal of phenol and total hydrocarbons and 52% of sulphur recovery. The optimum HRT of aerobic moving bed reactor was observed as 16 h (total HRT of 64 h for anoxic and aerobic reactors) for complete removals of phenol, total hydrocarbons, COD (chemical oxygen demand) and ammonia-nitrogen with nitrification.

Test-retest reliability of the trauma and life events self-report inventory.

PubMed

Hovens, J E; Bramsen, I; van der Ploeg, H M; Reuling, I E

2000-12-01

Three groups of first-year male and female medical students (total N = 90) completed the Trauma and Life Events Self-report Inventory twice. Test-retest reliability for the three different time periods was .82, .89, and .75, respectively.

Validation of a Computerized test of Functional Capacity.

PubMed

Keefe, Richard S E; Davis, Vicki G; Atkins, Alexandra S; Vaughan, Adam; Patterson, Tom; Narasimhan, Meera; Harvey, Philip D

2016-08-01

Regulatory guidance for schizophrenia cognition clinical trials requires that the assessment of cognitive change is accompanied by a functionally meaningful endpoint. However, currently available measures are challenged by resistance to change, psychometric weaknesses, and for interview-based assessments, dependence upon the presence of an informant. The aims of the current study were to: 1) assess the validity, sensitivity, and reliability of the Virtual Reality Functional Capacity Assessment Tool (VRFCAT) as a measure of functional capacity; 2) determine the association between performance on the VRFCAT and performance on the MATRICS Consensus Cognitive Battery (MCCB); and 3) compare the metrics of the VRFCAT with the UCSD Performance-based Skills Assessment (UPSA). 167 patients with schizophrenia and 166 healthy controls completed the VRFCAT, UPSA, and the MCCB at baseline. The VRFCAT and UPSA were completed again at follow-up. The VRFCAT, MCCB, and UPSA were very sensitive to impairment in schizophrenia (d=1.16 to 1.22). High test-retest reliability was demonstrated for VRFCAT total completion time and the UPSA total score in patients (ICC=0.81 and 0.78, respectively). The UPSA demonstrated significant practice effects in patients (d=0.35), while the VRFCAT did not (d=-0.04). VRFCAT total completion time was correlated with both UPSA (r=-0.56, p<0.0001 for patients and -0.58, p<0.0001 for controls) and MCCB Composite (r=-0.57, p<0.0001 for patients and -0.68, p<0.0001 for controls). The VRFCAT is a highly reliable and sensitive measure of functional capacity with associations to the UPSA and MCCB. These results provide encouraging support for a computerized functional capacity assessment for use in schizophrenia. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Validation of a Computerized Test of Functional Capacity

PubMed Central

Keefe, Richard S.E.; Davis, Vicki G.; Atkins, Alexandra S.; Vaughan, Adam; Patterson, Tom; Narasimhan, Meera; Harvey, Philip D.

2016-01-01

Regulatory guidance for schizophrenia cognition clinical trials requires that the assessment of cognitive change is accompanied by a functionally meaningful endpoint. However, currently available measures are challenged by resistance to change, psychometric weaknesses, and for interview-based assessments, dependence upon the presence of an informant. The aims of the current study were to: 1) assess the validity, sensitivity, and reliability of the Virtual Reality Functional Capacity Assessment Tool (VRFCAT) as a measure of functional capacity; 2) determine the association between performance on the VRFCAT and performance on the MATRICS Consensus Cognitive Battery (MCCB); and 3) compare the metrics of the VRFCAT with the UCSD Performance-based Skills Assessment (UPSA). 167 patients with schizophrenia and 166 healthy controls completed the VRFCAT, UPSA, and the MCCB at baseline. The VRFCAT and UPSA were completed again at follow-up. The VRFCAT, MCCB, and UPSA were very sensitive to impairment in schizophrenia (d = 1.16 to 1.22). High test-retest reliability was demonstrated for VRFCAT total completion time and the UPSA total score in patients (ICC=0.81 and 0.78, respectively). The UPSA demonstrated significant practice effects in patients (d=0.35), while the VRFCAT did not (d=−0.04). VRFCAT total completion time was correlated with both UPSA (r=−0.56, p<0.0001 for patients and −0.58, p<0.0001 for controls) and MCCB Composite (r=−0.57, p<0.0001 for patients and −0.68, p<0.0001 for controls). The VRFCAT is a highly reliable and sensitive measure of functional capacity with associations to the UPSA and MCCB. These results provide encouraging support for a computerized functional capacity assessment for use in schizophrenia. PMID:27091656

Radiotherapy Monte Carlo simulation using cloud computing technology.

PubMed

Poole, C M; Cornelius, I; Trapp, J V; Langton, C M

2012-12-01

Cloud computing allows for vast computational resources to be leveraged quickly and easily in bursts as and when required. Here we describe a technique that allows for Monte Carlo radiotherapy dose calculations to be performed using GEANT4 and executed in the cloud, with relative simulation cost and completion time evaluated as a function of machine count. As expected, simulation completion time decreases as 1/n for n parallel machines, and relative simulation cost is found to be optimal where n is a factor of the total simulation time in hours. Using the technique, we demonstrate the potential usefulness of cloud computing as a solution for rapid Monte Carlo simulation for radiotherapy dose calculation without the need for dedicated local computer hardware as a proof of principal.

Improving Project Management with Simulation and Completion Distribution Functions

NASA Technical Reports Server (NTRS)

Cates, Grant R.

2004-01-01

Despite the critical importance of project completion timeliness, management practices in place today remain inadequate for addressing the persistent problem of project completion tardiness. A major culprit in late projects is uncertainty, which most, if not all, projects are inherently subject to. This uncertainty resides in the estimates for activity durations, the occurrence of unplanned and unforeseen events, and the availability of critical resources. In response to this problem, this research developed a comprehensive simulation based methodology for conducting quantitative project completion time risk analysis. It is called the Project Assessment by Simulation Technique (PAST). This new tool enables project stakeholders to visualize uncertainty or risk, i.e. the likelihood of their project completing late and the magnitude of the lateness, by providing them with a completion time distribution function of their projects. Discrete event simulation is used within PAST to determine the completion distribution function for the project of interest. The simulation is populated with both deterministic and stochastic elements. The deterministic inputs include planned project activities, precedence requirements, and resource requirements. The stochastic inputs include activity duration growth distributions, probabilities for events that can impact the project, and other dynamic constraints that may be placed upon project activities and milestones. These stochastic inputs are based upon past data from similar projects. The time for an entity to complete the simulation network, subject to both the deterministic and stochastic factors, represents the time to complete the project. Repeating the simulation hundreds or thousands of times allows one to create the project completion distribution function. The Project Assessment by Simulation Technique was demonstrated to be effective for the on-going NASA project to assemble the International Space Station. Approximately $500 million per month is being spent on this project, which is scheduled to complete by 2010. NASA project stakeholders participated in determining and managing completion distribution functions produced from PAST. The first result was that project stakeholders improved project completion risk awareness. Secondly, using PAST, mitigation options were analyzed to improve project completion performance and reduce total project cost.

Complete mitochondrial genome of Cynopterus sphinx (Pteropodidae: Cynopterus).

PubMed

Li, Linmiao; Li, Min; Wu, Zhengjun; Chen, Jinping

2015-01-01

We have characterized the complete mitochondrial genome of Cynopterus sphinx (Pteropodidae: Cynopterus) and described its organization in this study. The total length of C. sphinx complete mitochondrial genome was 16,895 bp with the base composition of 32.54% A, 14.05% G, 25.82% T and 27.59% C. The complete mitochondrial genome included 13 protein-coding genes, 22 tRNA genes, 2 rRNA genes (12S rRNA and 16S rRNA) and 1 control region (D-loop). The control region was 1435 bp long with the sequence CATACG repeat 64 times. Three protein-coding genes (ND1, COI and ND4) were ended with incomplete stop codon TA or T.

High pressure, temperature and time-dependent effects on enzymatic and microbial properties of fresh sugarcane juice.

PubMed

Chauhan, O P; Ravi, N; Roopa, N; Kumar, Sumeet; Raju, P S

2017-11-01

Efficacy of variable high pressure, temperature and time on the browning causing enzymes and microbial activities, which are major spoilage factors during preservation of sugarcane juice, was studied. The juice was processed at 200-600 MPa pressure for 2-8 min at 40 and 60 °C and their effect on polyphenol oxidase and peroxidase as well as microbiological quality in terms of total plate count, yeast and molds and total coliforms was studied. Application of high pressures were found to cause significant decrease in enzymatic and microbial activities. The effects were found to be significantly more pronounced at 60 °C as compared to 40 °C. Process time also caused significant ( p  < 0.05) negative effect on microbial and enzyme activities. The sugarcane juice treated at 600 MPa for 6 min at 60 °C was found sufficient to inactivate the microbial counts completely. Whereas, enzymes were found to be completely inactivated in the samples processed at 600 MPa for 8 min at 60 °C. A pressure of 600 MPa at 60 °C for 8 min could be applied during commercial preservation of sugarcane juice for getting complete inactivation of browning causing enzymes and spoilage causing microorganisms.

A study of engineering student attributes and time to completion of first-year required courses at Texas A&M University

NASA Astrophysics Data System (ADS)

Kimball, Jorja Lay

For many years, colleges of engineering across the nation have required that a foundational set of courses be completed for entry into upper division coursework or into a specific engineering major. Since 1998, The Dwight Look College of Engineering at Texas A&M University (TAMU) has required that incoming first-time enrolling students complete a Core Body of Knowledge (CBK) with specific cumulative grade points required for specific majors. However, considerations of the time to completion of coursework and other student characteristics and academic factors have not been taken into consideration by TAMU, like most institutions. The purpose of this study is to determine for first year engineering students at TAMU the relationship of gender, ethnicity, engineering major, unmet financial need, cumulative grade point average, and total transfer hours on time to completion of CBK courses. The results of the analysis showed that cumulative grade point average (CGPA) had the strongest relationship to completion of CBK of any independent variable in this study. Statistical significance was found for the following variables in this study: CGPA, gender, ethnicity, and unmet financial need. For the study's variable of major, statistical significance was found for Chemical, Electrical, and Computer Engineering majors. The one variable in this study that did not show statistical significance in relation to time to completion of CBK was transfer credit. Findings with implications for recruitment and retention of underrepresented in engineering is a statistical significance indicating that on average females are taking less time than males to complete CBK. The conclusion from the study is that efforts to attract more women into engineering have merit as do programs to support underrepresented students in order that they may complete CBK at a faster pace. Further study to determine profiles of those majors where statistical significance was found for students taking a greater or lesser amount of time for CBK completion than the mean is recommended, as is ongoing data collection and comparison for current cohorts of engineering majors at TAMU.

Clinical Study on Lobaplatin Combined with 5-Fu and Concurrent Radiotherapy in Treating Patients with Inoperable Esophageal Cancer.

PubMed

Jia, Xiao-Jing; Huang, Jing-Zi

2015-01-01

To investigate short- and long-term treatment effects and side reactions of lobaplatin plus 5-Fu combined and concurrent radiotherapy in treating patients with inoperable middle-advanced stage esophageal cancer. Sixty patients with middle-advanced stage esophageal squamous cell cancer were retrospectively analyzed. All patients were administered lobaplatin (50 mg intravenously) for 2 h on day 1, and 5-Fu (500 mg/m2) injected intravenously from day 1 to 5 for 1 cycle, in an interval of 21 days for totally 4 cycles. At the same time, late-course accelerated hyperfractionated three-dimensional conformal radiotherapy was performed. Patients were firstly treated with conventional fractionated irradiation (1.8 Gy/d, 5 times/week, a total of 23 treatments, and DT41.4 Gy), and then treated with accelerated hyperfractionated irradiation (1.5 Gy, 2 times/d, a total of 27 Gy in 9 days, an entire course of 6-7 weeks, and DT 68.4 Gy). All patients completed treatment, including 10 complete response (CR), 41 partial response (PR), 7 stable disease (SD), and 2 progressive disease (PD). The total effective rate was 85.0% (51/60). Thirty-nine patients had an increased KPS score. One-, 2-, and 3-year survival rates were 85.3%, 57.5%, and 41.7%, respectively. The median survival time was 27 months. The adverse reactions included myelosuppression, which was mainly degreeI and II. The occurrence rate of radiation esophagitis was 17.5%. No significant hepatic or renal toxicity was observed. Lobaplatin plus 5-Fu combined with concurrent radiotherapy is safe and effective in treating patients with middle-advanced stage esophageal cancer. However, this result warrants further evaluation by randomized clinical studies.

High dose psilocybin is associated with positive subjective effects in healthy volunteers.

PubMed

Nicholas, Christopher R; Henriquez, Kelsey M; Gassman, Michele C; Cooper, Karen M; Muller, Daniel; Hetzel, Scott; Brown, Randall T; Cozzi, Nicholas V; Thomas, Chantelle; Hutson, Paul R

2018-06-01

The aim of the current study was to investigate the relationship between escalating higher doses of psilocybin and the potential psilocybin occasioned positive subjective effects. Healthy participants ( n=12) were given three escalating doses of oral psilocybin (0.3 mg/kg; 0.45 mg/kg; 0.6 mg/kg) or (18.8-36.6 mg; 27.1-54.0 mg; 36.3-59.2 mg) a minimum of four weeks apart in a supervised setting. Blood and urine samples, vital signs, and electrocardiograms were obtained. Subjective effects were assessed using the Mystical Experience Questionnaire and Persisting Effects Questionnaire. There was a significant linear dose-related response in Mystical Experience Questionnaire total score and the transcendence of time and space subscale, but not in the rate of a complete mystical experience. There was also a significant difference between dose 3 compared to dose 1 on the transcendence of time and space subscale, while no dose-related differences were found for Mystical Experience Questionnaire total scores or rate of a mystical experience. Persisting Effects Questionnaire positive composite scores 30 days after completion of the last dose were significantly higher than negative composite scores. Persisting Effects Questionnaire results revealed a moderate increase in sense of well-being or life satisfaction on average that was associated with the maximum Mystical Experience Questionnaire total score. Pharmacokinetic measures were associated with dose but not with Mystical Experience Questionnaire total scores or rate of a mystical experience. High doses of psilocybin elicited subjective effects at least as strong as the lower doses and resulted in positive persisting subjective effects 30 days after, indicating that a complete mystical experience was not a prerequisite for positive outcomes.

A two-stage path planning approach for multiple car-like robots based on PH curves and a modified harmony search algorithm

NASA Astrophysics Data System (ADS)

Zeng, Wenhui; Yi, Jin; Rao, Xiao; Zheng, Yun

2017-11-01

In this article, collision-avoidance path planning for multiple car-like robots with variable motion is formulated as a two-stage objective optimization problem minimizing both the total length of all paths and the task's completion time. Accordingly, a new approach based on Pythagorean Hodograph (PH) curves and Modified Harmony Search algorithm is proposed to solve the two-stage path-planning problem subject to kinematic constraints such as velocity, acceleration, and minimum turning radius. First, a method of path planning based on PH curves for a single robot is proposed. Second, a mathematical model of the two-stage path-planning problem for multiple car-like robots with variable motion subject to kinematic constraints is constructed that the first-stage minimizes the total length of all paths and the second-stage minimizes the task's completion time. Finally, a modified harmony search algorithm is applied to solve the two-stage optimization problem. A set of experiments demonstrate the effectiveness of the proposed approach.

Mastery-Based Virtual Reality Robotic Simulation Curriculum: The First Step Toward Operative Robotic Proficiency.

PubMed

Hogg, Melissa E; Tam, Vernissia; Zenati, Mazen; Novak, Stephanie; Miller, Jennifer; Zureikat, Amer H; Zeh, Herbert J

Hepatobiliary surgery is a highly complex, low-volume specialty with long learning curves necessary to achieve optimal outcomes. This creates significant challenges in both training and measuring surgical proficiency. We hypothesize that a virtual reality curriculum with mastery-based simulation is a valid tool to train fellows toward operative proficiency. This study evaluates the content and predictive validity of robotic simulation curriculum as a first step toward developing a comprehensive, proficiency-based pathway. A mastery-based simulation curriculum was performed in a virtual reality environment. A pretest/posttest experimental design used both virtual reality and inanimate environments to evaluate improvement. Participants self-reported previous robotic experience and assessed the curriculum by rating modules based on difficulty and utility. This study was conducted at the University of Pittsburgh Medical Center (Pittsburgh, PA), a tertiary care academic teaching hospital. A total of 17 surgical oncology fellows enrolled in the curriculum, 16 (94%) completed. Of 16 fellows who completed the curriculum, 4 fellows (25%) achieved mastery on all 24 modules; on average, fellows mastered 86% of the modules. Following curriculum completion, individual test scores improved (p < 0.0001). An average of 2.4 attempts was necessary to master each module (range: 1-17). Median time spent completing the curriculum was 4.2 hours (range: 1.1-6.6). Total 8 (50%) fellows continued practicing modules beyond mastery. Survey results show that "needle driving" and "endowrist 2" modules were perceived as most difficult although "needle driving" modules were most useful. Overall, 15 (94%) fellows perceived improvement in robotic skills after completing the curriculum. In a cohort of board-certified general surgeons who are novices in robotic surgery, a mastery-based simulation curriculum demonstrated internal validity with overall score improvement. Time to complete the curriculum was manageable. Published by Elsevier Inc.

Comparison of closed and open methods of pneumoperitonium in laparoscopic cholecystectomy.

PubMed

Akbar, Mohammad; Khan, Ishtiaq Ali; Naveed, Danish; Khattak, Irfanuddin; Zafar, Arshad; Wazir, Muhammad Salim; Khan, Asif Nawaz; Zia-ur-Rehman

2008-01-01

Pneumoperitonium is the first step in laparoscopic surgery including cholecystectomy. Two commonly used methods to create pneumoperitonium are closed and open technique. Both have advantages and disadvantages. The current study was designed to compare these two techniques in terms of safety and time required to complete the procedure. This was a randomized controlled prospective study conducted at Department of Surgery, Ayub Hospital Complex Abbottabad, from 1st June 2007 to 31st May 2008. Randomization was done into two groups randomly using sealed envelopes containing the questionnaire. Seventy envelopes were kept in the cupboard, containing 35 proformas for group A and 35 for group B. An envelope was randomly fetched and opened upon selection of the patient after taking the informed consent. Pneumoperitonium was created by closed technique in group A, and by open technique in group B. Time required for successful pneumoperitonium was calculated in each group. Failure to induce pneumoperitonium was determined for each technique. Time required to close the wounds at completion, total operating time and injuries sustained during induction of pneumoperitonium were compared in both techniques. Out of the total 70 patients included in study, 35 were in group A and 35 in group B. Mean time required for successful pneumoperitonium was 9.17 minutes in group A and 8.11 minutes in group B. Total operating time ranged from 55 minutes to 130 minutes in group A and from 45 minutes to 110 minutes in group B. Mean of total operating time was 78.34 and 67 minutes in group A and B respectively. Mean time needed to close the wound was 9.88 minutes in group A and 4.97 minutes in group B. Failure of technique was noted in three patients in group A while no failure was experienced in group B. In two cases in group A minor complications during creation of pneumoperitonium were observed while in group B no complication occurred. No patient died in the study. We concluded from this study that open technique of pneumoperitonium was, less time consuming and safer than the closed technique.

A comparison of hysteroscopic mechanical tissue removal with bipolar electrical resection for the management of endometrial polyps in an ambulatory care setting: preliminary results.

PubMed

Pampalona, Jennifer Rovira; Bastos, Maria Degollada; Moreno, Gemma Mancebo; Pust, Andrea Buron; Montesdeoca, Gemma Escribano; Guerra Garcia, Angel; Pruñonosa, Juan Carles Mateu; Collado, Ramon Carreras; Torras, Pere Bresco

2015-01-01

To assess and compare efficacy, pain, and the learning curve associated with diagnostic therapeutic hysteroscopy using mechanical tissue removal versus bipolar electrical resection in the management of endometrial polyps in an ambulatory care setting. A randomized controlled clinical trial (Canadian Task Force classification I). Hospital de Igulada, Barcelona, Spain. A total of 133 patients diagnosed with endometrial polyp(s) were included and randomly assigned to 1 of the 2 hysteroscopic methods. Criteria assessed were total hysteroscopy time, full polypectomy procedure time, pain experienced by patients, and learning curve of staff in training. The average time to perform total hysteroscopy using the mechanical tissue removal system (TRUCLEAR 5.0 System; Smith & Nephew Inc., Andover, MD) was 6 minutes 49 seconds versus 11 minutes 37 seconds required for the bipolar electrosurgery system (GYNECARE VERSAPOINT; Ethicon Inc, Somerville, NJ) (p < .01). Results for complete polypectomy time favored the TRUCLEAR System at 3 minutes 7 seconds over the VERSAPOINT System at 8 minutes 25 seconds (p < .01). If a successful procedure is predicated on access to cavity, visualization, and complete resection and excision of endometrial polyp, the mechanical TRUCLEAR Tissue Removal System shows a higher success rate than the VERSAPOINT Bipolar Electrosurgery System at 92% and 77%, respectively. Analysis of pain using the visual analog scale revealed no significant differences between the 2 techniques (p > .05). A study of the residents' learning curve showed a higher level of autonomy with hysteroscopy using the TRUCLEAR Tissue Removal System with which residents showed a higher level of confidence compared with hysteroscopy with the VERSAPOINT Bipolar Electrosurgery System. In hysteroscopic polypectomy, the mechanical tissue removal system was significantly faster, achieved a greater success rate for complete polypectomy, and required a shorter learning curve from staff being trained in the management of endometrial polyps when compared with bipolar electrical resection. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

Pulmonary function in children with development coordination disorder.

PubMed

Wu, Sheng K; Cairney, John; Lin, Hsiao-Hui; Li, Yao-Chuen; Song, Tai-Fen

2011-01-01

The purpose of this study was to compare pulmonary function in children with developmental coordination disorder (DCD) with children who are typically developing (TD), and also analyze possible gender differences in pulmonary function between these groups. The Movement ABC test was used to identify the movement coordination ability of children. Two hundred and fifty participants (90 children with DCD and 160 TD children) aged 9-10 years old completed this study. Using the KoKo spirometry, forced vital capacity (FVC) and forced expiratory volume in 1s (FEV(1.0)) were used to measure pulmonary function. The 800-m run was also conducted to assess cardiopulmonary fitness of children in the field. There was a significant difference in pulmonary function between TD children and those with DCD. The values of FVC and FEV(1.0) in TD children were significantly higher than in children with DCD. A significant, but low correlation (r = -0.220, p < .001) was found between total score on the MABC and FVC; similarly, a positive but low correlation (r = 0.252, p < .001) was found between total score on the MABC and the completion time of 800-m run. However, no significant correlation between FVC and the time of 800-m run was found (p > .05). Significant correlations between total score on the MABC and the completion time of the 800-m run (r = 0.352, p < .05) and between FVC and the time of 800-m run (r = -0.285, p < .05) were observed in girls with DCD but not boys with this condition. Based on the results of this study, pulmonary function in children with DCD was significantly lower than that of TD children. The field test, 800-m run, may not be a good indicator to distinguish aerobic ability between children with DCD and those who are TD. It is possible that poor pulmonary function in children with DCD is due to reduced physical activity in this population. Copyright © 2010 Elsevier Ltd. All rights reserved.

Emotional stimuli facilitate time perception in children with attention-deficit/hyperactivity disorder.

PubMed

Nazari, Mohammad A; Mirloo, Mohammad M; Rezaei, Mazaher; Soltanlou, Mojtaba

2018-06-01

The aim of this study was to compare the effect of different emotional stimuli (neutral, positive, and negative) on time perception in children with attention-deficit/hyperactivity disorder (ADHD) and normal children in dual-task form. Five hundred and ninety-nine students from primary schools were randomly selected. The Conner's Teacher Rating Scale (CTRS) questionnaire was completed by teachers. A total of 100 children with a score above the cut-off point for the CTRS were further assessed using the Child Symptom Inventory-4 (CSI-4). A total of 34 children with ADHD and 31 controls completed an emotional time discrimination task in two blocks of 1000 and 2000 ms duration. Children were asked to compare three image groups: neutral with neutral, neutral with positive, and neutral with negative images. Children with ADHD had significantly better performance in the emotional time discrimination task across all conditions when compared with controls: On average, discrimination thresholds were approximately 35 ms shorter for the children with ADHD. Our results indicate that children with ADHD have higher sensitivity to time relative to controls in a situation in which they must distribute resources between temporal and emotional processing. On the basis of the interference effect and the working memory capacity hypothesis, this dividing of attention causes a decrease of time accuracy in normal children. © 2016 The British Psychological Society.

Random placenta margin incision for control hemorrhage during cesarean delivery complicated by complete placenta previa: a prospective cohort study.

PubMed

Fan, Dazhi; Wu, Shuzhen; Ye, Shaoxin; Wang, Wen; Wang, Lijuan; Fu, Yao; Zeng, Meng; Liu, Yan; Guo, Xiaoling; Liu, Zhengping

2018-04-03

Complete placenta previa (CPP) is one of the most problematic types of abnormal placenta, which is further complicated by placenta accreta or percreta that can unexpectedly lead to catastrophic blood loss, infection, multiple complications, emergency hysterectomy, and even death. The present study aimed to assess the efficacy of random placenta margin incision in controlling intraoperative and total blood loss during cesarean section for CPP women. A prospective cohort study, including a total of 100 consecutive pregnant women with CPP, was performed at a tertiary university-affiliated medical center between March 2016 and July 2017. All of them underwent random placenta margin incision, and intraoperative and total blood loss were analyzed. Through antenatal diagnosis using color Doppler, women were further divided into abnormally invasive placenta (AIP) and non-AIP groups, and anterior and posterior placenta groups. The protocol was registered with the Clinical Trial Registry under registration number NCT02695069. Mean maternal age and gestational age at delivery were 32.26 ± 5.03 years old and 36.21 ± 2.07 weeks, respectively. Total duration of the surgical procedure time was 52.50 (42.43-64.00) min. Median estimated intraoperation blood loss was 746.43 (544.44-1092.86) ml. Total blood loss was 875.00 (604.50-1196.67) ml, and 38 (38.0%) had post-partum hemorrhage. The change from baseline in the median hemoglobin level was -0.33 (6.00-13.20). No women underwent hysterectomy due to massive hemorrhage during the study period. No women had an intraoperative urinary bladder injury, postoperative wound infection, and required relaparotomy, owing to intra-abdominal bleeding. The median hospitalization time was 5.41 (4.18-7.58) d. The random placenta margin incision may be a potentially valuable surgical procedure to control the volumes of intraoperative and postoperative blood loss and reduce the incidence of postpartum hemorrhage among women with complete placenta previa.

Insulin deficiency with and without glucagon: A comparative study between total pancreatectomy and type 1 diabetes.

PubMed

Niwano, Fumimaru; Hiromine, Yoshihisa; Noso, Shinsuke; Babaya, Naru; Ito, Hiroyuki; Yasutake, Sara; Matsumoto, Ippei; Takeyama, Yoshifumi; Kawabata, Yumiko; Ikegami, Hiroshi

2017-12-30

Patients with a total pancreatectomy and type 1 diabetes are similar in regard to absolute insulin deficiency, but different in regard to glucagon, providing a unique opportunity to study the contribution of glucagon to glucose metabolism in an insulin-dependent state. The aim of the present study was to investigate the contribution of glucagon to glucose homeostasis in complete insulin deficiency in vivo. A total of 38 individuals with a complete lack of endogenous insulin (fasting C-peptide <0.0066 nmol/L) and whose glycemic control was optimized with an insulin pump during hospitalization were retrospectively studied. The basal insulin requirement, time-to-time adjustment of the basal insulin infusion rate, prandial insulin requirement and fasting plasma glucagon were compared between patients with a total pancreatectomy (n = 10) and those with type 1 diabetes (n = 28) after achievement of optimal glycemic control. Total daily insulin (P = 0.03) and basal insulin (P = 0.000006), but not prandial insulin requirements, were significantly lower in total pancreatectomy patients than in type 1 diabetes patients. The basal percentage (basal insulin/total daily insulin) was also significantly lower in total pancreatectomy patients than in type 1 diabetes patients (15.8 ± 7.8 vs 32.9 ± 10.1%, P = 0.00003). An increase in the insulin infusion rate early in the morning was not necessary in most patients with a pancreatectomy. The fasting plasma glucagon concentration was significantly lower in total pancreatectomy patients than in type 1 diabetes patients (P = 0.00007), and was positively correlated with the basal insulin requirement (P = 0.038). The difference in insulin requirements between total pancreatectomy and type 1 diabetes patients suggests a contribution of glucagon to the basal insulin requirement and dawn phenomenon. © 2017 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

A time scheduling model of logistics service supply chain based on the customer order decoupling point: a perspective from the constant service operation time.

PubMed

Liu, Weihua; Yang, Yi; Xu, Haitao; Liu, Xiaoyan; Wang, Yijia; Liang, Zhicheng

2014-01-01

In mass customization logistics service, reasonable scheduling of the logistics service supply chain (LSSC), especially time scheduling, is benefit to increase its competitiveness. Therefore, the effect of a customer order decoupling point (CODP) on the time scheduling performance should be considered. To minimize the total order operation cost of the LSSC, minimize the difference between the expected and actual time of completing the service orders, and maximize the satisfaction of functional logistics service providers, this study establishes an LSSC time scheduling model based on the CODP. Matlab 7.8 software is used in the numerical analysis for a specific example. Results show that the order completion time of the LSSC can be delayed or be ahead of schedule but cannot be infinitely advanced or infinitely delayed. Obtaining the optimal comprehensive performance can be effective if the expected order completion time is appropriately delayed. The increase in supply chain comprehensive performance caused by the increase in the relationship coefficient of logistics service integrator (LSI) is limited. The relative concern degree of LSI on cost and service delivery punctuality leads to not only changes in CODP but also to those in the scheduling performance of the LSSC.

A Time Scheduling Model of Logistics Service Supply Chain Based on the Customer Order Decoupling Point: A Perspective from the Constant Service Operation Time

PubMed Central

Yang, Yi; Xu, Haitao; Liu, Xiaoyan; Wang, Yijia; Liang, Zhicheng

2014-01-01

In mass customization logistics service, reasonable scheduling of the logistics service supply chain (LSSC), especially time scheduling, is benefit to increase its competitiveness. Therefore, the effect of a customer order decoupling point (CODP) on the time scheduling performance should be considered. To minimize the total order operation cost of the LSSC, minimize the difference between the expected and actual time of completing the service orders, and maximize the satisfaction of functional logistics service providers, this study establishes an LSSC time scheduling model based on the CODP. Matlab 7.8 software is used in the numerical analysis for a specific example. Results show that the order completion time of the LSSC can be delayed or be ahead of schedule but cannot be infinitely advanced or infinitely delayed. Obtaining the optimal comprehensive performance can be effective if the expected order completion time is appropriately delayed. The increase in supply chain comprehensive performance caused by the increase in the relationship coefficient of logistics service integrator (LSI) is limited. The relative concern degree of LSI on cost and service delivery punctuality leads to not only changes in CODP but also to those in the scheduling performance of the LSSC. PMID:24715818

Complete mitochondrial genome of Eagle Owl (Bubo bubo, Strigiformes; Strigidae) from China.

PubMed

Hengjiu, Tian; Jianwei, Ji; Shi, Yang; Zhiming, Zhang; Laghari, Muhammad Younis; Narejo, Naeem Tariq; Lashari, Punhal

2016-01-01

In the present study, the complete mitochondrial genome sequence of Bubo bubo using PCR amplification, sequencing and assembling has been obtained for the first time. The total length of the mitochondrial genome was 16,250  bp, with the base composition of 29.88% A, 34.16% C, 14.35% G, and 21.58% T. It contained 37 genes (2 ribosomal RNA genes, 13 protein-coding genes and 22 transfer RNA genes) and a major non-coding control region (D-loop region). The complete mitochondrial genome sequence of Bubo bubo provides an important data set for further investigation on the phylogenetic relationships within Strigiformes.

Spectral line and continuum studies using Haystack antenna

NASA Technical Reports Server (NTRS)

1973-01-01

During the last half of 1972, the Haystack antenna was utilized 88% of the time. Of this useful time, 81% was devoted to radio astronomy investigations, 8% was spent on radar-related research and 11% was scheduled for maintenance and system improvements. Thirteen programs were completed of which 10 were spectral-line studies involving primarily recombination lines and H2O vapor investigations. The others involved 2 cm and 1.3 cm continuum observations. Fifteen new programs were accepted and the currently active radio observing programs totalled 24 as of 31 December 1973. The last radar measurements in the lunar topography program have now been completed. Radar activity, including measurements on Mercury, Venus and synchronous satellites has continued.

Jones index, secret sharing and total quantum dimension

NASA Astrophysics Data System (ADS)

Fiedler, Leander; Naaijkens, Pieter; Osborne, Tobias J.

2017-02-01

We study the total quantum dimension in the thermodynamic limit of topologically ordered systems. In particular, using the anyons (or superselection sectors) of such models, we define a secret sharing scheme, storing information invisible to a malicious party, and argue that the total quantum dimension quantifies how well we can perform this task. We then argue that this can be made mathematically rigorous using the index theory of subfactors, originally due to Jones and later extended by Kosaki and Longo. This theory provides us with a ‘relative entropy’ of two von Neumann algebras and a quantum channel, and we argue how these can be used to quantify how much classical information two parties can hide form an adversary. We also review the total quantum dimension in finite systems, in particular how it relates to topological entanglement entropy. It is known that the latter also has an interpretation in terms of secret sharing schemes, although this is shown by completely different methods from ours. Our work provides a different and independent take on this, which at the same time is completely mathematically rigorous. This complementary point of view might be beneficial, for example, when studying the stability of the total quantum dimension when the system is perturbed.

Time diary and questionnaire assessment of factors associated with academic and personal success among university undergraduates.

PubMed

George, Darren; Dixon, Sinikka; Stansal, Emory; Gelb, Shannon Lund; Pheri, Tabitha

2008-01-01

A sample of 231 students attending a private liberal arts university in central Alberta, Canada, completed a 5-day time diary and a 71-item questionnaire assessing the influence of personal, cognitive, and attitudinal factors on success. The authors used 3 success measures: cumulative grade point average (GPA), Personal Success--each participant's rating of congruence between stated goals and progress toward those goals--and Total Success--a measure that weighted GPA and Personal Success equally. The greatest predictors of GPA were time-management skills, intelligence, time spent studying, computer ownership, less time spent in passive leisure, and a healthy diet. Predictors of Personal Success scores were clearly defined goals, overall health, personal spirituality, and time-management skills. Predictors of Total Success scores were clearly defined goals, time-management skills, less time spent in passive leisure, healthy diet, waking up early, computer ownership, and less time spent sleeping. Results suggest alternatives to traditional predictors of academic success.

Contacting passengers after exposure to measles on an international flight: Implications for responding to new disease threats and bioterrorism.

PubMed

Lasher, Lara E; Ayers, Tracy L; Amornkul, Pauli N; Nakatab, Michele N; Effler, Paul V

2004-01-01

On May 21, 2000, a passenger with measles traveled from Japan to Hawai'i on a seven-hour flight. When the flight landed, the U.S. Public Health Service (USPHS) Quarantine Station in Honolulu alerted passengers that a suspected case of measles had been identified, but they were not detained. The next day, to offer appropriate post-exposure prophylaxis, the Hawai'i Department of Health (HDOH) attempted to contact all passengers from the flight using information from the airline, U.S. Customs declaration forms, and tour agencies. Of 335 total passengers, 270 (81%) were successfully reached and provided complete information. The mean time from exposure to contact for all respondents was 61 hours (95% confidence interval 57, 66). A total of 202 (75%) of the responding passengers were contacted within 72 hours after exposure, the time period during which administration of measles vaccine would have provided protection for susceptible individuals. The time-to-contact was significantly longer for passengers who did not stay in hotels than for hotel guests. Customs forms proved to be of limited utility in contacting international travelers. This experience highlights the need for more complete and timely methods of contacting passengers potentially exposed to infectious agents aboard flights.

Contacting passengers after exposure to measles on an international flight: Implications for responding to new disease threats and bioterrorism.

PubMed Central

Lasher, Lara E.; Ayers, Tracy L.; Amornkul, Pauli N.; Nakatab, Michele N.; Effler, Paul V.

2004-01-01

On May 21, 2000, a passenger with measles traveled from Japan to Hawai'i on a seven-hour flight. When the flight landed, the U.S. Public Health Service (USPHS) Quarantine Station in Honolulu alerted passengers that a suspected case of measles had been identified, but they were not detained. The next day, to offer appropriate post-exposure prophylaxis, the Hawai'i Department of Health (HDOH) attempted to contact all passengers from the flight using information from the airline, U.S. Customs declaration forms, and tour agencies. Of 335 total passengers, 270 (81%) were successfully reached and provided complete information. The mean time from exposure to contact for all respondents was 61 hours (95% confidence interval 57, 66). A total of 202 (75%) of the responding passengers were contacted within 72 hours after exposure, the time period during which administration of measles vaccine would have provided protection for susceptible individuals. The time-to-contact was significantly longer for passengers who did not stay in hotels than for hotel guests. Customs forms proved to be of limited utility in contacting international travelers. This experience highlights the need for more complete and timely methods of contacting passengers potentially exposed to infectious agents aboard flights. PMID:15313108

Pessimism and Homework in CBT for Depression.

PubMed

Sachsenweger, Mieke A; Fletcher, Richard B; Clarke, Dave

2015-12-01

To investigate the moderating effects of attributional style on the relationship between client-rated benefits of homework completion and depression throughout a course of cognitive behavior therapy (CBT). A total of 28 clients, aged 20 to 65 years, experiencing their first major depressive episode completed up to 20 sessions of CBT plus a follow-up session at 2 months. Clients, therapists, and independent observers completed the measures. Multilevel modeling was used for a within-person longitudinal analysis of data. Pessimism slightly moderated the relationship between quantity-quality of homework completion and depression severity over time. Decreases in depression severity were largely independent of level of homework completion. While CBT is effective in reducing depression, pessimistic attributional style can affect the perception that clients bring to the quantity and quality of homework completion. Clinicians could thus focus on dealing with pessimistic style for treatment and homework to moderate the severity of depression. © 2015 Wiley Periodicals, Inc.

NATIONAL EXPOSURE RESEARCH LABORATORY (NERL) INTEGRATED INFORMATOIN AND QUALITY MANAGEMENT PLAN TRAINING

EPA Science Inventory

The success of the NERL quality system relies on participation by all managers and staff. This training was developed for the purpose of communicating the basic features of the quality system in a convenient and efficient manner. The total time to complete a review of all five ...

Student Endodontic Performance with and without Numerical Requirements.

ERIC Educational Resources Information Center

Lee, Charles Q.; And Others

1994-01-01

A study compared dental student performance in clinical endodontics under two instructional approaches, one in which number of procedures completed by students (n=79) was measured and one (n=84 students) emphasizing total patient care and stricter accounting of clinical treatment time. Results indicated the latter group treated fewer teeth but…

Pathways of Influence: Chinese Parents' Expectations, Parenting Styles, and Child Social Competence

ERIC Educational Resources Information Center

Ren, Lixin; Edwards, Carolyn Pope

2015-01-01

This study examines relations among Chinese parents' expectations for children's development of social-emotional skills, parenting styles, and child social competence. A total of 154 parents with preschool-aged children from mainland China completed questionnaires measuring their timing of expectations for children's mastery of social-emotional…

Unenhanced MR Angiography of Uterine and Ovarian Arteries after Uterine Artery Embolization: Differences between Patients with Incomplete and Complete Fibroid Infarction

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

Mori, Kensaku, E-mail: moriken@md.tsukuba.ac.jp; Saida, Tsukasa; Shibuya, Yoko

Purpose: To compare the status of uterine and ovarian arteries after uterine artery embolization (UAE) in patients with incomplete and complete fibroid infarction via unenhanced 3D time-of-flight magnetic resonance (MR) angiography. Materials and Methods: Thirty-five consecutive women (mean age 43 years; range 26-52 years) with symptomatic uterine fibroids underwent UAE and MR imaging before and within 2 months after UAE. The patients were divided into incomplete and complete fibroid infarction groups on the basis of the postprocedural gadolinium-enhanced MR imaging findings. Two independent observers reviewed unenhanced MR angiography before and after UAE to determine bilateral uterine and ovarian arterial flowmore » scores. The total arterial flow scores were calculated by summing the scores of the 4 arteries. All scores were compared with the Mann-Whitney test. Results: Fourteen and 21 patients were assigned to the incomplete and complete fibroid infarction groups, respectively. The total arterial flow score in the incomplete fibroid infarction group was significantly greater than that in the complete fibroid infarction group (P = 0.019 and P = 0.038 for observers 1 and 2, respectively). In 3 patients, additional therapy was recommended for insufficient fibroid infarction. In 1 of the 3 patients, bilateral ovarian arteries were invisible before UAE but seemed enlarged after UAE. Conclusion: The total arterial flow from bilateral uterine and ovarian arteries in patients with incomplete fibroid infarction is less well reduced than in those with complete fibroid infarction. Postprocedural MR angiography provides useful information to estimate the cause of insufficient fibroid infarction in individual cases.« less

Isoniazid completion rates for latent tuberculosis infection among college students managed by a community pharmacist.

PubMed

Hess, Karl; Goad, Jeffery; Wu, Joanne; Johnson, Kathleen

2009-01-01

The authors' objective was to document 9-month and previously recommended 6-month treatment completion rates for latent tuberculosis infection (LTBI) in a pharmacist-managed LTBI clinic in a community pharmacy on a college campus, and to describe patient characteristics. Participants were university students diagnosed with LTBI. The authors conducted a retrospective review of pharmacy records from 2000 to 2006. Main outcome measures included 6-month and 9-month LTBI treatment completion rates, total isoniazid (INH) tablets taken, characteristics of completers versus noncompleters, average time to treatment completion, and reported adverse drug events. The 9-month completion rate was 59%, and the 6-month completion rate was 67%. Among those not completing treatment, 15.2% experienced fatigue and 2.2% experienced a rash (p=.04 and p=.03, respectively). LTBI clinics are a unique niche for community pharmacies and can provide individualized patient care to ensure LTBI treatment adherence, monitoring for disease progression, and safety of INH.

Establishing a community pharmacy residency at an independent pharmacy: Time allocation and valuation.

PubMed

Shugart, Katherine; Bryant, Jason; Kress, Dean; Ziegler, Bryan; Connelly, Lynn; Brittain, Kristy

2015-12-01

The value of a first-year community pharmacy residency program (CPRP) at an independent pharmacy was estimated based on time allocation for resident responsibilities. Predefined time allocation categories for the pharmacy resident were used to consistently classify and document time completing residency activities. Benefit-to-cost ratio was determined by tabulating total costs and total benefits of the residency program. A retrospective-prospective comparison of overall change in revenue, operating expense, and prescription volume was performed between the preresident time period (July 2012 to June 2013) and the postresident time period (July 2013 to June 2014). This comparison accounted for resident activities that did not directly generate revenue. Time allocations for the resident out of 2,221 total hours logged were dispensing (40%), clinical setup (16%), research (8%), professional meetings (7%), clinical activities (5%), resident education (5%), site precepting (4%), residency meetings (4%), didactic teaching (3%), miscellaneous (3%), marketing (2%), training (2%), and public health promotion (1%). Total costs were $77,422, and total benefits were $118,410. The benefit-to-cost ratio was 1.53. The postresident time interval had $172,451 more revenue and $6,622 more in operating expenses than the preresident time interval, and prescription volume decreased by 2,000 prescriptions compared to the previous year. The benefit-to-cost analysis indicated a $1.53 return for every $1.00 invested into a CPRP. An increase in revenue and operating expenses for the pharmacy was observed after implementation of the CPRP compared to the previous year. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Modularity and hierarchical organization of action programs in children's acquisition of graphic skills.

PubMed

Manoel, Edison de J; Dantas, Luiz; Gimenez, Roberto; de Oliveira, Dalton Lustosa

2011-10-01

The organization of actions is based on modules in memory as a result of practice, easing the demand of performing more complex actions. If this modularization occurs, the elements of the module must remain invariant in new tasks. To test this hypothesis, 35 children, age 10 yr., practiced a graphic criterion task on a digital tablet and completed a complex graphic task enclosing the previous one. Total movement and pause times to draw the figure indicated skill acquisition. A module was identified by the variability of relative timing, pause time, and sequencing. Total movement to perform the criterion task did not increase significantly when it was embedded in the more complex task. Modularity was evidenced by the stability of relative timing and pause time and sequencing. The spatial position of new elements did not perturb the module, so the grammar of action may still have been forming.

Robotic Single-Site and Conventional Laparoscopic Surgery in Gynecology: Clinical Outcomes and Cost Analysis of a Matched Case-Control Study.

PubMed

El Hachem, Lena; Andikyan, Vaagn; Mathews, Shyama; Friedman, Kathryn; Poeran, Jashvant; Shieh, Kenneth; Geoghegan, Michael; Gretz, Herbert F

2016-01-01

To assess the clinical outcomes and costs associated with robotic single-site (RSS) surgery compared with those of conventional laparoscopy (CL) in gynecology. Retrospective case-control study (Canadian Task Force classification II-2). University-affiliated community hospital. Female patients undergoing RSS or CL gynecologic procedures. Comparison of consecutive RSS gynecologic procedures (cases) undertaken between October 2013 and March 2014 with matched CL procedures (controls) completed during the same time period by the same surgeon. Patient demographic data, operative data, and hospital financial data were abstracted from the electronic charts and financial systems. An incremental cost analysis based on the use of disposable equipment was performed. Total hospital charges were determined for matched RSS cases vs CL cases. RSS surgery was completed in 25 out of 33 attempts; 3 cases were aborted before docking, and 5 were converted to a multisite surgery. There were no intraoperative complications or conversions to laparotomy. The completed cases included 11 adnexal cases and 14 hysterectomies, 3 of which included pelvic lymph node dissection. Compared with the CL group, total operative times were higher in the RSS group; however, there were no significant between-group differences in estimated blood loss, length of hospital stay, or complication rates. Disposable equipment cost per case, direct costs, and total hospital charges were evaluated. RSS was associated with an increased disposable cost per case of $248 to $378, depending on the method used for vaginal cuff closure. The average total hospital charges for matched outpatient adnexal surgery were $15,450 for the CL controls and $18,585 for the RSS cases (p < .001), and the average total hospital charges for matched outpatient benign hysterectomy were $14,623 for the CL controls and $21,412 for the RSS cases (p < .001). Although RSS surgery and CL have comparable clinical outcomes in selected patients, RSS surgery remains associated with increased incremental disposable cost per case and total hospital charges. Careful case selection and judicious use of equipment are necessary to maximize cost-effectiveness in RSS gynecologic surgery. Copyright © 2016 AAGL. Published by Elsevier Inc. All rights reserved.

Air Vehicle Integration and Technology Research (AVIATR). Task Order 0003: Condition-Based Maintenance Plus Structural Integrity (CBM+SI) Demonstration (September 2012 to March 2013)

DTIC Science & Technology

2013-03-01

inputs can trigger very opposite results in the outputs the plots of the projected total Fleet Downtime are now compared to the projected Maintenance ...actions, it is logical the delay increases the total time (and thus maintenance labor hours) to complete the repairs. The graphs in Figure 31 show the...AFRL-RQ-WP-TR-2013-0221 AIR VEHICLE INTEGRATION AND TECHNOLOGY RESEARCH (AVIATR) Task Order 0003: Condition-Based Maintenance Plus

Combining of ETHOS Operating Ergonomic Platform, Three-dimensional Laparoscopic Camera, and Radius Surgical System Manipulators Improves Ergonomy in Urologic Laparoscopy: Comparison with Conventional Laparoscopy and da Vinci in a Pelvi Trainer.

PubMed

Tokas, Theodoros; Gözen, Ali Serdar; Avgeris, Margaritis; Tschada, Alexandra; Fiedler, Marcel; Klein, Jan; Rassweiler, Jens

2017-10-01

Posture, vision, and instrumentation limitations are the main predicaments of conventional laparoscopy. To combine the ETHOS surgical chair, the three-dimensional laparoscope, and the Radius Surgical System manipulators, and compare the system with conventional laparoscopy and da Vinci in terms of task completion times and discomfort. Fifteen trainees performed the three main laparoscopic suturing tasks of the Heilbronn training program (IV: simulation of dorsal venous complex suturing; V: circular suturing of tubular structure; and VI: urethrovesical anastomosis) in a pelvi trainer. The tasks were performed conventionally, utilizing the three devices, and robotically. Task completion times were recorded and the surgeon discomfort was evaluated using questionnaires. Task completion times were compared using nonparametric Wilcoxon signed rank test and ergonomic scores were compared using Pearson chi-square test. The use of the full laparoscopic set (ETHOS chair, three-dimensional laparoscopic camera, Radius Surgical System needle holders), resulted in a significant improvement of the completion time of the three tested tasks compared with conventional laparoscopy (p<0.001) and similar to da Vinci surgery. After completing Tasks IV, V, and VI conventionally, 12 (80%), 13 (86.7%), and 13 (86.7%) of the 15 trainees, respectively, reported heavy total discomfort. The full laparoscopic system nullified heavy discomfort for Tasks IV and V and minimized it (6.7%) for the most demanding Task VI. Especially for Task VI, all trainees gained benefit, by using the system, in terms of task completion times and discomfort. The limited trainee robotic experience and the questionnaire subjectivity could be a potential limitation. The ergonomic laparoscopic system offers significantly improved task completion times and ergonomy than conventional laparoscopy. Furthermore, it demonstrates comparable results to robotic surgery. The study was conducted in a pelvi trainer and no patients were recruited. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Electrodermal lability as an indicator for subjective sleepiness during total sleep deprivation.

PubMed

Michael, Lars; Passmann, Sven; Becker, Ruth

2012-08-01

The present study addresses the suitability of electrodermal lability as an indicator of individual vulnerability to the effects of total sleep deprivation. During two complete circadian cycles, the effects of 48h of total sleep deprivation on physiological measures (electrodermal activity and body temperature), subjective sleepiness (measured by visual analogue scale and tiredness symptom scale) and task performance (reaction time and errors in a go/no go task) were investigated. Analyses of variance with repeated measures revealed substantial decreases of the number of skin conductance responses, body temperature, and increases for subjective sleepiness, reaction time and error rates. For all changes, strong circadian oscillations could be observed as well. The electrodermal more labile subgroup reported higher subjective sleepiness compared with electrodermal more stable participants, but showed no differences in the time courses of body temperature and task performance. Therefore, electrodermal lability seems to be a specific indicator for the changes in subjective sleepiness due to total sleep deprivation and circadian oscillations, but not a suitable indicator for vulnerability to the effects of sleep deprivation per se. © 2011 European Sleep Research Society.

Inheriting the Learner's View: A Google Glass-Based Wearable Computing Platform for Improving Surgical Trainee Performance.

PubMed

Brewer, Zachary E; Fann, Hutchinson C; Ogden, W David; Burdon, Thomas A; Sheikh, Ahmad Y

2016-01-01

It is speculated that, in operative environments, real-time visualization of the trainee's viewpoint by the instructor may improve performance and teaching efficacy. We hypothesized that introduction of a wearable surgical visualization system allowing the instructor to visualize otherwise "blind" areas in the operative field could improve trainee performance in a simulated operative setting. A total of 11 surgery residents (4 in general surgery training and 7 in an integrated 6-year cardiothoracic surgery program) participated in the study. Google (Mountain View, CA) Glass hardware running proprietary software from CrowdOptic (San Francisco, CA) was utilized for creation of the wearable surgical visualization system. Both the learner and trainer wore the system, and video was streamed from the learner's system in real time to the trainer, who directed the learner to place needles in a simulated operative field. Subjects placed a total of 5 needles in each of 4 quadrants. A composite error score was calculated based on the accuracy of needle placement in relation to the intended needle trajectories as described by the trainer. Time to task completion (TTC) was also measured and participants completed an exit questionnaire. All residents completed the protocol tasks and the survey. Introduction of the wearable surgical visualization system did not affect mean time to task completion (278 ± 50 vs. 282 ± 69 seconds, p = NS). However, mean composite error score fell significantly once the wearable system was deployed (18 ± 5 vs. 15 ± 4, p < 0.05), demonstrating improved accuracy of needle placement. Most of the participants deemed the device unobtrusive, easy to operate, and useful for communication and instruction. This study suggests that wearable surgical visualization systems allowing for adoption of the learner's perspective may be a useful educational adjunct in the training of surgeons. Further evaluations of the efficacy of wearable technology in the operating room environment are warranted. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Cone-beam computed tomography fusion and navigation for real-time positron emission tomography-guided biopsies and ablations: a feasibility study.

PubMed

Abi-Jaoudeh, Nadine; Mielekamp, Peter; Noordhoek, Niels; Venkatesan, Aradhana M; Millo, Corina; Radaelli, Alessandro; Carelsen, Bart; Wood, Bradford J

2012-06-01

To describe a novel technique for multimodality positron emission tomography (PET) fusion-guided interventions that combines cone-beam computed tomography (CT) with PET/CT before the procedure. Subjects were selected among patients scheduled for a biopsy or ablation procedure. The lesions were not visible with conventional imaging methods or did not have uniform uptake on PET. Clinical success was defined by adequate histopathologic specimens for molecular profiling or diagnosis and by lack of enhancement on follow-up imaging for ablation procedures. Time to target (time elapsed between the completion of the initial cone-beam CT scan and first tissue sample or treatment), total procedure time (time from the moment the patient was on the table until the patient was off the table), and number of times the needle was repositioned were recorded. Seven patients underwent eight procedures (two ablations and six biopsies). Registration and procedures were completed successfully in all cases. Clinical success was achieved in all biopsy procedures and in one of the two ablation procedures. The needle was repositioned once in one biopsy procedure only. On average, the time to target was 38 minutes (range 13-54 min). Total procedure time was 95 minutes (range 51-240 min, which includes composite ablation). On average, fluoroscopy time was 2.5 minutes (range 1.3-6.2 min). An integrated cone-beam CT software platform can enable PET-guided biopsies and ablation procedures without the need for additional specialized hardware. Copyright © 2012 SIR. Published by Elsevier Inc. All rights reserved.

Communication: Electron ionization of DNA bases.

PubMed

Rahman, M A; Krishnakumar, E

2016-04-28

No reliable experimental data exist for the partial and total electron ionization cross sections for DNA bases, which are very crucial for modeling radiation damage in genetic material of living cell. We have measured a complete set of absolute partial electron ionization cross sections up to 500 eV for DNA bases for the first time by using the relative flow technique. These partial cross sections are summed to obtain total ion cross sections for all the four bases and are compared with the existing theoretical calculations and the only set of measured absolute cross sections. Our measurements clearly resolve the existing discrepancy between the theoretical and experimental results, thereby providing for the first time reliable numbers for partial and total ion cross sections for these molecules. The results on fragmentation analysis of adenine supports the theory of its formation in space.

Social support and social norms: do both contribute to predicting leisure-time exercise?

PubMed

Okun, Morris A; Ruehlman, Linda; Karoly, Paul; Lutz, Rafer; Fairholme, Chris; Schaub, Rachel

2003-01-01

To clarify the contribution of social support and social norms to exercise behavior. A sample of 363 college students completed a questionnaire that assessed social support and social negativity from friends, descriptive and injunctive social norms related to friends, perceived behavioral control, attitude, intention, and leisure-time exercise. Esteem social support was the strongest predictor of total and strenuous leisure-time exercise (P < .001), and descriptive norm was a significant (P < .01 predictor of strenuous leisure-time exercise. Social support and social norms contribute independently to our understanding of variation in the frequency of strenuous leisure-time exercise.

Consistency of near-death experience accounts over two decades: are reports embellished over time?

PubMed

Greyson, Bruce

2007-06-01

"Near-death experiences," commonly reported after clinical death and resuscitation, may require intervention and, if reliable, may elucidate altered brain functioning under extreme stress. It has been speculated that accounts of near-death experiences are exaggerated over the years. The objective of this study was to test the reliability over two decades of accounts of near-death experiences. Seventy-two patients with near-death experience who had completed the NDE scale in the 1980s (63% of the original cohort still alive) completed the scale a second time, without reference to the original scale administration. The primary outcome was differences in NDE scale scores on the two administrations. The secondary outcome was the statistical association between differences in scores and years elapsed between the two administrations. Mean scores did not change significantly on the total NDE scale, its 4 factors, or its 16 items. Correlation coefficients between scores on the two administrations were significant at P<0.001 for the total NDE scale, for its 4 factors, and for its 16 items. Correlation coefficients between score changes and time elapsed between the two administrations were not significant for the total NDE scale, for its 4 factors, or for its 16 items. Contrary to expectation, accounts of near-death experiences, and particularly reports of their positive affect, were not embellished over a period of almost two decades. These data support the reliability of near-death experience accounts.

[Malignant ovarian tumors and second look operations].

PubMed

Yasuda, M

1983-08-01

There are many problems that, the timing of S.L.O. the range of reduction, and side effects etc., we studied retrospectively for the S.L.O. The number of subjects were 302 of common epithelial and 251 of germinal cell tumors, totalling 553 cases. Among them, 41 cases were common epithelial and 49 cases germ cell origine respectively, totalling 90 cases of S.L.O. were carried out. Conclusion The 5 year survival rate of S.L.O. was observed to a significant extent. The mean survival time of S.L.O. group: were significantly prolonged. Complete surgery at the S.L.O. of the patient with epithelial and germinal affected the survival rate significantly.

'Real-life' study of imatinib therapy in chronic phase-chronic myeloid leukemia: A novel retrospective observational longitudinal analysis.

PubMed

Merante, Serena; Ferretti, Virginia; Elena, Chiara; Calvello, Celeste; Rocca, Barbara; Zappatore, Rita; Cavigliano, Paola; Orlandi, Ester

2017-01-01

Imatinib is a cornerstone of treatment of chronic myeloid leukemia. It remains unclear whether transient treatment discontinuation or dose changes affect outcome and this approach has not yet been approved for use outside clinical trials. We conducted a retrospective single-institution observational study to evaluate factors affecting response in 'real-life' clinical practice in 138 chronic myeloid leukemia patients in chronic phase treated with imatinib. We used a novel longitudinal data analytical model, with a generalized estimating equation model, to study BCR-ABL variation according to continuous standard dose, change in dose or discontinuation; BCR-ABL transcript levels were recorded. Treatment history was subdivided into time periods for which treatment was given at constant dosage (total 483 time periods). Molecular and cytogenetic complete response was observed after 154 (32%) and 358 (74%) time periods, respectively. After adjusting for length of time period, no association between dose and cytogenetic complete response rate was observed. There was a significantly lower molecular complete response rate after time periods at a high imatinib dosage. This statistical approach can identify individual patient variation in longitudinal data collected over time and suggests that changes in dose or discontinuation of therapy could be considered in patients with appropriate biological characteristics.

Preliminary Experience Using Eye-Tracking Technology to Differentiate Novice and Expert Image Interpretation for Ultrasound-Guided Regional Anesthesia.

PubMed

Borg, Lindsay K; Harrison, T Kyle; Kou, Alex; Mariano, Edward R; Udani, Ankeet D; Kim, T Edward; Shum, Cynthia; Howard, Steven K

2018-02-01

Objective measures are needed to guide the novice's pathway to expertise. Within and outside medicine, eye tracking has been used for both training and assessment. We designed this study to test the hypothesis that eye tracking may differentiate novices from experts in static image interpretation for ultrasound (US)-guided regional anesthesia. We recruited novice anesthesiology residents and regional anesthesiology experts. Participants wore eye-tracking glasses, were shown 5 sonograms of US-guided regional anesthesia, and were asked a series of anatomy-based questions related to each image while their eye movements were recorded. The answer to each question was a location on the sonogram, defined as the area of interest (AOI). The primary outcome was the total gaze time in the AOI (seconds). Secondary outcomes were the total gaze time outside the AOI (seconds), total time to answer (seconds), and time to first fixation on the AOI (seconds). Five novices and 5 experts completed the study. Although the gaze time (mean ± SD) in the AOI was not different between groups (7 ± 4 seconds for novices and 7 ± 3 seconds for experts; P = .150), the gaze time outside the AOI was greater for novices (75 ± 18 versus 44 ± 4 seconds for experts; P = .005). The total time to answer and total time to first fixation in the AOI were both shorter for experts. Experts in US-guided regional anesthesia take less time to identify sonoanatomy and spend less unfocused time away from a target compared to novices. Eye tracking is a potentially useful tool to differentiate novices from experts in the domain of US image interpretation. © 2017 by the American Institute of Ultrasound in Medicine.

Simulated Environments with Animated Agents: Effects on Visual Attention, Emotion, Performance, and Perception

ERIC Educational Resources Information Center

Romero-Hall, E.; Watson, G. S.; Adcock, A.; Bliss, J.; Adams Tufts, K.

2016-01-01

This research assessed how emotive animated agents in a simulation-based training affect the performance outcomes and perceptions of the individuals interacting in real time with the training application. A total of 56 participants consented to complete the study. The material for this investigation included a nursing simulation in which…

48 CFR 15.407-3 - Forward pricing rate agreements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... data submitted in connection with the FPRA, updated as necessary, form a part of the total data that the offeror certifies to be accurate, complete, and current at the time of agreement on price for an initial contract or for a contract modification. (See the Certificate of Current Cost or Pricing Data at...

48 CFR 15.407-3 - Forward pricing rate agreements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... data submitted in connection with the FPRA, updated as necessary, form a part of the total data that the offeror certifies to be accurate, complete, and current at the time of agreement on price for an initial contract or for a contract modification. (See the Certificate of Current Cost or Pricing Data at...

Relationship between Spatial Abilities, Mental Rotation and Functional Anatomy Learning

ERIC Educational Resources Information Center

Guillot, Aymeric; Champely, Stephane; Batier, Christophe; Thiriet, Patrice; Collet, Christian

2007-01-01

This study investigated the relationship between visuo-spatial representation, mental rotation (MR) and functional anatomy examination results. A total of 184 students completed the Group Embedded Figures Test (GEFT), Mental Rotation Test (MRT) and Gordon Test of Visual Imagery Control. The time spent on personal assignment was also considered.…

Social Information Processing as a Mediator between Cognitive Schemas and Aggressive Behavior in Adolescents

ERIC Educational Resources Information Center

Calvete, Esther; Orue, Izaskun

2012-01-01

This longitudinal investigation assessed whether cognitive schemas of justification of violence, mistrust, and narcissism predicted social information processing (SIP), and SIP in turn predicted aggressive behavior in adolescents. A total of 650 adolescents completed measures of cognitive schemas at Time 1, SIP in ambiguous social scenarios at…

26 CFR 1.48-2 - New section 38 property.

Code of Federal Regulations, 2012 CFR

2012-04-01

... of property, the adjusted basis of the reconstructed property as of the time such reconstruction is... machine acquired by the taxpayer will not be treated as being put to original use by the taxpayer. The... following examples: Example 1. If a machine with a total cost of $100,000 is completed after December 31...

26 CFR 1.48-2 - New section 38 property.

Code of Federal Regulations, 2013 CFR

2013-04-01

... of property, the adjusted basis of the reconstructed property as of the time such reconstruction is... machine acquired by the taxpayer will not be treated as being put to original use by the taxpayer. The... following examples: Example 1. If a machine with a total cost of $100,000 is completed after December 31...

26 CFR 1.48-2 - New section 38 property.

Code of Federal Regulations, 2011 CFR

2011-04-01

... of property, the adjusted basis of the reconstructed property as of the time such reconstruction is... machine acquired by the taxpayer will not be treated as being put to original use by the taxpayer. The... following examples: Example 1. If a machine with a total cost of $100,000 is completed after December 31...

26 CFR 1.48-2 - New section 38 property.

Code of Federal Regulations, 2014 CFR

2014-04-01

... of property, the adjusted basis of the reconstructed property as of the time such reconstruction is... machine acquired by the taxpayer will not be treated as being put to original use by the taxpayer. The... following examples: Example 1. If a machine with a total cost of $100,000 is completed after December 31...

75 FR 54907 - Information Collection Sent to the Office of Management and Budget (OMB) for Approval; OMB...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-09

... sport fish and wildlife management and restoration, including: Improvement of fish and wildlife habitats... and 91400-9782-Survey-7B] Information Collection Sent to the Office of Management and Budget (OMB) for... of Activity household participant Completion time per Total burden responses responses response hours...

Pima Community College Summary of 2000-2001 Student Enrollment.

ERIC Educational Resources Information Center

Attinasi, Louis; Hennessey, Brendan; Reece, Dee

This report summarizes the annual unduplicated headcount enrollment and the annual full-time student equivalents (FTSE) generated by students in credit classes and by completers of clock-hour programs during fiscal year 2000-2001 at Pima Community College (Arizona). Highlights include: (1) Pima's total annual unduplicated headcount was 65,221 and…

Assessment of Age-Related Differences in Functional Capacity Using the Virtual Reality Functional Capacity Assessment Tool (VRFCAT)

PubMed Central

Atkins, A.S.; Stroescu, I.; Spagnola, N.B.; Davis, V.G.; Patterson, T.D.; Narasimhan, M.; Harvey, P.D.; Keefe, R.S.E.

2015-01-01

Clinical trials for primary prevention and early intervention in preclinical AD require measures of functional capacity with improved sensitivity to deficits in healthier, non-demented individuals. To this end, the Virtual Reality Functional Capacity Assessment Tool (VRFCAT) was developed as a direct performance-based assessment of functional capacity that is sensitive to changes in function across multiple populations. Using a realistic virtual reality environment, the VRFCAT assesses a subject's ability to complete instrumental activities associated with a shopping trip. The present investigation represents an initial evaluation of the VRFCAT as a potential co-primary measure of functional capacity in healthy aging and preclinical MCI/AD by examining test-retest reliability and associations with cognitive performance in healthy young and older adults. The VRFCAT was compared and contrasted with the UPSA-2-VIM, a traditional performance-based assessment utilizing physical props. Results demonstrated strong age-related differences in performance on each VRFCAT outcome measure, including total completion time, total errors, and total forced progressions. VRFCAT performance showed strong correlations with cognitive performance across both age groups. VRFCAT Total Time demonstrated good test-retest reliability (ICC=.80 in young adults; ICC=.64 in older adults) and insignificant practice effects, indicating the measure is suitable for repeated testing in healthy populations. Taken together, these results provide preliminary support for the VRFCAT as a potential measure of functionally relevant change in primary prevention and preclinical AD/MCI trials. PMID:26618145

Improved operative efficiency using a real-time MRI-guided stereotactic platform for laser amygdalohippocampotomy.

PubMed

Ho, Allen L; Sussman, Eric S; Pendharkar, Arjun V; Le, Scheherazade; Mantovani, Alessandra; Keebaugh, Alaine C; Drover, David R; Grant, Gerald A; Wintermark, Max; Halpern, Casey H

2018-04-01

OBJECTIVE MR-guided laser interstitial thermal therapy (MRgLITT) is a minimally invasive method for thermal destruction of benign or malignant tissue that has been used for selective amygdalohippocampal ablation for the treatment of temporal lobe epilepsy. The authors report their initial experience adopting a real-time MRI-guided stereotactic platform that allows for completion of the entire procedure in the MRI suite. METHODS Between October 2014 and May 2016, 17 patients with mesial temporal sclerosis were selected by a multidisciplinary epilepsy board to undergo a selective amygdalohippocampal ablation for temporal lobe epilepsy using MRgLITT. The first 9 patients underwent standard laser ablation in 2 phases (operating room [OR] and MRI suite), whereas the next 8 patients underwent laser ablation entirely in the MRI suite with the ClearPoint platform. A checklist specific to the real-time MRI-guided laser amydalohippocampal ablation was developed and used for each case. For both cohorts, clinical and operative information, including average case times and accuracy data, was collected and analyzed. RESULTS There was a learning curve associated with using this real-time MRI-guided system. However, operative times decreased in a linear fashion, as did total anesthesia time. In fact, the total mean patient procedure time was less in the MRI cohort (362.8 ± 86.6 minutes) than in the OR cohort (456.9 ± 80.7 minutes). The mean anesthesia time was significantly shorter in the MRI cohort (327.2 ± 79.9 minutes) than in the OR cohort (435.8 ± 78.4 minutes, p = 0.02). CONCLUSIONS The real-time MRI platform for MRgLITT can be adopted in an expedient manner. Completion of MRgLITT entirely in the MRI suite may lead to significant advantages in procedural times.

Improvements in Obstacle Clearance Parameters and Reaction Time Over a Series of Obstacles Revealed After Five Repeated Testing Sessions in Older Adults.

PubMed

Jehu, Deborah A; Lajoie, Yves; Paquet, Nicole

2017-12-21

The purpose of this study was to investigate obstacle clearance and reaction time parameters when crossing a series of six obstacles in older adults. A second aim was to examine the repeated exposure of this testing protocol once per week for 5 weeks. In total, 10 older adults (five females; age: 67.0 ± 6.9 years) walked onto and over six obstacles of varying heights (range: 100-200 mm) while completing no reaction time, simple reaction time, and choice reaction time tasks once per week for 5 weeks. The highest obstacles elicited the lowest toe clearance, and the first three obstacles revealed smaller heel clearance compared with the last three obstacles. Dual tasking negatively impacted obstacle clearance parameters when information processing demands were high. Longer and less consistent time to completion was observed in Session 1 compared with Sessions 2-5. Finally, improvements in simple reaction time were displayed after Session 2, but choice reaction time gradually improved and did not reach a plateau after repeated testing.

Sedentary and active: self-reported sitting time among marathon and half-marathon participants.

PubMed

Whitfield, Geoffrey; Pettee Gabriel, Kelley K; Kohl, Harold William

2014-01-01

Emerging evidence suggests that combined physical activity (PA) and inactivity may be more important for chronic disease risk than PA alone. A highly active yet highly sedentary population is needed to study this interaction. The present purpose is to describe the sitting habits of a group of recreational runners and determine if sitting varies with reported training duration or anticipated running velocity. Marathon and half-marathon participants completed the Multicontext Sitting Time Questionnaire and reported peak training duration, anticipated finishing time, and demographic information. Sitting time was described across 5 contexts for workdays and nonworkdays. Total sitting time was analyzed by tertiles of training duration and anticipated event running velocity. 218 participants took part in this study. Median reported training time was 6.5 hours per week. Median total sitting time was higher on workdays than nonworkdays (645 and 480 minutes, respectively, P < .0001). Total sitting time was not associated with training duration or anticipated event running velocity. These results suggest that recreational distance runners are simultaneously highly sedentary and highly active, supporting independence of sedentary behaviors and moderate- to vigorous-intensity PA. This population may provide the characteristics needed to study the joint effects of active and sedentary behaviors on health outcomes.

The variability in Oxford hip and knee scores in the preoperative period: is there an ideal time to score?

PubMed

Quah, C; Holmes, D; Khan, T; Cockshott, S; Lewis, J; Stephen, A

2018-01-01

Background All NHS-funded providers are required to collect and report patient-reported outcome measures for hip and knee arthroplasty. Although there are established guidelines for timing such measures following arthroplasty, there are no specific time-points for collection in the preoperative period. The primary aim of this study was to identify whether there was a significant amount of variability in the Oxford hip and knee scores prior to surgical intervention when completed in the outpatient clinic at the time of listing for arthroplasty or when completed at the preoperative assessment clinic. Methods A prospective cohort study of patients listed for primary hip or knee arthroplasty was conducted. Patients were asked to fill in a preoperative Oxford score in the outpatient clinic at the time of listing. They were then invited to fill in the official outcome measures questionnaire at the preoperative assessment clinic. The postoperative Oxford score was then completed when the patient was seen again at their postoperative follow up in clinic. Results Of the total of 109 patients included in this study period, there were 18 (17%) who had a worse score of 4 or more points difference and 43 (39.4%) who had an improvement of 4 or more points difference when the scores were compared between time of listing at the outpatient and at the preoperative assessment clinic. There was a statistically significant difference (P = 0.0054) in the mean Oxford scores. Conclusions The results of our study suggest that there should be standardisation of timing for completing the preoperative patient-reported outcome measures.

Video capsule endoscopy after bariatric and gastric surgery: oral ingestion is associated with satisfactory completion rate.

PubMed

Stanich, Peter P; Kleinman, Bryan; Porter, Kyle M; Meyer, Marty M

2015-01-01

To investigate the outcomes of video capsule endoscopy (VCE) performed on patients after bariatric and gastric surgery with a focus on delivery method (oral ingestion or endoscopic placement). There is minimal published data regarding the use of VCE in patients after bariatric and gastric surgery and the optimal delivery method is unknown. Retrospective case series of patients with bariatric or gastric surgery undergoing VCE in a tertiary care center over 3 years. Outcomes of interest were completion of the procedure and bowel transit times. Twenty-three patients met study criteria. They underwent 24 VCE in the study period, with 13/16 (81.3%; 95% CI, 54%-96%) completed to the colon after oral ingestion and 5/8 (62.5%; 95% CI, 24%-91%) completed after endoscopic deployment. The median gastric transit time after oral ingestion was <1 minute (IQR, <1 to 99). Median total transit time after oral ingestion was 291 minutes (IQR, 213 to 434) and after endoscopic deployment was 364 minutes (IQR, 233 to >440) (P=0.48). There were no instances of capsule retention. Oral ingestion of VCE resulted in a satisfactory completion rate with rapid gastric transit after bariatric and gastric surgery. There were no capsule retention events. Given this and the favorable risk and cost profile, oral ingestion should be favored over endoscopic placement in this patient population.

Maximum bite force in elderly indigenous and non-indigenous denture wearers.

PubMed

Borie, Eduardo; Orsi, Iara A; Fuentes, Ramón; Beltrán, Víctor; Navarro, Pablo; Pareja, Felipe; Raimundo, Lariça B

2014-01-01

The aim of this study was to compare the measures of maximum bite force (MBF) in elderly edentulous indigenous (Mapuche) and non-indigenous individuals with new complete dentures at two different measuring times. A sample of 100 elderly subjects was divided into two groups: 50 indigenous and 50 non-indigenous, each including 25 females and 25 males. All individuals were totally edentulous, with new maxillary and mandibular removable complete dentures. Measurements were taken at the time of new prosthesis placement and after 1 month of use. Subjects were asked to perform with maximum effort three bites per side at maximum intercuspidation, with a rest time of 2 minutes in between. Statistics were analyzed with Student 's t-test. The MBF values were significantly higher in indigenous than non-indigenous subjects. Force after 1 month of wearing the new prosthesis was significantly higher than at the time of new prosthesis placement. No significant difference was found between sides. Elderly indigenous complete denture wearers had the greatest MBF values. Denture wearers were observed to undergo an adaptation process to the new prosthesis, with MBF increasing considerably after one month of use.

Assessment of Undiscovered Oil and Gas Resources of the Uinta-Piceance Province of Colorado and Utah, 2002

USGS Publications Warehouse

,

2002-01-01

The U.S. Geological Survey (USGS) recently completed an assessment of the undiscovered oil and gas potential of the UintaPiceance Province of northwestern Colorado and northeastern Utah (fig. 1). The assessment of the Uinta-Piceance Province is geology based and uses the Total Petroleum System concept. The geologic elements of Total Petroleum Systems include hydrocarbon source rocks (source rock maturation, hydrocarbon generation and migration), reservoir rocks (sequence stratigraphy, petrophysical properties), and hydrocarbon traps (trap formation and timing). Using this geologic framework, the USGS defined five Total Petroleum Systems and 20 Assessment Units within these Total Petroleum Systems, and quantitatively estimated the undiscovered oil and gas resources within each Assessment Unit (table 1).

Determinants of complete resection of thymoma by minimally invasive and open thymectomy: analysis of an international registry

PubMed Central

Burt, Bryan M.; Yao, Xiaopan; Shrager, Joseph; Antonicelli, Alberto; Padda, Sukhmani; Reiss, Jonathan; Wakelee, Heather; Su, Stacey; Huang, James; Scott, Walter

2017-01-01

INTRODUCTION Minimally invasive thymectomy (MIT) is a surgical approach to thymectomy that has more favorable short-term outcomes than open thymectomy (OT) for myasthenia gravis. When performed for thymoma, the oncologic outcomes of MIT have not been rigorously evaluated. We analyzed determinants of complete (R0) resection among patients undergoing MIT and open thymectomy in a large international database. METHODS The retrospective database of the International Thymic Malignancy Interest Group (ITMIG) was queried. Chi-Square and Wilcoxon rank-sum tests, multivariate logistic regression models, and propensity matching were performed. RESULTS A total of 2514 patients underwent thymectomy for thymoma between 1997 and 2012. 2053 (82%) patients underwent OT, 461 (18%) patients underwent MIT, and the use of MIT increased significantly in recent years. The rate of R0 resection among patients undergoing OT was 86%, and among those undergoing MIT was 94%, respectively (p<0.0001). In propensity matched MIT and OT groups (n=266 each group), however, the rate of R0 resection did not differ significantly (MIT 96%, OT 96%, p=0.7). Multivariate analyses were performed to identify determinants of complete resection. Factors independently associated with R0 resection were geographical region, later time period, less advanced Masaoka stage, total thymectomy, and the absence of radiotherapy. Surgical approach, whether minimally invasive or open, was not associated with completeness of resection. CONCLUSIONS The use of MIT for resection of thymoma is increasing substantially over time, and MIT can achieve similar rates of R0 resection for thymoma as OT. PMID:27566187

Effect of complete and partial removable dentures on chewing movements.

PubMed

Gonçalves, T M S V; Vilanova, L S R; Gonçalves, L M; Rodrigues Garcia, R C M

2014-03-01

Partial or complete edentulism impairs mastication. However, it is unclear how the chewing cycle is affected by prosthetics. We evaluated the chewing movements of patients fitted with complete (CD) or removable partial denture (RPD). A total of 29 subjects were kinesiographically evaluated during chewing of peanuts and Optocal portions in a random sequence. The subjects were divided into two groups according to prosthesis type. Group RPD was composed of 14 partially edentulous patients using a lower distal extension RPD (mean age 61 ± 8 years), and group CD contained 15 completely edentulous patients using CD (mean age 65·9 ± 7·9 years) in both jaws. Opening, closing, occlusal and masticatory cycle times, movement angle (opening and closing), maximum velocity (opening and closing), total area and chewing cycle amplitudes were evaluated. The results were subjected to anova and Tukey's HSD test at a significance level of 5%. The RPD group exhibited shorter opening and closing phases and masticatory cycle time (P < 0·05). Maximum velocities were also higher in the RPD group, irrespective of the test material (P < 0·05). The area and amplitude of the chewing envelope was smaller in the CD group (P < 0·0001). The test material did not influence chewing cycles in any of the parameters evaluated (P > 0·05). RPD wearers use a faster chewing sequence with greater vertical and lateral jaw excursions compared with CD wearers. © 2013 John Wiley & Sons Ltd.

Determinants of Time to Fatigue during Non-Motorized Treadmill Exercise

NASA Technical Reports Server (NTRS)

DeWitt, John K.; Lee, M. C.; Wilson, Cassie A.; Hagan, R. Donald

2007-01-01

Treadmill exercise is commonly used for aerobic and anaerobic conditioning. During non-motorized treadmill exercise, the subject must provide the power necessary to drive the treadmill belt. The purpose of this study was to determine what factors affected the time to fatigue on a pair of non-motorized treadmills. Twenty subjects (10 males/10 females) attempted to complete five minutes of locomotion during separate trials at 3.22, 4.83, 6.44, 8.05, 9.66, and 11.27 km (raised dot) h(sup -1). Total exercise time (less than or equal to 5 min) was recorded. Exercise time was converted to the amount of 15 second intervals completed. Peak oxygen uptake (VO2) was measured using a graded exercise test on a standard treadmill, and anthropometric measures were collected from each subject before entering into the study. A Cox proportional hazards regression model was used to determine significant predictive factors in a multivariate analysis. Non-motorized treadmill speed and absolute peak VO2 were found to be significant predictors of exercise time, but there was no effect of anthropometric characteristics. Gender was found to be a predictor of treadmill time, but this was likely due to a higher peak VO2 in males than in females. These results were not affected by the type of treadmill tested in this study. Coaches and therapists should consider the cardiovascular fitness of an athlete or client when prescribing target speed since these factors are related to the total exercise time than can be achieved on a non-motorized treadmill.

Speech Privacy Problems

DTIC Science & Technology

1945-08-18

were interconnected, how? ever,, it was found that one of the oscillators had an intermit - tent, defect-. This trouble was cleared by removing the...switches> i.e., two pairsL are included in.the unit," one of ä pair of selectors {the " fast selector") steps .each time the latch operates, the other (the...34slow seleotor") steps oiice eaoh time the fast seleotor completes 25 steps. Thus, a total of 625 steps, or changes in permutation, is involved be

Health related quality of life is differently associated with leisure-time physical activity intensities according to gender: a cross-sectional approach.

PubMed

Nakamura, Priscila Missaki; Teixeira, Inaian Pignatti; Smirmaul, Bruno Paula Caraça; Sebastião, Emerson; Papini, Camila Bosquiero; Gobbi, Sebastião; Kokubun, Eduardo

2014-08-18

Several studies have demonstrated a positive association between physical activity (PA) and health-related quality of life (HRQL). However, studies have suggested that this association depends both on the PA intensity and the domain of HRQL evaluated. This study aimed to explore the association between physical, mental and overall HRQL with recommended levels of PA. PA levels were divided into moderate and vigorous intensity leisure-time PA and total leisure-time PA. The study included 1001 adults, 582 women (46 ± 17 years) and 419 men (43 ± 16 years), residents in Rio Claro-SP, Brazil. All participants completed the SF-36 questionnaire to assess HRQL and the long version of the International Physical Activity Questionnaire (IPAQ) to assess level and intensities of leisure-time PA. Total leisure-time PA at moderate intensity was classified as: less than 9 min/week, 10-149 min/week, 150-299 min/week and 300 min/week or more. Total leisure-time PA at vigorous intensity was classified as: less than 9 min/week, 10 to 74.9 min/week, 75-149 min/week and 150 min/week or more. Multiple linear regression was performed in STATA version 12.0. Among women, moderate intensity and total leisure-time PA were associated with physical health. Among men, moderate and vigorous intensity and total leisure-time PA were associated with physical health and overall HRQL. Furthermore, moderate intensity and total leisure-time PA were associated with mental health in men. However, vigorous intensity PA was not associated with mental health for this group. The different domains of HRQL were associated with different levels and intensities of PA in leisure-time according to gender of adults. These findings indicate the complexity and importance of evaluating the HRQL stratified by gender and consider the different levels and intensities of PA.

Complete Numerical Solution of the Diffusion Equation of Random Genetic Drift

PubMed Central

Zhao, Lei; Yue, Xingye; Waxman, David

2013-01-01

A numerical method is presented to solve the diffusion equation for the random genetic drift that occurs at a single unlinked locus with two alleles. The method was designed to conserve probability, and the resulting numerical solution represents a probability distribution whose total probability is unity. We describe solutions of the diffusion equation whose total probability is unity as complete. Thus the numerical method introduced in this work produces complete solutions, and such solutions have the property that whenever fixation and loss can occur, they are automatically included within the solution. This feature demonstrates that the diffusion approximation can describe not only internal allele frequencies, but also the boundary frequencies zero and one. The numerical approach presented here constitutes a single inclusive framework from which to perform calculations for random genetic drift. It has a straightforward implementation, allowing it to be applied to a wide variety of problems, including those with time-dependent parameters, such as changing population sizes. As tests and illustrations of the numerical method, it is used to determine: (i) the probability density and time-dependent probability of fixation for a neutral locus in a population of constant size; (ii) the probability of fixation in the presence of selection; and (iii) the probability of fixation in the presence of selection and demographic change, the latter in the form of a changing population size. PMID:23749318

Feasibility of a novel low-volume and sodium phosphate-free bowel preparation regimen for colon capsule endoscopy.

PubMed

Zhou, Jieqiong; Tang, Xiaowei; Wang, Jing; Chen, Zhenyu; Wang, Xinying; Jiang, Bo

2017-08-01

Bowel preparation regimens for colon capsule endoscopy are not yet standardized since they are not well optimized. The aim of the present study was to evaluate the feasibility of a novel low-volume and sodium phosphate-free bowel preparation regimen for colon capsule endoscopy. A total of 31 patients were prospectively enrolled. In the novel regimen, on the day prior to examination, a low-fiber diet was permitted, 5 mg mosapride citrate was administered twice (1 h prior to lunch and supper) and 1 l polyethylene glycol was administered in the evening. On the day of the examination, an additional 1 l polyethylene glycol, 5 mg mosapride citrate and 200 mg simethicone were administered before capsule ingestion. Polyethylene glycol booster (0.5 l) was administered twice, at 1 and 4 h following capsule ingestion. Colon cleansing levels, ileocecal valve transit time and completion rate were evaluated. A total of 29 patients were included in the final analysis, 90% of whom achieved adequate preparation of the overall colon. Ileocecal valve transit time was 2.35±0.82 h and completion rate was 79.3%. The results revealed that the novel low-volume and sodium phosphate-free bowel preparation regimen for colon capsule endoscopy was feasible, with adequate colon cleansing and completion rates, and has the potential to be used as an alternative regimen.

Compliance With Neuromuscular Training and Anterior Cruciate Ligament Injury Risk Reduction in Female Athletes: A Meta-Analysis

PubMed Central

Sugimoto, Dai; Myer, Gregory D.; Bush, Heather M.; Klugman, Maddie F.; McKeon, Jennifer M. Medina; Hewett, Timothy E.

2012-01-01

Context No consensus exists about the influence of compliance with neuromuscular training programs on reduction of the risk of anterior cruciate ligament (ACL) injury. Objective To systematically review and synthesize the published literature to determine if compliance with neuromuscular training is associated with reduced incidence of ACL injury in young female athletes. Data Sources We searched PubMed, SPORTDiscus, CINAHL, and MEDLINE for articles published from 1995 to 2010 using the key words anterior cruciate ligament prevention, ACL prevention, knee prevention, prospective knee prevention, neuromuscular training, and neuromuscular intervention. Study Selection Criteria for inclusion required that (1) the number of ACL injuries was reported, (2) a neuromuscular training program was used, (3) females were included as participants, (4) the study design was prospective and controlled, and (5) compliance data for the neuromuscular training program were provided. Data Extraction Extracted data included the number of ACL injuries, total number of participants per group, observation time period, number of participants who completed each session, number of sessions completed by an entire team, and number of total sessions. Attendance was calculated as the number of participants who completed each session converted into a percentage of the total number of participants. Intervention completion was calculated as the number of sessions completed by an entire team converted into a percentage of the total number of training sessions. These data were used to calculate an overall rate of compliance. Data Synthesis Six of 205 identified studies were included. Incidence rates of ACL injury were lower in studies with high rates of compliance with neuromuscular training than in studies with low compliance rates (incidence rate ratio = 0.27 [95% confidence interval = 0.07, 0.80]). Tertile analysis indicated rates of ACL injury incidence were lower in studies with high compliance rates than in studies with moderate and low compliance rates (incidence rate ratio = 0.18 [95% confidence interval = 0.02, 0.77]). Conclusions A potential inverse dose-response relationship exists between compliance with neuromuscular training and incidence of ACL injury. Attending and completing recommended neuromuscular sessions appears to be an important factor for preventing ACL injuries. PMID:23182020

Butorphanol, azaperone, and medetomidine anesthesia in free-ranging white-tailed deer (Odocoileus virginianus) using radiotransmitter darts.

PubMed

Siegal-Willott, Jessica; Citino, Scott B; Wade, Scotty; Elder, Laura; Hayek, Lee-Ann C; Lance, William R

2009-04-01

Fourteen free-ranging white-tailed deer (Odocoileus virginianus) were successfully anesthetized for a total of 15 anesthetic events using a combination of butorphanol (mean+/-SD, 0.58+/-0.1 mg/kg), azaperone (0.37+/-0.06 mg/kg), and medetomidine (0.19+/-0.03 mg/kg) (BAM) administered by radiotelemetry darts from hunting blinds between November 2006 and May 2007. Mean time to locate deer (mean+/-SD, 17. 3+/-7 min), to recumbency (21.4+/-5 min), to initiation of data acquisition (27.5+/-8 min), total down time (37+/-6 min), and average distance run (161+/-82 m) were recorded. Physiologic monitoring was done every 5 min for a total of 20 min. Arterial blood gases were collected every 10 min. Mild to moderate hypoxemia and mildly depressed ventilation occurred in some animals. Muscle relaxation and plane of anesthesia were adequate for completion of all procedures; two deer were administered intravenous butorphanol supplementation to achieve light anesthesia (mean+/-SD, 0.19 mg/kg; 0.12 mg/kg). Recovery following intramuscular administration of naltrexone (1.34+/-0.42 mg/kg; 2x butorphanol dose) and atipamezole (0.93+/-0.14 mg/kg; 5x medetomidine dose) was rapid, smooth, and complete. Mean+/-SD recovery time was 4.5+/-1.5 min. Overall efficacy of the Pneu-Dart radiotelemetry system was 65%. Negative attributes of this protocol included long induction time and dart failure. No known mortalities occurred as a result of the study. This drug combination provided safe, reliable, short-term anesthesia of free-ranging white-tailed deer. Further evaluation for use in field procedures in other cervids is warranted.

Relationship between the Handball-Specific Complex-Test and Intermittent Field Test performance in professional players.

PubMed

Hermassi, Souhail; Hoffmeyer, Birgit; Irlenbusch, Lars; Fieseler, Georg; Noack, Frank; Delank, Karl-Stefan; Gabbett, Tim J; Souhaiel Chelly, Mohamed; Schwesig, René

2018-01-01

We investigated the relationship between the Handball Complex-Test (HBCT) and two selected field performance tests (the repeated sprint ability [RSA], and the Yo-Yo Intermittent Recovery Test) in elite handball players. Nineteen handball players (age: 25.7±5.1 years) were drawn from the First Professional German League. The HBCT consists of four activity series (AS): agility parcours, defensive action, sprint (10 m, 20 m) and throw-on-goal parcours; these activities were completed twice, with five active pauses of 30-35 s, and a follow-up of recovery over the subsequent 10 minutes. The RSA comprised 6 x (15+15 m) sprints starting every 20 s; scoring noted best time (RSAbest), total time (RSATT) and decrement (RSAdec). In the Yo-Yo Intermittent Recover, we recorded the total distance covered (TD). Heart rates (HR) were recorded throughout and recovery was assessed for measurements immediately post-test (R0) and 10 minutes after completing the test (R10). A strong correlation was found between HBCT and fastest 10 m and 20 m RSA sprint times (r=0.811, r=0.815, respectively). Also, the HBCT total 10 m and 20 m sprint times showed a strong positive association with RSATT (r=0.70; r=0.63, respectively), and the RSA heart rate post-test was strongly correlated with the HBCT heart rate after round two (r=0.865). Data from the match-specific HBCT Test shows a strong positive association with other more generic intermittent field test measurements. These observations support the validity of using the generic tests to monitor current fitness and responses to training in team handball players.

The 1987 Airborne Antarctic Ozone Experiment: the Nimbus-7 TOMS Data Atlas

NASA Technical Reports Server (NTRS)

Krueger, Arlin J.; Ardanuy, Philip E.; Sechrist, Frank S.; Penn, Lanning M.; Larko, David E.; Doiron, Scott D.; Galimore, Reginald N.

1988-01-01

Total ozone data taken by the Nimbus-7 Total Ozone Mapping Spectrometer (TOMS) played a central role in the successful outcome of the 1987 Airborne Antarctic Ozone Experiment. The near-real-time TOMS total ozone observations were suppled within hours of real time to the operations center in Punta Arenas, Chile, over a telecommunications network designed specifically for this purpose. The TOMS data preparation and method of transfer over the telecommunications links are reviewed. This atlas includes a complete set of the near-real-time TOMS orbital overpass data over regions around the Palmer Peninsula of Antarctica for the period of August 8 through September 29, 1987. Also provided are daily polar orthographic projections of TOMS total ozone measurements over the Southern Hemisphere from August through November 1987. In addition, a chronology of the salient points of the experiment, along with some latitudinal cross sections and time series at locations of interest of the TOMS total ozone observations are presented. The TOMS total ozone measurements are evaluated along the flight tracks of each of the ER-2 and DC-8 missions during the experiment. The ozone hole is shown here to develop in a monotonic progression throughout late August and September. The minimum total ozone amount was found on 5 October, when its all-time lowest value of 109 DU is recorded. The hole remains well defined, but fills gradually from mid-October through mid-November. The hole's dissolution is observed here to begin in mid-November, when it elongates and begins to rotate. By the end of November, the south pole is no longer located within the ozone hole.

Communication: Electron ionization of DNA bases

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

Rahman, M. A.; Krishnakumar, E., E-mail: ekkumar@tifr.res.in

2016-04-28

No reliable experimental data exist for the partial and total electron ionization cross sections for DNA bases, which are very crucial for modeling radiation damage in genetic material of living cell. We have measured a complete set of absolute partial electron ionization cross sections up to 500 eV for DNA bases for the first time by using the relative flow technique. These partial cross sections are summed to obtain total ion cross sections for all the four bases and are compared with the existing theoretical calculations and the only set of measured absolute cross sections. Our measurements clearly resolve themore » existing discrepancy between the theoretical and experimental results, thereby providing for the first time reliable numbers for partial and total ion cross sections for these molecules. The results on fragmentation analysis of adenine supports the theory of its formation in space.« less

Low-thrust chemical orbit to orbit propulsion system propellant management study

NASA Technical Reports Server (NTRS)

Dergance, R. H.

1980-01-01

Propellant requirements, tankage configurations, preferred propellant management techniques, propulsion systems weights, and technology deficiencies for low thrust expendable propulsion systems are examined. A computer program was utilized which provided a complete propellant inventory (including boil-off for cryogenic cases), pressurant and propellant tank dimensions for a given ullage, pressurant requirements, insulation requirements, and miscellaneous masses. The output also includes the masses of all tanks; the mass of the insulation, engines and other components; total wet system and burnout mass; system mass fraction; total impulse and burn time.

A system for the real time, direct measurement of natural gas flow

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

Sowell, T.

1995-12-31

PMI/Badger Meter, Inc. with partial sponsorship from the Gas Research Institute, has designed and developed direct measurement total energy flow metering instrumentation. As industry demands for improved accuracy and speed of measurement have increased so has the complexity of the overall hardware and software systems. Considering traditional system approaches, few companies have the in house capability of maintaining a complete system. This paper addresses efforts to implement a direct, total gas energy flow metering system which is simple to use and cost effective.

Total dissolved gas and water temperature in the lower Columbia River, Oregon and Washington, water year 2010: Quality-assurance data and comparison to water-quality standards

USGS Publications Warehouse

Tanner, Dwight Q.; Bragg, Heather M.; Johnston, Matthew W.

2011-01-01

For the eight monitoring stations in water year 2010, a total of 99.7 percent of the TDG data were received in real time and were within 1-percent saturation of the expected value on the basis of calibration data, replicate quality-control measurements in the river, and comparison to ambient river conditions at adjacent stations. Data received from the individual stations ranged from 98.4 to 100.0 percent complete.

Rover Takes a Sunday Drive

NASA Technical Reports Server (NTRS)

2004-01-01

This animation, made with images from the Mars Exploration Rover Spirit hazard-identification camera, shows the rover's perspective of its first post-egress drive on Mars Sunday. Engineers drove Spirit approximately 3 meters (10 feet) toward its first rock target, a football-sized, mountain-shaped rock called Adirondack. The drive took approximately 30 minutes to complete, including time stopped to take images. Spirit first made a series of arcing turns totaling approximately 1 meter (3 feet). It then turned in place and made a series of short, straightforward movements totaling approximately 2 meters (6.5 feet).

Total dissolved gas and water temperature in the lower Columbia River, Oregon and Washington, water year 2009: Quality-assurance data and comparison to water-quality standards

USGS Publications Warehouse

Tanner, Dwight Q.; Bragg, Heather M.; and Johnston, Matthew W.

2010-01-01

For the eight monitoring stations in water year 2009, a total of 99.2 percent of the TDG data were received in real time by the USGS satellite downlink and were within 1-percent saturation of the expected value on the basis of calibration data, replicate quality-control measurements in the river, and comparison to ambient river conditions at adjacent sites. Data received from the individual stations ranged from 97.0 to 100.0 percent complete.

Total dissolved gas and water temperature in the lower Columbia River, Oregon and Washington, 2007: Quality-assurance data and comparison to water-quality standards

USGS Publications Warehouse

Tanner, Dwight Q.; Bragg, Heather M.; Johnston, Matthew W.

2007-01-01

For the eight monitoring sites in water year 2007, an average of 99.5% of the total-dissolved-gas data were received in real time by the USGS satellite downlink and were within 1% saturation of the expected value on the basis of calibration data, replicate quality-control measurements in the river, and comparison to ambient river conditions at adjacent sites. Data received from the sites ranged from 97.9% to 100.0% complete.

Dry eye disease and work productivity loss in visual display users: the Osaka study.

PubMed

Uchino, Miki; Uchino, Yuichi; Dogru, Murat; Kawashima, Motoko; Yokoi, Norihiko; Komuro, Aoi; Sonomura, Yukiko; Kato, Hiroaki; Kinoshita, Shigeru; Schaumberg, Debra A; Tsubota, Kazuo

2014-02-01

To estimate the impact of dry eye disease (DED) on work performance and productivity in office workers using visual display terminals (VDTs). Cross-sectional study. Six hundred seventy-two Japanese young and middle-aged office workers using VDTs completed a questionnaire that was designed to measured at-work performance deficits and productivity losses using the Japanese version of the Work Limitations Questionnaire, completed by e-mail. Using the Japanese dry eye diagnostic criteria, respondents were classified into 3 groups: definite DED, probable DED, and non DED. Of the 672 office workers, 553 subjects (82.3%), including 366 men and 187 women, completed the questionnaire and underwent clinical evaluation. As for the total workplace productivity loss, the non DED group demonstrated a loss of 3.56%, those with probable DED demonstrated a loss of 4.06%, and those with definite DED demonstrated a loss of 4.82%, indicating significantly worse performance and productivity (P = .014, trend test). For the 4 subscales, DED was associated with significantly lower on-the-job time management (P = .009, trend test) and combined mental performance and interpersonal functioning (P = .011, trend test). After controlling for age, sex, VDT working hours, and diagnosis of DED, time management, physical demands, and mental and interpersonal functioning showed a significant relationship to DED (each P > .05). Annual DED productivity losses were estimated to be $6160 per employee when measured by total production and $1178 per employee calculated by wage. This study indicated that there is a significant impact of DED on the total productivity of Japanese VDT users. Copyright © 2014 Elsevier Inc. All rights reserved.

Assessing the impact of typeface design in a text-rich automotive user interface.

PubMed

Reimer, Bryan; Mehler, Bruce; Dobres, Jonathan; Coughlin, Joseph F; Matteson, Steve; Gould, David; Chahine, Nadine; Levantovsky, Vladimir

2014-01-01

Text-rich driver-vehicle interfaces are increasingly common in new vehicles, yet the effects of different typeface characteristics on task performance in this brief off-road based glance context remains sparsely examined. Subjects completed menu selection tasks while in a driving simulator. Menu text was set either in a 'humanist' or 'square grotesque' typeface. Among men, use of the humanist typeface resulted in a 10.6% reduction in total glance time as compared to the square grotesque typeface. Total response time and number of glances showed similar reductions. The impact of typeface was either more modest or not apparent for women. Error rates for both males and females were 3.1% lower for the humanist typeface. This research suggests that optimised typefaces may mitigate some interface demands. Future work will need to assess whether other typeface characteristics can be optimised to further reduce demand, improve legibility, increase usability and help meet new governmental distraction guidelines. Practitioner Summary: Text-rich in-vehicle interfaces are increasingly common, but the effects of typeface on task performance remain sparsely studied. We show that among male drivers, menu selection tasks are completed with 10.6% less visual glance time when text is displayed in a 'humanist' typeface, as compared to a 'square grotesque'.

Assessing the impact of typeface design in a text-rich automotive user interface

PubMed Central

Reimer, Bryan; Mehler, Bruce; Dobres, Jonathan; Coughlin, Joseph F.; Matteson, Steve; Gould, David; Chahine, Nadine; Levantovsky, Vladimir

2014-01-01

Text-rich driver–vehicle interfaces are increasingly common in new vehicles, yet the effects of different typeface characteristics on task performance in this brief off-road based glance context remains sparsely examined. Subjects completed menu selection tasks while in a driving simulator. Menu text was set either in a ‘humanist’ or ‘square grotesque’ typeface. Among men, use of the humanist typeface resulted in a 10.6% reduction in total glance time as compared to the square grotesque typeface. Total response time and number of glances showed similar reductions. The impact of typeface was either more modest or not apparent for women. Error rates for both males and females were 3.1% lower for the humanist typeface. This research suggests that optimised typefaces may mitigate some interface demands. Future work will need to assess whether other typeface characteristics can be optimised to further reduce demand, improve legibility, increase usability and help meet new governmental distraction guidelines. Practitioner Summary: Text-rich in-vehicle interfaces are increasingly common, but the effects of typeface on task performance remain sparsely studied. We show that among male drivers, menu selection tasks are completed with 10.6% less visual glance time when text is displayed in a ‘humanist’ typeface, as compared to a ‘square grotesque’. PMID:25075429

Small Steps: Preliminary effectiveness and feasibility of an incremental goal-setting intervention to reduce sitting time in older adults.

PubMed

Lewis, L K; Rowlands, A V; Gardiner, P A; Standage, M; English, C; Olds, T

2016-03-01

This study aimed to evaluate the preliminary effectiveness and feasibility of a theory-informed program to reduce sitting time in older adults. Pre-experimental (pre-post) study. Thirty non-working adult (≥ 60 years) participants attended a one hour face-to-face intervention session and were guided through: a review of their sitting time; normative feedback on sitting time; and setting goals to reduce total sitting time and bouts of prolonged sitting. Participants chose six goals and integrated one per week incrementally for six weeks. Participants received weekly phone calls. Sitting time and bouts of prolonged sitting (≥ 30 min) were measured objectively for seven days (activPAL3c inclinometer) pre- and post-intervention. During these periods, a 24-h time recall instrument was administered by computer-assisted telephone interview. Participants completed a post-intervention project evaluation questionnaire. Paired t tests with sequential Bonferroni corrections and Cohen's d effect sizes were calculated for all outcomes. Twenty-seven participants completed the assessments (71.7 ± 6.5 years). Post-intervention, objectively-measured total sitting time was significantly reduced by 51.5 min per day (p=0.006; d=-0.58) and number of bouts of prolonged sitting by 0.8 per day (p=0.002; d=-0.70). Objectively-measured standing increased by 39 min per day (p=0.006; d=0.58). Participants self-reported spending 96 min less per day sitting (p<0.001; d=-0.77) and 32 min less per day watching television (p=0.005; d=-0.59). Participants were highly satisfied with the program. The 'Small Steps' program is a feasible and promising avenue for behavioral modification to reduce sitting time in older adults. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Effects of sleep timing, sleep quality and sleep duration on school achievement in adolescents.

PubMed

Tonetti, Lorenzo; Fabbri, Marco; Filardi, Marco; Martoni, Monica; Natale, Vincenzo

2015-08-01

The aim of this study was to examine the effects of sleep timing, quality and duration on school achievement in adolescents. Thirty-six Italian students (mean age: 18.14 ± 0.49 years) attending their last year of high school participated in the study. They completed the Morningness-Eveningness Questionnaire for Children and Adolescents (MEQ-CA). This was used to determine their ideal sleep timing by computing the total score, with higher scores corresponding to a greater tendency toward morningness. In addition, students underwent two non-consecutive weeks of actigraphy in one-month period to objectively assess: habitual sleep timing through the midpoint of sleep (MS); habitual sleep quality through the parameter of sleep efficiency (SE); and habitual sleep duration through the parameter of total sleep time (TST). Participants also completed the Mini Sleep Questionnaire, which allowed us to assess perceived sleep quality, at the end of each actigraphic-recording week. School performance was assessed using the grades obtained by students in their school leaving exams taken at the end of the school year. A significant positive correlation was observed between SE and exam grades, as well as MEQ-CA scores and grades. Multiple regression analysis showed that only SE was significantly and positively related to the final grade. Examining objective and ecological measures, SE (indicator of sleep quality) had the strongest effect on school achievement in adolescents. Copyright © 2015 Elsevier B.V. All rights reserved.

Remote magnetic navigation for circumferential pulmonary vein ablation: single-catheter technique or additional use of a circular mapping catheter?

PubMed

Vollmann, Dirk; Lüthje, Lars; Seegers, Joachim; Sohns, Christian; Sossalla, Samuel; Sohns, Jan; Röver, Christian; Hasenfuß, Gerd; Zabel, Markus

2014-10-01

Remote magnetic navigation (RMN) is utilized for catheter guidance during pulmonary vein ablation (PVA). We aimed to determine whether the additional use of a circular mapping catheter (CMC) influences efficacy and outcome of RMN-guided PVA. A total of 80 consecutive subjects (65 % male, age 62 ± 9 years) underwent circumferential PVA with a 3D mapping system and an RMN-guided irrigated catheter. Procedural endpoint was complete PV isolation (PVI), total radiofrequency (RF) time >60 min, or procedure duration >5 h. PVI was defined as an entrance and/or exit block, diagnosed with a CMC within the PV ostium or by pacing via the roving RMN-guided catheter (single-catheter technique). Prolonged Holter monitoring after 3 and 6 months was used to detect atrial tachyarrhythmia (AT/AF) recurrences. Complete PVI was achieved in 56 % (45/80) of all subjects (isolated PVs per patient, 3.1 ± 1.2; RF time, 56.3 ± 17.2 min; procedure duration, 3.8 ± 0.8 h). Prospective validation of the single-catheter technique for diagnosing PVI demonstrated high concordance (94 %) with blinded CMC results. CMC use in first-time PVA was associated with similar total RF and procedure times but higher PV isolation rate. Upon multivariate analysis, CMC use, female gender, left PV, smaller PV ostium and repeat PVA predicted PVI during RMN-guided ablation. Persistent AF and mitral regurgitation at baseline and the number of non-isolated PVs predicted AT/AF recurrence during follow-up. Concomitant CMC use for first-time, RMN-guided PVA is associated with similar procedure duration but higher PV isolation rates as compared to a single-catheter approach. Since the number of isolated PVs predicts freedom from AT/AF, CMC utilization appears advisable for first-time, RMN-guided PVA.

Effect of external PEEP in patients under controlled mechanical ventilation with an auto-PEEP of 5 cmH2O or higher.

PubMed

Natalini, Giuseppe; Tuzzo, Daniele; Rosano, Antonio; Testa, Marco; Grazioli, Michele; Pennestrì, Vincenzo; Amodeo, Guido; Berruto, Francesco; Fiorillo, Marialinda; Peratoner, Alberto; Tinnirello, Andrea; Filippini, Matteo; Marsilia, Paolo F; Minelli, Cosetta; Bernardini, Achille

2016-12-01

In some patients with auto-positive end-expiratory pressure (auto-PEEP), application of PEEP lower than auto-PEEP maintains a constant total PEEP, therefore reducing the inspiratory threshold load without detrimental cardiovascular or respiratory effects. We refer to these patients as "complete PEEP-absorbers." Conversely, adverse effects of PEEP application could occur in patients with auto-PEEP when the total PEEP rises as a consequence. From a pathophysiological perspective, all subjects with flow limitation are expected to be "complete PEEP-absorbers," whereas PEEP should increase total PEEP in all other patients. This study aimed to empirically assess the extent to which flow limitation alone explains a "complete PEEP-absorber" behavior (i.e., absence of further hyperinflation with PEEP), and to identify other factors associated with it. One hundred patients with auto-PEEP of at least 5 cmH2O at zero end-expiratory pressure (ZEEP) during controlled mechanical ventilation were enrolled. Total PEEP (i.e., end-expiratory plateau pressure) was measured both at ZEEP and after applied PEEP equal to 80 % of auto-PEEP measured at ZEEP. All measurements were repeated three times, and the average value was used for analysis. Forty-seven percent of the patients suffered from chronic pulmonary disease and 52 % from acute pulmonary disease; 61 % showed flow limitation at ZEEP, assessed by manual compression of the abdomen. The mean total PEEP was 7 ± 2 cmH2O at ZEEP and 9 ± 2 cmH2O after the application of PEEP (p < 0.001). Thirty-three percent of the patients were "complete PEEP-absorbers." Multiple logistic regression was used to predict the behavior of "complete PEEP-absorber." The best model included a respiratory rate lower than 20 breaths/min and the presence of flow limitation. The predictive ability of the model was excellent, with an overoptimism-corrected area under the receiver operating characteristics curve of 0.89 (95 % CI 0.80-0.97). Expiratory flow limitation was associated with both high and complete "PEEP-absorber" behavior, but setting a relatively high respiratory rate on the ventilator can prevent from observing complete "PEEP-absorption." Therefore, the effect of PEEP application in patients with auto-PEEP can be accurately predicted at the bedside by measuring the respiratory rate and observing the flow-volume loop during manual compression of the abdomen.

[Changes in index-F and index-delta 4P in normal pregnancy, labor and the puerperium].

PubMed

Kamada, T

1984-04-01

Index-F and index-delta 4P (cortisol and progesterone which are not bound to corticosteroid-binding globulin (CBG) in the umbilical cord vein and the maternal blood were determined during pregnancy, at delivery and puerperium. Index-F and index-delta 4P were calculated as the total cortisol or total progesterone X% unbound to CBG divided by 100. The level of index-F showed a gradual rise during pregnancy, and in late pregnancy reached about 1.5 times as high as that of non-pregnant women, whereas the total cortisol level was about 3.3 times. Near delivery, index-F was almost completely stable, but at delivery, it increased suddenly in proportion to the rise in the total cortisol level. This rise is probably due to stress. In the umbilical cord vein blood, the level of index-F was 1.5 times higher than that in the maternal plasma before delivery; however the total cortisol level was lower than that of the maternal plasma. The levels of both index-delta 4P and total progesterone showed a gradual increase during pregnancy in parallel, and each value in late pregnancy was about 4.5 to 4.9 times that of early pregnant women. At or near delivery, the level of index-delta 4P was almost stable and no decrease occurred. In the umbilical cord vein plasma, the levels of index-delta 4P and total progesterone were extremely high. However, the meaning of these results isn't clear.

Evaluation of Electronic Health Record Implementation in Ophthalmology at an Academic Medical Center (An American Ophthalmological Society Thesis)

PubMed Central

Chiang, Michael F.; Read-Brown, Sarah; Tu, Daniel C.; Choi, Dongseok; Sanders, David S.; Hwang, Thomas S.; Bailey, Steven; Karr, Daniel J.; Cottle, Elizabeth; Morrison, John C.; Wilson, David J.; Yackel, Thomas R.

2013-01-01

Purpose: To evaluate three measures related to electronic health record (EHR) implementation: clinical volume, time requirements, and nature of clinical documentation. Comparison is made to baseline paper documentation. Methods: An academic ophthalmology department implemented an EHR in 2006. A study population was defined of faculty providers who worked the 5 months before and after implementation. Clinical volumes, as well as time length for each patient encounter, were collected from the EHR reporting system. To directly compare time requirements, two faculty providers who utilized both paper and EHR systems completed time-motion logs to record the number of patients, clinic time, and nonclinic time to complete documentation. Faculty providers and databases were queried to identify patient records containing both paper and EHR notes, from which three cases were identified to illustrate representative documentation differences. Results: Twenty-three faculty providers completed 120,490 clinical encounters during a 3-year study period. Compared to baseline clinical volume from 3 months pre-implementation, the post-implementation volume was 88% in quarter 1, 93% in year 1, 97% in year 2, and 97% in year 3. Among all encounters, 75% were completed within 1.7 days after beginning documentation. The mean total time per patient was 6.8 minutes longer with EHR than paper (P<.01). EHR documentation involved greater reliance on textual interpretation of clinical findings, whereas paper notes used more graphical representations, and EHR notes were longer and included automatically generated text. Conclusion: This EHR implementation was associated with increased documentation time, little or no increase in clinical volume, and changes in the nature of ophthalmic documentation. PMID:24167326

Age Differences in Recall and Information Processing in Verbal and Spatial Learning.

ERIC Educational Resources Information Center

Mungas, Dan; And Others

1991-01-01

Three age groups of 24 people each completed verbal word list tasks and spatial learning tasks 5 times each. Significant age differences were found for total recall and type of task. Younger subjects showed increased levels of clustering--organizing information according to semantic or spatial clusters. Age was not related to temporal order of…

The Constant Error of the Halo in Educational Outcomes Research. AIR 1998 Annual Forum Paper.

ERIC Educational Resources Information Center

Pike, Gary R.

This study examined whether halo error--the masking of college gains by general gains in intellectual development--influenced students' ratings of their learning and development during college. A total of 1,084 first-time freshmen at the University of Missouri-Columbia (MU) completed the College Student Experiences Questionnaire (CSEQ) during the…

Learning Wellness: A Water Exercise Class in Zagreb, Croatia

ERIC Educational Resources Information Center

Roberson, Donald N., Jr.

2007-01-01

The research reported in this article investigated the dynamics of a water exercise class with older adults in Zagreb, Croatia. It focused on 3 classes of older swimmers at a community exercise center. A total of 105 participants were asked to complete a short questionnaire. The questionnaire contained items on demographics, use of free time, and…

Impact of Online Social Network on American College Students' Reading Practices

ERIC Educational Resources Information Center

Huang, SuHua; Capps, Matthew

2013-01-01

The purpose of this study was to investigate social networking sites (SNS) and ways college students spend their time on both conventional academic and recreational reading. A total of 1,265 (466 male and 799 female) college students voluntarily participated in the study by completing a self-report survey. Descriptive analysis indicated that the…

Self-Efficacy and Outcome Expectancy in Beginning Weight Training Class: Their Relations to Students' Behavioral Intention and Actual Behavior

ERIC Educational Resources Information Center

Gao, Zan; Xiang, Ping; Lee, Amelia M.; Harrison, Louis, Jr.

2008-01-01

This study was an initial attempt to investigate the relationships among self-efficacy, outcome expectancy, behavioral intention, and actual behavior over time in a beginning weight training class. A total of 109 participants completed questionnaires assessing their self-efficacy, outcome expectancy, and intentions for future weight training.…

Total VET Graduate Outcomes, 2016: Australian Vocational Education and Training Statistics

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2016

2016-01-01

This publication provides a summary of the outcomes of graduates who completed their vocational education and training (VET) in Australia during 2015 and were awarded a qualification. For the first time, the outcomes of all graduates are reported; that is, those in receipt of Commonwealth or state funding and those who paid for their training. The…

Beyond the Sticker Price: A Closer Look at Canadian University Tuition Fees

ERIC Educational Resources Information Center

Usher, Alex

2006-01-01

At some point every August, Statistics Canada releases its annual tuition fee report. Statistics Canada's numbers are accurate, so far as they go. The weighted provincial and national fee totals accurately reflect the amount of tuition charged by institution. And yet, the tuition report is at the same time a completely inadequate tool for…

A methodology for the evaluation of program cost and schedule risk for the SEASAT program

NASA Technical Reports Server (NTRS)

Abram, P.; Myers, D.

1976-01-01

An interactive computerized project management software package (RISKNET) is designed to analyze the effect of the risk involved in each specific activity on the results of the total SEASAT-A program. Both the time and the cost of each distinct activity can be modeled with an uncertainty interval so as to provide the project manager with not only the expected time and cost for the completion of the total program, but also with the expected range of costs corresponding to any desired level of significance. The nature of the SEASAT-A program is described. The capabilities of RISKNET and the implementation plan of a RISKNET analysis for the development of SEASAT-A are presented.

Development of a questionnaire to assess sedentary time in older persons – a comparative study using accelerometry

PubMed Central

2013-01-01

Background There is currently no validated questionnaire available to assess total sedentary time in older adults. Most studies only used TV viewing time as an indicator of sedentary time. The first aim of our study was to investigate the self-reported time spent by older persons on a set of sedentary activities, and to compare this with objective sedentary time measured by accelerometry. The second aim was to determine what set of self-reported sedentary activities should be used to validly rank people’s total sedentary time. Finally we tested the reliability of our newly developed questionnaire using the best performing set of sedentary activities. Methods The study sample included 83 men and women aged 65–92 y, a random sample of Longitudinal Aging Study Amsterdam participants, who completed a questionnaire including ten sedentary activities and wore an Actigraph GT3X accelerometer for 8 days. Spearman correlation coefficients were calculated to examine the association between self-reported time and objective sedentary time. The test-retest reliability was calculated using the intraclass correlation coefficient (ICC). Results Mean total self-reported sedentary time was 10.4 (SD 3.5) h/d and was not significantly different from mean total objective sedentary time (10.2 (1.2) h/d, p = 0.63). Total self-reported sedentary time on an average day (sum of ten activities) correlated moderately (Spearman’s r = 0.35, p < 0.01) with total objective sedentary time. The correlation improved when using the sum of six activities (r = 0.46, p < 0.01), and was much higher than when using TV watching only (r = 0.22, p = 0.05). The test-retest reliability of the sum of six sedentary activities was 0.71 (95% CI 0.57-0.81). Conclusions A questionnaire including six sedentary activities was moderately associated with accelerometry-derived sedentary time and can be used to reliably rank sedentary time in older persons. PMID:23899190

Lessons learned from the usability assessment of home-based telemedicine systems.

PubMed

Agnisarman, Sruthy Orozhiyathumana; Chalil Madathil, Kapil; Smith, Kevin; Ashok, Aparna; Welch, Brandon; McElligott, James T

2017-01-01

At-home telemedicine visits are quickly becoming an acceptable alternative for in-person patient visits. However, little work has been done to understand the usability of these home-based telemedicine solutions. It is critical for user acceptance and real-world applicability to evaluate available telemedicine solutions within the context-specific needs of the users of this technology. To address this need, this study evaluated the usability of four home-based telemedicine software platforms: Doxy.me, Vidyo, VSee, and Polycom. Using a within-subjects experimental design, twenty participants were asked to complete a telemedicine session involving several tasks using the four platforms. Upon completion of these tasks for each platform, participants completed the IBM computer system usability questionnaire (CSUQ) and the NASA Task Load Index test. Upon completing the tasks on all four platforms, the participants completed a final post-test subjective questionnaire ranking the platforms based on their preference. Of the twenty participants, 19 completed the study. Statistically significant differences among the telemedicine software platforms were found for task completion time, total workload, mental demand, effort, frustration, preference ranking and computer system usability scores. Usability problems with installation and account creation led to high mental demand and task completion time, suggesting the participants preferred a system without such requirements. Majority of the usability issues were identified at the telemedicine initiation phase. The findings from this study can be used by software developers to develop user-friendly telemedicine systems. Copyright © 2016 Elsevier Ltd. All rights reserved.

Distribution of mercury in the environment at Almaden, Spain

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

Hildebrand, S.G.; Huckabee, J.W.; Diaz, F.S.

1980-10-01

An ecological survey of the concentration and distribution of mercury in terrestrial and aquatic systems near the mercury mine at Almaden, Spain, was initiated in 1974. Field studies were completed in 1977, and chemical analyses were completed in 1979. Sample collection at Almaden followed a trophic-level approach in which certain compartments were sampled at a given instant in time (fall 1974, fall 1975, spring 1976, fall 1976, spring 1977). Mean total mercury concentration in terrestrial plants (8 taxa combined) ranged from >100 ..mu..g/g within 0.5 km of the mine to 1 ..mu..g/g 20 km distant from the mine. Different plantmore » species had different affinities for mercury, but moss species usually had higher total mercury concentration than vascular plants. Woody plants were lower in mercury concentration than forbs. Total mercury concentration in muscle, brain, kidney, and liver tissue from mice was highest at a station near the stream receiving liquid effluent from the mine (mean total mercury at this station ranging from 0.18 ..mu..g/g in muscle to 4.74 ..mu..g/g in kidney). Approximately 15 to 30% of total mercury in mouse tissue was in the methylated form. Total mercury concentration in muscle tissue from house sparrows varied inversely with distance from the mine, with highest concentrations exceeding 0.1 ..mu..g/g. Approximately 1 to 4% of total mercury in sparrow muscle was in the methylated form.« less

The complete mitochondrial genome of the Feral Rock Pigeon (Columba livia breed feral).

PubMed

Li, Chun-Hong; Liu, Fang; Wang, Li

2014-10-01

Abstract In the present work, we report the complete mitochondrial genome sequence of feral rock pigeon for the first time. The total length of the mitogenome was 17,239 bp with the base composition of 30.3% for A, 24.0% for T, 31.9% for C, and 13.8% for G and an A-T (54.3 %)-rich feature was detected. It harbored 13 protein-coding genes, 2 ribosomal RNA genes, 22 transfer RNA genes and 1 non-coding control region (D-loop region). The arrangement of all genes was identical to the typical mitochondrial genomes of pigeon. The complete mitochondrial genome sequence of feral rock pigeon would serve as an important data set of the germplasm resources for further study.

The complete mitochondrial genome sequence of the Datong yak (Bos grunniens).

PubMed

Wu, Xiaoyun; Chu, Min; Liang, Chunnian; Ding, Xuezhi; Guo, Xian; Bao, Pengjia; Yan, Ping

2016-01-01

Datong yak is a famous artificially cultivated breed in China. In the present work, we report the complete mitochondrial genome sequence of Datong yak for the first time. The total length of the mitogenome is 16,323 bp long, containing 13 protein-coding genes, 22 tRNA genes, two rRNA genes and one non-coding region (D-loop region). The gene order of Datong yak mitogenome is identical to that observed in most other vertebrates. The overall base composition is 33.71% A, 25.8.0% C, 13.21% G and 27.27% T, with an A + T content of 60.98%. The complete mitogenome sequence information of Datong yak can provide useful data for further studies on molecular breeding and taxonomic status.

Characterization of the complete mitochondrial genome sequence of Gannan yak (Bos grunniens).

PubMed

Wu, Xiaoyun; Ding, Xuezhi; Chu, Min; Guo, Xian; Bao, Pengjia; Liang, Chunnian; Yan, Ping

2016-01-01

Gannan yak is the native breed of Gansu province in China. In this work, the complete mitochondrial genome sequence of Gannan yak was determined for the first time. The total length of the mitogenome is 16,322 bp long, with the base composition of 33.74% A, 25.84% T, 13.18% C, and 27.24% G. It contained 13 protein-coding genes, 22 tRNA genes, two rRNA genes and one non-coding region (D-loop region). The gene order of Gannan yak mitogenome is identical to that observed in most other vertebrates. The complete mitogenome sequence information of Gannan yak can provide useful data for further studies on protection of genetic resources and phylogenetic relationships within Bos grunniens.

The independent roles of cardiorespiratory fitness and sedentary time on chronic conditions and Body Mass Index in older adults.

PubMed

Stathokostas, L; Dogra, S; Paterson, D H

2015-10-01

The aim of this paper was to examine the independent influence of cardiorespiratory fitness and sedentary behavior on chronic disease incidence and body composition in older adults. A sample of 292 community dwelling men and women (mean 69.3±8.1 years) underwent maximal treadmill testing and completed questionnaires relating to their leisure-time physical activity, sedentary time, and health. The average V O2 of the sample was approximately 21 ml.kg(-1).min(-1) with the average sedentary time being over 3 hours per day. Cardiorespiratory fitness was found to be a stronger predictor of number of chronic conditions and BMI than total physical activity and sedentary. Those with a higher cardiorespiratory fitness had fewer chronic conditions and a lower BMI. No such associations were seen for either total physical activity levels or sedentary time. Cardiorespiratory fitness is a stronger predictor of health among older adults and further highlights the importance of promoting public health guidelines for cardiorespiratory fitness.

Bicycle weight and commuting time: randomised trial.

PubMed

Groves, J

2010-12-09

To determine whether the author's 20.9 lb (9.5 kg) carbon frame bicycle reduced commuting time compared with his 29.75 lb (13.5 kg) steel frame bicycle. Randomised trial. Sheffield and Chesterfield, United Kingdom, between mid-January 2010 and mid-July 2010. One consultant in anaesthesia and intensive care. Total time to complete the 27 mile (43.5 kilometre) journey from Sheffield to Chesterfield Royal Hospital and back. The total distance travelled on the steel frame bicycle during the study period was 809 miles (1302 km) and on the carbon frame bicycle was 711 miles (1144 km). The difference in the mean journey time between the steel and carbon bicycles was 00:00:32 (hr:min:sec; 95% CI -00:03:34 to 00:02:30; P=0.72). A lighter bicycle did not lead to a detectable difference in commuting time. Cyclists may find it more cost effective to reduce their own weight rather than to purchase a lighter bicycle.

Timeliness and completeness of measles vaccination among children in rural areas of Guangxi, China: A stratified three-stage cluster survey.

PubMed

Tang, Xianyan; Geater, Alan; McNeil, Edward; Zhou, Hongxia; Deng, Qiuyun; Dong, Aihu

2017-07-01

Large-scale outbreaks of measles occurred in 2013 and 2014 in rural Guangxi, a region in Southwest China with high coverage for measles-containing vaccine (MCV). This study aimed to estimate the timely vaccination coverage, the timely-and-complete vaccination coverage, and the median delay period for MCV among children aged 18-54 months in rural Guangxi. Based on quartiles of measles incidence during 2011-2013, a stratified three-stage cluster survey was conducted from June through August 2015. Using weighted estimation and finite population correction, vaccination coverage and 95% confidence intervals (CIs) were calculated. Weighted Kaplan-Meier analyses were used to estimate the median delay periods for the first (MCV1) and second (MCV2) doses of the vaccine. A total of 1216 children were surveyed. The timely vaccination coverage rate was 58.4% (95% CI, 54.9%-62.0%) for MCV1, and 76.9% (95% CI, 73.6%-80.0%) for MCV2. The timely-and-complete vaccination coverage rate was 47.4% (95% CI, 44.0%-51.0%). The median delay period was 32 (95% CI, 27-38) days for MCV1, and 159 (95% CI, 118-195) days for MCV2. The timeliness and completeness of measles vaccination was low, and the median delay period was long among children in rural Guangxi. Incorporating the timeliness and completeness into official routine vaccination coverage statistics may help appraise the coverage of vaccination in China. Copyright © 2017 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

Lactulose Breath Test Gas Production in Childhood IBS Is Associated With Intestinal Transit and Bowel Movement Frequency.

PubMed

Chumpitazi, Bruno P; Weidler, Erica M; Shulman, Robert J

2017-04-01

In adults with irritable bowel syndrome (IBS), bacterial gas production (colonic fermentation) is related to both symptom generation and intestinal transit. Whether gas production affects symptom generation, psychosocial distress, or intestinal transit in childhood IBS is unknown. Children (ages 7-17 years) with pediatric Rome III IBS completed validated psychosocial questionnaires and a 2-week daily diary capturing pain and stooling characteristics. Stool form determined IBS subtype. Subjects then completed a 3-hour lactulose breath test for measurement of total breath hydrogen and methane production. Carmine red was used to determine whole intestinal transit time. A total of 87 children (mean age 13 ± 2.6 [standard deviation] years) were enrolled, of whom 50 (57.5%) were girls. All children produced hydrogen and 51 (58.6%) produced methane. Hydrogen and methane production did not correlate with either abdominal pain frequency/severity or psychosocial distress. Hydrogen and methane production did not differ significantly by IBS subtype. Methane production correlated positively with whole intestinal transit time (r = 0.31, P < 0.005) and inversely with bowel movement frequency (r = -0.245, P < 0.05). Methane production (threshold 3 ppm) as a marker for identifying IBS-C had a sensitivity of 60% and specificity of 42.9%. Lactulose breath test total methane production may serve as a biomarker of whole intestinal transit time and bowel movement frequency in children with IBS. In children with IBS, lactulose breath test hydrogen and methane production did not, however, correlate with abdominal pain, IBS subtype, or psychosocial distress.

A physical activity program to mobilize older people: a practical and sustainable approach.

PubMed

Jancey, Jonine M; Clarke, Ann; Howat, Peter A; Lee, Andy H; Shilton, Trevor; Fisher, John

2008-04-01

Despite the documented benefits of physical activity, it remains difficult to motivate older adults to start and maintain regular physical activity. This study tested an innovative intervention for mobilizing older adults into a neighborhood-based walking program. Researchers recruited a total of 260 healthy but insufficiently active adults aged 65 to 74 years and randomly selected from the Australian electoral roll from 30 Perth metropolitan neighborhoods. Social cognitive theory guided the design of the program. Researchers collected both qualitative and quantitative data to inform the development, together with ongoing process evaluation. A total of 65% of participants completed the program. Their mean weekly walking time for recreation increased by about 100 min, and 80% of participants reported that they would continue to walk twice per week upon program completion. This practical program is potentially effective and sustainable with respect to mobilizing physically inactive older people.

Physical activity, sedentary behavior time and lipid levels in the Observation of Cardiovascular Risk Factors in Luxembourg study.

PubMed

Crichton, Georgina E; Alkerwi, Ala'a

2015-08-11

Recently attention has been drawn to the health impacts of time spent engaging in sedentary behaviors. While many studies have investigated general physical activity (PA) in relation to blood lipid levels, the current study aimed to examine the intensity of activity, including sedentary behavior time, and time spent engaging in moderate and intense PA, with concentrations of HDL and LDL-cholesterol, total cholesterol, and triglycerides. Participants comprised 1331 individuals, aged 18 to 70 years, from the Observation of Cardiovascular Risk Factors in Luxembourg (ORISCAV-LUX) study, who underwent objective cardiovascular health assessments and completed the International Physical Activity Questionnaire (IPAQ). Time spent engaging in sedentary behaviors (screen time on a workday and a day off, and total sitting time on a work day), and moderate and intense PA, were related to levels of HDL and LDL-cholesterol, total cholesterol, and triglycerides. Analyses were conducted in the whole sample, and then with stratification according to BMI (normal weight versus overweight/obese). Both lower screen time during days off and higher intense PA time were significantly associated with higher HDL-cholesterol after full adjustment for socio-demographic factors, dietary factors and smoking (both p < 0.05). In normal weight individuals, consistent positive relations between triglycerides, LDL, and total cholesterol with all sedentary behavior time variables were observed (all p < 0.05; adjusted for age, education, gender). There were no statistically significant associations between any intensity level of PA or sedentary behavior time variable and lipid levels in those overweight or obese. Spending less time in sedentary behaviors, and engaging in medium levels of intense physical activity may be associated with a more favorable blood lipid profile, particularly with regard to levels of HDL and triglycerides.

Kinetic and kinematic differences between squats performed with and without elastic bands.

PubMed

Israetel, Michael A; McBride, Jeffrey M; Nuzzo, James L; Skinner, Jared W; Dayne, Andrea M

2010-01-01

The purpose of this investigation was to compare kinetic and kinematic variables between squats performed with and without elastic bands equalized for total work. Ten recreationally weight trained males completed 1 set of 5 squats without (Wht) and with (Band) elastic bands as resistance. Squats were completed while standing on a force platform with bar displacement measured using 2 potentiometers. Electromyography (EMG) was obtained from the vastus lateralis. Average force-time, velocity-time, power-time, and EMG-time graphs were generated and statistically analyzed for mean differences in values between the 2 conditions during the eccentric and concentric phases. The Band condition resulted in significantly higher forces in comparison to the Wht condition during the first 25% of the eccentric phase and the last 10% of the concentric phase (p < or = 0.05). However, the Wht condition resulted in significantly higher forces during the last 5% of the eccentric phase and the first 5% of the concentric phase in comparison to the Band condition. The Band condition resulted in significantly higher power and velocity values during the first portion of the eccentric phase and the latter portion of the concentric phase. Vastus lateralis muscle activity during the Band condition was significantly greater during the first portion of the eccentric phase and latter portion of the concentric phase as well. This investigation indicates that squats equalized for total work with and without elastic bands significantly alter the force-time, power-time, velocity-time, and EMG-time curves associated with the movements. Specifically, elastic bands seem to increase force, power, and muscle activity during the early portions of the eccentric phase and latter portions of the concentric phase.

Are patients satisfied with a web-based followup after total joint arthroplasty?

PubMed

Marsh, Jacquelyn; Bryant, Dianne; MacDonald, Steven J; Naudie, Douglas; Remtulla, Alliya; McCalden, Richard; Howard, James; Bourne, Robert; McAuley, James

2014-06-01

A web-based followup assessment may be a feasible, cost-saving alternative of tracking patient outcomes after total joint arthroplasty. However, before implementing a web-based program, it is important to determine patient satisfaction levels with the new followup method. Satisfaction with the care received is becoming an increasingly important metric, and we do not know to what degree patients are satisfied with an approach to followup that does not involve an in-person visit with their surgeons. We determined (1) patient satisfaction and (2) patients' preferences for followup method (web-based or in-person) after total joint arthroplasty. We randomized patients who were at least 12 months after primary THA or TKA to complete a web-based followup or to have their appointment at the clinic. There were 410 eligible patients contacted for the study during the recruitment period. Of these, 256 agreed to participate, and a total of 229 patients completed the study (89% of those enrolled, 56% of those potentially eligible; 111 in the usual-care group, 118 in the web-based group). Their mean age was 69 years (range, 38-86 years). There was no crossover between groups. All 229 patients completed a satisfaction questionnaire at the time of their followup appointments. Patients in the web-based group also completed a satisfaction and preference questionnaire 1 year later. Only patients from the web-based group were asked to indicate preference as they had experienced the web-based and in-person followup methods. We used descriptive statistics to summarize the satisfaction questionnaires and compared results using Pearson's chi-square test. Ninety-one patients (82.0%) in the usual-care group indicated that they were either extremely or very satisfied with the followup process compared with 90 patients (75.6%) who were in the web-based group (p < 0.01; odds ratio [OR] = 3.95; 95% CI, 1.79-8.76). Similarly, patients in the usual care group were more satisfied with the care they received from their surgeon, compared with patients in the web-based group (92.8% versus 73.9%; p < 0.01, OR = 1.37; 95% CI, 0.73-2.57). Forty-four percent of patients preferred the web-based method, 36% preferred the usual method, and 16% had no preference (p = 0.01). Our results show moderate to high satisfaction levels with a web-based followup assessment. Patients who completed the usual method of in-person followup assessment reported greater satisfaction; however, the difference was small and may not outweigh the additional cost and time-saving benefits of the web-based followup method. Level I, therapeutic study. See the Instructions for Authors for a complete description of levels of evidence.

Exact time-dependent solutions for a self-regulating gene.

PubMed

Ramos, A F; Innocentini, G C P; Hornos, J E M

2011-06-01

The exact time-dependent solution for the stochastic equations governing the behavior of a binary self-regulating gene is presented. Using the generating function technique to rephrase the master equations in terms of partial differential equations, we show that the model is totally integrable and the analytical solutions are the celebrated confluent Heun functions. Self-regulation plays a major role in the control of gene expression, and it is remarkable that such a microscopic model is completely integrable in terms of well-known complex functions.

Initial Design and Construction of a Mobil Regenerative Fuel Cell System

NASA Technical Reports Server (NTRS)

Colozza, Anthony J.; Maloney, Thomas; Hoberecht, Mark (Technical Monitor)

2003-01-01

The design and initial construction of a mobile regenerative power system is described. The main components of the power system consists of a photovoltaic array, regenerative fuel cell and electrolyzer. The system is mounted on a modified landscape trailer and is completely self contained. An operational analysis is also presented that shows predicted performance for the system at various times of the year. The operational analysis consists of performing an energy balance on the system based on array output and total desired operational time.

Military Manpower Training Report for FY 1981.

DTIC Science & Technology

1980-03-01

1,167 483 102 Fort Benning, GA 2,808 1,081 134 Fort B. Harrison, IN 2,444 379 92 Fort Bliss, TX 1,442 958 265 Fort Bragg, NC 446 618 90 Fort Devens ...management action to reduce the administrative time used to form recruit training platoons. This action reduces the average time in training for new...must be made for course attrition, the number of students entering a course of instruction who fail to complete it. The total input requirement must

How to deal with missing longitudinal data in cost of illness analysis in Alzheimer's disease-suggestions from the GERAS observational study.

PubMed

Belger, Mark; Haro, Josep Maria; Reed, Catherine; Happich, Michael; Kahle-Wrobleski, Kristin; Argimon, Josep Maria; Bruno, Giuseppe; Dodel, Richard; Jones, Roy W; Vellas, Bruno; Wimo, Anders

2016-07-18

Missing data are a common problem in prospective studies with a long follow-up, and the volume, pattern and reasons for missing data may be relevant when estimating the cost of illness. We aimed to evaluate the effects of different methods for dealing with missing longitudinal cost data and for costing caregiver time on total societal costs in Alzheimer's disease (AD). GERAS is an 18-month observational study of costs associated with AD. Total societal costs included patient health and social care costs, and caregiver health and informal care costs. Missing data were classified as missing completely at random (MCAR), missing at random (MAR) or missing not at random (MNAR). Simulation datasets were generated from baseline data with 10-40 % missing total cost data for each missing data mechanism. Datasets were also simulated to reflect the missing cost data pattern at 18 months using MAR and MNAR assumptions. Naïve and multiple imputation (MI) methods were applied to each dataset and results compared with complete GERAS 18-month cost data. Opportunity and replacement cost approaches were used for caregiver time, which was costed with and without supervision included and with time for working caregivers only being costed. Total costs were available for 99.4 % of 1497 patients at baseline. For MCAR datasets, naïve methods performed as well as MI methods. For MAR, MI methods performed better than naïve methods. All imputation approaches were poor for MNAR data. For all approaches, percentage bias increased with missing data volume. For datasets reflecting 18-month patterns, a combination of imputation methods provided more accurate cost estimates (e.g. bias: -1 % vs -6 % for single MI method), although different approaches to costing caregiver time had a greater impact on estimated costs (29-43 % increase over base case estimate). Methods used to impute missing cost data in AD will impact on accuracy of cost estimates although varying approaches to costing informal caregiver time has the greatest impact on total costs. Tailoring imputation methods to the reason for missing data will further our understanding of the best analytical approach for studies involving cost outcomes.

Costs to physician offices of providing medications to medically indigent patients via pharmaceutical manufacturer prescription assistance programs.

PubMed

Clay, Patrick; Vaught, Eric; Glaros, Alan; Mangum, Stacy; Hansen, Daniel; Lindsey, Cameron

2007-01-01

Prescription assistance programs (PAPs) are offered by pharmaceutical manufacturers to provide medications at no out-of-pocket cost to various categories of medically indigent patients. some PAPs require only 1 application whereas others require as many as 4 applications per year per drug per patient, depending on the manufacturer's requirements. to measure the costs incurred by a medical clinic that provides chronic prescription medications via PAPs. this project was conducted in a free-standing, inner-city, Midwestern health clinic on the PAP application process for 1 representative drug for 32 pharmaceutical manufacturers that offered PAPs for drugs taken on a long-term basis for chronic conditions. time and motion studies were conducted using a medical assistant with the greatest amount of PAP experience. Assessment of time-to-access and time-to-complete forms was performed outside of normal clinic business hours to avoid interruptions. Personnel time costs also included receipt and delivery of drug to the patient (drug distribution time), which were assessed during normal business hours for actual medications received for 10 patients and included the time required to notify the patient of the arrival of the drug and to dispense the medication to the patient. supply costs for this PAP service included printing and copying costs. submission costs associated with mailing or faxing the documents were determined and calculated using the price of materials only. total application cost was calculated by adding the personnel time cost, supply cost, and submission cost. Annual PAP time was the time spent completing PAPs for 1 medication for 1 patient for 1 year. the time and resources required and the associated costs were aggregated separately for the pharmaceutical manufacturers that required 1, 2, or 4 applications per drug per patient per year. The total average application cost for all 32 companies was $25.18 [SD, $17.23]. Personnel time costs accounted for half or more of the total application cost, regardless of submission mode. the time to complete the form for any PAP was 0:06:20 [SD, 0:05:03] minutes with a range from 0:03:01 to 0:34:22 minutes. Printing costs were $0.20 [SD, $0.10] and copying costs were $1.96 [SD, $0.21]. Average supply costs were $2.16 [SD, $0.23]. Faxing versus mailing PAPs saved $17.90 per application. total annual clinic cost to assist patients in obtaining drugs through a PAP ranged from $10.42 per patient for a drug that requires 1 application per year (15 manufacturers, 47%) to $46.30 per patient for a drug in a PAP that requires 4 (re)applications per year (12 manufacturers, 38%). PAPs transmitted by mail required 0:49:18 [SD, 0:32:18] minutes, approximately 0:25:00 [SD, 0:21:00] minutes more than by fax (0:24:13 [SD, 0:11:32] minutes) or by Internet submissions (0:28:20 minutes), respectively. The number of PAP applications required per patient per medication annually has the greatest impact on clinic time and financial resources. Application submission method also influences the overall costs of providing this service in the clinical setting. Medical clinics should base their decision to provide a PAP application service to patients on the time and costs associated over the course of 1 year and not on the 1-time application cost.

Complete surgical resection improves outcome in INRG high-risk patients with localized neuroblastoma older than 18 months.

PubMed

Fischer, Janina; Pohl, Alexandra; Volland, Ruth; Hero, Barbara; Dübbers, Martin; Cernaianu, Grigore; Berthold, Frank; von Schweinitz, Dietrich; Simon, Thorsten

2017-08-04

Although several studies have been conducted on the role of surgery in localized neuroblastoma, the impact of surgical timing and extent of primary tumor resection on outcome in high-risk patients remains controversial. Patients from the German neuroblastoma trial NB97 with localized neuroblastoma INSS stage 1-3 age > 18 months were included for retrospective analysis. Imaging reports were reviewed by two independent physicians for Image Defined Risk Factors (IDRF). Operation notes and corresponding imaging reports were analyzed for surgical radicality. The extent of tumor resection was classified as complete resection (95-100%), gross total resection (90-95%), incomplete resection (50-90%), and biopsy (<50%) and correlated with local control rate and outcome. Patients were stratified according to the International Neuroblastoma Risk Group (INRG) staging system. Survival curves were estimated according to the method of Kaplan and Meier and compared by the log-rank test. A total of 179 patients were included in this study. 77 patients underwent more than one primary tumor operation. After best surgery, 68.7% of patients achieved complete resection of the primary tumor, 16.8% gross total resection, 14.0% incomplete surgery, and 0.5% biopsy only. The cumulative complication rate was 20.3% and the surgery associated mortality rate was 1.1%. Image defined risk factors (IDRF) predicted the extent of resection. Patients with complete resection had a better local-progression-free survival (LPFS), event-free survival (EFS) and OS (overall survival) than the other groups. Subgroup analyses showed better EFS, LPFS and OS for patients with complete resection in INRG high-risk patients. Multivariable analyses revealed resection (complete vs. other), and MYCN (non-amplified vs. amplified) as independent prognostic factors for EFS, LPFS and OS. In patients with localized neuroblastoma age 18 months or older, especially in INRG high-risk patients harboring MYCN amplification, extended surgery of the primary tumor site improved local control rate and survival with an acceptable risk of complications.

Analysis of 2009 pandemic influenza A/H1N1 outcomes in 19 European countries: association with completeness of national strategic plans

PubMed Central

Meeyai, Aronrag; Cooper, Ben S; Coker, Richard

2013-01-01

Objective To describe changes in reported influenza activity associated with the 2009 H1N1 pandemic in European countries and determine whether there is a correlation between these changes and completeness of national strategic pandemic preparedness. Design A retrospective correlational study. Setting Countries were included if their national strategic plans had previously been analysed and if weekly influenza-like illness (ILI) data from sentinel networks between week 21, 2006 and week 20, 2010 were more than 50% complete. Outcome measures For each country we calculated three outcomes: the percentage change in ILI peak height during the pandemic relative to the prepandemic mean; the timing of the ILI peak and the percentage change in total cases relative to the prepandemic mean. Correlations between these outcomes and completeness of a country's national strategic pandemic preparedness plan were assessed using the Pearson product–moment correlation coefficient. Results Nineteen countries were included. The ILI peak occurred earlier than the mean seasonal peak in 17 countries. In 14 countries the pandemic peak was higher than the seasonal peak, though the difference was large only in Norway, the UK and Greece. Nine countries experienced more total ILI cases during the pandemic compared with the mean for prepandemic years. Five countries experienced two distinct pandemic peaks. There was no clear pattern of correlation between overall completeness of national strategic plans and pandemic influenza outcome measures and no evidence of association between these outcomes and components of pandemic plans that might plausibly affect influenza outcomes (public health interventions, vaccination, antiviral use, public communication). Amongst the 17 countries with a clear pandemic peak, only the correlation between planning for essential services and change in total ILI cases significantly differed from zero: correlation coefficient (95% CI) 0.50 (0.02, 0.79). Conclusions The diversity of pandemic influenza outcomes across Europe is not explained by the marked variation in the completeness of pandemic plans. PMID:23524042

Relationships of self-reported physical activity domains with accelerometry recordings in French adults.

PubMed

Jacobi, David; Charles, Marie-Aline; Tafflet, Muriel; Lommez, Agnès; Borys, Jean-Michel; Oppert, Jean-Michel

2009-01-01

The objective was to examine the relationships of self-reported physical activity (PA) by domain (leisure, occupational, other) with PA and sedentary time as measured objectively by accelerometry. Subjects were adults with low habitual PA levels from a community in northern France. Among subjects in the lowest tertile of a PA score from a screening questionnaire, 160 (37% males, age: 41.0 +/- 10.8 years, BMI: 25.1 +/- 4.1 kg/m(2), mean +/- SD) completed a detailed instrument (Modifiable Activity Questionnaire), and wore an accelerometer (Actigraph) for seven consecutive days. Relationships between questionnaire domains (occupational, leisure, and "non-occupational non-leisure") and accelerometry measures (total activity and sedentary time) were assessed using Spearman correlation coefficients. In this population, the highest contributor to total reported PA (h/week) was occupational PA. Time spent in non-occupational non-leisure PA ranked second in women and third in men. The most frequent non-occupational non-leisure PA were shopping and household chores. In women, non-occupational non-leisure PA contributed more than occupational or leisure-time PA to total PA energy expenditure (median: 18.0, 9.1, and 4.9 MET-h/week, respectively). Total PA by accelerometry (count/day) was correlated to leisure-time PA in women (r = 0.22, P < 0.05) and to occupational (r = 0.43, P < 0.01) and total reported PA (r = 0.39, P < 0.01) in men (all in MET-h/week). There was an inverse relationship between accelerometry sedentary time (h/day) and non-occupational non-leisure PA (MET-h/week, r = -0.30, P < 0.001). These findings indicate the importance of assessing non-occupational non-leisure PA for a better understanding of how individuals partition their time between active or sedentary occupations.

Characteristics and follow-up of postmarketing studies of conditionally authorized medicines in the EU.

PubMed

Hoekman, Jarno; Klamer, Thea T; Mantel-Teeuwisse, Aukje K; Leufkens, Hubert G M; De Bruin, Marie L

2016-07-01

The aim of the present study was to provide an insight into the characteristics and follow-up of postmarketing studies of medicines that were conditionally authorized in the European Union (EU). We compiled a list of all postmarketing studies attached as specific obligations to the licence of medicines that were granted conditional marketing authorization from January 2006 to April 2014. Studies were characterized based on their objective, design, status upon marketing authorization (MA) and due data set by authorities. They were linked to online study registrations (Clinicaltrials.gov, ENCePP) to determine completion date. We described and associated characteristics of studies and medicines, and determined whether studies were completed on time. A total of 59 postmarketing studies were requested for 21 conditionally authorized medicines. Most studies had an interventional study design (73%), were ongoing upon MA (61%) and aimed to provide additional data on efficacy (45%). Interventional studies were more often ongoing and providing efficacy data, while observational and other studies were more often new and providing safety data. Frequent grounds for requesting postmarketing studies were 'long-term follow-up' and 'increase data on subpopulations'. Of the 34 studies eligible for follow-up analysis, 26 (76%) were completed and 17 (50%) completed on time. Actual completion time took a median (interquartile range) of 274 (-121 to 556) days longer than expected. Our results indicated that most postmarketing studies attached to a conditional marketing authorization were eventually completed but that half were completed with a substantial delay. The observations suggest caution when broadening the use of postmarketing studies for resolving uncertainties about benefits and risks after MA. © 2016 The British Pharmacological Society.

Characteristics and follow‐up of postmarketing studies of conditionally authorized medicines in the EU

PubMed Central

Klamer, Thea T.; Mantel‐Teeuwisse, Aukje K.; Leufkens, Hubert G. M.; De Bruin, Marie L.

2016-01-01

Aim The aim of the present study was to provide an insight into the characteristics and follow‐up of postmarketing studies of medicines that were conditionally authorized in the European Union (EU). Methods We compiled a list of all postmarketing studies attached as specific obligations to the licence of medicines that were granted conditional marketing authorization from January 2006 to April 2014. Studies were characterized based on their objective, design, status upon marketing authorization (MA) and due data set by authorities. They were linked to online study registrations (Clinicaltrials.gov, ENCePP) to determine completion date. We described and associated characteristics of studies and medicines, and determined whether studies were completed on time. Results A total of 59 postmarketing studies were requested for 21 conditionally authorized medicines. Most studies had an interventional study design (73%), were ongoing upon MA (61%) and aimed to provide additional data on efficacy (45%). Interventional studies were more often ongoing and providing efficacy data, while observational and other studies were more often new and providing safety data. Frequent grounds for requesting postmarketing studies were ‘long‐term follow‐up’ and ‘increase data on subpopulations’. Of the 34 studies eligible for follow‐up analysis, 26 (76%) were completed and 17 (50%) completed on time. Actual completion time took a median (interquartile range) of 274 (−121 to 556) days longer than expected. Conclusions Our results indicated that most postmarketing studies attached to a conditional marketing authorization were eventually completed but that half were completed with a substantial delay. The observations suggest caution when broadening the use of postmarketing studies for resolving uncertainties about benefits and risks after MA. PMID:26992001

Are graduate students rational? Evidence from the market for biomedical scientists.

PubMed

Blume-Kohout, Margaret E; Clack, John W

2013-01-01

The U.S. National Institutes of Health (NIH) budget expansion from 1998 through 2003 increased demand for biomedical research, raising relative wages and total employment in the market for biomedical scientists. However, because research doctorates in biomedical sciences can often take six years or more to complete, the full labor supply response to such changes in market conditions is not immediate, but rather is observed over a period of several years. Economic rational expectations models assume that prospective students anticipate these future changes, and also that students take into account the opportunity costs of their pursuing graduate training. Prior empirical research on student enrollment and degree completions in science and engineering (S&E) fields indicates that "cobweb" expectations prevail: that is, at least in theory, prospective graduate students respond to contemporaneous changes in market wages and employment, but do not forecast further changes that will arise by the time they complete their degrees and enter the labor market. In this article, we analyze time-series data on wages and employment of biomedical scientists versus alternative careers, on completions of S&E bachelor's degrees and biomedical sciences PhDs, and on research expenditures funded both by NIH and by biopharmaceutical firms, to examine the responsiveness of the biomedical sciences labor supply to changes in market conditions. Consistent with previous studies, we find that enrollments and completions in biomedical sciences PhD programs are responsive to market conditions at the time of students' enrollment. More striking, however, is the close correspondence between graduate student enrollments and completions, and changes in availability of NIH-funded traineeships, fellowships, and research assistantships.

Measuring older adults' sedentary time: reliability, validity, and responsiveness.

PubMed

Gardiner, Paul A; Clark, Bronwyn K; Healy, Genevieve N; Eakin, Elizabeth G; Winkler, Elisabeth A H; Owen, Neville

2011-11-01

With evidence that prolonged sitting has deleterious health consequences, decreasing sedentary time is a potentially important preventive health target. High-quality measures, particularly for use with older adults, who are the most sedentary population group, are needed to evaluate the effect of sedentary behavior interventions. We examined the reliability, validity, and responsiveness to change of a self-report sedentary behavior questionnaire that assessed time spent in behaviors common among older adults: watching television, computer use, reading, socializing, transport and hobbies, and a summary measure (total sedentary time). In the context of a sedentary behavior intervention, nonworking older adults (n = 48, age = 73 ± 8 yr (mean ± SD)) completed the questionnaire on three occasions during a 2-wk period (7 d between administrations) and wore an accelerometer (ActiGraph model GT1M) for two periods of 6 d. Test-retest reliability (for the individual items and the summary measure) and validity (self-reported total sedentary time compared with accelerometer-derived sedentary time) were assessed during the 1-wk preintervention period, using Spearman (ρ) correlations and 95% confidence intervals (CI). Responsiveness to change after the intervention was assessed using the responsiveness statistic (RS). Test-retest reliability was excellent for television viewing time (ρ (95% CI) = 0.78 (0.63-0.89)), computer use (ρ (95% CI) = 0.90 (0.83-0.94)), and reading (ρ (95% CI) = 0.77 (0.62-0.86)); acceptable for hobbies (ρ (95% CI) = 0.61 (0.39-0.76)); and poor for socializing and transport (ρ < 0.45). Total sedentary time had acceptable test-retest reliability (ρ (95% CI) = 0.52 (0.27-0.70)) and validity (ρ (95% CI) = 0.30 (0.02-0.54)). Self-report total sedentary time was similarly responsive to change (RS = 0.47) as accelerometer-derived sedentary time (RS = 0.39). The summary measure of total sedentary time has good repeatability and modest validity and is sufficiently responsive to change suggesting that it is suitable for use in interventions with older adults.

Barriers towards the publication of academic drug trials. Follow-up of trials approved by the Danish Medicines Agency.

PubMed

Berendt, Louise; Petersen, Lene Grejs; Bach, Karin Friis; Poulsen, Henrik Enghusen; Dalhoff, Kim

2017-01-01

To characterize and quantify barriers towards the publication of academic drug trials. We identified academic drug trials approved during a 3-year period (2004-2007) by the Danish Medicines Agency. We conducted a survey among the trial sponsors to describe the rates of initiation, completion, and publication, and the reasons for the failure to reach each of these milestones. Information on size and methodological characteristics of the trials was extracted from the EudraCT database, a prospective register of all approved clinical drug trials submitted to European medicines agencies since 2004. A total of 181 academic drug trials were eligible for inclusion, 139 of which participated in our survey (response rate: 77%). Follow-up time ranged from 5.1 to 7.9 years. Most trials were randomized controlled trials (73%, 95% CI 65-81%). Initiation and completion rates were 92% (95% CI: 88-97%) and 93% (95% CI: 89-97%) respectively. The publication rate of completed trials was 73% (95% CI: 62-79%). RCTs were published faster than non-RCTs (quartile time to publication 2.9 vs. 3.1 years, p = 0.0412). Many academic drug trials are left unpublished. Main barriers towards publication were related to the process from completion to publication. Hence, there is much to gain by facilitating the process from analysis to publication. Research institutions and funders should actively influence this process, e.g. by requiring the publication of trial results within a given time after completion.

The Feasibility of Real-Time Intraoperative Performance Assessment With SIMPL (System for Improving and Measuring Procedural Learning): Early Experience From a Multi-institutional Trial.

PubMed

Bohnen, Jordan D; George, Brian C; Williams, Reed G; Schuller, Mary C; DaRosa, Debra A; Torbeck, Laura; Mullen, John T; Meyerson, Shari L; Auyang, Edward D; Chipman, Jeffrey G; Choi, Jennifer N; Choti, Michael A; Endean, Eric D; Foley, Eugene F; Mandell, Samuel P; Meier, Andreas H; Smink, Douglas S; Terhune, Kyla P; Wise, Paul E; Soper, Nathaniel J; Zwischenberger, Joseph B; Lillemoe, Keith D; Dunnington, Gary L; Fryer, Jonathan P

Intraoperative performance assessment of residents is of growing interest to trainees, faculty, and accreditors. Current approaches to collect such assessments are limited by low participation rates and long delays between procedure and evaluation. We deployed an innovative, smartphone-based tool, SIMPL (System for Improving and Measuring Procedural Learning), to make real-time intraoperative performance assessment feasible for every case in which surgical trainees participate, and hypothesized that SIMPL could be feasibly integrated into surgical training programs. Between September 1, 2015 and February 29, 2016, 15 U.S. general surgery residency programs were enrolled in an institutional review board-approved trial. SIMPL was made available after 70% of faculty and residents completed a 1-hour training session. Descriptive and univariate statistics analyzed multiple dimensions of feasibility, including training rates, volume of assessments, response rates/times, and dictation rates. The 20 most active residents and attendings were evaluated in greater detail. A total of 90% of eligible users (1267/1412) completed training. Further, 13/15 programs began using SIMPL. Totally, 6024 assessments were completed by 254 categorical general surgery residents (n = 3555 assessments) and 259 attendings (n = 2469 assessments), and 3762 unique operations were assessed. There was significant heterogeneity in participation within and between programs. Mean percentage (range) of users who completed ≥1, 5, and 20 assessments were 62% (21%-96%), 34% (5%-75%), and 10% (0%-32%) across all programs, and 96%, 75%, and 32% in the most active program. Overall, response rate was 70%, dictation rate was 24%, and mean response time was 12 hours. Assessments increased from 357 (September 2015) to 1146 (February 2016). The 20 most active residents each received mean 46 assessments by 10 attendings for 20 different procedures. SIMPL can be feasibly integrated into surgical training programs to enhance the frequency and timeliness of intraoperative performance assessment. We believe SIMPL could help facilitate a national competency-based surgical training system, although local and systemic challenges still need to be addressed. Copyright © 2016. Published by Elsevier Inc.

A spatio-temporal analysis of suicide in El Salvador.

PubMed

Carcach, Carlos

2017-04-20

In 2012, international statistics showed El Salvador's suicide rate as 40th in the world and the highest in Latin America. Over the last 15 years, national statistics show the suicide death rate declining as opposed to an increasing rate of homicide. Though completed suicide is an important social and health issue, little is known about its prevalence, incidence, etiology and spatio-temporal behavior. The primary objective of this study was to examine completed suicide and homicide using the stream analogy to lethal violence within a spatio-temporal framework. A Bayesian model was applied to examine the spatio-temporal evolution of the tendency of completed suicide over homicide in El Salvador. Data on numbers of suicides and homicides at the municipal level were obtained from the Instituto de Medicina Legal (IML) and population counts, from the Dirección General de Estadística y Censos (DIGESTYC), for the period of 2002 to 2012. Data on migration were derived from the 2007 Population Census, and inequality data were obtained from a study by Damianović, Valenzuela and Vera. The data reveal a stable standardized rate of total lethal violence (completed suicide plus homicide) across municipalities over time; a decline in suicide; and a standardized suicide rate decreasing with income inequality but increasing with social isolation. Municipalities clustered in terms of both total lethal violence and suicide standardized rates. Spatial effects for suicide were stronger among municipalities located in the north-east and center-south sides of the country. New clusters of municipalities with large suicide standardized rates were detected in the north-west, south-west and center-south regions, all of which are part of time-stable clusters of homicide. Prevention efforts to reduce income inequality and mitigate the negative effects of weak relational systems should focus upon municipalities forming time-persistent clusters with a large rate of death by suicide. In municipalities that are part of newly-formed suicide clusters and also are located in areas with a large rate of homicide, interrupting the expansion of spatial concentrations of suicide over time may require the implementation of both public health and public safety interventions.

The Importance of Self-Determination to Perceived Quality of Life for Youth and Young Adults with Chronic Conditions and Disabilities

ERIC Educational Resources Information Center

McDougall, Janette; Evans, Jan; Baldwin, Patricia

2010-01-01

This study examined the relationship between self-determination and perceived quality of life for youth and young adults with chronic conditions and disabilities over time. A total of 34 individuals completed the "Life Satisfaction Index-Adolescents" and the "Arc's Self-Determination Scale" at study baseline and again 1 year…

78 FR 75373 - Agency Information Collection Activities: Proposed Collection; Comments Requested; Application To...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-11

... to the form are to allow applicants to pay the transfer tax by credit or debit card, and combine... amount of time estimated for an average respondent to respond: It is estimated that 9,662 respondents will take an average of approximately 1.69 hours to complete. (6) An estimate of the total burden (in...

78 FR 75375 - Agency Information Collection Activities; Proposed Collection; Comments Requested: Application...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-11

... and local law. The changes to the form are to allow the applicant to pay the transfer tax by credit or...) An estimate of the total number of respondents and the amount of time estimated for an average respondent to respond: It is estimated that 65,085 respondents will take an average of 1.68 hours to complete...

Affective Influences on the Reading-Language Arts Development of Native American Students.

ERIC Educational Resources Information Center

Gold, David A. S.

To this time, language arts-reading programs established by the Bureau of Indian Affairs (BIA) totally immerse the young Indian student in a complete English environment. The real problem is not so much the type of program used, but the feelings of the teachers working with the students. Until very recently, few of the teachers in BIA schools were…

Onekotan Island, Kurile Chain, Russia as seen from STS-59

NASA Technical Reports Server (NTRS)

1994-01-01

The narrow end of Onekotan Island is to the north by northeast. This is one of several volcanic islands extending south by southwest between the southern tip of Kamchatka and Japan. The exposure was stopped down to provide extremely fine detail in the totally snow-covered landscape, at the same time making the dark sea look completely black.

An Investigation of Consulting-Training; as a Part-Time or Ultimate Career Option for Business Educators and Their Graduates.

ERIC Educational Resources Information Center

Church, Olive D.

A study examined the feasibility of consulting-training as a career option for business professionals. Data were gathered from a mail survey completed by a total of 60 firms in Arizona and Colorado and also from interviews, the investigator's participation and collaboration experiences with consultants, and a comparison of the literature on…

The Relationship Between Homework Compliance and Therapy Outcomes: An Updated Meta-Analysis.

PubMed

Mausbach, Brent T; Moore, Raeanne; Roesch, Scott; Cardenas, Veronica; Patterson, Thomas L

2010-10-01

The current study was an updated meta-analysis of manuscripts since the year 2000 examining the effects of homework compliance on treatment outcome. A total of 23 studies encompassing 2,183 subjects were included. Results indicated a significant relationship between homework compliance and treatment outcome suggesting a small to medium effect (r = .26; 95% CI = .19-.33). Moderator analyses were conducted to determine the differential effect size of homework on treatment outcome by target symptoms (e.g., depression; anxiety), source of homework rating (e.g., client; therapist), timing of homework rating (e.g., retroactive vs. contemporaneous), and type of homework rating (e.g., Likert; total homeworks completed). Results indicated that effect sizes were robust across target symptoms, but differed by source of homework rating, timing of homework rating, and type of homework rating. Specifically, studies utilizing combined client and therapist ratings of compliance had significantly higher mean effect size relative to those using therapist only assessments and those using objective assessments. Further, studies that rated the percentage of homeworks completed had a significantly lower mean effect size compared to studies using Likert ratings, and retroactive assessments had higher effect size than contemporaneous assessments.

The Relationship Between Homework Compliance and Therapy Outcomes: An Updated Meta-Analysis

PubMed Central

Moore, Raeanne; Roesch, Scott; Cardenas, Veronica; Patterson, Thomas L.

2010-01-01

The current study was an updated meta-analysis of manuscripts since the year 2000 examining the effects of homework compliance on treatment outcome. A total of 23 studies encompassing 2,183 subjects were included. Results indicated a significant relationship between homework compliance and treatment outcome suggesting a small to medium effect (r = .26; 95% CI = .19–.33). Moderator analyses were conducted to determine the differential effect size of homework on treatment outcome by target symptoms (e.g., depression; anxiety), source of homework rating (e.g., client; therapist), timing of homework rating (e.g., retroactive vs. contemporaneous), and type of homework rating (e.g., Likert; total homeworks completed). Results indicated that effect sizes were robust across target symptoms, but differed by source of homework rating, timing of homework rating, and type of homework rating. Specifically, studies utilizing combined client and therapist ratings of compliance had significantly higher mean effect size relative to those using therapist only assessments and those using objective assessments. Further, studies that rated the percentage of homeworks completed had a significantly lower mean effect size compared to studies using Likert ratings, and retroactive assessments had higher effect size than contemporaneous assessments. PMID:20930925

A web-based appointment system to reduce waiting for outpatients: a retrospective study.

PubMed

Cao, Wenjun; Wan, Yi; Tu, Haibo; Shang, Fujun; Liu, Danhong; Tan, Zhijun; Sun, Caihong; Ye, Qing; Xu, Yongyong

2011-11-22

Long waiting times for registration to see a doctor is problematic in China, especially in tertiary hospitals. To address this issue, a web-based appointment system was developed for the Xijing hospital. The aim of this study was to investigate the efficacy of the web-based appointment system in the registration service for outpatients. Data from the web-based appointment system in Xijing hospital from January to December 2010 were collected using a stratified random sampling method, from which participants were randomly selected for a telephone interview asking for detailed information on using the system. Patients who registered through registration windows were randomly selected as a comparison group, and completed a questionnaire on-site. A total of 5641 patients using the online booking service were available for data analysis. Of them, 500 were randomly selected, and 369 (73.8%) completed a telephone interview. Of the 500 patients using the usual queuing method who were randomly selected for inclusion in the study, responses were obtained from 463, a response rate of 92.6%. Between the two registration methods, there were significant differences in age, degree of satisfaction, and total waiting time (P<0.001). However, gender, urban residence, and valid waiting time showed no significant differences (P>0.05). Being ignorant of online registration, not trusting the internet, and a lack of ability to use a computer were three main reasons given for not using the web-based appointment system. The overall proportion of non-attendance was 14.4% for those using the web-based appointment system, and the non-attendance rate was significantly different among different hospital departments, day of the week, and time of the day (P<0.001). Compared to the usual queuing method, the web-based appointment system could significantly increase patient's satisfaction with registration and reduce total waiting time effectively. However, further improvements are needed for broad use of the system.

Impact of a Pharmacist-Provided Spirometry Service on Access to Results in a Primary Care Setting.

PubMed

Mueller, Lisa A; Valentino, Alexa Sevin; Clark, Aaron D; Li, Junan

2018-01-01

The primary objective of this study was to determine the effect of a pharmacist-provided spirometry service within a federally qualified health center on the percentage of spirometry referrals completed with results reviewed by the ordering provider. Secondary objectives evaluated differences between internal and external referrals, medication recommendations made by the pharmacist, and revenue brought in by the service. Chart reviews were completed to determine the referral completion rates between patients who received a spirometry referral before (December 2014-September 2015) and after (January 2016-October 2016) the implementation of the pharmacy-provided spirometry service. Chart reviews were also used to determine the number and completion rate among referrals for internal and external services in the postimplementation time frame. Chart reviews also assessed medication recommendations made by the pharmacist. The results demonstrate an increase in referral completion rate from 38.1% to 47.0% ( P = .08) between the pre- and postimplementation time frames. In the postimplementation time frame, there was a statistically significant difference in the percentage of referrals completed between in-house referrals and external referrals (70.0% and 40.9%, respectively, P = .0004). Comparing clinics with and without the spirometry service, there was a statistically significant difference in the total number of spirometry referrals (1.13% and 0.59%, respectively, P < .0001) and the percent of referrals completed (0.55% and 0.27%, respectively, P = .0002). The results suggest that offering spirometry within the primary care setting helps to increase the rate of completed spirometry tests with results available to the primary care provider. Additionally, the results show that there is an increased completion rate in patients who receive an internal spirometry referral, which may be due to reduced barriers in obtaining this testing. Overall, these results demonstrate that providing spirometry in the primary care setting helps to increase spirometry results obtained and could be beneficial in other primary care settings.

Aircraft Trajectory Optimization and Contrails Avoidance in the Presence of Winds

NASA Technical Reports Server (NTRS)

Ng, Hok K.; Chen, Neil Y.

2010-01-01

There are indications that persistent contrails can lead to adverse climate change, although the complete effect on climate forcing is still uncertain. A flight trajectory optimization algorithm with fuel and contrails models, which develops alternative flight paths, provides policy makers the necessary data to make tradeoffs between persistent contrails mitigation and aircraft fuel consumption. This study develops an algorithm that calculates wind-optimal trajectories for cruising aircraft while avoiding the regions of airspace prone to persistent contrails formation. The optimal trajectories are developed by solving a non-linear optimal control problem with path constraints. The regions of airspace favorable to persistent contrails formation are modeled as penalty areas that aircraft should avoid and are adjustable. The tradeoff between persistent contrails formation and additional fuel consumption is investigated, with and without altitude optimization, for 12 city-pairs in the continental United States. Without altitude optimization, the reduction in contrail travel times is gradual with increase in total fuel consumption. When altitude is optimized, a two percent increase in total fuel consumption can reduce the total travel times through contrail regions by more than six times. Allowing further increase in fuel consumption does not seem to result in proportionate decrease in contrail travel times.

Blowdown heat transfer separate-effects program. Quarterly progress report, October--December 1977. [PWR

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

Thomas, D.G.; Baucum, W.E.; Bohanan, R.E.

1977-10-01

The Thermal-Hydraulic Test Facility (THTF) has completed 20 powered rod blowdowns through October 13, 1977. Of these blowdowns, 5 were completed with all 49 rods powered, 2 were completed with 2 inactive rods, and 13 were completed with 4 inactive rods. Initial system pressure was 15.5 MPa, test section inlet temperature was 559 K, and break area was equivalent to a 200% break with the total area usually split between inlet and outlet in the ratio 0.40 : 0.60. Heater rod power was 80, 100, or 122 kW/rod, and the test section temperature was 607 K, 598 K, or 589more » K. Mean time to critical heat flux (CHF) varied from 0.7 to 1.4 sec with delayed CHF of 2.5 sec occurring in the upper half of the bundle in some tests.« less

Assessment of three-dimensional high-definition visualization technology to perform microvascular anastomosis.

PubMed

Wong, Alex K; Davis, Gabrielle B; Nguyen, T JoAnna; Hui, Kenneth J W S; Hwang, Brian H; Chan, Linda S; Zhou, Zhao; Schooler, Wesley G; Chandrasekhar, Bala S; Urata, Mark M

2014-07-01

Traditional visualization techniques in microsurgery require strict positioning in order to maintain the field of visualization. However, static posturing over time may lead to musculoskeletal strain and injury. Three-dimensional high-definition (3DHD) visualization technology may be a useful adjunct to limiting static posturing and improving ergonomics in microsurgery. In this study, we aimed to investigate the benefits of using the 3DHD technology over traditional techniques. A total of 14 volunteers consisting of novice and experienced microsurgeons performed femoral anastomoses on male Sprague-Dawley retired breeder rats using traditional techniques as well as the 3DHD technology and compared the two techniques. Participants subsequently completed a questionnaire regarding their preference in terms of operational parameters, ergonomics, overall quality, and educational benefits. Efficiency was also evaluated by mean times to complete the anastomosis with each technique. A total of 27 anastomoses were performed, 14 of 14 using the traditional microscope and 13 of 14 using the 3DHD technology. Preference toward the traditional modality was noted with respect to the parameters of precision, field adjustments, zoom and focus, depth perception, and overall quality. The 3DHD technique was preferred for improved stamina and less back and eye strain. Participants believed that the 3DHD technique was the better method for learning microsurgery. Longer mean time of anastomosis completion was noted in participants utilizing the 3DHD technique. The 3DHD technology may prove to be valuable in improving proper ergonomics in microsurgery. In addition, it may be useful in medical education when applied to the learning of new microsurgical skills. More studies are warranted to determine its efficacy and safety in a clinical setting. Copyright © 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Off-the-job microsurgical training on dry models: Siberian experience.

PubMed

Belykh, Evgenii; Byvaltsev, Vadim

2014-01-01

Microsurgical training has become an obligatory part of many neurosurgical training programs. To assess the cost and effectiveness of acquiring and maintaining microneurosurgical skills by training on an off-the-job basis using dry models. A dry off-the-job microneurosurgical training module was set up. Training exercises involved microdissection in a deep operation field, suturing and tying on gauze, untying, pushing of thread end, and microanastomosis. The time to complete the task and success rate were evaluated. The total cost of all necessary equipment and expendables for the training module was US$910. Fifteen residents participated in the continuous off-the-job training. The average time taken to perform the anastomosis decreased after the month of training from 90 to 20 minutes. Authors revealed that at 2 months, the total time and time to complete anastomosis increased significantly for the participants who discontinued practice after the first month, compared with those who just practiced suturing on gauze after the first month (P < 0.01). The average Northwestern Objective Microanastomosis Assessment Tool score was 36 for novice and 65 for experienced participants. The dry off-the-job training showed to be readily available and can be helpful for microsurgical training in the low-income regions of the world. Our data suggest that microsurgical training should be continuous and repetitive. Simulation training may benefit from models for repetitive training of relevant technical part-skills. Copyright © 2014 Elsevier Inc. All rights reserved.

[Effect of a change in posture on the diurnal variations of fructosamine concentration in diabetic patients].

PubMed

Willms, B; Schumann, E

1990-01-01

Daily profiles of blood glucose, HbA1c, total protein and fructosamine were measured in 10 diabetic patients and the factor fructosamine x 7/g total protein was calculated. Measurements were done at 4 a.m. to be sure that the patients were sleeping for some time, during the day and the following evening at 11 p.m., when the patients were lying again, so that the influence of orthostasis, the difference between bed rest and walking could be demonstrated. The blood glucose profile was typical whereas the HbA1c concentration was very stable and constant. Total protein and fructosamine increased significantly by orthostasis; the correction of fructosamine by total protein diminished the differences, but did not completely eliminate the effect of orthostasis. However, fructosamine should be corrected by the total protein concentration in order to increase the diagnostic value of the parameter.

Maximizing Total QoS-Provisioning of Image Streams with Limited Energy Budget

NASA Astrophysics Data System (ADS)

Lee, Wan Yeon; Kim, Kyong Hoon; Ko, Young Woong

To fully utilize the limited battery energy of mobile electronic devices, we propose an adaptive adjustment method of processing quality for multiple image stream tasks running with widely varying execution times. This adjustment method completes the worst-case executions of the tasks with a given budget of energy, and maximizes the total reward value of processing quality obtained during their executions by exploiting the probability distribution of task execution times. The proposed method derives the maximum reward value for the tasks being executable with arbitrary processing quality, and near maximum value for the tasks being executable with a finite number of processing qualities. Our evaluation on a prototype system shows that the proposed method achieves larger reward values, by up to 57%, than the previous method.

Observation of a Pharmacist-Conducted Group A Streptococcal Pharyngitis Point-of-Care Test: A Time and Motion Study.

PubMed

Corn, Carolyn E; Klepser, Donald G; Dering-Anderson, Allison M; Brown, Terrence G; Klepser, Michael E; Smith, Jaclyn K

2018-06-01

Acute pharyngitis is among the most common infectious diseases encountered in the United States, resulting in 13 million patient visits annually, with group A streptococcus (GAS) being a common causative pathogen. It is estimated that annual expenditures for the treatment of adult pharyngitis will exceed US$1.2 billion annually. This substantial projection reinforces the need to evaluate diagnosis and treatment of adult pharyngitis in nontraditional settings. The objective of this research is to quantify the amount of pharmacist time required to complete a point-of-care (POC) test for a patient presenting with pharyngitis symptoms. A standardized patient with pharyngitis symptoms visited 11 pharmacies for POC testing services for a total of 33 patient encounters. An observer was present at each encounter and recorded the total encounter time, divided into 9 categories. Pharmacists conducted POC testing in 1 of 2 ways: sequence 1-pharmacists performed all service-related tasks; sequence 2-both pharmacists and pharmacist interns performed service-related tasks. The average time for completion of a POC test for GAS pharyngitis was 25.3 ± 4.8 minutes. The average pharmacist participation time per encounter was 12.7 ± 3.0 minutes (sequence 1), which decreased to 2.6 ± 1.1 minutes when pharmacist interns were involved in the testing (sequence 2). Although additional studies are required to further assess service feasibility, this study indicates that a GAS POC testing service could be implemented in a community pharmacy with limited disruption or change to workflow and staff.

The reliability and validity of the Complex Task Performance Assessment: A performance-based assessment of executive function.

PubMed

Wolf, Timothy J; Dahl, Abigail; Auen, Colleen; Doherty, Meghan

2017-07-01

The objective of this study was to evaluate the inter-rater reliability, test-retest reliability, concurrent validity, and discriminant validity of the Complex Task Performance Assessment (CTPA): an ecologically valid performance-based assessment of executive function. Community control participants (n = 20) and individuals with mild stroke (n = 14) participated in this study. All participants completed the CTPA and a battery of cognitive assessments at initial testing. The control participants completed the CTPA at two different times one week apart. The intra-class correlation coefficient (ICC) for inter-rater reliability for the total score on the CTPA was .991. The ICCs for all of the sub-scores of the CTPA were also high (.889-.977). The CTPA total score was significantly correlated to Condition 4 of the DKEFS Color-Word Interference Test (p = -.425), and the Wechsler Test of Adult Reading (p  = -.493). Finally, there were significant differences between control subjects and individuals with mild stroke on the total score of the CTPA (p = .007) and all sub-scores except interpretation failures and total items incorrect. These results are also consistent with other current executive function performance-based assessments and indicate that the CTPA is a reliable and valid performance-based measure of executive function.

Fast Determination of Distribution-Connected PV Impacts Using a Variable Time-Step Quasi-Static Time-Series Approach: Preprint

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

Mather, Barry

The increasing deployment of distribution-connected photovoltaic (DPV) systems requires utilities to complete complex interconnection studies. Relatively simple interconnection study methods worked well for low penetrations of photovoltaic systems, but more complicated quasi-static time-series (QSTS) analysis is required to make better interconnection decisions as DPV penetration levels increase. Tools and methods must be developed to support this. This paper presents a variable-time-step solver for QSTS analysis that significantly shortens the computational time and effort to complete a detailed analysis of the operation of a distribution circuit with many DPV systems. Specifically, it demonstrates that the proposed variable-time-step solver can reduce themore » required computational time by as much as 84% without introducing any important errors to metrics, such as the highest and lowest voltage occurring on the feeder, number of voltage regulator tap operations, and total amount of losses realized in the distribution circuit during a 1-yr period. Further improvement in computational speed is possible with the introduction of only modest errors in these metrics, such as a 91 percent reduction with less than 5 percent error when predicting voltage regulator operations.« less

Integrative exercise and lifestyle intervention increases leisure-time activity in breast cancer patients.

PubMed

Casla, Soraya; Hojman, Pernille; Cubedo, Ricardo; Calvo, Isabel; Sampedro, Javier; Barakat, Ruben

2014-11-01

Physical activity has been demonstrated to increase survival in breast cancer patients, but few breast cancer patients meet the general recommendations for physical activity. The aim of this pilot study was to investigate if a supervised integrated counseling and group-based exercise program could increase leisure-time activity in women with breast cancer. This pilot project, designed as a single-arm study with pre-post testing, consisted of 24 classes of combined aerobic and strength exercise training as well as classes on dietary and health behavior. A total of 48 women with breast cancer who were undergoing or had recently completed anticancer treatment completed the study. Leisure-time physical activity, grip strength, functional capacity, quality of life (QoL), and depression were assessed at baseline, after intervention, and at the 12-week follow-up after intervention. The breast cancer patients increased their leisure-time physical activity (P = .004), global strength (P = .004), functional capacity (P = .001), and QoL (P = .009), and their depression score (P = .004) significantly decreased. These improvements were independent of whether the patients were in ongoing therapy or had completed their treatment. This integrated intervention may produce lifestyle changes in breast cancer patients and survivors using the teachable moment to increase their leisure-time physical activity and, thereby, their QoL. © The Author(s) 2014.

The Cost and Burden of the Residency Match in Emergency Medicine.

PubMed

Blackshaw, Aaron M; Watson, Simon C; Bush, Jeffrey S

2017-01-01

To obtain a residency match, medical students entering emergency medicine (EM) must complete away rotations, submit a number of lengthy applications, and travel to multiple programs to interview. The expenses incurred acquiring this residency position are burdensome, but there is little specialty-specific data estimating it. We sought to quantify the actual cost spent by medical students applying to EM residency programs by surveying students as they attended a residency interview. Researchers created a 16-item survey, which asked about the time and monetary costs associated with the entire EM residency application process. Applicants chosen to interview for an EM residency position at our institution were invited to complete the survey during their interview day. In total, 66 out of a possible 81 residency applicants (an 81% response rate) completed our survey. The "average applicant" who interviewed at our residency program for the 2015-16 cycle completed 1.6 away, or "audition," rotations, each costing an average of $1,065 to complete. This "average applicant" applied to 42.8 programs, and then attended 13.7 interviews. The cost of interviewing at our program averaged $342 and in total , an average of $8,312 would be spent in the pursuit of an EM residency. Due to multiple factors, the costs of securing an EM residency spot can be expensive. By understanding the components that are driving this trend, we hope that the academic EM community can explore avenues to help curtail these costs.

Does live music benefits patients with brain and spinal injury?

PubMed

Zhang, C-C; Mou, L; Wang, X; Guo, D

2015-09-01

The purpose of this study is to examine the feasibility and prospective success associated with implementing and evaluating a six-week live music intervention on an inpatient neurorehabilitation ward. In total 26 patients were included in this study. Out of which, 15 were patients and 11 were staff members. Staff participants completed wellbeing measures at before and after music. Patients completed an assortment of validated measures at five consecutive time points from baseline to follow-up. Staff participants experienced a minor decrease in wellbeing over time. The majority of the data collected from patients illustrated positive trends, with improvements in wellbeing, pain, cognition functioning, independent functioning, and mobility. The feasibility indicates that with modifications that this project is a viable venture. We found that live music appears to be promising new addition to neurorehabilitation.

Shallow-Water Nitrox Diving, the NASA Experience

NASA Technical Reports Server (NTRS)

Fitzpatrick, Daniel T.

2009-01-01

NASA s Neutral Buoyancy Laboratory (NBL) contains a 6.2 million gallon, 12-meter deep pool where astronauts prepare for space missions involving space walks (extravehicular activity EVA). Training is conducted in a space suit (extravehicular mobility unit EMU) pressurized to 4.0 - 4.3 PSI for up to 6.5 hours while breathing a 46% NITROX mix. Since the facility opened in 1997, over 30,000 hours of suited training has been completed with no occurrence of decompression sickness (DCS) or oxygen toxicity. This study examines the last 5 years of astronaut suited training runs. All suited runs are computer monitored and data is recorded in the Environmental Control System (ECS) database. Astronaut training runs from 2004 - 2008 were reviewed and specific data including total run time, maximum depth and average depth were analyzed. One hundred twenty seven astronauts and cosmonauts completed 2,231 training runs totaling 12,880 exposure hours. Data was available for 96% of the runs. It was revealed that the suit configuration produces a maximum equivalent air depth of 7 meters, essentially eliminating the risk of DCS. Based on average run depth and time, approximately 17% of the training runs exceeded the NOAA oxygen maximum single exposure limits, with no resulting oxygen toxicity. The NBL suited training protocols are safe and time tested. Consideration should be given to reevaluate the NOAA oxygen exposure limits for PO2 levels at or below 1 ATA.

Continuous degradation of a mixture of sulfonamides by Trametes versicolor and identification of metabolites from sulfapyridine and sulfathiazole.

PubMed

Rodríguez-Rodríguez, Carlos E; García-Galán, M A Jesús; Blánquez, Paqui; Díaz-Cruz, M Silvia; Barceló, Damià; Caminal, Glòria; Vicent, Teresa

2012-04-30

In this study, we assessed the degradation of the sulfonamides sulfapyridine (SPY) and sulfathiazole (STZ) by the white-rot fungus Trametes versicolor. Complete degradation was accomplished in fungal cultures at initial pollutant concentrations of approximately 10 mg L(-1), although a longer period of time was needed to completely remove STZ in comparison to SPY. When cytochrome P450 inhibitors were added to the fungal cultures, STZ degradation was partially suppressed, while no additional effect was observed for SPY. Experiments with purified laccase and laccase mediators caused the removal of greater than 75% of each antibiotic. Ultra-performance liquid chromatography-quadupole time of flight mass spectrometry (UPLC-QqTOF-MS) analyses allowed the identification of a total of eight degradation intermediates of SPY in both the in vivo and the laccase experiments, being its desulfonated moiety the commonly detected product. For STZ, a total of five products were identified. A fluidized bed reactor with T. versicolor pellets degraded a mixture of sulfonamides (SPY, STZ and sulfamethazine, SMZ) by greater than 94% each at a hydraulic residence time of 72 h. Because wastewater contains many diverse pollutants, these results highlight the potential of T. versicolor as a bioremediation agent not only for the removal of antibiotics but also for the elimination of a wide range of contaminants. Copyright © 2012 Elsevier B.V. All rights reserved.

A prospective randomized cost billing comparison of local fasciocutaneous perforator versus free Gracilis flap reconstruction for lower limb in a developing economy.

PubMed

Abdelrahman, Islam; Moghazy, Amr; Abbas, Ashraf; Elmasry, Moustafa; Adly, Osama; Elbadawy, Mohamed; Steinvall, Ingrid; Sjoberg, Folke

2016-08-01

Distal half leg complex wounds are usually a formidable problem that necessitates either local or free flap coverage. The aim of this study was to compare cost billing charges in free Gracilis flap (fGF) and local fasciocutaneous perforator flap (lFPF) in reconstructing complex soft tissue leg and foot defects. Thirty consecutive adult (>15-year-old) patients with soft tissue defects in the leg and/or foot requiring tissue coverage with a flap in the period between 2012 and 2015 were randomly assigned (block randomization) to either an fGF or lFPF procedure. The outcome measures addressed were total billed charges costs, perioperative billed charges cost, partial or complete flap loss, length of hospital stay, inpatient postsurgical care duration, complications, operating time and number of operative scrub staff. One patient suffered from complete flap loss in each group. Reconstruction with lFPF showed total lower billed charges costs by 62% (2509 USD) (p < 0.001) and perioperative billed charges cost by 54% (779 USD) (p < 0.001), and shorter total hospital stay (36.5 days; p < 0.001), inpatient postsurgical care duration (6.4 days; p < 0.001), operating time (4.3 h; p < 0.001) and fewer scrub staff (2.2 persons; p < 0.001). These results suggest that neither flap is totally superior to the other; the choice should instead be based on the outcome sought and logistics. lFPF requires lower billed charges cost and resource use and saves operative time and personnel and reduces length of hospital stay. Our approach changed towards using perforator flaps in medium-sized defects, keeping the free flap option for larger defects. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

A comparative analysis of salivary factors and maxillary denture retention in different arch forms: An in vivo study.

PubMed

Shekhar, Abhishek; Das, Samiran; Bhattacharyya, Jayanta; Goel, Preeti; Majumdar, Sayan; Ghosh, Soumitra

2018-01-01

This study aims to find the effect of change in different salivary factors before and after complete denture insertion and to measure the maxillary denture retention in different arch forms. Thirty completely edentulous individuals (10 each of square, tapered, and ovoid arch form of maxilla) belonging to the age group of 40-70 years were selected. Salivary factors (flow, density, pH, viscosity, and total protein) were evaluated before and after denture insertion. Retention of maxillary denture was measured in all the different arch forms. Student's independent sample's t -test was applied. The correlation was analyzed by Pearson's correlation analysis. While mean flow rate and pH of saliva increased, mean viscosity, total protein, and density of saliva decreased after maxillary complete denture insertion. A positive correlation was found between retention and total maxillary basal surface area. Retention value was found to be greatest in square type and least in tapered type. Complete denture acts as a mechanical stimulant thus increasing flow rate and pH immediately after complete denture insertion. Density, total protein, and viscosity of saliva decreased after complete denture insertion which may be due to increase in water content of saliva. The retention of maxillary complete denture does not seem to depend on the rate of change of the salivary factors, before and after complete denture insertion. Total basal surface area and maxillary denture retention values were highest in square arch form and least in tapered arch form.

The complete mitochondrial genome of the Border Collie dog.

PubMed

Wu, An-Quan; Zhang, Yong-Liang; Li, Li-Li; Chen, Long; Yang, Tong-Wen

2016-01-01

Border Collie dog is one of the famous breed of dog. In the present work we report the complete mitochondrial genome sequence of Border Collie dog for the first time. The total length of the mitogenome was 16,730 bp with the base composition of 31.6% for A, 28.7% for T, 25.5% for C, and 14.2% for G and an A-T (60.3%)-rich feature was detected. It harbored 13 protein-coding genes, two ribosomal RNA genes, 22 transfer RNA genes and one non-coding control region (D-loop region). The arrangement of all genes was identical to the typical mitochondrial genomes of dogs.

The complete mitochondrial genome of the black field cricket, Teleogryllus oceanicus.

PubMed

Zhou, Jiu-Xuan; Jia, Yong-Chao; Yang, Xue-Chao; Li, Qiang

2017-03-01

In this study, the complete mitochondrial genome sequence of the black field cricket, Teleogryllus oceanicus, with the total length of 15 660 bp is determined for the first time. This mitochondrial genome harbors 13 protein-coding genes (PCGs), 22 transfer RNA genes (tRNA), two ribosomal RNA genes (rRNA), and one control region (D-loop). The overall base composition is A (40.44%), C (17.12%), G (9.84%), and T (32.60%), so the slight A-T bias (73.04%) was detected. Phylogenetic analysis showed that T. oceanicus is closely related to T. emma that is also a member of the genus Teleogryllus.

V380 Dra: New short-period totally eclipsing active binary

NASA Astrophysics Data System (ADS)

Özdarcan, O.

2014-02-01

In this study, first complete and standard BVR light curves and photometric analysis of the eclipsing binary system V380 Dra are presented. Photometric analysis result indicates that the system has components which are cool main sequence stars. In light and color curves, remarkable asymmetry is observed, especially after secondary minimum, which is believed to be a result of chromospheric activity in one or both components. O-C diagram of available small number of eclipse times, together with new eclipse timings in this work, exhibits no significant variation. Preliminary light curve solution shows that the secondary minimum is total eclipse. By using the advantage of total eclipse and mass-luminosity relation, it is found that the system has a possible mass ratio of q = 0.81. First estimation of masses and radii of primary and secondary components are M1 = 0.77 M⊙,M2 = 0.62 M⊙ and R1 = 0.93 R⊙,R2 = 0.77 R⊙, respectively.

Development and reprotuction of Spodoptera eridania on natural hosts and artificial diet.

PubMed

Silva, A; Baronio, C A; Galzer, E C W; Garcia, M S; Botton, M

2018-04-09

The development and reproductive potential of Spodoptera eridania (Stoll, 1782) (Lepidoptera, Noctuidae) was compared on natural and artificial diets. Its biology was determined under laboratory conditions, providing an artificial diet, leaves of white clover and the peach cultivar 'Chimarrita' and fruits and leaves of the apple cultivar 'Gala'. Larvae of S. eridania could not complete their biological cycle when fed on apple fruits or peach leaves. The artificial diet provided the shortest development time, with a cycle of 28.5±0.14 days from egg to adult and 37.3% total viability. Apple leaves led to a longer development time from egg to adult (62.8±1.22 days) and lower total viability (23%) and white clover provided the highest total viability (54.3%). The results showed that S. eridania can use white clover and apple leaves to develop normally in apple orchards. The reduction of food sources such as white clover used by the larvae results in infestation and damage to fruits from "test bites".

Are Graduate Students Rational? Evidence from the Market for Biomedical Scientists

PubMed Central

Blume-Kohout, Margaret E.; Clack, John W.

2013-01-01

The U.S. National Institutes of Health (NIH) budget expansion from 1998 through 2003 increased demand for biomedical research, raising relative wages and total employment in the market for biomedical scientists. However, because research doctorates in biomedical sciences can often take six years or more to complete, the full labor supply response to such changes in market conditions is not immediate, but rather is observed over a period of several years. Economic rational expectations models assume that prospective students anticipate these future changes, and also that students take into account the opportunity costs of their pursuing graduate training. Prior empirical research on student enrollment and degree completions in science and engineering (S&E) fields indicates that “cobweb” expectations prevail: that is, at least in theory, prospective graduate students respond to contemporaneous changes in market wages and employment, but do not forecast further changes that will arise by the time they complete their degrees and enter the labor market. In this article, we analyze time-series data on wages and employment of biomedical scientists versus alternative careers, on completions of S&E bachelor's degrees and biomedical sciences PhDs, and on research expenditures funded both by NIH and by biopharmaceutical firms, to examine the responsiveness of the biomedical sciences labor supply to changes in market conditions. Consistent with previous studies, we find that enrollments and completions in biomedical sciences PhD programs are responsive to market conditions at the time of students' enrollment. More striking, however, is the close correspondence between graduate student enrollments and completions, and changes in availability of NIH-funded traineeships, fellowships, and research assistantships. PMID:24376573

Robotic Cholecystectomy Using the Newly Developed Korean Robotic Surgical System, Revo-i: A Preclinical Experiment in a Porcine Model.

PubMed

Kang, Chang Moo; Chong, Jae Uk; Lim, Jin Hong; Park, Dong Won; Park, Sung Jun; Gim, Suhyeon; Ye, Hye Jin; Kim, Se Hoon; Lee, Woo Jung

2017-09-01

One Korean company recently successfully produced a robotic surgical system prototype called Revo-i (MSR-5000). We, therefore, conducted a preclinical study for robotic cholecystectomy using Revo-i, and this is a report of the first case of robotic cholecystectomy performed using the Revo-i system in a preclinical porcine model. Revo-i consists of a surgeon console (MSRC-5000), operation cart (MSRO-5000) and vision cart (MSRV-5000), and a 40 kg-healthy female porcine was prepared for robotic cholecystectomy with general anesthesia. The primary end point was the safe completion of these procedures using Revo-i: The total operation time was 88 minutes. The dissection time was defined as the time from the initial dissection of the Calot area to the time to complete gallbladder detachment from the liver bed: The dissection time required 14 minutes. The surgical console time was 45 minutes. There was no gallbladder perforation or significant bleeding noted during the procedure. The porcine survived for two weeks postoperatively without any complications. Like the da Vinci surgical system, the Revo-i provides a three-dimensional operative view and allows for angulated instrument motion (forceps, needle-holders, clip-appliers, scissors, bipolar energy, and hook monopolar energy), facilitating an effective laparoscopic procedure. Our experience suggests that robotic cholecystectomy can be safely completed in a porcine model using Revo-i. © Copyright: Yonsei University College of Medicine 2017.

Laparoscopic reoperation with total fundoplication for failed Heller myotomy: is it a possible option? Personal experience and review of literature.

PubMed

Rossetti, Gianluca; del Genio, Gianmattia; Maffettone, Vincenzo; Fei, Landino; Brusciano, Luigi; Limongelli, Paolo; Pizza, Francesco; Tolone, Salvatore; Di Martino, Maria; del Genio, Federica; del Genio, Alberto

2009-01-01

Laparoscopic Heller myotomy with antireflux procedure seems the procedure of choice in the treatment of patients with esophageal achalasia. Persistent or recurrent symptoms occur in 10% to 20% of patients. Few reports on reoperation after failed Heller myotomy have been published. No author has reported the realization of a total fundoplication in these patient groups. The aim of this study is to evaluate the efficacy of laparoscopic reoperation with the realization of a total fundoplication after failed Heller myotomy for esophageal achalasia. From 1992 to December 2007, 5 out of a series of 242 patients (2.1%), along with 2 patients operated elsewhere, underwent laparoscopic reintervention for failed Heller myotomy. Symptoms leading to reoperation included persistent dysphagia in 3 patients, recurrent dysphagia in another 3, and heartburn in 1 patient. Mean time from the first to the second operation was 49.7 months (range, 4-180 months). Always, the intervention was completed via a laparoscopic approach and a Nissen-Rossetti fundoplication was realized or left in place after a complete Heller myotomy. Mean operative time was 160 minutes (range, 60-245 minutes). Mean postoperative hospital stay was 3.1 +/- 1.5 days. No major morbidity or mortality occurred. At a mean follow-up of 16.1 months, reoperation must be considered successful in 5 out of 7 patients (71.4%). The dysphagia DeMeester score fell from 2.71 +/- 0.22 to 0.91 +/- 0.38 postoperatively. The regurgitation score changed from 2.45 +/- 0.34 to 0.68 +/- 0.23. Laparoscopic reoperation for failed Heller myotomy with the realization of a total fundoplication is safe and is associated with good long-term results if performed by an experienced surgeon in a center with a long tradition of esophageal surgery.

Bibliography on Tidal Hydraulics. Supplementary Material Compiled from June 1983 to June 1986. Tidal Flows in Rivers and Harbors. Supplement Number 10.

DTIC Science & Technology

1987-06-01

Section VIII.) the total time. The reverse of this cir- culation (surface inflow, outflow at Edinger, J. E., and Buchak, E. M. "Estu- depth) and storage ...respect to their applicabil- Attempts have been made to determine the ity. Hourly sampled 70-hours time series flow characteristics in the estuary, ana- of...Integration Using Pumped Storage ." cient equations, it is obvious that the (See complete entry in Section V.) flow will not be properly simulated with

Optimal Black Start Resource Allocation

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

Qiu, Feng; Wang, Jianhui; Chen, Chen

The restoration of the bulk power system after a partial or complete blackout relies on black-start (BS) resources. To prepare for system restoration, it is important to procure the right amount of BS resources at the right locations in the grid so that the total restoration time can be minimized. Achieving this goal requires that resource procurement planning takes the restoration process into account. In this study, we integrate the BS resource procurement decision with a restoration planning model and develop an optimization model that produces a minimal cost procurement plan that satisfies the restoration time requirement.

Sleep Perception and Misperception in Chronic Cocaine Users During Abstinence.

PubMed

Hodges, Sarah E; Pittman, Brian; Morgan, Peter T

2017-03-01

During abstinence, chronic cocaine users experience an objective worsening of sleep that is perceived as qualitatively improving. This phenomenon has been termed "occult insomnia." The objective of this study was to determine whether chronic cocaine users experience positive sleep state misperception during abstinence. Forty-three cocaine-dependent persons were admitted to an inpatient research facility for 12 days and 11 nights to participate in a treatment study of modafinil. Polysomnographic sleep recordings were performed on study nights 3, 4, 10, and 11, when participants were on average 1 and 2 weeks abstinent from cocaine. Participants also completed sleep diary questionnaires every evening before bed and every morning upon awakening. Polysomnographic and sleep diary measurements of total sleep time, sleep latency, time awake after sleep onset, and time in bed after final awakening were compared. Chronic cocaine users accurately reported total sleep time after 1 week of abstinence but overreported total sleep time by an average of 40 min after 2 weeks of abstinence. Underestimating sleep latency and time spent awake after sleep onset were responsible for this difference. Positive sleep state misperception is revealed in chronic cocaine users after 2 weeks of abstinence and is consistent with the previously identified "occult insomnia" in this population. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Intraindividual variation in levels of serum testosterone and other reproductive and adrenal hormones in men.

PubMed

Brambilla, Donald J; O'Donnell, Amy B; Matsumoto, Alvin M; McKinlay, John B

2007-12-01

Estimates of intraindividual variation in hormone levels provide the basis for interpreting hormone measurements clinically and for developing eligibility criteria for trials of hormone replacement therapy. However, reliable systematic estimates of such variation are lacking. To estimate intraindividual variation of serum total, free and bioavailable testosterone (T), dihydrotestosterone (DHT), SHBG, LH, dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulphate (DHEAS), oestrone, oestradiol and cortisol, and the contributions of biological and assay variation to the total. Paired blood samples were obtained 1-3 days apart at entry and again 3 months and 6 months later (maximum six samples per subject). Each sample consisted of a pool of equal aliquots of two blood draws 20 min apart. Men aged 30-79 years were randomly selected from the respondents to the Boston Area Community Health Survey, a study of the health of the general population of Boston, MA, USA. Analysis was based on 132 men, including 121 who completed all six visits, 8 who completed the first two visits and 3 who completed the first four visits. Day-to-day and 3-month (long-term) intraindividual standard deviations, after transforming measurements to logarithms to eliminate the contribution of hormone level to intraindividual variation. Biological variation generally accounted for more of total intraindividual variation than did assay variation. Day-to-day biological variation accounted for more of the total than did long-term biological variation. Short-term variability was greater in hormones with pulsatile secretion (e.g. LH) than those that exhibit less ultradian variation. Depending on the hormone, the intraindividual standard deviations imply that a clinician can expect to see a difference exceeding 18-28% about half the time when two measurements are made on a subject. The difference will exceed 27-54% about a quarter of the time. Given the level of intraindividual variability in hormone levels found in this study, one sample is generally not sufficient to characterize an individual's hormone levels but collecting more than three is probably not warranted. This is true for clinical measurements and for hormone measurements used to determine eligibility for a clinical trial of hormone replacement therapy.

Impact of a radio frequency management information system on the process and timing of providing respiratory care services.

PubMed

Stoller, James K; Kester, Lucy; Orens, Douglas K; McCarthy, Kevin

2002-08-01

Although radio frequency (RF) systems have proliferated and are designed to simplify care delivery in many clinical settings, little information is available on the impact of such RF systems on the delivery of patient care. Having used a hand-held-device-based management information system in our Respiratory Therapy Section for 16 years, we assessed the impact of an RF system on the delivery of respiratory therapy (RT) services. A single nursing unit dedicated to pulmonary and ear, nose, and throat care was selected for the RF system trial. Baseline (pre-RF) data were collected over 2 separate 1-month intervals (February 1999 and February 2000). The main outcome measures were (1) the amount of time needed at the beginning of the shift to organize and assign orders for RT services, (2) the time interval between notification of an RT consult order and completion of the RT consult, and (3) the time interval between notification of an RT treatment order and completion of the RT treatment. The activities required for organizing and assigning the orders were manually timed. Starting 6 weeks after therapists were trained to use the RF system, similar data were collected while using the RF system for two 1-month intervals (February and March 2001). The mean +/- SD time interval between receiving an RT consult order and completing the consult was reduced from 7.8 +/- 18.9 h to 2.8 +/- 2.4 h (p = 0.002). The percentage of patients who waited longer than 8 hours between receipt of a consult order and completion of the consult decreased from 18% to 4.7% (p = 0.026). The total time required for organizing and assigning RT work was reduced from 81.6 min to 43.6 min. The RF system had several advantages over the hand-held-device-based system: (1) shorter interval between the order for and completion of an RT consult, (2) lower percentage of patients for whom the interval between the order and the consult exceeded 8 hours, and (3) less time required to make shift assignments. These results invite assessment of whether accelerated delivery of RT services confers clinical benefits.

Impact of sleep duration on seizure frequency in adults with epilepsy: a sleep diary study.

PubMed

Cobabe, Maurine M; Sessler, Daniel I; Nowacki, Amy S; O'Rourke, Colin; Andrews, Noah; Foldvary-Schaefer, Nancy

2015-02-01

Prolonged sleep deprivation activates epileptiform EEG abnormalities and seizures in people with epilepsy. Few studies have addressed the effect of chronic partial sleep deprivation on seizure occurrence in populations with epilepsy. We tested the primary hypothesis that partial sleep deprivation over 24- and 72-hour periods increases seizure occurrence in adults with epilepsy. Forty-four subjects completed a series of self-reported instruments, as well as 1-month sleep and seizure diaries, to characterize their sleep and quality of life. Diaries were used to determine the relationship between seizure occurrence and total sleep time 24 and 72h before seizure occurrence using random effects models and a logistic regression model fit by generalized estimating equations. A total of 237 seizures were recorded during 1295 diary days, representing 5.5±7.0 (mean±SD) seizures per month. Random effects models for 24- and 72-hour total sleep times showed no clinically or statistically significant differences in the total sleep time between preseizure periods and seizure-free periods. The average 24-hour total sleep time during preseizure 24-hour periods was 8min shorter than that during seizure-free periods (p=0.51). The average 72-hour total sleep time during preseizure periods was 20min longer than that during seizure-free periods (p=0.86). The presence of triggers was a significant predictor of seizure occurrence, with stress/anxiety noted most often as a trigger. Mean total sleep time was 9h, and subjects took an average of 12±10 naps per month, having a mean duration of 1.9±1.2h. Daytime sleepiness, fatigue, and insomnia symptoms were commonly reported. Small degrees of sleep loss were not associated with seizure occurrence in our sample of adults with epilepsy. Our results also include valuable observations of the altered sleep times and frequent napping habits of adults with refractory epilepsy and the potential contribution of these habits to quality of life and seizure control. Copyright © 2014 Elsevier Inc. All rights reserved.

Quiet eye training improves surgical knot tying more than traditional technical training: a randomized controlled study.

PubMed

Causer, Joe; Harvey, Adrian; Snelgrove, Ryan; Arsenault, Gina; Vickers, Joan N

2014-08-01

We examined the effectiveness of technical training (TT) and quiet eye training (QE) on the performance of one-handed square knot tying in surgical residents. Twenty surgical residents were randomly assigned to the 2 groups and completed pretest, training, retention, and transfer tests. Participants wore a mobile eye tracker that simultaneously recorded their gaze and hand movements. Dependent variables were knot tying performance (%), QE duration (%), number of fixations, total movement time (s), and hand movement phase time (s). The QE training group had significantly higher performance scores, a longer QE duration, fewer fixations, faster total knot tying times, and faster movement phase times compared with the TT group. The QE group maintained performance in the transfer test, whereas the TT group significantly decreased performance from retention to transfer. QE training significantly improved learning, retention, and transfer of surgical knot tying compared with a traditional technical approach. Both performance effectiveness (performance outcome) and movement efficiency (hand movement times) were improved using QE modeling, instruction, and feedback. Copyright © 2014 Elsevier Inc. All rights reserved.

Improving completion rates for client intake forms through Audio Computer-Assisted Self-Interview (ACASI): results from a pilot study with the Avon Breast Health Outreach Program.

PubMed

Hallum-Montes, Rachel; Senter, Lindsay; D'Souza, Rohan; Gates-Ferris, Kathryn; Hurlbert, Marc; Anastario, Michael

2014-01-01

This study compares rates of completion of client intake forms (CIFs) collected via three interview modes: audio computer-assisted self-interview (ACASI), face-to-face interview (FFI), and self-administered paper-based interview (SAPI). A total of 303 clients served through the Avon Breast Health Outreach Program (BHOP) were sampled from three U.S. sites. Clients were randomly assigned to complete a standard CIF via one of the three interview modes. Logistic regression analyses demonstrated that clients were significantly more likely to complete the entire CIF via ACASI than either FFI or SAPI. The greatest observed differences were between ACASI and SAPI; clients were almost six times more likely to complete the CIF via ACASI as opposed to SAPI (AOR = 5.8, p < .001). We recommend that where feasible, ACASI be utilized as an effective means of collecting client-level data in healthcare settings. Adoption of ACASI in health centers may translate into higher completion rates of intake forms by clients, as well as reduced burden on clinic staff to enter data and review intake forms for completion. © 2013 National Association for Healthcare Quality.

Teaching binocular indirect ophthalmoscopy to novice residents using an augmented reality simulator.

PubMed

Rai, Amandeep S; Rai, Amrit S; Mavrikakis, Emmanouil; Lam, Wai Ching

2017-10-01

To compare the traditional teaching approach of binocular indirect ophthalmoscopy (BIO) to the EyeSI augmented reality (AR) BIO simulator. Prospective randomized control trial. 28 post-graduate year one (PGY1) ophthalmology residents. Residents were recruited at the 2012 Toronto Ophthalmology Residents Introductory Course (TORIC). 15 were randomized to conventional teaching (Group 1), and 13 to augmented reality simulator training (Group 2). 3 vitreoretinal fellows were enrolled to serve as experts. Evaluations were completed on the simulator, with 3 tasks, and outcome measures were total raw score, total time elapsed, and performance. Following conventional training, Group 1 residents were outperformed by vitreoretinal fellows with respect to all 3 outcome measures. Following AR training, Group 2 residents demonstrated superior total scores and performance compared to Group 1 residents. Once the Group 1 residents also completed the AR BIO training, there was a significant improvement compared to their baseline scores, and were now on par with Group 2 residents. This study provides construct validity for the EyeSI AR BIO simulator and demonstrates that it may be superior to conventional BIO teaching for novice ophthalmology residents. Copyright © 2017 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

The Polyp Manager: a new tool for optimal polyp documentation during colonoscopy. A pilot study.

PubMed Central

van de Meeberg, Maartje M.; Ouwendijk, Rob J. Th.; ter Borg, Pieter C. J.; van den Hazel, Sven J.; van de Meeberg, Paul C.

2016-01-01

Background and study aims: Conventional reporting of polyps is often incomplete. We tested the Polyp Manager (PM), a new software application permitting the endoscopist to document polyps in real time during colonoscopy. We studied completeness of polyp descriptions, user-friendliness and the potential time benefit. Patients and methods: In two Dutch hospitals colonoscopies were performed with PM (as a touchscreen endoscopist-operated device or nurse-operated desktop application). Completeness of polyp descriptions was compared to a historical group with conventional reporting (CRH). Prospectively, we compared user-friendliness (VAS-scores) and time benefit of the endoscopist-operated PM to conventional reporting (CR) in one hospital. Duration of colonoscopy and time needed to report polyps and provide a pathology request were measured. Provided that using PM does not prolong colonoscopy, the sum of the latter two was considered as a potential time-benefit if the PM were fully integrated into a digital reporting system. Results: A total of 144 regular colonoscopies were included in the study. Both groups were comparable with regard to patient characteristics, duration of colonoscopy and number of polyps. Using the PM did reduce incomplete documentation of the following items in CRH-reports: location (96 % vs 82 %, P = 0.01), size (95 % vs 89 %, P = 0.03), aspect (71 % vs 36 %, P < 0.001) and completeness of removal (61 % vs 37 %, P < 0.001). In the prospective study 23 PM-colonoscopies where compared to 28 CR-colonoscopies. VAS-scores were significantly higher in the endoscopist-operated PM group. Time to report was 01:27 ± 01:43 minutes (median + interquartile range) in the entire group (PM as CR), reflecting potential time benefit per colonoscopy. Conclusions: The PM is a user-friendly tool that seems to improve completeness of polyp reporting. Once integrated with digital reporting systems, it is probably time saving as well. PMID:27227117

Effect of training frequency on the learning curve on the da Vinci Skills Simulator.

PubMed

Walliczek, Ute; Förtsch, Arne; Dworschak, Philipp; Teymoortash, Afshin; Mandapathil, Magis; Werner, Jochen; Güldner, Christian

2016-04-01

The purpose of this study was to evaluate the effect of training on the performance outcome with the da Vinci Skills Simulator. Forty novices were enrolled in a prospective training curriculum. Participants were separated into 2 groups. Group 1 performed 4 training sessions and group 2 had 2 training sessions over a 4-week period. Five exercises were performed 3 times consecutively. On the last training day, a new exercise was added. A significant skills gain from the first to the final practice day in overall performance, time to complete, and economy of motion was seen for both groups. Group 1 had a significantly better outcome in overall performance, time to complete, and economy of motion in all exercises. There was no significant difference found regarding the new exercise in group 1 versus group 2 in nearly all parameters. Longer time distances between training sessions are assumed to play a secondary role, whereas total repetition frequency is crucial for improvement of technical performance. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1762-E1769, 2016. © 2015 Wiley Periodicals, Inc.

Independent and incremental prognostic value of Doppler-derived left ventricular total isovolumic time in patients with systolic heart failure.

PubMed

Bajraktari, Gani; Dini, Frank Lloyd; Fontanive, Paolo; Elezi, Shpend; Berisha, Venera; Napoli, Anna Maria; Ciuti, Manrico; Henein, Michael

2011-05-05

A prolonged total isovolumic time (T-IVT) has been shown to be associated with worsening survival in patients submitted to coronary artery surgery. However, it is not known whether it has prognostic significance in patients with chronic systolic heart failure (HF). To determine the prognostic value of T-IVT in comparison with other clinical, biochemical and echocardiographic variables in patients with chronic systolic HF. Patients (n=107; age 68±12 years, 25% women) with chronic systolic HF, left ventricular ejection fraction (EF)<45%, and sinus rhythm, underwent a complete Doppler echocardiographic study, that included tissue Doppler long axis velocities and total isovolumic time (T-IVT), determined as [60-(total ejection time+total filling time)]. Plasma N-terminal pro-B natriuretic peptide (NT-pro-BNP) was also measured. The associations of dichotomous variables selected according to the Receiver Operator Characteristic analysis were assessed using the Cox proportional hazard model. Follow-up period was 37±18 months. Multivariate predictors of events were T-IVT≥12.3% s/min, mean E/Em ratio≥10, log NT-pro-BNP levels≥2.47 pg/ml and LV EF≤32.5%. On Kaplan-Meier analysis, patients with prolonged T-IVT, high mean E/Em ratio, increased NT-pro-BNP levels and decreased LV EF had a worse outcome compared with those without. The addition of T-IVT and NT-pro-BNP to conventional clinical and echocardiographic variables significantly improved the chi-square for the prediction of the outcome from 33.1 to 38.0, (P<0.001). Prolonged T-IVT added to the prognostic stratification of patients with systolic HF. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

Decreasing laboratory turnaround time and patient wait time by implementing process improvement methodologies in an outpatient oncology infusion unit.

PubMed

Gjolaj, Lauren N; Gari, Gloria A; Olier-Pino, Angela I; Garcia, Juan D; Fernandez, Gustavo L

2014-11-01

Prolonged patient wait times in the outpatient oncology infusion unit indicated a need to streamline phlebotomy processes by using existing resources to decrease laboratory turnaround time and improve patient wait time. Using the DMAIC (define, measure, analyze, improve, control) method, a project to streamline phlebotomy processes within the outpatient oncology infusion unit in an academic Comprehensive Cancer Center known as the Comprehensive Treatment Unit (CTU) was completed. Laboratory turnaround time for patients who needed same-day lab and CTU services and wait time for all CTU patients was tracked for 9 weeks. During the pilot, the wait time from arrival to CTU to sitting in treatment area decreased by 17% for all patients treated in the CTU during the pilot. A total of 528 patients were seen at the CTU phlebotomy location, representing 16% of the total patients who received treatment in the CTU, with a mean turnaround time of 24 minutes compared with a baseline turnaround time of 51 minutes. Streamlining workflows and placing a phlebotomy station inside of the CTU decreased laboratory turnaround times by 53% for patients requiring same day lab and CTU services. The success of the pilot project prompted the team to make the station a permanent fixture. Copyright © 2014 by American Society of Clinical Oncology.

Effects of coffee consumption on gut recovery after surgery of gynecological cancer patients: a randomized controlled trial.

PubMed

Güngördük, Kemal; Özdemir, İsa Aykut; Güngördük, Özgü; Gülseren, Varol; Gokçü, Mehmet; Sancı, Muzaffer

2017-02-01

Paralytic ileus that develops after elective surgery is a common and uncomfortable complication and is considered inevitable after an intraperitoneal operation. The purpose of this study was to investigate whether coffee consumption accelerates the recovery of bowel function after complete staging surgery of gynecologic cancers. In this randomized controlled trial, 114 patients were allocated preoperatively to either postoperative coffee consumption with 3 times daily (n=58) or routine postoperative care without coffee consumption (n=56). Total abdominal hysterectomy and bilateral salpingo-oophorectomy with systematic pelvic and paraaortic lymphadenectomy were performed on all patients as part of complete staging surgery for endometrial, ovarian, cervical, or tubal cancer. The primary outcome measure was the time to the first passage of flatus after surgery. Secondary outcomes were the time to first defecation, time to first bowel movement, and time to tolerance of a solid diet. The mean time to flatus (30.2±8.0 vs 40.2±12.1 hours; P<.001), mean time to defecation (43.1±9.4 vs 58.5±17.0 hours; P<.001), and mean time to the ability to tolerate food (3.4±1.2 vs 4.7±1.6 days; P<.001) were reduced significantly in patients who consumed coffee compared with control subjects. Mild ileus symptoms were observed in 17 patients (30.4%) in the control group compared with 6 patients (10.3%) in the coffee group (P=.01). Coffee consumption was well-tolerated and well-accepted by patients, and no intervention-related side-effects were observed. Coffee consumption after total abdominal hysterectomy and systematic paraaortic lymphadenectomy expedites the time to bowel motility and the ability to tolerate food. This simple, cheap, and well-tolerated treatment should be added as an adjunct to the postoperative care of gynecologic oncology patients. Copyright © 2016 Elsevier Inc. All rights reserved.

Precision of Times-of-Minima and the Detection of Low-Mass Third Bodies Orbiting Eclipsing Binaries

NASA Astrophysics Data System (ADS)

Genet, R. M.; Smith, T. C.

2004-12-01

Low-mass third bodies orbiting eclipsing binaries are difficult to detect by way of periodic shifts in photometric times-of-minima because the observational precision of these timings are of the same order as the expected effects of any low-mass companions. We are implementing three approaches to increasing the precision of our times-of-minima. First, we are obtaining many times-of-minima by utilizing relatively low-cost, dedicated telescopes and CCD cameras (10- and 14-inch Meade LX-200 telescopes and SBIG ST7-XE cameras). Operating in a semiautomatic mode, we select an eclipsing binary system, based on its placement in the sky, and observe it all night long - usually many nights in a row. We choose binaries with short enough periods to assure us of obtaining a complete light curve (and hence an eclipse) every night we observe. Second, we are striving to increase the photometric precision of each observation through the use of multiple comparison stars (ensemble photometry). We are also, in conjunction with California Polytechnic State University, investigating other ways of increasing the photometric precision of these low-cost systems (see E. Sturm this conference). Finally, we are utilizing complete, as opposed to partial, light curves in our analysis. Information outside primary eclipses is gathered as a matter of course, and its use can improve precision. A total of 186 complete light curves were obtained at the Dark Ridge and Orion Observatories during the 2004 observing season on six eclipsing binaries (TZ Boo, V523 Cas, RW Com, V1191 Cyg, GM Dra, and V400 Lyr). Please see T. Smith and R. Genet (this conference) for preliminary results on V523 Cas (30+ complete light curves).

Tuberculosis incidence and treatment completion among Ugandan prison inmates

PubMed Central

Schwitters, A.; Kaggwa, M.; Omiel, P.; Nagadya, G.; Kisa, N.; Dalal, S.

2016-01-01

SUMMARY BACKGROUND The Uganda Prisons Service (UPS) is responsible for the health of approximately 32 500 inmates in 233 prisons. In 2008 a rapid UPS assessment estimated TB prevalence at 654/100 000, three times that of the general population (183/100 000). Although treatment programs exist, little is known about treatment completion in sub-Saharan African prisons. METHODS We conducted a retrospective study of Ugandan prisoners diagnosed with TB from June 2011 to November 2012. We analyzed TB diagnosis, TB-HIV comorbidity and treatment completion from national registers and tracked prison transfers and releases. RESULTS A total of 469 prisoners were diagnosed with TB over the 1.5-year period (incidence 955/100 000 person-years). Of 466 prisoners starting treatment, 48% completed treatment, 43% defaulted, 5% died and 4% were currently on treatment. During treatment, 12% of prisoners remaining in the same prison defaulted, 53% of transfers defaulted and 81% of those released were lost to follow-up. The odds of defaulting were 8.36 times greater among prisoners who were transferred during treatment. CONCLUSIONS TB incidence and treatment default are high among Ugandan prisoners. Strategies to improve treatment completion and prevent multidrug resistance could include avoiding transfer of TB patients, improving communications between prisons to ensure treatment follow-up after transfer and facilitating transfer to community clinics for released prisoners. PMID:24902552

Implementation of total focusing method for phased array ultrasonic imaging on FPGA

NASA Astrophysics Data System (ADS)

Guo, JianQiang; Li, Xi; Gao, Xiaorong; Wang, Zeyong; Zhao, Quanke

2015-02-01

This paper describes a multi-FPGA imaging system dedicated for the real-time imaging using the Total Focusing Method (TFM) and Full Matrix Capture (FMC). The system was entirely described using Verilog HDL language and implemented on Altera Stratix IV GX FPGA development board. The whole algorithm process is to: establish a coordinate system of image and divide it into grids; calculate the complete acoustic distance of array element between transmitting array element and receiving array element, and transform it into index value; then index the sound pressure values from ROM and superimpose sound pressure values to get pixel value of one focus point; and calculate the pixel values of all focus points to get the final imaging. The imaging result shows that this algorithm has high SNR of defect imaging. And FPGA with parallel processing capability can provide high speed performance, so this system can provide the imaging interface, with complete function and good performance.

Operative experience of surgery residents: trends and challenges.

PubMed

Malangoni, Mark A; Biester, Thomas W; Jones, Andrew T; Klingensmith, Mary E; Lewis, Frank R

2013-01-01

To evaluate trends in operative experience and to determine the effect of establishing the Surgical Council on Resident Education (SCORE) operative classification system on changes in operative volume among graduating surgery residents. The general surgery operative logs of graduating surgery residents from 2005 were retrospectively compared with residents who completed training in 2010 and 2011. Nonparametric statistical analyses were used (Mann-Whitney and median test) with significance set at p<0.01. A total of 1022 residents completing residency in 2005 were compared with 1923 residents completing training in 2010-2011. Total operations reported increased from a median of 1023 to 1238 (21%) between 2005 and 2010-2011 (p<0.001). Cases increased in most SCORE categories. The median numbers of total, basic, and complex laparoscopic operations increased by 49%, 37%, and 82%, respectively, over the 5-year interval (p<0.001). Open cavitary (thoracic + abdominal) operations decreased by 5%, whereas other major operations increased by 35% (both p<0.001). The frequency of discrete operations done at least 10 times during residency did not change. The median number of SCORE essential-common operations performed ranged from 1 to 107, whereas essential-uncommon operations ranged from 0 to 4. Twenty-three of 67 SCORE essential-common operations (34%) had a median of less than 5 and 4 had a median of 0. The operative volume of graduating surgical residents has increased by 21% since 2005; however, the number of operations done 10 times or greater has not changed. Although open cavitary procedures continue to decline, there has been a large increase in endoscopy, complex laparoscopic, and other major operations. Some essential-common operations continue to be performed infrequently. These results suggest that education in the operating room must improve and alternate methods for teaching infrequently performed procedures are needed. © 2013 Published by Association of Program Directors in Surgery on behalf of Association of Program Directors in Surgery.

The complete mitochondrial genome of the ice pigeon (Columba livia breed ice).

PubMed

Zhang, Rui-Hua; He, Wen-Xiao

2015-02-01

The ice pigeon is a breed of fancy pigeon developed over many years of selective breeding. In the present work, we report the complete mitochondrial genome sequence of ice pigeon for the first time. The total length of the mitogenome was 17,236 bp with the base composition of 30.2% for A, 24.0% for T, 31.9% for C, and 13.9% for G and an A-T (54.2 %)-rich feature was detected. It harbored 13 protein-coding genes, 2 ribosomal RNA genes, 22 transfer RNA genes and 1 non-coding control region (D-loop region). The arrangement of all genes was identical to the typical mitochondrial genomes of pigeon. The complete mitochondrial genome sequence of ice pigeon would serve as an important data set of the germplasm resources for further study.

The complete mitochondrial genome of the Jacobin pigeon (Columba livia breed Jacobin).

PubMed

He, Wen-Xiao; Jia, Jin-Feng

2015-06-01

The Jacobin is a breed of fancy pigeon developed over many years of selective breeding that originated in Asia. In the present work, we report the complete mitochondrial genome sequence of Jacobin pigeon for the first time. The total length of the mitogenome was 17,245 bp with the base composition of 30.18% for A, 23.98% for T, 31.88% for C, and 13.96% for G and an A-T (54.17 %)-rich feature was detected. It harbored 13 protein-coding genes, 2 ribosomal RNA genes, 22 transfer RNA genes and 1 non-coding control region. The arrangement of all genes was identical to the typical mitochondrial genomes of pigeon. The complete mitochondrial genome sequence of Jacobin pigeon would serve as an important data set of the germplasm resources for further study.

The complete mitochondrial genome of the Fancy Pigeon, Columba livia (Columbiformes: Columbidae).

PubMed

Zhang, Rui-Hua; Xu, Ming-Ju; Wang, Cun-Lian; Xu, Tong; Wei, Dong; Liu, Bao-Jian; Wang, Guo-Hua

2015-02-01

The fancy pigeons are domesticated varieties of the rock pigeon developed over many years of selective breeding. In the present work, we report the complete mitochondrial genome sequence of fancy pigeon for the first time. The total length of the mitogenome was 17,233 bp with the base composition of 30.1% for A, 24.0% for T, 31.9% for C, and 14.0% for G and an A-T (54.2 %)-rich feature was detected. It harbored 13 protein-coding genes, 2 ribosomal RNA genes, 22 transfer RNA genes and 1 non-coding control region (D-loop region). The arrangement of all genes was identical to the typical mitochondrial genomes of pigeon. The complete mitochondrial genome sequence of fancy pigeon would serve as an important data set of the germplasm resources for further study.

[A case of advanced gastric cancer with multiple liver metastases completely responding long term to paclitaxel plus S-1 therapy].

PubMed

Kanou, Mikihiro; Kurisu, Yoshihiro; Akagi, Shinji; Tanaka, Tomoko; Toge, Kunio

2010-01-01

A 69-year-old man was admitted to our hospital with complaints of loss of appetite, fatigue and dysphasia. Upper gastroscopy revealed advanced gastric cancer. Abdominal CT suggested liver metastases. At first we thought the liver metastases has been completely resected, but we found multiple liver metastases unexpectedly. So only total gastric resection and liver biopsy were performed. The pathological diagnosis was metastatic carcinoma. Paclitaxel (PTX) and S-1 combination chemotherapy was started after operation and was continued for 42 courses. A CT scan showed a complete response, and he has been well without tumor re-growth ever since. The combination of PTX and S-1 not only may be an effective regimen for gastric cancer with liver metastases, but also can be used without side effects for a long time.

Hand function with touch screen technology in children with normal hand formation, congenital differences, and neuromuscular disease.

PubMed

Shin, David H; Bohn, Deborah K; Agel, Julie; Lindstrom, Katy A; Cronquist, Sara M; Van Heest, Ann E

2015-05-01

To measure and compare hand function for children with normal hand development, congenital hand differences (CHD), and neuromuscular disease (NMD) using a function test with touch screen technology designed as an iPhone application. We measured touch screen hand function in 201 children including 113 with normal hand formation, 43 with CHD, and 45 with NMD. The touch screen test was developed on the iOS platform using an Apple iPhone 4. We measured 4 tasks: touching dots on a 3 × 4 grid, dragging shapes, use of the touch screen camera, and typing a line of text. The test takes 60 to 120 seconds and includes a pretest to familiarize the subject with the format. Each task is timed independently and the overall time is recorded. Children with normal hand development took less time to complete all 4 subtests with increasing age. When comparing children with normal hand development with those with CHD or NMD, in children aged less than 5 years we saw minimal differences; those aged 5 to 6 years with CHD took significantly longer total time; those aged 7 to 8 years with NMD took significantly longer total time; those aged 9 to 11 years with CHD took significantly longer total time; and those aged 12 years and older with NMD took significantly longer total time. Touch screen technology has becoming increasingly relevant to hand function in modern society. This study provides standardized age norms and shows that our test discriminates between normal hand development and that in children with CHD or NMD. Diagnostic III. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

The Component Timed-Up-and-Go test: the utility and psychometric properties of using a mobile application to determine prosthetic mobility in people with lower limb amputations.

PubMed

Clemens, Sheila M; Gailey, Robert S; Bennett, Christopher L; Pasquina, Paul F; Kirk-Sanchez, Neva J; Gaunaurd, Ignacio A

2018-03-01

Using a custom mobile application to evaluate the reliability and validity of the Component Timed-Up-and-Go test to assess prosthetic mobility in people with lower limb amputation. Cross-sectional design. National conference for people with limb loss. A total of 118 people with non-vascular cause of lower limb amputation participated. Subjects had a mean age of 48 (±13.7) years and were an average of 10 years post amputation. Of them, 54% ( n = 64) of subjects were male. None. The Component Timed-Up-and-Go was administered using a mobile iPad application, generating a total time to complete the test and five component times capturing each subtask (sit to stand transitions, linear gait, turning) of the standard timed-up-and-go test. The outcome underwent test-retest reliability using intraclass correlation coefficients (ICCs) and convergent validity analyses through correlation with self-report measures of balance and mobility. The Component Timed-Up-and-Go exhibited excellent test-retest reliability with ICCs ranging from .98 to .86 for total and component times. Evidence of discriminative validity resulted from significant differences in mean total times between people with transtibial (10.1 (SD: ±2.3)) and transfemoral (12.76 (SD: ±5.1) amputation, as well as significant differences in all five component times ( P < .05). Convergent validity of the Component Timed-Up-and-Go was demonstrated through moderate correlations with the PLUS-M ( r s  = -.56). The Component Timed-Up-and-Go is a reliable and valid clinical tool for detailed assessment of prosthetic mobility in people with non-vascular lower limb amputation. The iPad application provided a means to easily record data, contributing to clinical utility.

Real Time Monitoring of Containerless Microreactions in Acoustically Levitated Droplets via Ambient Ionization Mass Spectrometry.

PubMed

Crawford, Elizabeth A; Esen, Cemal; Volmer, Dietrich A

2016-09-06

Direct in-droplet (in stillo) microreaction monitoring using acoustically levitated micro droplets has been achieved by combining acoustic (ultrasonic) levitation for the first time with real time ambient tandem mass spectrometry (MS/MS). The acoustic levitation and inherent mixing of microliter volumes of reactants (3 μL droplets), yielding total reaction volumes of 6 μL, supported monitoring the acid-catalyzed degradation reaction of erythromycin A. This reaction was chosen to demonstrate the proof-of-principle of directly monitoring in stillo microreactions via hyphenated acoustic levitation and ambient ionization mass spectrometry. The microreactions took place completely in stillo over 30, 60, and 120 s within the containerless stable central pressure node of an acoustic levitator, thus readily promoting reaction miniaturization. For the evaluation of the miniaturized in stillo reactions, the degradation reactions were also carried out in vials (in vitro) with a total reaction volume of 400 μL. The reacted in vitro mixtures (6 μL total) were similarly introduced into the acoustic levitator prior to ambient ionization MS/MS analysis. The in stillo miniaturized reactions provided immediate real-time snap-shots of the degradation process for more accurate reaction monitoring and used a fraction of the reactants, while the larger scale in vitro reactions only yielded general reaction information.

Feasibility of robotic exoskeleton ambulation in a C4 person with incomplete spinal cord injury: a case report.

PubMed

Lester, Robert M; Gorgey, Ashraf S

2018-01-01

To determine whether an individual with C4 incomplete spinal cord injury (SCI) with limited hand functions can effectively operate a powered exoskeleton (Ekso) to improve parameters of physical activity as determined by swing-time, up-time, walk-time, and total number of steps. A 21-year-old male with incomplete chronic (>1 year postinjury) SCI C4, participated in a clinical exoskeleton program to determine the feasibility of standing up and walking with limited hand functions. The participant was invited to attend 3 sessions including fitting, familiarization and gait training separated by one week intervals. Walk-time, up-time and total number of steps were measured during each training session. A complete body composition assessment using dual-energy X-ray absorptiometry (DXA) of the spine, knees and hips was conducted before training.Using a platform walker and cuffing both hands, the participant managed to stand up and ambulate successfully using exoskeleton. Over the course of 2 weeks, maximum walk-time increased from 7 to 17 min and number of steps increased from 83 to 589 steps. The total up-time increased from 19 to 31 min. Exoskeleton training may be a safe and feasible approach for persons with higher levels of SCI after effectively providing a supportive assistive device for weight shifting. The current case study demonstrates the use of a powered exoskeleton for an individual with high level tetraplegia (C4 and above) and limited hand functions.

Neither snow nor rain: contingency planning by a clinical reference laboratory courier service for weather related emergencies.

PubMed

Bankson, Daniel D; Heim, Joseph A

2014-01-01

To optimize transportation processes, we present herein a contingency plan that coordinates interim measures used to ensure continued and timely services when climate based events might cause an interruption of the usual specimen transportation processes. As an example, we outline the implementation and effectiveness of a contingency plan for network laboratory courier automobile transportation during times of mountain pass highway closure. Data available from an approximately 3-year period from October 10, 2010 through August 29, 2013 revealed a total of 690 complete closures in the eastbound or westbound lanes of the Interstate-90 highway in the Snoqualmie Pass area in the state of Washington. Despite the frequency of closures, the Washington State Department of Transportation was effective in limiting the duration of closures. Road closures of less than 1 hour accounted for 58.7% of the total closures. No recorded closures prevented dispatched couriers from completing a prescheduled Snoqualmie Pass route. We identified no delays as being clinically significant, despite that there were 5 instances of delays greater than 4 hours. We implemented a contingency plan of aiding courier logistics during all times of pass closure. The plan includes an easy to interpret Condition Dashboard as a status indicator and a Decision Tree that references and summarizes information. Overall, the contingency plan allows for an objective, robust, proactive decision support system that has enabled operational flexibility and has contributed to continued safe, on-time specimen transportation; clients and courier and reference laboratory staff have appreciated these features and associated outcomes. Copyright© by the American Society for Clinical Pathology (ASCP).

The Reading Interests of Gifted Students and Curriculum Adaptations in the Secondary School: A Comparison Over Time.

ERIC Educational Resources Information Center

Van Nord, Joan E.

A survey of the reading choices made by academically gifted secondary school students was conducted in 1978 to determine if these choices differed from those revealed in a survey undertaken at the same school in 1973. It was hypothesized that there would be only minor changes in patterns of interest by grade. A total of 172 students completed the…

Changing Land Use: The Fens of England. A Case Study in Land Reclamation [And] Student Work Book.

ERIC Educational Resources Information Center

Laws, Kevin

A social studies unit and student workbook explore changes in land use that have occurred in the Fenlands of England since the time it was first inhabited. Fens are lowlying land which is partially or completely covered with water. The English Fens are located on the eastern side of the British Isles and cover a total area of about 2,000 square…

Digital Copy of the Pulkovo Plate Collection

NASA Astrophysics Data System (ADS)

Kanaev, I.; Kanaeva, N.; Poliakow, E.; Pugatch, T.

Report is devoted to a problem of saving of the Pulkovo plate collection. In total more than 50 thousand astronegatives are stored in the observatory. First of them are dated back to 1893. A risk of emulsion corrupting raises with current of time. Since 1996 the operation on digitization and record of the images of plates on electronic media (HDD, CD) are carried out in the observatory. The database ECSIP - Electronic Collection of the Star Images of the Pulkovo is created. There are recorded in it both complete, and extracted (separate areas) images of astronegatives. The plates as a whole are scanned on the photoscanner with rather rough optical resolution 600-2400 dpi. The matrixes with the separate images are digitized on the precision measuring machine "Fantasy" with high (6000-25400 dpi) resolution. The DB ECSIP allows to accept and to store different types of data of a matrix structure, including, CCD-frames. Structure of the ECSIP's software includes systems of visualization, processing and manipulation by the images, and also programs for position and photometric measurements. To the present time more than 40% completed and 10% extracted images from its total amount are digitized and recorded in DB ECSIP. The project is fulfilled at financial support by the Ministry of Science of Russian Federation, grant 01-54 "The coordinate -measuring astrographic machine "Fantasy".

Time of Decline in Sexual Function After External Beam Radiotherapy for Prostate Cancer

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

Siglin, Joshua; Kubicek, Gregory J.; Leiby, Benjamin

Purpose: Erectile dysfunction is one of the most concerning toxicities for patients in the treatment of prostate cancer. The inconsistent evaluation of sexual function (SF) and limited follow-up data have necessitated additional study to clarify the rate and timing of erectile dysfunction after external beam radiotherapy (EBRT) for prostate cancer. Methods and Materials: A total of 143 men completed baseline data on SF before treatment and at the subsequent follow-up visits. A total of 1187 validated SF inventories were analyzed from the study participants. Multiple domains of SF (sex drive, erectile function, ejaculatory function, and overall satisfaction) were analyzed formore » <=8 years of follow-up. Results: The median follow-up was 4.03 years. The strongest predictor of SF after EBRT was SF before treatment. For all domains of SF, the only statistically significant decrease in function occurred in the first 24 months after EBRT. SF stabilized 2 years after treatment completion, with no statistically significant change in any area of SF >2 years after the end of EBRT. Conclusion: These data suggest that SF does not have a continuous decline after EBRT. Instead, SF decreases maximally within the first 24 months after EBRT, with no significant changes thereafter.« less

Identifying EGRET Sources

NASA Technical Reports Server (NTRS)

Schlegel, E.; Norris, Jay P. (Technical Monitor)

2002-01-01

This project was awarded funding from the CGRO program to support ROSAT and ground-based observations of unidentified sources from data obtained by the EGRET instrument on the Compton Gamma-Ray Observatory. The critical items in the project are the individual ROSAT observations that are used to cover the 99% error circle of the unidentified EGRET source. Each error circle is a degree or larger in diameter. Each ROSAT field is about 30 deg in diameter. Hence, a number (>4) of ROSAT pointings must be obtained for each EGRET source to cover the field. The scheduling of ROSAT observations is carried out to maximize the efficiency of the total schedule. As a result, each pointing is broken into one or more sub-pointings of various exposure times. This project was awarded ROSAT observing time for four unidentified EGRET sources, summarized in the table. The column headings are defined as follows: 'Coverings' = number of observations to cover the error circle; 'SubPtg' = total number of sub-pointings to observe all of the coverings; 'Rec'd' = number of individual sub-pointings received to date; 'CompFlds' = number of individual coverings for which the requested complete exposure has been received. Processing of the data can not occur until a complete exposure has been accumulated for each covering.

Effects of learning duration on implicit transfer.

PubMed

Tanaka, Kanji; Watanabe, Katsumi

2015-10-01

Implicit learning and transfer in sequence acquisition play important roles in daily life. Several previous studies have found that even when participants are not aware that a transfer sequence has been transformed from the learning sequence, they are able to perform the transfer sequence faster and more accurately; this suggests implicit transfer of visuomotor sequences. Here, we investigated whether implicit transfer could be modulated by the number of trials completed in a learning session. Participants learned a sequence through trial and error, known as the m × n task (Hikosaka et al. in J Neurophysiol 74:1652-1661, 1995). In the learning session, participants were required to successfully perform the same sequence 4, 12, 16, or 20 times. In the transfer session, participants then learned one of two other sequences: one where the button configuration Vertically Mirrored the learning sequence, or a randomly generated sequence. Our results show that even when participants did not notice the alternation rule (i.e., vertical mirroring), their total working time was less and their total number of errors was lower in the transfer session compared with those who performed a Random sequence, irrespective of the number of trials completed in the learning session. This result suggests that implicit transfer likely occurs even over a shorter learning duration.

Return of Postural Control to Baseline After Anaerobic and Aerobic Exercise Protocols

PubMed Central

Fox, Zachary G; Mihalik, Jason P; Blackburn, J Troy; Battaglini, Claudio L; Guskiewicz, Kevin M

2008-01-01

Context: With regard to sideline concussion testing, the effect of fatigue associated with different types of exercise on postural control is unknown. Objective: To evaluate the effects of fatigue on postural control in healthy college-aged athletes performing anaerobic and aerobic exercise protocols and to establish an immediate recovery time course from each exercise protocol for postural control measures to return to baseline status. Design: Counterbalanced, repeated measures. Setting: Research laboratory. Patients Or Other Participants: Thirty-six collegiate athletes (18 males, 18 females; age  =  19.00 ± 1.01 years, height  =  172.44 ± 10.47 cm, mass  =  69.72 ± 12.84 kg). Intervention(s): Participants completed 2 counterbalanced sessions within 7 days. Each session consisted of 1 exercise protocol followed by postexercise measures of postural control taken at 3-, 8-, 13-, and 18-minute time intervals. Baseline measures were established during the first session, before the specified exertion protocol was performed. Main Outcome Measure(s): Balance Error Scoring System (BESS) results, sway velocity, and elliptical sway area. Results: We found a decrease in postural control after each exercise protocol for all dependent measures. An interaction was noted between exercise protocol and time for total BESS score (P  =  .002). For both exercise protocols, all measures of postural control returned to baseline within 13 minutes. Conclusions: Postural control was negatively affected after anaerobic and aerobic exercise protocols as measured by total BESS score, elliptical sway area, and sway velocity. The effect of exertion lasted up to 13 minutes after each exercise was completed. Certified athletic trainers and clinicians should be aware of these effects and their recovery time course when determining an appropriate time to administer sideline assessments of postural control after a suspected mild traumatic brain injury. PMID:18833307

Return of postural control to baseline after anaerobic and aerobic exercise protocols.

PubMed

Fox, Zachary G; Mihalik, Jason P; Blackburn, J Troy; Battaglini, Claudio L; Guskiewicz, Kevin M

2008-01-01

With regard to sideline concussion testing, the effect of fatigue associated with different types of exercise on postural control is unknown. To evaluate the effects of fatigue on postural control in healthy college-aged athletes performing anaerobic and aerobic exercise protocols and to establish an immediate recovery time course from each exercise protocol for postural control measures to return to baseline status. Counterbalanced, repeated measures. Research laboratory. Thirty-six collegiate athletes (18 males, 18 females; age = 19.00 +/- 1.01 years, height = 172.44 +/- 10.47 cm, mass = 69.72 +/- 12.84 kg). Participants completed 2 counterbalanced sessions within 7 days. Each session consisted of 1 exercise protocol followed by postexercise measures of postural control taken at 3-, 8-, 13-, and 18-minute time intervals. Baseline measures were established during the first session, before the specified exertion protocol was performed. Balance Error Scoring System (BESS) results, sway velocity, and elliptical sway area. We found a decrease in postural control after each exercise protocol for all dependent measures. An interaction was noted between exercise protocol and time for total BESS score (P = .002). For both exercise protocols, all measures of postural control returned to baseline within 13 minutes. Postural control was negatively affected after anaerobic and aerobic exercise protocols as measured by total BESS score, elliptical sway area, and sway velocity. The effect of exertion lasted up to 13 minutes after each exercise was completed. Certified athletic trainers and clinicians should be aware of these effects and their recovery time course when determining an appropriate time to administer sideline assessments of postural control after a suspected mild traumatic brain injury.

Curriculum time compared to clinical procedures in amalgam and composite posterior restorations in U.S. dental schools: a preliminary study.

PubMed

Rey, Rosalia; Nimmo, Susan; Childs, Gail S; Behar-Horenstein, Linda S

2015-03-01

Dental clinicians have an expanding range of biomaterial choices for restoring tooth structure. Scientific developments in cariology, advances in dental biomaterials, and patients' esthetic concerns have led to a reduction in amalgam restorations and an increase in composite restorations. The aim of this study was to compare teaching time with students' clinical procedures in amalgam and composite posterior restorations in dental schools across the United States. Academic deans in 60 schools were invited to complete a survey that asked for the amount of instructional time for amalgam and composite posterior restorations and the number of clinical restorations performed by their Classes of 2009, 2010, and 2011. Of these 60, 12 returned surveys with complete data, for a 20% response rate. Responses from these schools showed little change in lecture and preclinical laboratory instruction from 2009 to 2011. There was a slight increase in two-surface restorations for both amalgam and composites; however, the total number of reported composite and amalgam restorations remained the same. Of 204,864 restorations reported, 53% were composite, and 47% were amalgam. There were twice as many multisurface large or complex amalgam restorations as composites. One-surface composite restorations exceeded amalgams. Among the participating schools, there was little to no change between curriculum time and clinical procedures. Findings from this preliminary study reflect a modest increase in two-surface resin-based restorations placed by dental students from 2009 to 2011 and little change in curricular time devoted to teaching amalgam restorations. The total number of posterior composite restorations placed by students in these schools was slightly higher than amalgams.

Estimation of immunization providers' activities cost, medication cost, and immunization dose errors cost in Iraq.

PubMed

Al-lela, Omer Qutaiba B; Bahari, Mohd Baidi; Al-abbassi, Mustafa G; Salih, Muhannad R M; Basher, Amena Y

2012-06-06

The immunization status of children is improved by interventions that increase community demand for compulsory and non-compulsory vaccines, one of the most important interventions related to immunization providers. The aim of this study is to evaluate the activities of immunization providers in terms of activities time and cost, to calculate the immunization doses cost, and to determine the immunization dose errors cost. Time-motion and cost analysis study design was used. Five public health clinics in Mosul-Iraq participated in the study. Fifty (50) vaccine doses were required to estimate activities time and cost. Micro-costing method was used; time and cost data were collected for each immunization-related activity performed by the clinic staff. A stopwatch was used to measure the duration of activity interactions between the parents and clinic staff. The immunization service cost was calculated by multiplying the average salary/min by activity time per minute. 528 immunization cards of Iraqi children were scanned to determine the number and the cost of immunization doses errors (extraimmunization doses and invalid doses). The average time for child registration was 6.7 min per each immunization dose, and the physician spent more than 10 min per dose. Nurses needed more than 5 min to complete child vaccination. The total cost of immunization activities was 1.67 US$ per each immunization dose. Measles vaccine (fifth dose) has a lower price (0.42 US$) than all other immunization doses. The cost of a total of 288 invalid doses was 744.55 US$ and the cost of a total of 195 extra immunization doses was 503.85 US$. The time spent on physicians' activities was longer than that spent on registrars' and nurses' activities. Physician total cost was higher than registrar cost and nurse cost. The total immunization cost will increase by about 13.3% owing to dose errors. Copyright © 2012 Elsevier Ltd. All rights reserved.

Analysis of the tractive force pattern on a knot by force measurement during laparoscopic knot tying.

PubMed

Takayasu, Kenta; Yoshida, Kenji; Kinoshita, Hidefumi; Yoshimoto, Syunsuke; Oshiro, Osamu; Matsuda, Tadashi

2017-07-19

Quantifying surgical skills assists novice surgeons when learning operative techniques. We measured the interaction force at a ligation point and clarified the features of the force pattern among surgeons with different skill levels during laparoscopic knot tying. Forty-four surgeons were divided into three groups based on experience: 13 novice (0-5 years), 16 intermediate (6-15 years), and 15 expert (16-30 years). To assess the tractive force direction and volume during knot tying, we used a sensor that measures six force-torque values (x-axis: Fx, y-axis: Fy, z-axis: Fz, and xy-axis: Fxy) attached to a slit Penrose drain. All participants completed one double knot and five single knot sequences. We recorded completion time, force volume (FV), maximum force (MF), time over 1.5 N, duration of non-zero force, and percentage time when vertical force exceeded horizontal force (PTz). There was a significant difference between groups for completion time (p = 0.007); FV (total: p = 0.002; Fx: p = 0.004, Fy: p = 0.007, Fxy: p = 0.004, Fz: p < 0.001, Fxy/Fz: p = 0.003), MF (total: p = 0.004; Fx: p = 0.015, Fy: p = 0.035, Fxy: p = 0.009, Fz: p = 0.001, Fxy/Fz: p = 0.041); time over 1.5 N (p = 0.002); duration of non-zero force (p = 0.029); and PTz (p < 0.001). PTz showed the only significant difference comparing intermediates with experts (intermediates: 13.7 ± 9.0, experts: 4.9 ± 3.2; p < 0.001). We clarified the characteristics of the force pattern at the ligation point during suturing by surgeons with three levels of experience using a force measurement system. We revealed that both force volume and force direction differed depending on surgeons' skill level during knot tying. Copyright © 2017. Published by Elsevier Inc.

The Cost and Burden of the Residency Match in Emergency Medicine

PubMed Central

Blackshaw, Aaron M.; Watson, Simon C.; Bush, Jeffrey S.

2017-01-01

Introduction To obtain a residency match, medical students entering emergency medicine (EM) must complete away rotations, submit a number of lengthy applications, and travel to multiple programs to interview. The expenses incurred acquiring this residency position are burdensome, but there is little specialty-specific data estimating it. We sought to quantify the actual cost spent by medical students applying to EM residency programs by surveying students as they attended a residency interview. Methods Researchers created a 16-item survey, which asked about the time and monetary costs associated with the entire EM residency application process. Applicants chosen to interview for an EM residency position at our institution were invited to complete the survey during their interview day. Results In total, 66 out of a possible 81 residency applicants (an 81% response rate) completed our survey. The “average applicant” who interviewed at our residency program for the 2015–16 cycle completed 1.6 away, or “audition,” rotations, each costing an average of $1,065 to complete. This “average applicant” applied to 42.8 programs, and then attended 13.7 interviews. The cost of interviewing at our program averaged $342 and in total, an average of $8,312 would be spent in the pursuit of an EM residency. Conclusion Due to multiple factors, the costs of securing an EM residency spot can be expensive. By understanding the components that are driving this trend, we hope that the academic EM community can explore avenues to help curtail these costs. PMID:28116032

What are the cost savings associated with providing access to specialist care through the Champlain BASE eConsult service? A costing evaluation

PubMed Central

Liddy, Clare; Drosinis, Paul; Deri Armstrong, Catherine; McKellips, Fanny; Afkham, Amir; Keely, Erin

2016-01-01

Objective This study estimates the costs and potential savings associated with all eConsult cases completed between 1 April 2014 and 31 March 2015. Design Costing evaluation from the societal perspective estimating the costs and potential savings associated with all eConsults completed during the study period. Setting Champlain health region in Eastern Ontario, Canada. Population Primary care providers and specialists registered to use the eConsult service. Main outcome measures Costs included (1) delivery costs; (2) specialist remuneration; (3) costs associated with traditional (face-to-face) referrals initiated as a result of eConsult. Potential savings included (1) costs of traditional referrals avoided; (2) indirect patient savings through avoided travel and lost wages/productivity. Net potential societal cost savings were estimated by subtracting total costs from total potential savings. Results A total of 3487 eConsults were completed during the study period. In 40% of eConsults, a face-to-face specialist visit was originally contemplated but avoided as result of eConsult. In 3% of eConsults, a face-to-face specialist visit was not originally contemplated but was prompted as a result of the eConsult. From the societal perspective, total costs were estimated at $207 787 and total potential savings were $246 516. eConsult led to a net societal saving of $38 729 or $11 per eConsult. Conclusions Our findings demonstrate potential cost savings from the societal perspective, as patients avoided the travel costs and lost wages/productivity associated with face-to-face specialist visits. Greater savings are expected once we account for other costs such as avoided tests and visits and potential improved health outcomes associated with shorter wait times. Our findings are valuable for healthcare delivery decision-makers as they seek solutions to improve care in a patient-centred and efficient manner. PMID:27338880

Time needed to achieve completeness and accuracy in bedside lung ultrasound reporting in intensive care unit.

PubMed

Tutino, Lorenzo; Cianchi, Giovanni; Barbani, Francesco; Batacchi, Stefano; Cammelli, Rita; Peris, Adriano

2010-08-12

The use of lung ultrasound (LUS) in ICU is increasing but ultrasonographic patterns of lung are often difficult to quantify by different operators. The aim of this study was to evaluate the accuracy and quality of LUS reporting after the introduction of a standardized electronic recording sheet. Intensivists were trained for LUS following a teaching programme. From April 2008, an electronic sheet was designed and introduced in ICU database in order to uniform LUS examination reporting. A mark from 0 to 24 has been given for each exam by two senior intensivists not involved in the survey. The mark assigned was based on completeness of a precise reporting scheme, concerning the main finding of LUS. A cut off of 15 was considered sufficiency. The study comprehended 12 months of observations and a total of 637 LUS. Initially, although some improvement in the reports completeness, still the accuracy and precision of examination reporting was below 15. The time required to reach a sufficient quality was 7 months. A linear trend in physicians progress was observed. The uniformity in teaching programme and examinations reporting system permits to improve the level of completeness and accuracy of LUS reporting, helping physicians in following lung pathology evolution.

Evaluation of Sensibility Threshold for Interocclusal Thickness of Patients Wearing Complete Dentures

PubMed Central

Shala, Kujtim Sh.; Ahmedi, Enis F.; Tmava-Dragusha, Arlinda

2017-01-01

Objective The aim of this study was to evaluate sensibility threshold for interocclusal thickness in experienced and nonexperienced denture wearers after the insertion of new complete dentures. Materials and Methods A total of 88 patients with complete dentures have participated in this study. The research was divided into two experimental groups, compared with the previous experience prosthetic dental treatment. The sensibility threshold for interocclusal thickness was measured with metal foil with 8 μm thickness and width of 8 mm, placed between the upper and lower incisor region. Statistical analysis was performed using standard software package BMDP (biomedical statistical package). Results Results suggest that time of measurement affects the average values of the sensibility threshold for interocclusal thickness (F = 242.68, p = 0.0000). Gender appeared to be a significant factor when it interacted with time measurement resulting in differences in sensibility threshold for interocclusal thickness (gender: F = 9.84, p = 0.018; F = 4.83, p = 0.0003). Conclusion The sensibility threshold for interocclusal thickness was the most important functional adaptation in patient with complete dentures. A unique trait of this indicator is the progressive reduction of initial values and a tendency to reestablish the stationary state in the fifteenth week after dentures is taken off. PMID:28702055

Renal Cell Carcinoma Perfusion before and after Radiofrequency Ablation Measured with Dynamic Contrast Enhanced MRI: A Pilot Study.

PubMed

Wah, Tze Min; Sourbron, Steven; Wilson, Daniel Jonathan; Magee, Derek; Gregory, Walter Martin; Selby, Peter John; Buckley, David L

2018-01-08

To investigate if the early treatment effects of radiofrequency ablation (RFA) on renal cell carcinoma (RCC) can be detected with dynamic contrast enhanced (DCE)-MRI and to correlate RCC perfusion with RFA treatment time. 20 patients undergoing RFA of their 21 RCCs were evaluated with DCE-MRI before and at one month after RFA treatment. Perfusion was estimated using the maximum slope technique at two independent sittings. Total RCC blood flow was correlated with total RFA treatment time, tumour location, size and histology. DCE-MRI examinations were successfully evaluated for 21 RCCs (size from 1.3 to 4 cm). Perfusion of the RCCs decreased significantly ( p < 0.0001) from a mean of 203 (±80) mL/min/100 mL before RFA to 8.1 (±3.1) mL/min/100 mL after RFA with low intra-observer variability ( r ≥ 0.99, p < 0.0001). There was an excellent correlation ( r = 0.95) between time to complete ablation and pre-treatment total RCC blood flow. Tumours with an exophytic location exhibit the lowest mean RFA treatment time. DCE-MRI can detect early treatment effects by measuring RCC perfusion before and after RFA. Perfusion significantly decreases in the zone of ablation, suggesting that it may be useful for the assessment of treatment efficacy. Pre-RFA RCC blood flow may be used to predict RFA treatment time.

The effect of a short-term high-intensity circuit training program on work capacity, body composition, and blood profiles in sedentary obese men: a pilot study.

PubMed

Miller, Matthew B; Pearcey, Gregory E P; Cahill, Farrell; McCarthy, Heather; Stratton, Shane B D; Noftall, Jennifer C; Buckle, Steven; Basset, Fabien A; Sun, Guang; Button, Duane C

2014-01-01

The objective of this study was to determine how a high-intensity circuit-training (HICT) program affects key physiological health markers in sedentary obese men. Eight obese (body fat percentage >26%) males completed a four-week HICT program, consisting of three 30-minute exercise sessions per week, for a total of 6 hours of exercise. Participants' heart rate (HR), blood pressure (BP), rating of perceived exertion, total work (TW), and time to completion were measured each exercise session, body composition was measured before and after HICT, and fasting blood samples were measured before throughout, and after HICT program. Blood sample measurements included total cholesterol, triacylglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, glucose, and insulin. Data were analyzed by paired t-tests and one-way ANOVA with repeated measures. Statistical significance was set to P < 0.05. Data analyses revealed significant (P < 0.05) improvements in resting HR (16% decrease), systolic BP (5.5% decrease), TW (50.7%), fat tissue percentage (3.6%), lean muscle tissue percentage (2%), cholesterol (13%), triacylglycerol (37%), and insulin (18%) levels from before to after HICT program. Overall, sedentary obese males experienced a significant improvement in biochemical, physical, and body composition characteristics from a HICT program that was only 6 hours of the total exercise.

Assessing the efficacy of rescue equipment in lifeguard resuscitation efforts for drowning.

PubMed

Barcala-Furelos, Roberto; Szpilman, David; Palacios-Aguilar, Jose; Costas-Veiga, Javier; Abelairas-Gomez, Cristian; Bores-Cerezal, Antonio; López-García, Sergio; Rodríguez-Nuñez, Antonio

2016-03-01

The whole drowning process usually occurs within seconds to a few minutes. An early rescue may stop and/or prevent most medical complications. Fins, rescue tube, and rescue board (RB) are the equipment most frequently used by lifeguards. Our objective was to compare, in a water rescue quasiexperimental trial, these different pieces of rescue equipment to define the safest and with the lower rescue time as well as to assess their effects on the lifeguards' physiological state and cardiopulmonary resuscitation (CPR) performance. A controlled trial was conducted to study the time effect of 4 different rescue techniques and assess CPR quality, along with the physiological effects of each rescue technique (blood lactate and subjective Borg's scale effort perception) on 35 lifeguards. Among the final sample subjects (n = 23), a total of 92 rescues were completed. Total water rescue time was longer without equipment (NE). The total rescue time was significantly lower using RB (P < .001). Similar good quality of CPR before and after water rescue was observed in all trials (P > .05), although correct ventilations represented less than 50% of total in all trials. Blood lactate increased after all rescues. The subjective effort Borg's scale showed significantly less effort using RB vs without equipment, fins, and fins and rescue tube. The use of propelling and/or floating equipment saves precious time with repercussions in the reduction of drowning mortality and morbidity. The RB offers a significant advantage. Lifeguards need more CPR training, especially considering the importance of efficient ventilations for drowning victims. Copyright © 2015 Elsevier Inc. All rights reserved.

The complete sequence of the mitochondrial genome of Arctic fox (Alopex lagopus).

PubMed

Yan, Shou-Qing; Guo, Peng-Cheng; Yue, Yuan; Li, Wan-Hong; Bai, Chun-Yan; Li, Yu-Mei; Sun, Jin-Hai; Zhao, Zhi-Hui

2016-11-01

In the present study, the complete mitochondrial genome sequence of Arctic fox (Alopex lagopus) was determined for the first time. It has a total length of 16,656 bp, and contains 13 protein-coding genes, 22 tRNA genes, 2 ribosome RNA genes and 1 control region. The nucleotide composition is 31.3% for A, 26.2% for C, 14.8% for G and 27.7% for T, respectively. The D-loop region located between tRNA Pro and tRNA Phe contains a (ACACGTACACGCAT) 18 tandem repeat array. The data will be useful for the investigation of the genetic structure and diversity in the natural and farmed population of Arctic foxes.

Application of intraoperative magnetic resonance imaging in large invasive pituitary adenoma surgery.

PubMed

Li, Jie; Cong, Zixiang; Ji, Xueman; Wang, Xiaoliang; Hu, Zhigang; Jia, Yue; Wang, Handong

2015-07-01

To investigate the clinical application value of intraoperative magnetic resonance imaging (iMRI) in large invasive pituitary adenoma surgery. A total of 30 patients with large pituitary adenoma underwent microscopic tumor resection under the assistance of an iMRI system; 26 cases received surgery through the nasal-transsphenoidal approach, and the remaining four cases received surgery through the pterion approach. iMRI was performed one or two times depending on the need of the surgeon. If a residual tumor was found, further resection was conducted under iMRI guidance. iMRI revealed residual tumors in 12 cases, among which nine cases received further resection. Of these nine cases, iMRI rescanning confirmed complete resection in six cases, and subtotal resection in the remaining three. Overall, 24 cases of tumor were totally resected, and six cases were subtotally resected. The total resection rate of tumors increased from 60% to 80%. iMRI can effectively determine the resection extent of pituitary adenomas. In addition, it provides an objective basis for real-time judgment of surgical outcome, subsequently improving surgical accuracy and safety, and increasing the total tumor resection rate. Copyright © 2015. Published by Elsevier Taiwan.

Developmental trajectory of time perspective: From children to older adults.

PubMed

Chen, Tao; Liu, Lu-Lu; Cui, Ji-Fang; Chen, Xing-Jie; Wang, Ya

2016-12-01

Time perspective is a fundamental dimension of the psychological time construct, with a pervasive and powerful influence on human behavior. However, the developmental trajectory of time perspective across a human lifespan remains unclear. The current study aimed to portray the developmental trajectory of all dimensions of time perspectives from children to older adults in a large sample. A total of 1,901 individuals (aged 9-84 years) completed measures of time perspective. They were then divided into five age groups: children, teenagers, young adults, middle-aged adults, and older adults. Results suggested that each time perspective showed a unique developmental pattern across the lifespan. Moreover, perceived economic situation and education were related to some dimensions of time perspective. © 2016 The Institute of Psychology, Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.

Curriculum for Commissioning Energy Efficient Buildings

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

Webster, Lia

2012-12-27

In July 2010, the U.S. Department of Energy (DOE) awarded funding to PECI to develop training curriculum in commercial energy auditing and building commissioning. This program was created in response to the high demand for auditing and commissioning services in the U.S. commercial buildings market and to bridge gaps and barriers in existing training programs. Obstacles addressed included: lack of focus on entry level candidates; prohibitive cost and time required for training; lack of hands-on training; trainings that focus on certifications & process overviews; and lack of comprehensive training. PECI organized several other industry players to create a co-funded projectmore » sponsored by DOE, PECI, New York State Energy and Research Development Authority (NYSERDA), California Energy Commission (CEC), Northwest Energy Efficiency Alliance (NEEA) and California Commissioning Collaborative (CCC). After awarded, PECI teamed with another DOE awardee, New Jersey Institute of Technology (NJIT), to work collaboratively to create one comprehensive program featuring two training tracks. NJIT’s Center for Building Knowledge is a research and training institute affiliated with the College of Architecture and Design, and provided e-learning and video enhancements. This project designed and developed two training programs with a comprehensive, energy-focused curriculum to prepare new entrants to become energy auditors or commissioning authorities (CxAs). The following are the key elements of the developed trainings, which is depicted graphically in Figure 1: • Online classes are self-paced, and can be completed anywhere, any time • Commissioning Authority track includes 3 online modules made up of 24 courses delivered in 104 individual lessons, followed by a 40 hour hands-on lab. Total time required is between 75 and 100 hours, depending on the pace of the independent learner. • Energy Auditor track includes 3 online modules made up of 18 courses delivered in 72 individual lessons, followed by a 24 hour hands-on lab. Total time required is between 50 and 70 hours, depending on the pace of the independent learner. • Individual courses can be taken for continuing education credits. • Assessments are included for each course, and a score of at least 80% is required for completion. • Completion of Modules 1 through 3 is prerequisite for participating in the laboratory. More experienced participants have the option to test out of Modules 1 and 2 and complete Module 3 to progress to the laboratory.« less

Independent and joint effects of sedentary time and cardiorespiratory fitness on all-cause mortality: the Cooper Center Longitudinal Study

PubMed Central

Shuval, Kerem; Finley, Carrie E; Barlow, Carolyn E; Nguyen, Binh T; Njike, Valentine Y; Pettee Gabriel, Kelley

2015-01-01

Objectives To examine the independent and joint effects of sedentary time and cardiorespiratory fitness (fitness) on all-cause mortality. Design, setting, participants A prospective study of 3141 Cooper Center Longitudinal Study participants. Participants provided information on television (TV) viewing and car time in 1982 and completed a maximal exercise test during a 1-year time frame; they were then followed until mortality or through 2010. TV viewing, car time, total sedentary time and fitness were the primary exposures and all-cause mortality was the outcome. The relationship between the exposures and outcome was examined utilising Cox proportional hazard models. Results A total of 581 deaths occurred over a median follow-up period of 28.7 years (SD=4.4). At baseline, participants’ mean age was 45.0 years (SD=9.6), 86.5% were men and their mean body mass index was 24.6 (SD=3.0). Multivariable analyses revealed a significant linear relationship between increased fitness and lower mortality risk, even while adjusting for total sedentary time and covariates (p=0.02). The effects of total sedentary time on increased mortality risk did not quite reach statistical significance once fitness and covariates were adjusted for (p=0.05). When examining this relationship categorically, in comparison to the reference category (≤10 h/week), being sedentary for ≥23 h weekly increased mortality risk by 29% without controlling for fitness (HR=1.29, 95% CI 1.03 to 1.63); however, once fitness and covariates were taken into account this relationship did not reach statistical significance (HR=1.20, 95% CI 0.95 to 1.51). Moreover, spending >10 h in the car weekly significantly increased mortality risk by 27% in the fully adjusted model. The association between TV viewing and mortality was not significant. Conclusions The relationship between total sedentary time and higher mortality risk is less pronounced when fitness is taken into account. Increased car time, but not TV viewing, is significantly related to higher mortality risk, even when taking fitness into account, in this cohort. PMID:26525421

Longitudinal relations of television, electronic games, and digital versatile discs with changes in diet in adolescents.

PubMed

Falbe, Jennifer; Willett, Walter C; Rosner, Bernard; Gortmaker, Steve L; Sonneville, Kendrin R; Field, Alison E

2014-10-01

Youth spend more time with screens than any activity except sleeping. Screen time is a risk factor for obesity, possibly because of the influence of food and beverage advertising on diet. We sought to assess longitudinal relations of screen time [ie, television, electronic games, digital versatile discs (DVDs)/videos, and total screen time] with the 2-y changes in consumption of foods of low nutritional quality (FLNQ) that are commonly advertised on screens [ie, sugar-sweetened beverages, fast food, sweets, salty snacks, and the sum of these foods (total FLNQ)] and fruit and vegetables. With the use of 2004, 2006, and 2008 waves of the Growing Up Today Study II, which consisted of a cohort of 6002 female and 4917 male adolescents aged 9-16 y in 2004, we assessed screen time (change and baseline) in relation to the 2-y dietary changes. Regression models included 4604 girls and 3668 boys with complete screen time and diet data on ≥2 consecutive questionnaires. Each hour-per-day increase in television, electronic games, and DVDs/videos was associated with increased intake of total FLNQ (range: 0.10-0.28 servings/d; P < 0.05). Each hour-per-day increase in total screen time predicted increased intakes of sugar-sweetened beverages, fast food, sweets, and salty snacks (range: 0.02-0.06 servings/d; P < 0.001) and decreased intakes of fruit and vegetables (range: -0.05 to -0.02 servings/d; P < 0.05). Greater screen time at baseline (except electronic games in boys) was associated with subsequent increased intake of total FLNQ, and greater screen time at baseline (except DVDs/videos) was associated with decreased intake of fruit and vegetables (P < 0.05). Across sex and food groups and in sensitivity analyses, television was most consistently associated with dietary changes. Increases in screen time were associated with increased consumption of foods and beverages of low nutritional quality and decreased consumption of fruit and vegetables. Our results caution against excessive use of screen media, especially television, in youth. © 2014 American Society for Nutrition.

Optimizing MRI Logistics: Prospective Analysis of Performance, Efficiency, and Patient Throughput.

PubMed

Beker, Kevin; Garces-Descovich, Alejandro; Mangosing, Jason; Cabral-Goncalves, Ines; Hallett, Donna; Mortele, Koenraad J

2017-10-01

The objective of this study is to optimize MRI logistics through evaluation of MRI workflow and analysis of performance, efficiency, and patient throughput in a tertiary care academic center. For 2 weeks, workflow data from two outpatient MRI scanners were prospectively collected and stratified by value added to the process (i.e., value-added time, business value-added time, or non-value-added time). Two separate time cycles were measured: the actual MRI process cycle as well as the complete length of patient stay in the department. In addition, the impact and frequency of delays across all observations were measured. A total of 305 MRI examinations were evaluated, including body (34.1%), neurologic (28.9%), musculoskeletal (21.0%), and breast examinations (16.1%). The MRI process cycle lasted a mean of 50.97 ± 24.4 (SD) minutes per examination; the mean non-value-added time was 13.21 ± 18.77 minutes (25.87% of the total process cycle time). The mean length-of-stay cycle was 83.51 ± 33.63 minutes; the mean non-value-added time was 24.33 ± 24.84 minutes (29.14% of the total patient stay). The delay with the highest frequency (5.57%) was IV or port placement, which had a mean delay of 22.82 minutes. The delay with the greatest impact on time was MRI arthrography for which joint injection of contrast medium was necessary but was not accounted for in the schedule (mean delay, 42.2 minutes; frequency, 1.64%). Of 305 patients, 34 (11.15%) did not arrive at or before their scheduled time. Non-value-added time represents approximately one-third of the total MRI process cycle and patient length of stay. Identifying specific delays may expedite the application of targeted improvement strategies, potentially increasing revenue, efficiency, and overall patient satisfaction.

Complete denture services: clinical technique, lab costs, manpower, and reimbursement. One-year review.

PubMed

Ewoldsen, Nels

2011-01-01

Complete denture services at comprehensive care public health clinics are not common in part because of clinician concerns regarding outcomes. Educational debt forgiveness has attracted recent dental graduates to public health dentistry; however, not all recent graduates receive denture education experiences necessary to attain proficiency. While fundamental patient assessment and denture construction are taught, psychological assessment and communication with denture patients requires experience. A thorough understanding of occlusion, phonetics, esthetics and laboratory steps is also necessary. Expecting recent dental graduates to become proficient providing complete dentures at minimal reimbursement levels, with no mentorship or on-site laboratory support, is unrealistic. Public health dental clinics operate at full capacity performing emergency, preventive and restorative procedures. Complete dentures come with a laboratory fee approximately one-half the total reimbursement, meaning a remake drops clinic revenue to zero while doubling expenses. It is understandable that full schedules, marginal reimbursement, unpredictability and the risk of an occasional failure block clinician interest in providing denture services. This one-year report of services describes a three-appointment complete denture technique offering improved patient and laboratory communication, reduced chair time and controlled cost, resulting in high-quality complete dentures.

Evaluation of Surgical Devices Using an Artificial Pediatric Thoracic Model: A Comparison Between Robot-Assisted Thoracoscopic Suturing Versus Conventional Video-Assisted Thoracoscopic Suturing.

PubMed

Takazawa, Shinya; Ishimaru, Tetsuya; Harada, Kanako; Deie, Kyoichi; Hinoki, Akinari; Uchida, Hiroo; Sugita, Naohiko; Mitsuishi, Mamoru; Iwanaka, Tadashi; Fujishiro, Jun

2018-05-01

Pediatric robot-assisted surgery is increasingly being performed, but it is difficult to perform this procedure in infants. A pediatric thoracoscopic model of a 1-year-old patient was developed in our previous study, and this model was used to evaluate the use of a surgical robot for infant surgery. Eight pediatric surgeons performed an intracorporeal suturing and knot-tying task using the da Vinci Xi Robotic Surgical System. The task completion time, number of needle manipulations, and force applied during suturing of the robot-assisted thoracoscopic surgery (RATS) group were compared with those of the video-assisted thoracoscopic surgery (VATS) group whose data had been collected from the same 8 surgeons in our previous study. The RATS group showed a significantly shorter completion time than the VATS group in the knot-tying phase (P = .016) and in the total phase (P = .0078). The RATS group showed a significantly smaller number of manipulations than the VATS group in the total phase (P = .039). The RATS group showed a significantly smaller pushing force index than the VATS group in the suturing phase (P = .031), knot-tying phase (P = .031), and in the total phase (P = .031). A seventh rib in the model was dislocated in all RATS group cases. The da Vinci Surgical System might be useful in infants because of fast movement and small pushing force. However, the robotic 8 mm instruments were too large for use in the thoracic cavity of the 1-year-old infant.

A parent-report gender identity questionnaire for children.

PubMed

Johnson, Laurel L; Bradley, Susan J; Birkenfeld-Adams, Andrea S; Kuksis, Myra A Radzins; Maing, Dianne M; Mitchell, Janet N; Zucker, Kenneth J

2004-04-01

This paper reports on the psychometric properties of a 16-item parent-report Gender Identity Questionnaire, originally developed by P. H. Elizabeth and R. Green (1984), to aid in the assessment of children with potential problems in their gender identity development. The questionnaire, which covered aspects of the core phenomenology of gender identity disorder (GID), was completed by parents of gender-referred children (N = 325) and controls (siblings, clinic-referred, and nonreferred; N = 504), who ranged in age from 2.5-12 years (mean age, 7.6 years). Factor-analysis indicated that a one-factor solution, containing 14 of the 16 items with factor loadings > or =.30, best fit the data, accounting for 43.7% of the variance. The gender-referred children had a significantly more deviant total score than did the controls, with a large effect size of 3.70. The GIQ total score had negligible age effects, indicating that the questionnaire has utility for assessing change over time. The gender-referred children who met the complete DSM criteria for GID had a significantly more deviant total score than did the children who were subthreshold for GID, although the latter group had a mean score that was closer to the threshold cases than to the controls. With a specificity rate set at 95% for the controls, the sensitivity rate for the probands was 86.8%. It is concluded that this parent-report gender identity questionnaire has excellent psychometric properties and can serve as a useful screening device for front-line clinicians, for whom more extensive, expensive, and time-consuming assessment procedures may be precluded.

Adapting total quality management for general practice: evaluation of a programme.

PubMed Central

Lawrence, M; Packwood, T

1996-01-01

OBJECTIVE: Assessment of the benefits and limitations of a quality improvement programme based on total quality management principles in general practice over a period of one year (October 1993-4). DESIGN: Questionnaires to practice team members before any intervention and after one year. Three progress reports completed by facilitators at four month intervals. Semistructured interviews with a sample of staff from each practice towards the end of the year. SETTING: 18 self selected practices from across the former Oxford Region. Three members of each practice received an initial residential course and three one day seminars during the year. Each practice was supported by a facilitator from their Medical Audit Advisory Group. MEASURES: Extent of understanding and implementation of quality improvement methodology. Number, completeness, and evaluation of quality improvement projects. Practice team members' attitudes to and involvement in team working and quality improvement. RESULTS: 16 of the 18 practices succeeded in implementing the quality improvement methods. 48 initiatives were considered and staff involvement was broad. Practice members showed increased involvement in, and appreciation of, strategic planning and team working, and satisfaction from improved patients services. 11 of the practices intend to continue with the methodology. The commonest barrier expressed was time. CONCLUSION: Quality improvement programmes based on total quality management principles produce beneficial changes in service delivery and team working in most general practices. It is incompatible with traditional doctor centred practice. The methodology needs to be adapted for primary care to avoid quality improvement being seen as separate from routine activity, and to save time. PMID:10161529

Preoperative predictors of returning to work following primary total knee arthroplasty.

PubMed

Styron, Joseph F; Barsoum, Wael K; Smyth, Kathleen A; Singer, Mendel E

2011-01-05

There is little in the literature to guide clinicians in advising patients regarding their return to work following a primary total knee arthroplasty. In this study, we aimed to identify which factors are important in estimating a patient's time to return to work following primary total knee arthroplasty, how long patients can anticipate being off from work, and the types of jobs to which patients are able to return following primary total knee arthroplasty. A prospective cohort study was performed in which patients scheduled for a primary total knee arthroplasty completed a validated questionnaire preoperatively and at four to six weeks, three months, and six months postoperatively. The questionnaire assessed the patient's occupational physical demands, ability to perform job responsibilities, physical status, and motivation to return to work as well as factors that may impact his or her recovery and other workplace characteristics. Two survival analysis models were constructed to evaluate the time to return to work either at least part-time or full-time. Acceleration factors were calculated to indicate the relative percentage of time until the patient returned to work. The median time to return to work was 8.9 weeks. Patients who reported a sense of urgency about returning to work were found to return in half the time taken by other employees (acceleration factor = 0.468; p < 0.001). Other preoperative factors associated with a faster return to work included being female (acceleration factor = 0.783), self-employment (acceleration factor = 0.792), higher mental health scores (acceleration factor = 0.891), higher physical function scores (acceleration factor = 0.809), higher Functional Comorbidity Index scores (acceleration factor = 0.914), and a handicap accessible workplace (acceleration factor = 0.736). A slower return to work was associated with having less pain preoperatively (acceleration factor = 1.132), having a more physically demanding job (acceleration factor = 1.116), and receiving Workers' Compensation (acceleration factor = 4.360). Although the physical demands of a patient's job have a moderate influence on the patient's ability to return to work following a primary total knee arthroplasty, the patient's characteristics, particularly motivation, play a more important role.

Sleep restriction therapy for insomnia is associated with reduced objective total sleep time, increased daytime somnolence, and objectively impaired vigilance: implications for the clinical management of insomnia disorder.

PubMed

Kyle, Simon D; Miller, Christopher B; Rogers, Zoe; Siriwardena, A Niroshan; Macmahon, Kenneth M; Espie, Colin A

2014-02-01

To investigate whether sleep restriction therapy (SRT) is associated with reduced objective total sleep time (TST), increased daytime somnolence, and impaired vigilance. Within-subject, noncontrolled treatment investigation. Sleep research laboratory. Sixteen patients [10 female, mean age = 47.1 (10.8) y] with well-defined psychophysiological insomnia (PI), reporting TST ≤ 6 h. Patients were treated with single-component SRT over a 4-w protocol, sleeping in the laboratory for 2 nights prior to treatment initiation and for 3 nights (SRT night 1, 8, 22) during the acute interventional phase. The psychomotor vigilance task (PVT) was completed at seven defined time points [day 0 (baseline), day 1,7,8,21,22 (acute treatment) and day 84 (3 mo)]. The Epworth Sleepiness Scale (ESS) was completed at baseline, w 1-4, and 3 mo. Subjective sleep outcomes and global insomnia severity significantly improved before and after SRT. There was, however, a robust decrease in PSG-defined TST during acute implementation of SRT, by an average of 91 min on night 1, 78 min on night 8, and 69 min on night 22, relative to baseline (P < 0.001; effect size range = 1.60-1.80). During SRT, PVT lapses were significantly increased from baseline (at three of five assessment points, all P < 0.05; effect size range = 0.69-0.78), returning to baseline levels by 3 mo (P = 0.43). A similar pattern was observed for RT, with RTs slowing during acute treatment (at four of five assessment points, all P < 0.05; effect size range = 0.57-0.89) and returning to pretreatment levels at 3 mo (P = 0.78). ESS scores were increased at w 1, 2, and 3 (relative to baseline; all P < 0.05); by 3 mo, sleepiness had returned to baseline (normative) levels (P = 0.65). For the first time we show that acute sleep restriction therapy is associated with reduced objective total sleep time, increased daytime sleepiness, and objective performance impairment. Our data have important implications for implementation guidelines around the safe and effective delivery of cognitive behavioral therapy for insomnia.

Fast Timing Study of the β- Decay of 63Mn to 63Fe

NASA Astrophysics Data System (ADS)

Olaizola, B.; Fraile, L. M.; Mach, H.; Briz, J. A.; Cal-González, J.; Ghita, D.; Köster, U.; Kurcewicz, W.; Lesher, S. R.; Pauwels, D.; Picado, E.; Poves, A.; Radulov, D.; Simpson, G. S.; Udias, J. M.

The β- decay of 63Mn to 63Fe has been studied in an experiment at ISOLDE, CERN. The previously known 63Fe level scheme has been confirmed and greatly expanded, to a total of 31 levels and 73 γ lines. The energy of the 9/2+ isomer state has been measured for the first time at 475.0 keV, completing the systematics of such states in odd-Fe isotopes below 68Ni. In addition, the lifetimes of the low-lying states have been measured, allowing the tentative assignment of the spin-parity sequence for those levels.

Aerial Refueling Process Rescheduling Under Job Related Disruptions

NASA Technical Reports Server (NTRS)

Kaplan, Sezgin; Rabadi, Ghaith

2011-01-01

The Aerial Refueling Scheduling Problem (ARSP) can be defined as determining the refueling completion times for each fighter aircraft (job) on the multiple tankers (machines) to minimize the total weighted tardiness. ARSP assumes that the jobs have different release times and due dates. The ARSP is dynamic environment and unexpected events may occur. In this paper, rescheduling in the aerial refueling process with a time set of jobs will be studied to deal with job related disruptions such as the arrival of new jobs, the departure of an existing job, high deviations in the release times and changes in job priorities. In order to keep the stability and to avoid excessive computation, partial schedule repair algorithm is developed and its preliminary results are presented.

Evaluating the Recovery Curve for Clinically Assessed Reaction Time After Concussion.

PubMed

Del Rossi, Gianluca

2017-08-01

  A change in reaction time is one of various clinical measures of neurocognitive function that can be monitored after concussion and has been reported to be among the most sensitive indicators of cognitive impairment.   To determine the timeline for clinically assessed simple reaction time to return to baseline after a concussion in high school athletes.   Observational study.   Athletic training room.   Twenty-one high school-aged volunteers.   Participants completed 8 trials of the ruler-drop test during each session. Along with baseline measures, a total of 6 additional test sessions were completed over the course of 4 weeks after a concussion (days 3, 7, 10, 14, 21, and 28).   The mean reaction times calculated for all participants from each of the 7 test sessions were analyzed to assess the change in reaction time over the 7 time intervals.   After a concussion and compared with baseline, simple reaction time was, on average, 26 milliseconds slower at 48 to 72 hours postinjury (P < .001), almost 18 milliseconds slower on day 7 (P < .001), and about 9 milliseconds slower on day 10 (P < .001). Simple reaction time did not return to baseline levels until day 14 postinjury.   Clinically assessed simple reaction time appeared to return to baseline levels within a timeframe that mirrors other measures of cognitive performance (approximately 14 days).

Sleep Restriction Therapy for Insomnia is Associated with Reduced Objective Total Sleep Time, Increased Daytime Somnolence, and Objectively Impaired Vigilance: Implications for the Clinical Management of Insomnia Disorder

PubMed Central

Kyle, Simon D.; Miller, Christopher B.; Rogers, Zoe; Siriwardena, A. Niroshan; MacMahon, Kenneth M.; Espie, Colin A.

2014-01-01

Study Objectives: To investigate whether sleep restriction therapy (SRT) is associated with reduced objective total sleep time (TST), increased daytime somnolence, and impaired vigilance. Design: Within-subject, noncontrolled treatment investigation. Setting: Sleep research laboratory. Participants: Sixteen patients [10 female, mean age = 47.1 (10.8) y] with well-defined psychophysiological insomnia (PI), reporting TST ≤ 6 h. Interventions: Patients were treated with single-component SRT over a 4-w protocol, sleeping in the laboratory for 2 nights prior to treatment initiation and for 3 nights (SRT night 1, 8, 22) during the acute interventional phase. The psychomotor vigilance task (PVT) was completed at seven defined time points [day 0 (baseline), day 1,7,8,21,22 (acute treatment) and day 84 (3 mo)]. The Epworth Sleepiness Scale (ESS) was completed at baseline, w 1-4, and 3 mo. Measurement and results: Subjective sleep outcomes and global insomnia severity significantly improved before and after SRT. There was, however, a robust decrease in PSG-defined TST during acute implementation of SRT, by an average of 91 min on night 1, 78 min on night 8, and 69 min on night 22, relative to baseline (P < 0.001; effect size range = 1.60-1.80). During SRT, PVT lapses were significantly increased from baseline (at three of five assessment points, all P < 0.05; effect size range = 0.69-0.78), returning to baseline levels by 3 mo (P = 0.43). A similar pattern was observed for RT, with RTs slowing during acute treatment (at four of five assessment points, all P < 0.05; effect size range = 0.57-0.89) and returning to pretreatment levels at 3 mo (P = 0.78). ESS scores were increased at w 1, 2, and 3 (relative to baseline; all P < 0.05); by 3 mo, sleepiness had returned to baseline (normative) levels (P = 0.65). Conclusion: For the first time we show that acute sleep restriction therapy is associated with reduced objective total sleep time, increased daytime sleepiness, and objective performance impairment. Our data have important implications for implementation guidelines around the safe and effective delivery of cognitive behavioral therapy for insomnia. Citation: Kyle SD; Miller CB; Rogers Z; Siriwardena AN; MacMahon KM; Espie CA. Sleep restriction therapy for insomnia is associated with reduced objective total sleep time, increased daytime somnolence, and objectively impaired vigilance: implications for the clinical management of insomnia disorder. SLEEP 2014;37(2):229-237. PMID:24497651

Declining loneliness over time: evidence from american colleges and high schools.

PubMed

Clark, D Matthew T; Loxton, Natalie J; Tobin, Stephanie J

2015-01-01

We examined changes in loneliness over time. Study 1 was a cross-temporal meta-analysis of 48 samples of American college students who completed the Revised UCLA Loneliness Scale (total N = 13,041). In Study 1, loneliness declined from 1978 to 2009 (d = -0.26). Study 2 used a representative sample of high school students from the Monitoring the Future project (total N = 385,153). In Study 2, loneliness declined from 1991 to 2012. Declines were similar among White students (d = -0.14), Black students (d = -0.17), male students (d = -0.11), and female students (d = -0.11). Different loneliness factors showed diverging trends. Subjective isolation declined (d = -0.20), whereas social network isolation increased (d = 0.06). We discuss the declines in loneliness within the context of other cultural changes, including changes to group membership and personality. © 2014 by the Society for Personality and Social Psychology, Inc.

Effects of pulmonary rehabilitation in bronchiectasis: A retrospective study.

PubMed

Ong, H K; Lee, A L; Hill, C J; Holland, A E; Denehy, L

2011-01-01

There is limited information about the benefits of pulmonary rehabilitation (PR) in patients with bronchiectasis. This study aimed to evaluate the effects of an out-patient PR program in patients with a primary diagnosis of bronchiectasis and to compare them with a matched COPD group who completed the same PR program. A retrospective review was conducted of patients with bronchiectasis or COPD who completed 6 to 8 weeks of PR at two tertiary institutions. The outcome measures were the 6-minute walk distance (6MWD) and Chronic Respiratory Disease Questionnaire (CRQ). Ninety-five patients with bronchiectasis completed the PR (48 male; FEV(1) 63 [24] % predicted; age 67 [10] years). Significant improvements in 6MWD (mean change 53.4 m, 95% CI 45.0 to 61.7) and CRQ total score (mean change 14.0 units, 95% CI 11.3 to 16.7) were observed immediately following PR. In patients with complete follow-up (n = 37), these improvements remained significantly higher than baseline at 12 months (20.5 m, 95% CI 1.4 to 39.5 for 6MWD; 12.1 points, 95% CI 5.7 to 18.4 for CRQ total score). The time trend and changes in the 6MWD and CRQ scores were not significantly different between the bronchiectasis and the COPD groups (all p > 0.05). This study supports the inclusion of patients with bronchiectasis in existing PR programs. Further prospective RCTs are warranted to substantiate these findings.

Characterization of the complete mitochondrial genome of the king pigeon (Columba livia breed king).

PubMed

Zhang, Rui-Hua; He, Wen-Xiao; Xu, Tong

2015-06-01

The king pigeon is a breed of pigeon developed over many years of selective breeding primarily as a utility breed. In the present work, we report the complete mitochondrial genome sequence of king pigeon for the first time. The total length of the mitogenome was 17,221 bp with the base composition of 30.14% for A, 24.05% for T, 31.82% for C, and 13.99% for G and an A-T (54.22 %)-rich feature was detected. It harbored 13 protein-coding genes, two ribosomal RNA genes, 22 transfer RNA genes, and one non-coding control region (D-loop region). The arrangement of all genes was identical to the typical mitochondrial genomes of pigeon. The complete mitochondrial genome sequence of king pigeon would serve as an important data set of the germplasm resources for further study.

Do attachment representations predict depression and anxiety in psychiatrically hospitalized prepubertal children?

PubMed

Goodman, Geoff; Stroh, Martha; Valdez, Adina

2012-01-01

Thirty-six prepubertal inpatients were videotaped completing five stories thematically related to attachment experiences and classified by their attachment representations. Children also completed the Children's Depression Inventory and Diagnostic Interview for Children and Adolescents-Revised. Mothers completed demographic questionnaires. Percentage of secure (B) attachment was only about one tenth of the normative percentage, anxious-ambivalent (C) attachment was between two and three times the normative percentage, and disorganized (D) attachment was almost twice the normative percentage. Both D attachment and the total number of disorganized story responses were associated with negative self-esteem and clinical-range depression. Anxious-avoidant (A) attachment decreased the likelihood, while C and D attachment increased the likelihood, of separation anxiety disorder. Clinical intervention needs to focus on the meaning of parental relationships represented in the child's mind, specifically the negative self-esteem and separation anxiety associated with the lack of felt security provided by the parents.

Defense Finance and Accounting Service Needs to Improve Controls Over the Completeness and Accuracy of the Cash Management Report

DTIC Science & Technology

2011-08-15

resu lting from Navy subhead conversions and to timely address any new problems that may occur. Managemen t Comments: Stakeholder: Concur. DFAS...collection of information, including suggestions for reducing this burden, to Washington Headquarters Services, Directorate for Information Operations and...total disbursements reported on the CMR for the FY 2010, Operation and Maintenance (O&M) appropriation into agreement with the amount reported by the

Evaluation of Experimental Four-Day Week Class Schedule, January Through April 1974 at Lake City Community College.

ERIC Educational Resources Information Center

Hardman, Clark

Due to the energy disturbance during the fall and winter of 1973-74, Lake City Community College experimented with a 4-days-per-week schedule of classes. a student evaluation of the 4-day week was completed by 58 percent of the full-time students. Fifty-one percent of the total student sample preferred the 4-day week, and 30 percent preferred the…

Sasebo, A Case Study in Optimizing Official Vehicles

DTIC Science & Technology

2012-12-01

is estimated to average 1 hour per response, including the time for reviewing instruction, searching existing data sources, gathering and maintaining...the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of...that were estimated to reduce federal budget deficits by a total of at least $2.1 trillion over the 2012–2021 period…At least another $1.2 trillion

Understanding Combustion and Soot Formation in Diesel Engines

DTIC Science & Technology

2016-09-09

propagates with time. The temperature contours show the overall location of the flame. The oxygen is not completely consumed at the stoichiometric...characterization at 2 (upper) and 4 ms (lower). From left to right: mean mixture fraction, temperature , mass fractions of oxygen , OH and CH2O. Figure...half of total energy consumption should come from renewable sources, including biofuels, by 2020. One of the action items is to deploy a “Great Green

Is a Sense of Community Vital to Interagency Coordination? (Interagency Paper, Number 3, January 2011)

DTIC Science & Technology

2011-01-01

as clothes , signs, art, architecture, logos , landmarks, and flags that people can recognize. Somewhat Mostly Completely I put a lot of time and...Davidson, 2009). During recent years, the SOC has received significant attention from scholars as a viable psychological and sociological concept...and community. It appeared that O-3s (the youngest of the ranks surveyed) exhibited statistically significant less psychological SOC in total and in

Computerized Cognitive Training in Children With Autism and Intellectual Disabilities: Feasibility and Satisfaction Study

PubMed Central

Benyakorn, Songpoom; Calub, Catrina A; Riley, Steven J; Schneider, Andrea; Iosif, Ana-Maria; Solomon, Marjorie; Hessl, David

2018-01-01

Background Researchers are increasingly interested in testing and developing computerized cognitive training interventions for individuals with autism spectrum disorder due to the limited accessibility of treatments for this disorder. Understanding the feasibility of testing cognitive interventions for this population is critical, especially for individuals with ASD who have low to moderate intellectual ability. Objective The aim of the study was to evaluate the feasibility of computerized cognitive training as measured by attrition rate and a parent satisfaction survey. Methods A total of 26 participants aged 8-17 years with an autism spectrum disorder diagnosis and significant intellectual impairment were enrolled (mean age 11.1 years). They were instructed to complete 25 sessions of Cogmed Working Memory Training in 5 to 6 weeks with coach assistance. Attrition rate and parent satisfaction surveys were measured after the completion of training. Results Most participants (96%, 25/26) completed the training and indicated high satisfaction (>88%). However, among the participants who completed the training, 5 participants (19%) were unable to finish in 6 weeks, the recommended training period by Cogmed. Parents noted various positive (eg, voice-overs) and negative (eg, particular graphic and sounds associated with a stimulus) features of the game that they thought affected their child’s response. Conclusions Children with autism spectrum disorder and intellectual impairments can successfully participate in computerized cognitive training interventions but may require additional weeks to complete the training beyond the time needed for children without intellectual impairments. The overall completion rate, with extended time to complete the training, was high. Developers of cognitive training programs for this population should take into account potential issues regarding the noise level of stimuli and characteristics of the visual graphics. PMID:29802090

Arthroscopic Training Courses Improve Trainee Arthroscopy Skills: A Simulation-Based Prospective Trial.

PubMed

Martin, Kevin D; Patterson, David P; Cameron, Kenneth L

2016-11-01

To evaluate the correlation between timed task performance on an arthroscopy shoulder simulator and participation in a standardized expert shoulder arthroscopy educational course. Orthopaedic trainees were voluntarily recruited from over 25 residency programs throughout the United States and Canada. Each trainee was tested on arrival at the Arthroscopy Association of North America orthopaedic learning center on a virtual reality arthroscopy shoulder simulator, and his or her performance was objectively scored. Each trainee's postgraduate year level was recorded, as was his or her experience in residency with shoulder arthroscopy as measured by Accreditation Council for Graduate Medical Education case-log totals. After the focused 4-day training curriculum consisting of didactics and cadaveric experience, each trainee was re-evaluated on the same simulator. Statistical analysis was performed to determine if participation in the course was associated with changes in simulation performance from before to after assessment. Forty-eight trainees completed the testing. On completion of the course, trainees showed significant improvements in all objective measures recorded by the simulator. Total probe distance needed to complete the task decreased by 42% (from 420.4 mm to 245.3 mm, P < .001), arthroscope tip distance traveled decreased by 59% (from 194.1 mm to 80.2 mm, P < .001), and time to completion decreased by 38% (from 66.8 seconds to 41.6 seconds, P < .001). Highly significant improvements in all 3 measures suggest improved instrument handling, anatomic recognition, and arthroscopy-related visual-spatial ability. This study shows objective improvement in orthopaedic trainee basic arthroscopy skill and proficiency after a standardized 4-day arthroscopy training curriculum. The results validate the Arthroscopy Association of North America resident training course and its curriculum with objective evidence of benefit. Level III, prospective study of nonconsecutive participants. Published by Elsevier Inc.

The incorporation of focused history in checklist for early recognition and treatment of acute illness and injury.

PubMed

Jayaprakash, Namita; Ali, Rashid; Kashyap, Rahul; Bennett, Courtney; Kogan, Alexander; Gajic, Ognjen

2016-08-31

Diagnostic error and delay are critical impediments to the safety of critically ill patients. Checklist for early recognition and treatment of acute illness and injury (CERTAIN) has been developed as a tool that facilitates timely and error-free evaluation of critically ill patients. While the focused history is an essential part of the CERTAIN framework, it is not clear how best to choreograph this step in the process of evaluation and treatment of the acutely decompensating patient. An un-blinded crossover clinical simulation study was designed in which volunteer critical care clinicians (fellows and attendings) were randomly assigned to start with either obtaining a focused history choreographed in series (after) or in parallel to the primary survey. A focused history was obtained using the standardized SAMPLE model that is incorporated into American College of Trauma Life Support (ATLS) and Pediatric Advanced Life Support (PALS). Clinicians were asked to assess six acutely decompensating patients using pre - determined clinical scenarios (three in series choreography, three in parallel). Once the initial choreography was completed the clinician would crossover to the alternative choreography. The primary outcome was the cognitive burden assessed through the NASA task load index. Secondary outcome was time to completion of a focused history. A total of 84 simulated cases (42 in parallel, 42 in series) were tested on 14 clinicians. Both the overall cognitive load and time to completion improved with each successive practice scenario, however no difference was observed between the series versus parallel choreographies. The median (IQR) overall NASA TLX task load index for series was 39 (17 - 58) and for parallel 43 (27 - 52), p = 0.57. The median (IQR) time to completion of the tasks in series was 125 (112 - 158) seconds and in parallel 122 (108 - 158) seconds, p = 0.92. In this clinical simulation study assessing the incorporation of a focused history into the primary survey of a non-trauma critically ill patient, there was no difference in cognitive burden or time to task completion when using series choreography (after the exam) compared to parallel choreography (concurrent with the primary survey physical exam). However, with repetition of the task both overall task load and time to completion improved in each of the choreographies.

Response variability in rapid automatized naming predicts reading comprehension

PubMed Central

Li, James J.; Cutting, Laurie E.; Ryan, Matthew; Zilioli, Monica; Denckla, Martha B.; Mahone, E. Mark

2009-01-01

A total of 37 children ages 8 to 14 years, screened for word-reading difficulties (23 with attention-deficit/hyperactivity disorder, ADHD; 14 controls) completed oral reading and rapid automatized naming (RAN) tests. RAN trials were segmented into pause and articulation time and intraindividual variability. There were no group differences on reading or RAN variables. Color- and letter-naming pause times and number-naming articulation time were significant predictors of reading fluency. In contrast, number and letter pause variability were predictors of comprehension. Results support analysis of subcomponents of RAN and add to literature emphasizing intraindividual variability as a marker for response preparation, which has relevance to reading comprehension. PMID:19221923

Quantitative echocardiographic measures in the assessment of single ventricle function post-Fontan: Incorporation into routine clinical practice.

PubMed

Rios, Rodrigo; Ginde, Salil; Saudek, David; Loomba, Rohit S; Stelter, Jessica; Frommelt, Peter

2017-01-01

Quantitative echocardiographic measurements of single ventricular (SV) function have not been incorporated into routine clinical practice. A clinical protocol, which included quantitative measurements of SV deformation (global circumferential and longitudinal strain and strain rate), standard deviation of time to peak systolic strain, myocardial performance index (MPI), dP/dT from an atrioventricular valve regurgitant jet, and superior mesenteric artery resistance index, was instituted for all patients with a history of Fontan procedure undergoing echocardiography. All measures were performed real time during clinically indicated studies and were included in clinical reports. A total of 100 consecutive patients (mean age = 11.95±6.8 years, range 17 months-31.3 years) completed the protocol between September 1, 2014 to April 29, 2015. Deformation measures were completed in 100% of the studies, MPI in 93%, dP/dT in 55%, and superior mesenteric artery Doppler in 82%. The studies were reviewed to assess for efficiency in completing the protocol. The average time for image acquisition was 27.4±8.8 (range 10-62 minutes). The average time to perform deformation measures was 10.8±5.5 minutes (range 5-35 minutes) and time from beginning of imaging to report completion was 53.4±13.7 minutes (range 27-107 minutes). There was excellent inter-observer reliability when deformation indices were blindly repeated. Patients with a single left ventricle had significantly higher circumferential strain and strain rate, longitudinal strain and strain rate, and dP/dT compared to a single right ventricle. There were no differences in quantitative indices of ventricular function between patients <10 vs. >10 years post-Fontan. Advanced quantitative assessment of SV function post-Fontan can be consistently and efficiently performed real time during clinically indicated echocardiograms with excellent reliability. © 2016, Wiley Periodicals, Inc.

Pilot Study to Show the Feasibility of a Multicenter Trial of Home-based Assessment of People Over 75 Years Old

PubMed Central

Sano, Mary; Egelko, Susan; Ferris, Steven; Kaye, Jeffrey; Hayes, Tamara L.; Mundt, James C.; Donohue, Michael; Walter, Sarah; Sun, Shelly; Sauceda-Cerda, Luis

2012-01-01

This report describes a pilot study to evaluate feasibility of new home-based assessment technologies applicable to clinical trials for prevention of cognitive loss and Alzheimer disease. Methods Community-dwelling nondemented individuals ≥ 75 years old were recruited and randomized to 1 of 3 assessment methodologies: (1) mail-in questionnaire/live telephone interviews (MIP); (2) automated telephone with interactive voice recognition (IVR); and (3) internet-based computer Kiosk (KIO). Brief versions of cognitive and noncognitive outcomes were adapted to the different methodologies and administered at baseline and 1-month. An Efficiency measure, consisting of direct staff-to-participant time required to complete assessments, was also compared across arms. Results Forty-eight out of 60 screened participants were randomized. The dropout rate across arms from randomization through 1-month was different: 33% for KIO, 25% for IVR, and 0% for MIP (Fisher Exact Test P = 0.04). Nearly all participants who completed baseline also completed 1-month assessment (38 out of 39). The 1-way ANOVA across arms for total staff-to-participant direct contact time (ie, training, baseline, and 1-month) was significant: F (2,33) = 4.588; P = 0.017, with lowest overall direct time in minutes for IVR (Mn = 44.4; SD = 21.5), followed by MIP (Mn = 74.9; SD = 29.9), followed by KIO (Mn = 129.4; SD = 117.0). Conclusions In this sample of older individuals, a higher dropout rate occurred in those assigned to the high-technology assessment techniques; however, once participants had completed baseline in all 3 arms, they continued participation through 1 month. High-technology home-based assessment methods, which do not require live testers, began to emerge as more time-efficient over the brief time of this pilot, despite initial time-intensive participant training. PMID:20592583

Role of endoscopic biliary drainage in advanced hepatocellular carcinoma with jaundice

PubMed Central

Han, Sung Yong; Heo, Jeong; Kim, Dong Uk; Baek, Dong Hoon; Yoo, So Yong; Kim, Chang Won; Kim, Suk; Song, Geun Am; Cho, Mong; Kang, Dae Hwan

2017-01-01

Background Patients with advanced hepatocellular carcinoma (HCC) with jaundice have an extremely poor prognosis. Although biliary drainage can resolve obstructive jaundice, signs of obstruction may not be evident. This study evaluated the role of endoscopic biliary drainage in patients with advanced HCC and obstructive jaundice. Methods From 2010 to 2015, 74 patients underwent endoscopic biliary drainage for obstructive jaundice due to advanced HCC. Jaundice resolution was defined as complete response and total bilirubin concentration below 3 mg/dl. Results The technical success rate in the 74 patients was 92.1% (70/76). Of the 70 patients who underwent successful biliary drainage, 48 (68.6%) and 22 (31.4%) were Child-Pugh classes B and C, respectively, and 10 (14.3%) and 60 (85.7%) were BCLC stages B and C, respectively. Intrahepatic bile duct (IHD) dilatation was observed in 35 patients (50%). After drainage, the complete response rate was 35.7% (25/70). The mean time to resolution was 17.4 ±8.5 days. However, jaundice was re-aggravated in 74.3% (15/25) after a mean 103.5 ±96.4 days. Multivariate analysis showed that the absence of ascites, presence of IHD dilatation, normal range of prothrombin time, and lower MELD score were significantly associated with complete response. The overall survival rate was 15.7% (11/70) and the median survival time is 28 days (95% confidence interval 2.6–563 days). Complete response and HCC treatment after drainage were significantly associated with survival. Conclusion Effective endoscopic biliary drainage is an important palliative treatment in patients with advanced HCC and obstructive jaundice, especially those with IHD dilatation and preserved liver function, as determined by ascites, prothrombin time, and MELD score. PMID:29095941

Role of endoscopic biliary drainage in advanced hepatocellular carcinoma with jaundice.

PubMed

Woo, Hyun Young; Han, Sung Yong; Heo, Jeong; Kim, Dong Uk; Baek, Dong Hoon; Yoo, So Yong; Kim, Chang Won; Kim, Suk; Song, Geun Am; Cho, Mong; Kang, Dae Hwan

2017-01-01

Patients with advanced hepatocellular carcinoma (HCC) with jaundice have an extremely poor prognosis. Although biliary drainage can resolve obstructive jaundice, signs of obstruction may not be evident. This study evaluated the role of endoscopic biliary drainage in patients with advanced HCC and obstructive jaundice. From 2010 to 2015, 74 patients underwent endoscopic biliary drainage for obstructive jaundice due to advanced HCC. Jaundice resolution was defined as complete response and total bilirubin concentration below 3 mg/dl. The technical success rate in the 74 patients was 92.1% (70/76). Of the 70 patients who underwent successful biliary drainage, 48 (68.6%) and 22 (31.4%) were Child-Pugh classes B and C, respectively, and 10 (14.3%) and 60 (85.7%) were BCLC stages B and C, respectively. Intrahepatic bile duct (IHD) dilatation was observed in 35 patients (50%). After drainage, the complete response rate was 35.7% (25/70). The mean time to resolution was 17.4 ±8.5 days. However, jaundice was re-aggravated in 74.3% (15/25) after a mean 103.5 ±96.4 days. Multivariate analysis showed that the absence of ascites, presence of IHD dilatation, normal range of prothrombin time, and lower MELD score were significantly associated with complete response. The overall survival rate was 15.7% (11/70) and the median survival time is 28 days (95% confidence interval 2.6-563 days). Complete response and HCC treatment after drainage were significantly associated with survival. Effective endoscopic biliary drainage is an important palliative treatment in patients with advanced HCC and obstructive jaundice, especially those with IHD dilatation and preserved liver function, as determined by ascites, prothrombin time, and MELD score.

The Grapefruit: An Alternative Arthroscopic Tool Skill Platform.

PubMed

Molho, David A; Sylvia, Stephen M; Schwartz, Daniel L; Merwin, Sara L; Levy, I Martin

2017-08-01

To establish the construct validity of an arthroscopic training model that teaches arthroscopic tool skills including triangulation, grasping, precision biting, implant delivery and ambidexterity and uses a whole grapefruit for its training platform. For the grapefruit training model (GTM), an arthroscope and arthroscopic instruments were introduced through portals cut in the grapefruit skin of a whole prepared grapefruit. After institutional review board approval, participants performed a set of tasks inside the grapefruit. Performance for each component was assessed by recording errors, achievement of criteria, and time to completion. A total of 19 medical students, orthopaedic surgery residents, and fellowship-trained orthopaedic surgeons were included in the analysis and were divided into 3 groups based on arthroscopic experience. One-way analysis of variance (ANOVA) and the post hoc Tukey test were used for statistical analysis. One-way ANOVA showed significant differences in both time to completion and errors between groups, F(2, 16) = 16.10, P < .001; F(2, 16) = 17.43, P < .001. Group A had a longer time to completion and more errors than group B (P = .025, P = .019), and group B had a longer time to completion and more errors than group C (P = .023, P = .018). The GTM is an easily assembled and an alternative arthroscopic training model that bridges the gap between box trainers, cadavers, and virtual reality simulators. Our findings suggest construct validity when evaluating its use for teaching the basic arthroscopic tool skills. As such, it is a useful addition to the arthroscopic training toolbox. There is a need for validated low-cost arthroscopic training models that are easily accessible. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Nuclear powered Mars cargo transport mission utilizing advanced ion propulsion

NASA Technical Reports Server (NTRS)

Galecki, Diane L.; Patterson, Michael J.

1987-01-01

Nuclear-powered ion propulsion technology was combined with detailed trajectory analysis to determine propulsion system and trajectory options for an unmanned cargo mission to Mars in support of manned Mars missions. A total of 96 mission scenarios were identified by combining two power levels, two propellants, four values of specific impulse per propellant, three starting altitudes, and two starting velocities. Sixty of these scenarios were selected for a detailed trajectory analysis; a complete propulsion system study was then conducted for 20 of these trajectories. Trip times ranged from 344 days for a xenon propulsion system operating at 300 kW total power and starting from lunar orbit with escape velocity, to 770 days for an argon propulsion system operating at 300 kW total power and starting from nuclear start orbit with circular velocity. Trip times for the 3 MW cases studied ranged from 356 to 413 days. Payload masses ranged from 5700 to 12,300 kg for the 300 kW power level, and from 72,200 to 81,500 kg for the 3 MW power level.

Impact of high pressure processing on color, bioactive compounds, polyphenol oxidase activity, and microbiological attributes of pumpkin purée.

PubMed

González-Cebrino, Francisco; Durán, Rocío; Delgado-Adámez, Jonathan; Contador, Rebeca; Bernabé, Rosario Ramírez

2016-04-01

Physicochemical parameters, bioactive compounds' content (carotenoids and total phenols), total antioxidant activity, and enzymatic activity of polyphenol oxidase (PPO) were evaluated after high pressure processing (HPP) on a pumpkin purée (cv. 'Butternut'). Three pressure levels (400, 500, and 600 MPa) were combined with three holding times (200, 400, and 600 s). The applied treatments reduced the levels of total aerobic mesophilic (TAM), total psychrophilic and psychrotrophic bacteria (TPP), and molds and yeasts (M&Y). All applied treatments did not affect enzymatic activity of PPO. Pressure level increased CIE L* values, which could enhance the lightness perception of high pressure (HP)-treated purées. No differences were found between the untreated and HP-treated purées regarding total phenols and carotenoids content (lutein, α-carotene, and β-carotene) and total antioxidant activity. HPP did not affect most quality parameters and maintained the levels of bioactive compounds. However, it did not achieve the complete inhibition of PPO, which could reduce the shelf-life of the pumpkin purée. © The Author(s) 2015.

Influence of wholesale lamb marketing options and merchandising styles on retail yield and fabrication time.

PubMed

Lorenzen, C L; Martin, A M; Griffin, D B; Dockerty, T R; Walter, J P; Johnson, H K; Savell, J W

1997-01-01

Lamb carcasses (n = 94) from five packing plants, selected to vary in weight class and fat thickness, were used to determine retail yield and labor requirements of wholesale lamb fabrication. Carcasses were allotted randomly according to weight class to be fabricated as whole carcasses (n = 20), three-piece boxes (n = 22), or subprimals (n = 52). Processing times (seconds) were recorded and wholesale and retail weights (kilograms) were obtained to calculate retail yield. Subprimals were fabricated into bone-in retail cuts or boneless or semi-boneless retail cuts. Retail yield for subprimal lamb legs decreased from 85.3 +/- .6% for bone-in to 68.0 +/- .7% for a completely boneless retail product. Correspondingly, processing times increased from 126.1 +/- 5.4 s to 542.0 +/- 19.2 s for bone-in and boneless legs, respectively. For all subprimals, retail yield percentage tended to decrease and total processing time increase as cuts were fabricated to boneless or semi-boneless end points compared with a bone-in end point. Percentage retail yield did not differ (P > .05) among whole carcass, three-piece box, and subprimal marketing methods. Total processing time was shorter for subprimals (P < .05) than for the other two marketing methods.

Objective measurements of daily physical activity patterns and sedentary behaviour in older adults: Age, Gene/Environment Susceptibility-Reykjavik Study.

PubMed

Arnardottir, Nanna Yr; Koster, Annemarie; Van Domelen, Dane R; Brychta, Robert J; Caserotti, Paolo; Eiriksdottir, Gudny; Sverrisdottir, Johanna Eyrun; Launer, Lenore J; Gudnason, Vilmundur; Johannsson, Erlingur; Harris, Tamara B; Chen, Kong Y; Sveinsson, Thorarinn

2013-03-01

objectively measured population physical activity (PA) data from older persons is lacking. The aim of this study was to describe free-living PA patterns and sedentary behaviours in Icelandic older men and women using accelerometer. from April 2009 to June 2010, 579 AGESII-study participants aged 73-98 years wore an accelerometer (Actigraph GT3X) at the right hip for one complete week in the free-living settings. in all subjects, sedentary time was the largest component of the total wear time, 75%, followed by low-light PA, 21%. Moderate-vigorous PA (MVPA) was <1%. Men had slightly higher average total PA (counts × day(-1)) than women. The women spent more time in low-light PA but less time in sedentary PA and MVPA compared with men (P < 0.001). In persons <75 years of age, 60% of men and 34% of women had at least one bout ≥10 min of MVPA, which decreased with age, with only 25% of men and 9% of women 85 years and older reaching this. sedentary time is high in this Icelandic cohort, which has high life-expectancy and is living north of 60° northern latitude.

The timing of calcium measurements in helping to predict temporary and permanent hypocalcaemia in patients having completion and total thyroidectomies.

PubMed

Pfleiderer, A G; Ahmad, N; Draper, M R; Vrotsou, K; Smith, W K

2009-03-01

Postoperative hypocalaemia commonly occurs after extensive thyroid surgery and may require calcium and/or vitamin D supplements to alleviate or prevent the symptoms. In this study, we determined the risk factors for developing hypocalcaemia and whether early serum calcium levels can predict the development of or differentiate between temporary or permanent hypocalcaemia. A total of 162 patients who either had a completion or total thyroidectomy formed the basis of this prospective study. Serial serum calcium measurements were recorded as well as details of the operation, pathology, indications for surgery, number of parathyroids identified at operation and any complications. Eighty-four (52%) patients did not develop hypocalcaemia but 69 (43%) were found to have temporary hypocalcaemia and 9 (5%) had permanent hypocalcaemia. Hypocalcaemia was more common after total than completion thyroidectomies and the identification of parathyroids at operation appears to have a significant adverse effect on outcome. The calcium levels measured on day 1 postoperatively and the slope (serum calcium levels of day 1 postoperative minus day of operation) were statistically significant in predicting the development of hypocalcaemia and possibly to differentiate between temporary or permanent hypocalcaemia. Although almost half the patients having extensive thyroid surgery developed hypocalcaemia (as defined by any postoperative corrected serum calcium level of < 2.12 mmol/l) only 24% had a serum calcium of < 2.12 mmol/l associated with clinical symptoms of hypocalcaemia or a calcium level of < 2.0 mmol/l. Only 5% had persistent hypocalcaemia defined as requiring exogenous supplements at 6 months' postoperatively. Patients having a completion thyroidectomy appear to be less likely to develop hypocalcaemia perhaps as a result of any iatrogenic effects on the parathyroids at the first operation being reversed before the second operation. Identification and, therefore, exposure of parathyroids at operation may have an adverse effect on the blood supply to the glands affecting their function. Serum calcium levels measured 6 hours' post-surgery and on day 1 postoperatively can be useful in predicting if the patient will develop hypocalcaemia and the slope may indicate whether the hypocalcaemia will be temporary or permanent. Patients with toxic goitres and those having a one-stage total thyroidectomy are most at risk of developing hypocalcaemia.

The Timing of Calcium Measurements in Helping to Predict Temporary and Permanent Hypocalcaemia in Patients Having Completion and Total Thyroidectomies

PubMed Central

Pfleiderer, AG; Ahmad, N; Draper, MR; Vrotsou, K; Smith, WK

2009-01-01

INTRODUCTION Postoperative hypocalaemia commonly occurs after extensive thyroid surgery and may require calcium and/or vitamin D supplements to alleviate or prevent the symptoms. In this study, we determined the risk factors for developing hypocalcaemia and whether early serum calcium levels can predict the development of or differentiate between temporary or permanent hypocalcaemia. PATIENTS AND METHODS A total of 162 patients who either had a completion or total thyroidectomy formed the basis of this prospective study. Serial serum calcium measurements were recorded as well as details of the operation, pathology, indications for surgery, number of parathyroids identified at operation and any complications. RESULTS Eighty-four (52%) patients did not develop hypocalcaemia but 69 (43%) were found to have temporary hypocalcaemia and 9 (5%) had permanent hypocalcaemia. Hypocalcaemia was more common after total than completion thyroidectomies and the identification of parathyroids at operation appears to have a significant adverse effect on outcome. The calcium levels measured on day 1 postoperatively and the slope (serum calcium levels of day 1 postoperative minus day of operation) were statistically significant in predicting the development of hypocalcaemia and possibly to differentiate between temporary or permanent hypocalcaemia. DISCUSSION Although almost half the patients having extensive thyroid surgery developed hypocalcaemia (as defined by any postoperative corrected serum calcium level of < 2.12 mmol/l) only 24% had a serum calcium of < 2.12 mmol/l associated with clinical symptoms of hypocalcaemia or a calcium level of < 2.0 mmol/l. Only 5% had persistent hypocalcaemia defined as requiring exogenous supplements at 6 months' postoperatively. Patients having a completion thyroidectomy appear to be less likely to develop hypocalcaemia perhaps as a result of any iatrogenic effects on the parathyroids at the first operation being reversed before the second operation. Identification and, therefore, exposure of parathyroids at operation may have an adverse effect on the blood supply to the glands affecting their function. CONCLUSIONS Serum calcium levels measured 6 hours' post-surgery and on day 1 postoperatively can be useful in predicting if the patient will develop hypocalcaemia and the slope may indicate whether the hypocalcaemia will be temporary or permanent. Patients with toxic goitres and those having a one-stage total thyroidectomy are most at risk of developing hypocalcaemia. PMID:19317937

Accelerated hypofractionated three-dimensional conformal radiation therapy (3 Gy/fraction) combined with concurrent chemotherapy for patients with unresectable stage III non-small cell lung cancer: preliminary results of an early terminated phase II trial.

PubMed

Ren, Xiao-Cang; Wang, Quan-Yu; Zhang, Rui; Chen, Xue-Ji; Wang, Na; Liu, Yue-E; Zong, Jie; Guo, Zhi-Jun; Wang, Dong-Ying; Lin, Qiang

2016-04-23

Increasing the biological effective dose (BED) of radiotherapy for non-small cell lung cancer (NSCLC) can increase local control rates and improve overall survival. Compared with conventional fractionated radiotherapy, accelerated hypofractionated radiotherapy can yield higher BED, shorten the total treatment time, and theoretically obtain better efficacy. However, currently, there is no optimal hypofractionated radiotherapy regimen. Based on phase I trial results, we performed this phase II trial to further evaluate the safety and preliminary efficacy of accelerated hypofractionated three-dimensional conformal radiation therapy(3-DCRT) combined with concurrent chemotherapy for patients with unresectable stage III NSCLC. Patients with previously untreated unresectable stage III NSCLC received 3-DCRT with a total dose of 69 Gy, delivered at 3 Gy per fraction, once daily, five fractions per week, completed within 4.6 weeks. At the same time, platinum doublet chemotherapy was applied. After 12 patients were enrolled in the group, the trial was terminated early. There were five cases of grade III radiation esophagitis, of which four cases completed the radiation doses of 51 Gy, 51 Gy, 54 Gy, and 66 Gy, and one case had 16 days of radiation interruption. The incidence of grade III acute esophagitis in patients receiving an irradiation dose per fraction ≥2.7 Gy on the esophagus was 83.3% (5/6). The incidence of symptomatic grade III radiation pneumonitis among the seven patients who completed 69 Gy according to the plan was 28.6% (2/7). The median local control (LC) and overall survival (OS) were not achieved; the 1-year LC rate was 59.3%, and the 1-year OS rate was 78.6%. For unresectable stage III NSCLC, the accelerated hypofractionated radiotherapy with a total dose of 69 Gy (3 Gy/f) combined with concurrent chemotherapy might result in severe radiation esophagitis and pneumonitis to severely affect the completion of the radiotherapy. Therefore, we considered that this regimen was infeasible. During the hypofractionated radiotherapy with concurrent chemotherapy, the irradiation dose per fraction to esophagus should be lower than 2.7 Gy. Further studies should be performed using esophageal tolerance as a metric in dose escalation protocols. NCT02720614, the date of registration: March 23, 2016.

Occupational-Specific Strength Predicts Astronaut-Related Task Performance in a Weighted Suit.

PubMed

Taylor, Andrew; Kotarsky, Christopher J; Bond, Colin W; Hackney, Kyle J

2018-01-01

Future space missions beyond low Earth orbit will require deconditioned astronauts to perform occupationally relevant tasks within a planetary spacesuit. The prediction of time-to-completion (TTC) of astronaut tasks will be critical for crew safety, autonomous operations, and mission success. This exploratory study determined if the addition of task-specific strength testing to current standard lower body testing would enhance the prediction of TTC in a 1-G test battery. Eight healthy participants completed NASA lower body strength tests, occupationally specific strength tests, and performed six task simulations (hand drilling, construction wrenching, incline walking, collecting weighted samples, and dragging an unresponsive crewmember to safety) in a 48-kg weighted suit. The TTC for each task was recorded and summed to obtain a total TTC for the test battery. Linear regression was used to predict total TTC with two models: 1) NASA lower body strength tests; and 2) NASA lower body strength tests + occupationally specific strength tests. Total TTC of the test battery ranged from 20.2-44.5 min. The lower body strength test alone accounted for 61% of the variability in total TTC. The addition of hand drilling and wrenching strength tests accounted for 99% of the variability in total TTC. Adding occupationally specific strength tests (hand drilling and wrenching) to standard lower body strength tests successfully predicted total TTC in a performance test battery within a weighted suit. Future research should couple these strength tests with higher fidelity task simulations to determine the utility and efficacy of task performance prediction.Taylor A, Kotarsky CJ, Bond CW, Hackney KJ. Occupational-specific strength predicts astronaut-related task performance in a weighted suit. Aerosp Med Hum Perform. 2018; 89(1):58-62.

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

Xu, H; Guerrero, M; Prado, K

Purpose: Building up a TG-71 based electron monitor-unit (MU) calculation protocol usually involves massive measurements. This work investigates a minimum data set of measurements and its calculation accuracy and measurement time. Methods: For 6, 9, 12, 16, and 20 MeV of our Varian Clinac-Series linear accelerators, the complete measurements were performed at different depth using 5 square applicators (6, 10, 15, 20 and 25 cm) with different cutouts (2, 3, 4, 6, 10, 15 and 20 cm up to applicator size) for 5 different SSD’s. For each energy, there were 8 PDD scans and 150 point measurements for applicator factors,more » cutout factors and effective SSDs that were then converted to air-gap factors for SSD 99–110cm. The dependence of each dosimetric quantity on field size and SSD was examined to determine the minimum data set of measurements as a subset of the complete measurements. The “missing” data excluded in the minimum data set were approximated by linear or polynomial fitting functions based on the included data. The total measurement time and the calculated electron MU using the minimum and the complete data sets were compared. Results: The minimum data set includes 4 or 5 PDD’s and 51 to 66 point measurements for each electron energy, and more PDD’s and fewer point measurements are generally needed as energy increases. Using only <50% of complete measurement time, the minimum data set generates acceptable MU calculation results compared to those with the complete data set. The PDD difference is within 1 mm and the calculated MU difference is less than 1.5%. Conclusion: Data set measurement for TG-71 electron MU calculations can be minimized based on the knowledge of how each dosimetric quantity depends on various setup parameters. The suggested minimum data set allows acceptable MU calculation accuracy and shortens measurement time by a few hours.« less

Research on slow electron collision processes in gases. Final report, September 15, 1970--December 31, 1972

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

Baldwin, G C

1974-04-30

Research on low energy electron collisions in gases by the time-of- flight velocity selection technique included, as a preliminary to total cross section measurements, investigations of the statistical and systematic errors inherent in the technique. In particular, thermal transpiration and instrumental fluctuation errors in manometry were investigated, and the results embodied in computer programs for data reduction. The instrumental system was improved to permit extended periods of data accumulation without manual attention. Total cross section measurements in helium, made prior to, and in molecular nitrogen, made after the supporting work was completed, are reported. The total cross sec tion ofmore » helium is found to be higher than reported in previous beam determinations. That of nitrogen is found to be structureless at low energies. (auth)« less

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

Wagner, B.

A specially designed wire line retrievable continuous coring system cored its initial project wells to total depth in hard rock formations in less than half the time that would have been required by conventional coring rigs. The hybrid wire line coring systems have since been used on other wells in similar lithologies, with a total of 38,000 m (124,640 ft) of hole cored and with penetration rates averaging 2.27 m/hr (7.45 ft/hr). This paper reports that Parker Drilling Co. designed the hybrid rigs and has recently been contracted to wire line core several holes for oil and gas exploration inmore » the Congo. The first core hole has been completed to 1,490 m, and total depth was reached in 21 days. The rig is now being mobilized to a second hole in the Congo.« less

Dissociative and double photoionization of CO2 from threshold to 90 A

NASA Technical Reports Server (NTRS)

Masuoka, T.; Samson, J. A. R.

1979-01-01

The molecular photoionization, dissociative photoionization and double photoionization cross sections for CO2 were measured from their onsets down to 90 A by using various combinations of mass spectrometers (a coincidence time-of-flight mass spectrometer and a magnetic mass spectrometer) and light sources (synchrotron radiation, and glow and spark discharge). It is concluded that the one broad peak and the three shoulders in the total adsorption cross section curve between 640 and 90 A are caused completely by dissociative ionization processes. Several peaks observed in the cross section curve for the total fragmentation CO(+)3, O(+) and C(+) are compared with those in the photoelectron spectrum reported for CO2.

Association of Time between Surgery and Adjuvant Therapy with Survival in Oral Cavity Cancer.

PubMed

Chen, Michelle M; Harris, Jeremy P; Orosco, Ryan K; Sirjani, Davud; Hara, Wendy; Divi, Vasu

2018-06-01

Objective The National Cancer Center Network recommends starting radiation therapy within 6 weeks after surgery for oral cavity squamous cell carcinoma (OCSCC), but there is limited evidence of the importance of the total time from surgery to completion of radiation therapy (package time). We set out to determine if there was an association between package time and survival in OCSCC and to evaluate the impact of treatment location on outcomes. Study Design Retrospective cohort study. Setting Tertiary academic medical center. Subjects and Methods We reviewed the records of patients with OCSCC who completed postoperative radiation therapy at an academic medical center from 2008 to 2016. The primary endpoints were overall survival and recurrence-free survival. Statistical analysis included χ 2 tests and Cox proportional hazards regressions. Results We identified 132 patients with an average package time of 12.6 weeks. On multivariate analysis, package time >11 weeks was independently associated with decreased overall survival (hazard ratio, 6.68; 95% CI, 1.42-31.44) and recurrence-free survival (hazard ratio, 2.94; 95% CI, 1.20-7.18). Patients who received radiation therapy at outside facilities were more likely to have treatment delays (90.2% vs 62.9%, P = .001). Conclusions Prolonged package times are associated with decreased overall and recurrence-free survival among patients with OCSCC. Patients who received radiation therapy at outside facilities are more likely to have prolonged package times.

Consumer participation in quality improvements for chronic disease care: development and evaluation of an interactive patient-centered survey to identify preferred service initiatives.

PubMed

Fradgley, Elizabeth A; Paul, Christine L; Bryant, Jamie; Roos, Ian A; Henskens, Frans A; Paul, David J

2014-12-19

With increasing attention given to the quality of chronic disease care, a measurement approach that empowers consumers to participate in improving quality of care and enables health services to systematically introduce patient-centered initiatives is needed. A Web-based survey with complex adaptive questioning and interactive survey items would allow consumers to easily identify and prioritize detailed service initiatives. The aim was to develop and test a Web-based survey capable of identifying and prioritizing patient-centered initiatives in chronic disease outpatient services. Testing included (1) test-retest reliability, (2) patient-perceived acceptability of the survey content and delivery mode, and (3) average completion time, completion rates, and Flesch-Kincaid reading score. In Phase I, the Web-based Consumer Preferences Survey was developed based on a structured literature review and iterative feedback from expert groups of service providers and consumers. The touchscreen survey contained 23 general initiatives, 110 specific initiatives available through adaptive questioning, and a relative prioritization exercise. In Phase II, a pilot study was conducted within 4 outpatient clinics to evaluate the reliability properties, patient-perceived acceptability, and feasibility of the survey. Eligible participants were approached to complete the survey while waiting for an appointment or receiving intravenous therapy. The age and gender of nonconsenters was estimated to ascertain consent bias. Participants with a subsequent appointment within 14 days were asked to complete the survey for a second time. A total of 741 of 1042 individuals consented to participate (71.11% consent), 529 of 741 completed all survey content (78.9% completion), and 39 of 68 completed the test-retest component. Substantial or moderate reliability (Cohen's kappa>0.4) was reported for 16 of 20 general initiatives with observed percentage agreement ranging from 82.1%-100.0%. The majority of participants indicated the Web-based survey was easy to complete (97.9%, 531/543) and comprehensive (93.1%, 505/543). Participants also reported the interactive relative prioritization exercise was easy to complete (97.0%, 189/195) and helped them to decide which initiatives were of most importance (84.6%, 165/195). Average completion time was 8.54 minutes (SD 3.91) and the Flesch-Kincaid reading level was 6.8. Overall, 84.6% (447/529) of participants indicated a willingness to complete a similar survey again. The Web-based Consumer Preferences Survey is sufficiently reliable and highly acceptable to patients. Based on completion times and reading level, this tool could be integrated in routine clinical practice and allows consumers to easily participate in quality evaluation. Results provide a comprehensive list of patient-prioritized initiatives for patients with major chronic conditions and delivers practice-ready evidence to guide improvements in patient-centered care.

Psychological factors related to delay in consultation for cancer symptoms.

PubMed

Ristvedt, Stephen L; Trinkaus, Kathryn M

2005-05-01

This research investigated psychological characteristics associated with delay in seeking help for symptoms of rectal cancer. Sixty nine subjects reconstructed pivotal events beginning with symptom onset and ending with medical consultation, and completed the Temperament and Character Inventory (TCI) and the State-Trait Anxiety Inventory (STAI). The mean delay time was around 6 months, with about 1 out of 6 subjects waiting one year or more. Subjects estimated the lengths of two sequential segments of total time to consultation: (1) Symptom Appraisal time (from symptom onset to recognition of possible seriousness), and (2) Action Appraisal time (from recognition of seriousness to medical consultation). Symptom Appraisal time accounted for over two-thirds of total time and was associated with low scores on the TCI Harm Avoidance scale (TCI-HA), indicating dispositional insensitivity to threat, and marginally associated with less education and younger age. Action Appraisal time was not associated with any demographic or psychological variables. Low TCI-HA scores were also associated with lower likelihood of previous cancer screening, and with better judgments of premorbid health. Low STAI Trait scores were associated with better judgments of premorbid health and fewer doctor visits. Results are discussed regarding the importance of understanding dispositional characteristics related to health behavior. Copyright (c) 2004 John Wiley & Sons, Ltd.

Use of Jebsen Taylor Hand Function Test in evaluating the hand dexterity in people with Parkinson's disease.

PubMed

Mak, M K Y; Lau, E T L; Tam, V W K; Woo, C W Y; Yuen, S K Y

2015-01-01

To investigate the test-retest reliability of JTT in older patients with Parkinson's disease (PD); and to compare the Jebsen Taylor Hand Function Test (JTT) scores between PD and healthy subjects. Cross-sectional comparative study. Fifteen PD and fifteen healthy subjects performed the JTT and the time taken to complete the JTT was recorded. Test-retest reliabilities of JTT subtests and total score of both dominant and non-dominant hand were good to excellent (ICCs = 0.77-0.97) except J5 checkers which had moderate reliability. PD subjects required significantly longer time to finish subtests and the whole JTT (p < 0.05), except the subtest J1 writing of dominant hand that showed marginal significance (p = 0.059). JTT is a reliable and easily available assessment tool for assessing the hand function of PD subjects. PD subjects took a longer time to complete the JTT, suggesting that they have deficits in gross and fine functional dexterity. Copyright © 2015 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Patient Compliance With Electronic Patient Reported Outcomes Following Shoulder Arthroscopy.

PubMed

Makhni, Eric C; Higgins, John D; Hamamoto, Jason T; Cole, Brian J; Romeo, Anthony A; Verma, Nikhil N

2017-11-01

To determine the patient compliance in completing electronically administered patient-reported outcome (PRO) scores following shoulder arthroscopy, and to determine if dedicated research assistants improve patient compliance. Patients undergoing arthroscopic shoulder surgery from January 1, 2014, to December 31, 2014, were prospectively enrolled into an electronic data collection system with retrospective review of compliance data. A total of 143 patients were included in this study; 406 patients were excluded (for any or all of the following reasons, such as incomplete follow-up, inaccessibility to the order sets, and inability to complete the order sets). All patients were assigned an order set of PROs through an electronic reporting system, with order sets to be completed prior to surgery, as well as 6 and 12 months postoperatively. Compliance rates of form completion were documented. Patients who underwent arthroscopic anterior and/or posterior stabilization were excluded. The average age of the patients was 53.1 years, ranging from 20 to 83. Compliance of form completion was highest preoperatively (76%), and then dropped subsequently at 6 months postoperatively (57%) and 12 months postoperatively (45%). Use of research assistants improved compliance by approximately 20% at each time point. No differences were found according to patient gender and age group. Of those completing forms, a majority completed forms at home or elsewhere prior to returning to the office for the clinic visit. Electronic administration of PRO may decrease the amount of time required in the office setting for PRO completion by patients. This may be mutually beneficial to providers and patients. It is unclear if an electronic system improves patient compliance in voluntary completion PRO. Compliance rates at final follow-up remain a concern if data are to be used for establishing quality or outcome metrics. Level IV, case series. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Chinese and Australians showed difference in mental time travel in emotion and content but not specificity

PubMed Central

Chen, Xing-Jie; Liu, Lu-Lu; Cui, Ji-Fang; Wang, Ya; Shum, David H. K.; Chan, Raymond C. K.

2015-01-01

Mental time travel refers to the ability to recall episodic past and imagine future events. The present study aimed to investigate cultural differences in mental time travel between Chinese and Australian university students. A total of 231 students (108 Chinese and 123 Australians) participated in the study. Their mental time travel abilities were measured by the Sentence Completion for Events from the Past Test (SCEPT) and the Sentence Completion for Events in the Future Test (SCEFT). Results showed that there were no cultural differences in the number of specific events generated for the past or future. Significant differences between the Chinese and Australian participants were found mainly in the emotional valence and content of the events generated. Both Chinese and Australian participants generated more specific positive events compared to negative events when thinking about the future and Chinese participants were more positive about their past than Australian participants when recalling specific events. For content, Chinese participants recalled more events about their interpersonal relationships, while Australian participants imagined more about personal future achievements. These findings shed some lights on cultural differences in episodic past and future thinking. PMID:26167154

15 CFR 2301.24 - Final Federal payment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... reasonable costs incurred in completing the planning or construction project are less than the total project..., however, the actual costs incurred in completing the project are more than the estimated total project costs, in no case will the final Federal funds paid exceed the grant award. ...

Construct validity of the LapVR virtual-reality surgical simulator.

PubMed

Iwata, Naoki; Fujiwara, Michitaka; Kodera, Yasuhiro; Tanaka, Chie; Ohashi, Norifumi; Nakayama, Goro; Koike, Masahiko; Nakao, Akimasa

2011-02-01

Laparoscopic surgery requires fundamental skills peculiar to endoscopic procedures such as eye-hand coordination. Acquisition of such skills prior to performing actual surgery is highly desirable for favorable outcome. Virtual-reality simulators have been developed for both surgical training and assessment of performance. The aim of the current study is to show construct validity of a novel simulator, LapVR (Immersion Medical, San Jose, CA, USA), for Japanese surgeons and surgical residents. Forty-four subjects were divided into the following three groups according to their experience in laparoscopic surgery: 14 residents (RE) with no experience in laparoscopic surgery, 14 junior surgeons (JR) with little experience, and 16 experienced surgeons (EX). All subjects executed "essential task 1" programmed in the LapVR, which consists of six tasks, resulting in automatic measurement of 100 parameters indicating various aspects of laparoscopic skills. Time required for each task tended to be inversely correlated with experience in laparoscopic surgery. For the peg transfer skill, statistically significant differences were observed between EX and RE in three parameters, including total time and average time taken to complete the procedure and path length for the nondominant hand. For the cutting skill, similar differences were observed between EX and RE in total time, number of unsuccessful cutting attempts, and path length for the nondominant hand. According to the programmed comprehensive evaluation, performance in terms of successful completion of the task and actual experience of the participants in laparoscopic surgery correlated significantly for the peg transfer (P=0.007) and cutting skills (P=0.026). The peg transfer and cutting skills could best distinguish between EX and RE. This study is the first to provide evidence that LapVR has construct validity to discriminate between novice and experienced laparoscopic surgeons.

Women awaken faster than men after electroencephalogram-monitored propofol sedation for colonoscopy: A prospective observational study.

PubMed

Riphaus, Andrea; Slottje, Mark; Bulla, Jan; Keil, Carolin; Mentzel, Christian; Limbach, Vera; Schultz, Barbara; Unzicker, Christian

2017-10-01

Sedation for colonoscopy using intravenous propofol has become standard in many Western countries. Gender-specific differences have been shown for general anaesthesia in dentistry, but no such data existed for gastrointestinal endoscopy. A prospective observational study. An academic teaching hospital of Hannover Medical School. A total of 219 patients (108 women and 111 men) scheduled for colonoscopy. Propofol sedation using electroencephalogram monitoring during a constant level of sedation depth (D0 to D2) performed by trained nurses or physicians after a body-weight-adjusted loading dose. The primary end-point was the presence of gender-specific differences in awakening time (time from end of sedation to eye-opening and complete orientation); secondary outcome parameters analysed were total dose of propofol, sedation-associated complications (bradycardia, hypotension, hypoxaemia and apnoea), patient cooperation and patient satisfaction. Multivariate analysis was performed to correct confounding factors such as age and BMI. Women awakened significantly faster than men, with a time to eye-opening of 7.3 ± 3.7 versus 8.4 ± 3.4 min (P = 0.005) and time until complete orientation of 9.1 ± 3.9 versus 10.4 ± 13.7 min (P = 0.008). The propofol dosage was not significantly different, with some trend towards more propofol per kg body weight in women (3.98 ± 1.81 mg versus 3.72 ± 1.75 mg, P = 0.232). The effect of gender aspects should be considered when propofol is used as sedation for gastrointestinal endoscopy. That includes adequate dosing for women as well as caution regarding potential overdosing of male patients. ClinicalTrials.gov (Identifier: NCT02687568).

Impact of drug shortages on U.S. health systems.

PubMed

Kaakeh, Rola; Sweet, Burgunda V; Reilly, Cynthia; Bush, Colleen; DeLoach, Sherry; Higgins, Barb; Clark, Angela M; Stevenson, James

2011-10-01

A study was performed to quantify the personnel resources required to manage drug shortages, define the impact of drug shortages on health systems nationwide, and assess the adequacy of information resources available to manage drug shortages. An online survey was sent to the 1322 members of the American Society of Health-System Pharmacists who were identified as directors of pharmacy. Survey recipients were asked to identify which of the 30 most recent drug shortages listed affected their health system, to identify actions taken to manage the shortage, and to rate the impact of each shortage. Employees responsible for completing predefined tasks were identified, and the average time spent by each type of employee completing these tasks was estimated. Labor costs associated with managing shortages were calculated. A total of 353 respondents completed the survey, yielding a response rate of 27%. Pharmacists and pharmacy technicians spent more time managing drug shortages than did physicians and nurses. There was a significant association between the time spent managing shortages and the size of the institution, the number of shortages managed, and the institution's level of automation. Overall, 70% of the respondents felt that the information resources available to manage drug shortages were not good. The labor costs associated with managing shortages in the United States is an estimated $216 million annually. A survey of directors of pharmacy revealed that labor costs and the time required to manage drug shortages are significant and that current information available to manage drug shortages is considered suboptimal.

Effectiveness of cognitive-behavioural therapy for post-disaster distress in post-traumatic stress symptoms after Chilean earthquake and tsunami.

PubMed

Leiva-Bianchi, Marcelo; Cornejo, Felipe; Fresno, Andrés; Rojas, Carolina; Serrano, Camila

This is the first time that the effectiveness of cognitive-behavioural therapy for post-disaster stress (CBT-PD) in symptoms of posttraumatic stress disorder (PTSD) has been tested outside the United States of America. Quasi-experiment with three groups. In the quasi-control group, complete CBT-PD was applied even though its members did not have PTSD; in quasi-experimental conditions, participants received complete treatment because they had this diagnosis; and in the third group, participants with PTSD received an abbreviated treatment (double sessions) due to organisational requirements. Primary health care workers in Constitución (Chile), city exposed to earthquake and tsunami; public department workers in Talca (city exposed only to earthquake) and teachers from a school (Constitución). A total of 13 of the 91 people diagnosed with PTSD participated. In addition, 16 people without diagnosis voluntarily participated. The treatment was completed by 29 participants. There were no dropouts. Only 1 of the 9 participants in the quasi-experimental group did not respond to treatment. CBT-PD is a group therapy (10-12 sessions) that includes psychoeducation, breathing retraining, behavioural activation and cognitive restructuring. CBT-PD (complete and abbreviated) was applied between September and December 2010. Short Posttraumatic Stress Disorder Rating Interview (SPRINT-E) was used to measure PTSD symptoms before and after treatment. The group that received the complete treatment and was diagnosed with PTSD showed a significant decrease in the total symptoms to below dangerous levels (IGA AB : 31.556; p<0.01; 95%CI: 0.21-2.01]; η 2 =0.709). The effectiveness and benefits of incorporating CBT-PD in the health network after events like disasters were discussed. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Comparison of delayed versus immediate pushing during second stage of labor for nulliparous women with epidural anesthesia.

PubMed

Gillesby, Erica; Burns, Suzan; Dempsey, Amy; Kirby, Shirley; Mogensen, Kami; Naylor, Kelly; Petrella, Joann; Vanicelli, Rebecca; Whelan, Breon

2010-01-01

To determine if the use of delayed pushing after the onset of the second stage of labor decreases the time of active pushing and decreases maternal fatigue. Randomized clinical trial. Labor and delivery unit of a not-for-profit community hospital. Convenience sample of nulliparous laboring women with epidural anesthesia. Immediate or delayed pushing (2 hours) during the second stage of labor at the time of complete cervical dilatation. The length of pushing, total length of the second stage, and maternal fatigue. A total of 77 women were studied (immediate pushing group=39; delayed pushing=38). The immediate pushing group averaged 94 (± 57) minutes in active pushing, while the delayed pushing group averaged 68 (± 46) minutes, a statistically significant difference (p=.04). No significant differences were found in fatigue scores between the immediate and delayed pushing groups (p>.05). We found that by delaying the onset of active pushing for 2 hours after the beginning of the second stage of labor, the time that nulliparous women with epidural anesthesia spent in active pushing was significantly decreased by 27%. Although the delayed pushing group rested for up to 2 hours, the total time in the second stage of labor averaged only 59 minutes longer than the immediate pushing group. © 2010 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

Determinants of Complete Resection of Thymoma by Minimally Invasive and Open Thymectomy: Analysis of an International Registry.

PubMed

Burt, Bryan M; Yao, Xiaopan; Shrager, Joseph; Antonicelli, Alberto; Padda, Sukhmani; Reiss, Jonathan; Wakelee, Heather; Su, Stacey; Huang, James; Scott, Walter

2017-01-01

Minimally invasive thymectomy (MIT) is a surgical approach to thymectomy that has more favorable short-term outcomes for myasthenia gravis than open thymectomy (OT). The oncologic outcomes of MIT performed for thymoma have not been rigorously evaluated. We analyzed determinants of complete (R0) resection among patients undergoing MIT and OT in a large international database. The retrospective database of the International Thymic Malignancy Interest Group was queried. Chi-square and Wilcoxon rank sum tests, multivariate logistic regression models, and propensity matching were performed. A total of 2514 patients underwent thymectomy for thymoma between 1997 and 2012; 2053 of them (82%) underwent OT and 461 (18%) underwent MIT, with the use of MIT increasing significantly in recent years. The rate of R0 resection among patients undergoing OT was 86%, and among those undergoing MIT it was 94% (p < 0.0001). In propensity-matched MIT and OT groups (n = 266 in each group); however, the rate of R0 resection did not differ significantly (96% in both the MIT and OT groups, p = 0.7). Multivariate analyses were performed to identify determinants of R0 resection. Factors independently associated with R0 resection were geographical region, later time period, less advanced Masaoka stage, total thymectomy, and the absence of radiotherapy. Surgical approach, whether minimally invasive or open, was not associated with completeness of resection. The use of MIT for resection of thymoma has been increasing substantially over time, and MIT can achieve rates of R0 resection for thymoma similar to those achieved with OT. Copyright © 2016 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

Postoperative Functional Recovery After Gastrectomy in Patients Undergoing Enhanced Recovery After Surgery

PubMed Central

Jeong, Oh; Ryu, Seong Yeob; Park, Young Kyu

2016-01-01

Abstract Enhanced recovery after surgery (ERAS) is increasingly used in several abdominal surgeries to accelerate postoperative recovery and reduce the length of stay. The aim of this study was to investigate the pattern of functional recovery after gastrectomy in patients undergoing ERAS and to analyze factors that affect postoperative recovery. In all, 168 gastric cancer patients enrolled in a clinical trial evaluating ERAS compliance after gastrectomy were prospectively assessed with respect to postoperative functional recovery using discharge criteria, evaluating 4 major functional outcomes: adequate pain control, ability to mobilize and self-care, tolerance of oral intake, and no abnormal physical findings or laboratory test. The mean completion time of overall discharge criteria was 5.1 ± 3.2 days. The mean completion time for each dimension were 4.4 ± 0.9 days for adequate pain control, 4.1 ± 0.8 days for ability to mobilize and self-care, 4.3 ± 1.1 days for no abnormal physical signs or laboratory test, and 4.6 ± 1.2 days for tolerance of oral intake. The mean length of stay was 7.2 ± 3.2 days, and readmission rate was 2.4% (n = 4). There was 9.5% (n = 16) of morbidity and no hospital mortality. Female sex (P < 0.001) and age (≥65 years; P = 0.049) were significantly associated with a slower recovery in tolerance of oral intake, and total gastrectomy was significantly associated with delayed completion of adequate pain control (P = 0.003). Functional recovery after gastrectomy can be achieved after about 5 days in patients undergoing ERAS. Female sex, old age, and total gastrectomy are factors that delay normal functional recovery after gastrectomy. PMID:27057836

Development of a curriculum and training program in Woman Veterans Health for Internal Medical Residents.

PubMed

Ceylony, Manju; Porhomayon, Jahan; Pourafkari, Leili; Nader, Nader D

2017-09-26

Internal Medicine residents must develop competency as Primary Care Providers, but a gap exists in their curriculum and training with regard to women's reproductive health. With increasing need in VA due to new influx of women veterans it poses problems in recruitment of competent physicians trained in Women's health. An intensive, one-month women's reproductive health curriculum with hands on experience for Internal Medicine residents was provided. Curriculum was taught to the residents who rotated at the Women's Health Clinic for one month. Pre-test and post-test exams were administered. Increase in knowledge of residents in providing gender specific evaluations and management was objectively assessed by changes in post-test scores. Data were analyzed for statistically significant improvement in written tests scores. Total of 47 Internal Medicine residents rotated through Women's Health Center during the evaluation period. All residents completed both pre-test and post-test exams. The average time to complete the pre-test was 20.5 ± 5.4 min and 19.5 ± 4.8 min for post-test. There was no correlation between the time to complete the pre-test exam and the post-test exam. The total score was significantly improved from 8.5 ± 1.6 to 13.2 ± 1.8 (p < 0.0001). This study shows how to equip physicians in training with information on women's health that enables them to provide safe and gender appropriate care in primary care settings. This practice will reduce the need for frequent referrals for specialized care and thus provide cost saving for patient and health care on the whole.

Promising Technique for Facial Nerve Reconstruction in Extended Parotidectomy.

PubMed

Villarreal, Ithzel Maria; Rodríguez-Valiente, Antonio; Castelló, Jose Ramon; Górriz, Carmen; Montero, Oscar Alvarez; García-Berrocal, Jose Ramon

2015-11-01

Malignant tumors of the parotid gland account scarcely for 5% of all head and neck tumors. Most of these neoplasms have a high tendency for recurrence, local infiltration, perineural extension, and metastasis. Although uncommon, these malignant tumors require complex surgical treatment sometimes involving a total parotidectomy including a complete facial nerve resection. Severe functional and aesthetic facial defects are the result of a complete sacrifice or injury to isolated branches becoming an uncomfortable distress for patients and a major challenge for reconstructive surgeons. A case of a 54-year-old, systemically healthy male patient with a 4 month complaint of pain and swelling on the right side of the face is presented. The patient reported a rapid increase in the size of the lesion over the past 2 months. Imaging tests and histopathological analysis reported an adenoid cystic carcinoma. A complete parotidectomy was carried out with an intraoperative notice of facial nerve infiltration requiring a second intervention for nerve and defect reconstruction. A free ALT flap with vascularized nerve grafts was the surgical choice. A 6 month follow-up showed partial facial movement recovery and the facial defect mended. It is of critical importance to restore function to patients with facial nerve injury. Vascularized nerve grafts, in many clinical and experimental studies, have shown to result in better nerve regeneration than conventional non-vascularized nerve grafts. Nevertheless, there are factors that may affect the degree, speed and regeneration rate regarding the free fasciocutaneous flap. In complex head and neck defects following a total parotidectomy, the extended free fasciocutaneous ALT (anterior-lateral thigh) flap with a vascularized nerve graft is ideally suited for the reconstruction of the injured site. Donor-site morbidity is low and additional surgical time is minimal compared with the time of a single ALT flap transfer.

Update of the NEXT Ion Thruster Service Life Assessment with Post-Test Correlation to the Long Duration Test

NASA Technical Reports Server (NTRS)

Yim, John T.; Soulas, George C.; Shastry, Rohit; Choi, Maria; Mackey, Jonathan A.; Sarver-Verhey, Timothy R.

2017-01-01

The service life assessment for NASA's Evolutionary Xenon Thruster is updated to incorporate the results from the successful and voluntarily early completion of the 51,184 hour long duration test which demonstrated 918 kg of total xenon throughput. The results of the numerous post-test investigations including destructive interrogations have been assessed against all of the critical known and suspected failure mechanisms to update the life and throughput expectations for each major component. Analysis results of two of the most acute failure mechanisms, namely pit-and-groove erosion and aperture enlargement of the accelerator grid, are not updated in this work but will be published at a future time after analysis completion.

Measure-valued solutions to the complete Euler system revisited

NASA Astrophysics Data System (ADS)

Březina, Jan; Feireisl, Eduard

2018-06-01

We consider the complete Euler system describing the time evolution of a general inviscid compressible fluid. We introduce a new concept of measure-valued solution based on the total energy balance and entropy inequality for the physical entropy without any renormalization. This class of so-called dissipative measure-valued solutions is large enough to include the vanishing dissipation limits of the Navier-Stokes-Fourier system. Our main result states that any sequence of weak solutions to the Navier-Stokes-Fourier system with vanishing viscosity and heat conductivity coefficients generates a dissipative measure-valued solution of the Euler system under some physically grounded constitutive relations. Finally, we discuss the same asymptotic limit for the bi-velocity fluid model introduced by H.Brenner.

Experience and confidence of final year veterinary students in performing desexing surgeries.

PubMed

Gates, M C; Odom, T F; Sawicki, R K

2018-07-01

To describe the level of experience and confidence of veterinary students in performing canine and feline desexing procedures at the end of their final clinical year. A cross-sectional survey was conducted with veterinary students at Massey University in November 2017 after completion of their final clinical year. The questions included career plans after graduation, number of assisted and unassisted desexing procedures performed, approximate time to complete desexing surgeries, level of confidence with different aspects of desexing surgeries, what aspects of their desexing surgery training were most helpful, and what could be done to improve training in desexing surgical skills in veterinary school. The survey was completed by 70/95 (74%) students in their final clinical year. Among respondents, 55/70 (70%) had performed >2 unassisted feline neuters before graduation. However 38/70 (54%) students had never performed an unassisted feline spay, 31/70 (44%) had never performed an unassisted canine neuter, and 44/70 (63%) students had never performed an unassisted canine spay. The median reported times to complete a feline neuter, feline spay, canine neuter, and canine spay were 9, 40, 30 and 60 minutes, respectively. The median level of confidence for these procedures were 9, 6, 7 and 5 (on a scale from 1=least confident to 10=most confident), respectively. The reported time to complete procedures and the confidence in performing procedures did not change markedly with increasing total number of procedures performed. Students were most concerned about their ability to perform the desexing procedures in a reasonable amount of time and to prevent post-operative bleeding from occurring. Students were least concerned with their ability to manage post-operative pain in patients and to select the appropriate suture material. Free-text comments revealed that 62/70 (89%) students wanted more hands-on surgical experience prior to graduation. Many students are currently completing veterinary school with limited experience and low confidence with performing routine canine and feline desexing procedures. Further research is needed to identify the most effective ways for addressing this issue within the constraints of the veterinary curriculum and teaching hospital resources.

Worksite adjustments and work ability among employed cancer survivors.

PubMed

Torp, Steffen; Nielsen, Roy A; Gudbergsson, Sævar B; Dahl, Alv A

2012-09-01

This study was conducted to determine how many cancer survivors (CSs) make worksite adjustments and what kinds of adjustments they make. Changes in work ability among employed CSs were explored, and clinical, sociodemographic, and work-related factors associated with the current total work ability were studied. CSs of the ten most common invasive types of cancer for men and women in Norway completed a mailed questionnaire 15-39 months after being diagnosed with cancer. Included in the analyses were all participants who worked both at the time of diagnosis and at the time of the survey and who had not changed their labor force status since diagnosis (n = 563). The current total work ability was compared to the lifetime best (0-10 score). Twenty-six percent of the employed CSs had made adjustments at work, and the most common adjustment was changing the number of work hours per week. Despite the fact that 31% and 23% reported reduced physical and mental work abilities, respectively, more than 90% of the CSs reported that they coped well with their work demands. The mean total work ability score was high (8.6) among both men and women. Being self-employed and working part-time at the time of diagnosis showed significant negative correlations with total work ability, while a favorable psychosocial work environment showed a significant positive correlation. CSs with low work ability were more often in contact with the occupational health service and also made more worksite adjustments than others. The prospects of future work life seem optimistic for Norwegian employed CSs who return to work relatively soon after primary treatment.

Sleep Patterns Are Associated with Common Illness in Adolescents

PubMed Central

Orzech, Kathryn M.; Acebo, Christine; Seifer, Ronald; Barker, David; Carskadon, Mary A.

2014-01-01

Summary This prospective, field-based study examined the association between actigraphically-measured total sleep time and incident illness including cold, flu, gastroenteritis, and other common infectious diseases (e.g., strep throat) in adolescents over the course of a school semester. Participants were 56 adolescents ages 14–19 years (mean = 16.6 (standard deviation = 1.2), 39% male) from 5 high schools in Rhode Island. Beginning in late January, adolescents wore actigraphs (mean 91 (19) days, range 16 – 112 days) and were assigned post-hoc to Longer or Shorter sleep groups based on median splits. Adolescents were interviewed weekly across as many as 16 weeks (modal number of interviews = 13) using a structured protocol that included 14 health event questions. Illness events and illness-related school absences were coded for 710 completed interviews, with 681 illness events and 90 school absences reported. Outcomes (illness bouts, illness duration, and absences) were compared among sex, sleep, and academic year groups using non-parametric regression. In a subset of 18 subjects, mean actigraphically estimated total sleep time 6 nights before matched illness/wellness events was compared using MANOVA. Longer sleepers and males reported fewer illness bouts; total sleep time effects were more apparent in males than females. A trend was found for shorter total sleep time before ill events. The present findings in this small naturalistic sample indicate that acute illnesses were more frequent in otherwise healthy adolescents with shorter sleep, and illness events were associated with less sleep during the prior week than comparable matched periods without illness. PMID:24134661

Visualizing surgical quality data with treemaps.

PubMed

Hugine, Akilah L; Guerlain, Stephanie A; Turrentine, Florence E

2014-09-01

Treemaps are space-constrained visualizations for displaying hierarchical data structures using nested rectangles. The visualization allows large amounts of data to be examined in one display. The objective of this research was to examine the effects of using treemap visualizations to help surgeons assess surgical quality data from the American College of Surgeons created the National Surgical Quality Improvement Program database in a quick and timely manner. A controlled human subjects experiment was conducted to assess the ability of individuals to make quick and accurate judgments on surgery data by visualizing a treemap, with data hierarchically displayed by surgeon group, surgeon, and patient. Participants were given 20 task questions to complete involving examining the treemap and comparing surgeons' patients based on outcomes (dead or alive) and length of stay days. The outcomes measured were error (incorrect or correct) and task completion time. 120 participants completed 20 task questions for a total of 2400 responses. The main effects of layout and node size were found to be significant for absolute error, P < 0.0505 and P < 0.0185, respectively. The average judgment time to complete a task was 24 s with an accuracy rate of approximately 68%. This study served as a proof of concept to determine if treemaps could be beneficial in assessing surgical data retrospectively by allowing surgeons and healthcare administrators to make quick visual judgments. The study found that factors about the layout design affect judgment performance. Future research is needed to examine whether implementing the treemap within a dashboard system will improve on judgment accuracy for surgical quality questions. Published by Elsevier Inc.

48 CFR 1552.215-73 - General financial and organizational information.

Code of Federal Regulations, 2012 CFR

2012-10-01

... update all outdated information on file. (a) Contractor's Name: (b) Address (If financial records are...: Auditor: (f)(1) Work Distribution for the Last Completed Fiscal Accounting Period: Sales: Government cost... immediately preceding last completed fiscal year. Total Sales for First Preceding Fiscal Year $____ Total...

48 CFR 1552.215-73 - General financial and organizational information.

Code of Federal Regulations, 2011 CFR

2011-10-01

... update all outdated information on file. (a) Contractor's Name: (b) Address (If financial records are...: Auditor: (f)(1) Work Distribution for the Last Completed Fiscal Accounting Period: Sales: Government cost... immediately preceding last completed fiscal year. Total Sales for First Preceding Fiscal Year $____ Total...

48 CFR 1552.215-73 - General financial and organizational information.

Code of Federal Regulations, 2014 CFR

2014-10-01

... update all outdated information on file. (a) Contractor's Name: (b) Address (If financial records are...: Auditor: (f)(1) Work Distribution for the Last Completed Fiscal Accounting Period: Sales: Government cost... immediately preceding last completed fiscal year. Total Sales for First Preceding Fiscal Year $____ Total...

48 CFR 1552.215-73 - General financial and organizational information.

Code of Federal Regulations, 2013 CFR

2013-10-01

... update all outdated information on file. (a) Contractor's Name: (b) Address (If financial records are...: Auditor: (f)(1) Work Distribution for the Last Completed Fiscal Accounting Period: Sales: Government cost... immediately preceding last completed fiscal year. Total Sales for First Preceding Fiscal Year $____ Total...

Testing the validity, reliability and utility of the Self-Administration of Medication (SAM) tool in patients undergoing rehabilitation.

PubMed

Anderson, Jessica; Manias, Elizabeth; Kusljic, Snezana; Finch, Sue

2014-01-01

Determination of patients' ability to self-administer medications in the hospital has largely been determined using the subjective judgment of health professionals. To examine the validity, reliability and utility of the Self-Administration of Medication (SAM) tool as an objective means to determine patients' ability to self-administer in a rehabilitation unit of a public teaching hospital in Melbourne, Australia. To assess validity of the SAM tool, associations were examined between the total SAM tool score and of the patients' competence to self-administer from the perceptions of the tool administrator, patients and nurses. Validity also was determined from a principal component analysis. Pearson correlations were calculated for how SAM scores related to scores obtained from the Functional Independence Measure (FIM) and Barthel Score Index (BSI). To assess the SAM tool's reliability, a Cronbach's alpha coefficient was calculated. Utility of the SAM tool was evidenced by documenting its administration time. One hundred patients participated in this study. The SAM tool had a Cronbach's alpha coefficient of 0.75 and took a mean time of 5.36 min to complete. The capability to self-medicate section of the SAM tool had strong correlations with the FIM (r = 0.485) and BSI (r = 0.472) data, respectively, and the total SAM tool had moderate and strong correlations with the nurses' (r = 0.315) and tool administrator's (r = 0.632) perceptions of patients' ability to self-administer, respectively. Bland-Altman and ROC curve analyses showed poor agreement between the total SAM tool score and the nurses' perceptions. The SAM tool demonstrated acceptable overall internal consistency. It only requires a short time to be completed and is more objective than seeking out health professionals' perceptions. Additional research is needed to further validate this approach to determining patients' ability to self-medicate. Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.

Bronchoscopy Simulation Training as a Tool in Medical School Education.

PubMed

Gopal, Mallika; Skobodzinski, Alexus A; Sterbling, Helene M; Rao, Sowmya R; LaChapelle, Christopher; Suzuki, Kei; Litle, Virginia R

2018-07-01

Procedural simulation training is rare at the medical school level and little is known about its usefulness in improving anatomic understanding and procedural confidence in students. Our aim is to assess the impact of bronchoscopy simulation training on bronchial anatomy knowledge and technical skills in medical students. Medical students were recruited by email, consented, and asked to fill out a survey regarding their baseline experience. Two thoracic surgeons measured their knowledge of bronchoscopy on a virtual reality bronchoscopy simulator using the Bronchoscopy Skills and Tasks Assessment Tool (BSTAT), a validated 65-point checklist (46 for anatomy, 19 for simulation). Students performed four self-directed training sessions of 15 minutes per week. A posttraining survey and BSTAT were completed afterward. Differences between pretraining and posttraining scores were analyzed with paired Student's t tests and random intercept linear regression models accounting for baseline BSTAT score, total training time, and training year. The study was completed by 47 medical students with a mean training time of 81.5 ± 26.8 minutes. Mean total BSTAT score increased significantly from 12.3 ± 5.9 to 48.0 ± 12.9 (p < 0.0001); mean scores for bronchial anatomy increased from 0.1 ± 0.9 to 31.1 ± 12.3 (p < 0.0001); and bronchoscopy navigational skills increased from 12.1 ± 5.7 to 17.4 ± 2.5 (p < 0.0001). Total training time and frequency of training did not have a significant impact on level of improvement. Self-driven bronchoscopy simulation training in medical students led to improvements in bronchial anatomy knowledge and bronchoscopy skills. Further investigation is under way to determine the impact of bronchoscopy simulation training on future specialty interest and long-term skills retention. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Electron-helium S-wave model benchmark calculations. I. Single ionization and single excitation

NASA Astrophysics Data System (ADS)

Bartlett, Philip L.; Stelbovics, Andris T.

2010-02-01

A full four-body implementation of the propagating exterior complex scaling (PECS) method [J. Phys. B 37, L69 (2004)] is developed and applied to the electron-impact of helium in an S-wave model. Time-independent solutions to the Schrödinger equation are found numerically in coordinate space over a wide range of energies and used to evaluate total and differential cross sections for a complete set of three- and four-body processes with benchmark precision. With this model we demonstrate the suitability of the PECS method for the complete solution of the full electron-helium system. Here we detail the theoretical and computational development of the four-body PECS method and present results for three-body channels: single excitation and single ionization. Four-body cross sections are presented in the sequel to this article [Phys. Rev. A 81, 022716 (2010)]. The calculations reveal structure in the total and energy-differential single-ionization cross sections for excited-state targets that is due to interference from autoionization channels and is evident over a wide range of incident electron energies.

Productivity associated with visual status of computer users.

PubMed

Daum, Kent M; Clore, Katherine A; Simms, Suzanne S; Vesely, Jon W; Wilczek, Dawn D; Spittle, Brian M; Good, Greg W

2004-01-01

The aim of this project is to examine the potential connection between the astigmatic refractive corrections of subjects using computers and their productivity and comfort. We hypothesize that improving the visual status of subjects using computers results in greater productivity, as well as improved visual comfort. Inclusion criteria required subjects 19 to 30 years of age with complete vision examinations before being enrolled. Using a double-masked, placebo-controlled, randomized design, subjects completed three experimental tasks calculated to assess the effects of refractive error on productivity (time to completion and the number of errors) at a computer. The tasks resembled those commonly undertaken by computer users and involved visual search tasks of: (1) counties and populations; (2) nonsense word search; and (3) a modified text-editing task. Estimates of productivity for time to completion varied from a minimum of 2.5% upwards to 28.7% with 2 D cylinder miscorrection. Assuming a conservative estimate of an overall 2.5% increase in productivity with appropriate astigmatic refractive correction, our data suggest a favorable cost-benefit ratio of at least 2.3 for the visual correction of an employee (total cost 268 dollars) with a salary of 25,000 dollars per year. We conclude that astigmatic refractive error affected both productivity and visual comfort under the conditions of this experiment. These data also suggest a favorable cost-benefit ratio for employers who provide computer-specific eyewear to their employees.

The Effects of Switching to Vonoprazan, a Novel Potassium-Competitive Acid Blocker, on Gastric Acidity and Reflux Patterns in Patients with Erosive Esophagitis Refractory to Proton Pump Inhibitors.

PubMed

Yamashita, Hiroshi; Kanamori, Atsushi; Kano, Chise; Hashimura, Hiroki; Matsumoto, Kei; Tsujimae, Masahiro; Yoshizaki, Tetsuya; Momose, Kenji; Obata, Daisuke; Eguchi, Takaaki; Fujita, Mikio; Okada, Akihiko

2017-01-01

The effects of vonoprazan and proton pump inhibitors (PPIs) in patients with reflux esophagitis (RE) have not yet been compared using multichannel intraluminal impedance-pH (MII-pH). A total of 8 patients with persistent gastric mucosal injury, despite completing an 8-week standard PPI therapy, were enrolled in the study. While they were on standard PPI therapy, the baseline values of reflux parameters, holding time ratio (HTR) of gastric pH >4, and esophageal pH <4 were obtained by using 24 h MII-pH monitoring. They were re-evaluated after discontinuation of the therapy and 4 weeks of subsequent treatment with vonoprazan 20 mg/day. The patients were found to be CYP2C19 extensive metabolizers and negative for Helicobacter pylori infection. In 7 patients (87.5%), the mucosal lesions had healed completely after vonoprazan therapy. A significant increase in gastric pH >4 HTR was observed, from 26.5 to 78.0% (p = 0.029). A reduction in esophageal pH <4 HTR was also observed but it was not statistically significant. Furthermore, acid clearance time and the total number of reflux events, including acid and proximal reflux events, were significantly reduced. Vonoprazan may be a better therapy for the treatment of patients with PPI-refractory RE. © 2017 S. Karger AG, Basel.

Batch solar disinfection inactivates oocysts of Cryptosporidium parvum and cysts of Giardia muris in drinking water.

PubMed

McGuigan, K G; Méndez-Hermida, F; Castro-Hermida, J A; Ares-Mazás, E; Kehoe, S C; Boyle, M; Sichel, C; Fernández-Ibáñez, P; Meyer, B P; Ramalingham, S; Meyer, E A

2006-08-01

To determine whether batch solar disinfection (SODIS) can be used to inactivate oocysts of Cryptosporidium parvum and cysts of Giardia muris in experimentally contaminated water. Suspensions of oocysts and cysts were exposed to simulated global solar irradiation of 830 W m(-2) for different exposure times at a constant temperature of 40 degrees C. Infectivity tests were carried out using CD-1 suckling mice in the Cryptosporidium experiments and newly weaned CD-1 mice in the Giardia experiments. Exposure times of > or =10 h (total optical dose c. 30 kJ) rendered C. parvum oocysts noninfective. Giardia muris cysts were rendered completely noninfective within 4 h (total optical dose >12 kJ). Scanning electron microscopy and viability (4',6-diamidino-2-phenylindole/propidium iodide fluorogenic dyes and excystation) studies on oocysts of C. parvum suggest that inactivation is caused by damage to the oocyst wall. Results show that cysts of G. muris and oocysts of C. parvum are rendered completely noninfective after batch SODIS exposures of 4 and 10 h (respectively) and is also likely to be effective against waterborne cysts of Giardia lamblia. These results demonstrate that SODIS is an appropriate household water treatment technology for use as an emergency intervention in aftermath of natural or man-made disasters against not only bacterial but also protozoan pathogens.

Design of production process main shaft process with lean manufacturing to improve productivity

NASA Astrophysics Data System (ADS)

Siregar, I.; Nasution, A. A.; Andayani, U.; Anizar; Syahputri, K.

2018-02-01

This object research is one of manufacturing companies that produce oil palm machinery parts. In the production process there is delay in the completion of the Main shaft order. Delays in the completion of the order indicate the low productivity of the company in terms of resource utilization. This study aimed to obtain a draft improvement of production processes that can improve productivity by identifying and eliminating activities that do not add value (non-value added activity). One approach that can be used to reduce and eliminate non-value added activity is Lean Manufacturing. This study focuses on the identification of non-value added activity with value stream mapping analysis tools, while the elimination of non-value added activity is done with tools 5 whys and implementation of pull demand system. Based on the research known that non-value added activity on the production process of the main shaft is 9,509.51 minutes of total lead time 10,804.59 minutes. This shows the level of efficiency (Process Cycle Efficiency) in the production process of the main shaft is still very low by 11.89%. Estimation results of improvement showed a decrease in total lead time became 4,355.08 minutes and greater process cycle efficiency that is equal to 29.73%, which indicates that the process was nearing the concept of lean production.

Vaginal reconstruction following resection of primary locally advanced and recurrent colorectal malignancies.

PubMed

D'Souza, Dougal N; Pera, Miguel; Nelson, Heidi; Finical, Stephan J; Tran, Nho V

2003-12-01

Vertical rectus abdominus myocutaneous flap reconstruction facilitates healing within the radiated pelvis and preserves the possibility of subsequent sexual function in patients with colorectal cancer who require partial or complete resection of the vagina. A retrospective review of a consecutive series of patients. A tertiary referral center. All patients undergoing surgical treatment of locally advanced or recurrent colorectal cancer and vertical rectus abdominus myocutaneous flap reconstruction of the vagina. Vertical rectus abdominus myocutaneous flap reconstruction. Operative feasibility, complications, and sexual function. Twelve patients underwent extended resection for primary locally advanced or recurrent colorectal cancer including total or near total vaginectomy. Median age was 47 years. Tumors included 9 rectal adenocarcinomas, 2 anal squamous cell carcinomas, and 1 recurrent cecal adenocarcinoma. Surgical procedures included 8 abdominoperineal resections with posterior exenteration; resection of pelvic tumor and partial vaginectomy in 2 patients with previous abdominoperineal resection; 1 total exenteration; and 1 total proctocolectomy with posterior exenteration. The average operative time for tumor extirpation, irradiation, and reconstruction was more than 9 hours and all patients required blood transfusions. Despite 2 patients having superficial necrosis and 4 having mild wound infections, no patient required reoperation and all achieved complete healing. Five patients reported resuming sexual intercourse. The vertical rectus abdominus myocutaneous flap can be successfully used for vaginal reconstruction following resection of locally advanced colorectal cancer. It provides nonirradiated, vascularized tissue that fills the pelvic dead space, allows for stomal placement, and provides a chance for sexual function.

Cultured allogenic keratinocytes for extensive burns: a retrospective study over 15 years.

PubMed

Auxenfans, Celine; Shipkov, Hristo; Bach, Christine; Catherine, Zulma; Lacroix, Pierre; Bertin-Maghit, Marc; Damour, Odile; Braye, Fabienne

2014-02-01

The aim was to review the use and indications of cultured allogenic keratinocytes (CAlloK) in extensive burns and their efficiency. This retrospective study comprised 15 years (1997-2012). all patients who received CAlloK. patients who died before complete healing. Evaluation criteria were clinical. Time and success of wound healing after CAlloK use were evaluated. The CAlloK were used for 2 indications - STSG donor sites and deep 2nd degree burns in extensively burned patients. A total of 70 patients were included with severity Baux score of 99.2 (from 51 to 144) and mean percentage of TBSA of 63.49% (from 21 to 96%). Fifty nine patients received CAlloK for STSG donor sites with a mean number of applications of 4 and mean surface of 3800 cm(2) per patient. Treated donor sites were re-harvested 2.5 times. The mean time of complete epithelialization was 7 days. In 11 patients, CAlloK were used for deep 2nd degree burns. The mean percentage of burned surface was 73.7%. The mean surface of CAlloK per patient was 2545 cm(2). Complete healing was achieved in 6.4 days. The CAlloK allow rapid healing of STSG donor-sites and deep 2nd second degree burns in extensively burned patients. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

Endoscopic Submucosal Dissection Using a Novel Versatile Knife: An Animal Feasibility Study (with Video)

PubMed Central

Kwon, Chang-Il; Kim, Gwangil; Kim, Won Hee; Ko, Kwang Hyun; Hong, Sung Pyo; Jeong, Seok; Lee, Don Haeng

2014-01-01

Background/Aims In order to reduce the procedure time and the number of accessory changes during endoscopic submucosal dissection (ESD), we developed a novel versatile knife, which has the combined advantages of several conventional knives. The aim of this study was to compare the efficacy, safety, and histological quality of ESD performed using this novel versatile knife and a combination of several conventional knives. Methods This was an in vivo animal study comparing two different modalities of ESD in mini-pigs. Completion time of each resection was documented, and the resected specimens were retrieved and evaluated for completeness. To assess the quality control of the procedures and adverse events, detailed histopathological examinations were performed. Results A total of 18 specimens were dissected by ESD safely and easily (nine specimens using the new versatile knife; nine specimens by mixing conventional knives). All resections were completed as en bloc resections. There was no significant difference in procedure time between the 2 modalities (456 seconds vs. 355 seconds, p=0.258) and cutting speed (1.983 mm2/sec vs. 1.57 mm2/sec, p=1.000). The rate of adverse events and histological quality did not statistically differ between the modalities. Conclusions ESD with a versatile knife appeared to be an easy, safe, and technically efficient method. PMID:25505721

Time Spent, Workload, and Student and Faculty Perceptions in a Blended Learning Environment

PubMed Central

Schumacher, Christie; Arif, Sally

2016-01-01

Objective. To evaluate student perception and time spent on asynchronous online lectures in a blended learning environment (BLE) and to assess faculty workload and perception. Methods. Students (n=427) time spent viewing online lectures was measured in three courses. Students and faculty members completed a survey to assess perceptions of a BLE. Faculty members recorded time spent creating BLEs. Results. Total time spent in the BLE was less than the allocated time for two of the three courses by 3-15%. Students preferred online lectures for their flexibility, students’ ability to apply information learned, and congruence with their learning styles. Faculty members reported the BLE facilitated higher levels of learning during class sessions but noted an increase in workload. Conclusion. A BLE increased faculty workload but was well received by students. Time spent viewing online lectures was less than what was allocated in two of the three courses. PMID:27667839

On the Power of Abstract Interpretation

NASA Technical Reports Server (NTRS)

Reddy, Uday S.; Kamin, Samuel N.

1991-01-01

Increasingly sophisticated applications of static analysis place increased burden on the reliability of the analysis techniques. Often, the failure of the analysis technique to detect some information my mean that the time or space complexity of the generated code would be altered. Thus, it is important to precisely characterize the power of static analysis techniques. We follow the approach of Selur et. al. who studied the power of strictness analysis techniques. Their result can be summarized by saying 'strictness analysis is perfect up to variations in constants.' In other words, strictness analysis is as good as it could be, short of actually distinguishing between concrete values. We use this approach to characterize a broad class of analysis techniques based on abstract interpretation including, but not limited to, strictness analysis. For the first-order case, we consider abstract interpretations where the abstract domain for data values is totally ordered. This condition is satisfied by Mycroft's strictness analysis that of Sekar et. al. and Wadler's analysis of list-strictness. For such abstract interpretations, we show that the analysis is complete in the sense that, short of actually distinguishing between concrete values with the same abstraction, it gives the best possible information. We further generalize these results to typed lambda calculus with pairs and higher-order functions. Note that products and function spaces over totally ordered domains are not totally ordered. In fact, the notion of completeness used in the first-order case fails if product domains or function spaces are added. We formulate a weaker notion of completeness based on observability of values. Two values (including pairs and functions) are considered indistinguishable if their observable components are indistinguishable. We show that abstract interpretation of typed lambda calculus programs is complete up to this notion of indistinguishability. We use denotationally-oriented arguments instead of the detailed operational arguments used by Selur et. al.. Hence, our proofs are much simpler. They should be useful for further future improvements.

Real-time predictors of suicidal ideation: mobile assessment of hospitalized depressed patients.

PubMed

Ben-Zeev, Dror; Young, Michael A; Depp, Colin A

2012-05-15

Suicidal ideation is a risk factor for suicide attempt and completion. Cross-sectional or retrospective studies cannot capture the dynamic course and possible predictors of suicidal ideation as it occurs in daily life. This study utilizes an experience sampling paradigm to identify real-time predictors of suicidal ideation in inpatients with major depressive disorder. Thirty-one depressed patients admitted to a psychiatric unit were signaled by a mobile device to record suicidal ideation, affect, and other symptoms, multiple times a day over 1 week. Participants completed a total of 1350 questionnaires. Seventy-four percent of the sample reported suicidal ideation during the week. Time-lagged analyses revealed that momentary ratings of Sadness, Tension, and Boredom (as well as suicidal ideation itself) predicted subsequent suicidal thoughts in the following hours. Baseline severity of depression and past suicide attempts were both correlated with mean ideation severity during the week. A number of predictors identified in prior research (e.g. hopelessness) were unrelated to subsequent suicidal ideation in the current study. Momentary interventions that guide individuals through activities designed to reduce levels of Sadness, Tension, and Boredom in real-time (e.g., thought challenging, relaxation, behavioral activation) may be especially warranted. Copyright © 2012 Elsevier Ltd. All rights reserved.

Sports and leisure-time physical activity in pregnancy and birth weight: a population-based study.

PubMed

Hegaard, H K; Petersson, K; Hedegaard, M; Ottesen, B; Dykes, A K; Henriksen, T B; Damm, P

2010-02-01

We examined the association between sports and other leisure-time physical activities during pregnancy and birth weight of babies born after 37 completed weeks of gestation. All Danish-speaking pregnant women attending routine antenatal care at the Department of Obstetrics, Aarhus University Hospital, Denmark, from August 1989 to September 1991 were invited to participate in the study. A total of 4458 healthy women who delivered after 37 completed gestational weeks participated in this study. The associations between sports (0, 1-2, 3+ h/week) or leisure-time physical activity (sedentary, light, and moderate to heavy) and birth weight were examined by linear and logistic regression and adjusted for potential confounding factors such as smoking, parity, schooling, pre-pregnancy body mass index and gestational age. The results showed that pregnant women who practiced sports or were moderate to heavy leisure-time physical active during the early second or the early third trimester gave birth to infants with a similar birth weight as inactive women. The proportion of newborns with a low (<2500 g) or a high birth weight (>/=4500 g) was also unchanged. In conclusion, in this large population-based study, we found no association between sports and leisure-time physical activity and low-birth weight, high-birth weight, or average-birth weight.

Validity and reproducibility of self-reported total physical activity--differences by relative weight.

PubMed

Norman, A; Bellocco, R; Bergström, A; Wolk, A

2001-05-01

Physical activity is hypothesized to reduce the risk of obesity and several other chronic diseases and enhance longevity. However, most of the questionnaires used measure only part of total physical activity, occupational and/or leisure-time activity, which might lead to misclassification of total physical activity level and to dilution of risk estimates. We evaluated the validity and reproducibility of a short self-administered physical activity questionnaire, intended to measure long-term total daily 24 h physical activity. The questionnaire included questions on level of physical activity at work, hours per day of walking/bicycling, home/household work, leisure-time activity/inactivity and sleeping and was sent twice during one year (winter/spring and late summer). Two 7-day activity records, performed 6 months apart, were used as the reference method. One-hundred and eleven men, aged 44-78, completed the questionnaire and one or two activity records. The physical activity levels were measured as metabolic equivalents (MET)xh/day. Spearman correlation coefficient between total daily activity score estimated from the first questionnaire and the records (validity) was 0.56 (deattenuated) and between the first and the second questionnaire (reproducibility) 0.65. Significantly higher validity correlations were observed in men with self-reported body mass index below 26 kg/m(2) than in heavier men (r=0.73 vs r=0.39). This study indicates that the average total daily physical activity scores can be estimated satisfactorily in men using this simple self-administered questionnaire.

Sleep and daytime sleepiness of patients with left ventricular assist devices: a longitudinal pilot study.

PubMed

Casida, Jesus M; Davis, Jean E; Brewer, Robert J; Smith, Cheryl; Yarandi, Hossein

2011-06-01

No empirical longitudinal data on sleep and daytime sleepiness patterns in patients with an implantable left ventricular assist device (LVAD) exist. (1) To describe the sleep patterns (sleep onset latency, sleep efficiency, sleep fragmentation index, total sleep time, and wake after sleep onset), sleep quality, and daytime sleepiness variables and (2) to determine the change in the pattern of these variables before and up to 6 months after LVAD implantation. A longitudinal descriptive repeated-measures design was used. Patients wore wrist actigraphs (AW64 Actiwatch), which objectively measured sleep, for 3 consecutive days and nights before LVAD implant and at the first and second week and first, third, and sixth month after implantation. During these periods, patients also completed questionnaires on sleep quality and daytime sleepiness. Patients-Twelve of 15 patients completed the 6-month data. Data were analyzed by using descriptive statistics and repeated-measures analysis of variance. We found long sleep onset latencies and low sleep efficiency across time periods. High sleep fragmentation index was noted at baseline and 1 week after LVAD. Short total sleep times, long wake-after-sleep-onset durations, and poor sleep quality were evident at baseline and persisted up to 6 months after LVAD implantation. Low alertness level, a manifestation of sleepiness, was common during late morning to early evening hours. However, only sleep efficiency and wake after sleep onset showed significant changes in pattern (P < .05). Sleep disturbance and daytime sleepiness may be prevalent before and up to 6 months after LVAD implantation, warranting further investigation.

Using secure messaging to update medications list in ambulatory care setting.

PubMed

Raghu, T S; Frey, Keith; Chang, Yu-Hui; Cheng, Meng-Ru; Freimund, Sharon; Patel, Asha

2015-10-01

This study analyzed patient adoption of secure messaging to update medication list in an ambulatory care setting. The objective was to establish demographic differences between users and non-users of secure messaging for medications list update. Efficiency of secure messaging for the updates was compared to fax and telephone based updates. The study used a retrospective, cross-sectional study of patient medical records and pharmacy call logs at Mayo Clinic, Arizona from December 2012 to May 2013, approximately one year after organizing a pharmacy call center for medication updates. A subgroup analysis during a 2-week period was used to measure time to complete update. Main dependent variable is the frequency of medication list updates over the study duration. Technician time required for the update was also utilized. A total of 22,495 outpatient visits were drawn and 18,702 unique patients were included in the primary analysis. A total of 402 unique patients were included in sub-group analysis. Secure message response rate (49.5%) was statistically significantly lower than that for phone calls (54.8%, p<0.001). Time to complete the update was significantly higher for faxed medication lists (Wilcoxon rank-sum tests, p<0.001) when compared to those for secure message or phone. Around 50% of the patients respond to medication update requests before office visit when contacted using phone calls and secure messages. Given the demographic differences between users and non-users of patient portal, mixed mode communication with patients is likely to be the norm for the foreseeable future in outpatient settings. Copyright © 2015. Published by Elsevier Ireland Ltd.

Combination fracturing/gravel-packing completion technique on the Amberjack, Mississippi Canyon 109 field

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

Hannah, R.R.; Park, E.I.; Porter, D.A.

1994-11-01

This paper describes a one-step fracturing/gravel-pack (frac-and-pack) completion procedure conducted on the BP Exploration Amberjack platform beginning in early 1992. This platform is 35 miles southwest of Venice, LA. The first four completions on this platform had an average positive skin values of 21. The goal of the frac-and-pack procedure was to reduce these skins to nearly zero. In total, 24 frac-and-pack operations were performed. Details of the fracture design, prefracture testing, fracture design and execution, and production response and a continuing optimization program are discussed. The fractures were performed with the screens in place with the gravel pack aftermore » the fracturing operation. The treatments were designed for the tip screenout technique to create wide fractures and to provide proppant loadings exceeding 8 lbm/ft. This paper presents the trend of the declining skin values, along with a discussion of time-dependent skins. The changes in fluids, breakers, and proppants are also presented. The average skin on 14 frac-and-pack completions was 5.3. The average skin on the final eight completions was 0.2.« less

No Additional Benefits of Block- Over Evenly-Distributed High-Intensity Interval Training within a Polarized Microcycle

PubMed Central

McGawley, Kerry; Juudas, Elisabeth; Kazior, Zuzanna; Ström, Kristoffer; Blomstrand, Eva; Hansson, Ola; Holmberg, Hans-Christer

2017-01-01

Introduction: The current study aimed to investigate the responses to block- versus evenly-distributed high-intensity interval training (HIT) within a polarized microcycle. Methods: Twenty well-trained junior cross-country skiers (10 males, age 17.6 ± 1.5 and 10 females, age 17.3 ± 1.5) completed two, 3-week periods of training (EVEN and BLOCK) in a randomized, crossover-design study. In EVEN, 3 HIT sessions (5 × 4-min of diagonal-stride roller-skiing) were completed at a maximal sustainable intensity each week while low-intensity training (LIT) was distributed evenly around the HIT. In BLOCK, the same 9 HIT sessions were completed in the second week while only LIT was completed in the first and third weeks. Heart rate (HR), session ratings of perceived exertion (sRPE), and perceived recovery (pREC) were recorded for all HIT and LIT sessions, while distance covered was recorded for each HIT interval. The recovery-stress questionnaire for athletes (RESTQ-Sport) was completed weekly. Before and after EVEN and BLOCK, resting saliva and muscle samples were collected and an incremental test and 600-m time-trial (TT) were completed. Results: Pre- to post-testing revealed no significant differences between EVEN and BLOCK for changes in resting salivary cortisol, testosterone, or IgA, or for changes in muscle capillary density, fiber area, fiber composition, enzyme activity (CS, HAD, and PFK) or the protein content of VEGF or PGC-1α. Neither were any differences observed in the changes in skiing economy, V˙O2max or 600-m time-trial performance between interventions. These findings were coupled with no significant differences between EVEN and BLOCK for distance covered during HIT, summated HR zone scores, total sRPE training load, overall pREC or overall recovery-stress state. However, 600-m TT performance improved from pre- to post-training, irrespective of intervention (P = 0.003), and a number of hormonal and muscle biopsy markers were also significantly altered post-training (P < 0.05). Discussion: The current study shows that well-trained junior cross-country skiers are able to complete 9 HIT sessions within 1 week without compromising total work done and without experiencing greater stress or reduced recovery over a 3-week polarized microcycle. However, the findings do not support block-distributed HIT as a superior method to a more even distribution of HIT in terms of enhancing physiological or performance adaptions. PMID:28659826

No Additional Benefits of Block- Over Evenly-Distributed High-Intensity Interval Training within a Polarized Microcycle.

PubMed

McGawley, Kerry; Juudas, Elisabeth; Kazior, Zuzanna; Ström, Kristoffer; Blomstrand, Eva; Hansson, Ola; Holmberg, Hans-Christer

2017-01-01

Introduction: The current study aimed to investigate the responses to block- versus evenly-distributed high-intensity interval training (HIT) within a polarized microcycle. Methods: Twenty well-trained junior cross-country skiers (10 males, age 17.6 ± 1.5 and 10 females, age 17.3 ± 1.5) completed two, 3-week periods of training (EVEN and BLOCK) in a randomized, crossover-design study. In EVEN, 3 HIT sessions (5 × 4-min of diagonal-stride roller-skiing) were completed at a maximal sustainable intensity each week while low-intensity training (LIT) was distributed evenly around the HIT. In BLOCK, the same 9 HIT sessions were completed in the second week while only LIT was completed in the first and third weeks. Heart rate (HR), session ratings of perceived exertion (sRPE), and perceived recovery (pREC) were recorded for all HIT and LIT sessions, while distance covered was recorded for each HIT interval. The recovery-stress questionnaire for athletes (RESTQ-Sport) was completed weekly. Before and after EVEN and BLOCK, resting saliva and muscle samples were collected and an incremental test and 600-m time-trial (TT) were completed. Results: Pre- to post-testing revealed no significant differences between EVEN and BLOCK for changes in resting salivary cortisol, testosterone, or IgA, or for changes in muscle capillary density, fiber area, fiber composition, enzyme activity (CS, HAD, and PFK) or the protein content of VEGF or PGC-1α. Neither were any differences observed in the changes in skiing economy, [Formula: see text] or 600-m time-trial performance between interventions. These findings were coupled with no significant differences between EVEN and BLOCK for distance covered during HIT, summated HR zone scores, total sRPE training load, overall pREC or overall recovery-stress state. However, 600-m TT performance improved from pre- to post-training, irrespective of intervention ( P = 0.003), and a number of hormonal and muscle biopsy markers were also significantly altered post-training ( P < 0.05). Discussion: The current study shows that well-trained junior cross-country skiers are able to complete 9 HIT sessions within 1 week without compromising total work done and without experiencing greater stress or reduced recovery over a 3-week polarized microcycle. However, the findings do not support block-distributed HIT as a superior method to a more even distribution of HIT in terms of enhancing physiological or performance adaptions.

Time kinetics of physical activity, sitting, and quality of life measures within a regional workplace: a cross-sectional analysis.

PubMed

Lindsay, Daniel B; Devine, Sue; Sealey, Rebecca M; Leicht, Anthony S

2016-08-15

Interventions to increase physical activity and reduce sedentary behaviours within the workplace have been previously investigated. However, the evolution of these constructs without intervention has not been well documented. This retrospective study explored the natural progression or time kinetics of physical activity, sedentary behaviours and quality of life in a professional skilled workplace where focussed interventions were lacking. Participants (n = 346) employed as full-time staff members at a regional university completed an online survey in 2013 assessing physical activity and sedentary behaviours via the International Physical Activity Questionnaire, and quality of life via the Short-Form 36v2 questionnaire. Differences between that cohort of participants and an initial sample of similar participants (2009, n = 297), accounting for gender and staff categories (academic vs. professional), were examined using ANCOVAs with working hours as a co-variate. In comparison to the initial cohort, the follow-up cohort reported significantly less leisure-time, total walking, total vigorous and total physical activity levels, and lower overall physical health for quality of life (p < 0.05). In contrast, the follow-up cohort reported a significantly greater weekly sitting time, greater mental health scores for quality of life and greater total moderate physical activity levels (p < 0.05) compared to the initial cohort. Over a 4-year timeframe and without focussed workplace interventions, total physical activity levels were lower with sedentary behaviours greater at a rate twice that reported previously. Continuation of these undesirable health behaviours may impact negatively on worker productivity and health at a greater rate than that currently reported. Workplace interventions targeting sedentary behaviours and physical activity should be actively incorporated into organisations to counteract the alarming behavioural trends found in this study to maintain and/or enhance employee health and productivity.

[Rapid identification of meningitis due to bacterial pathogens].

PubMed

Ubukata, Kimiko

2013-01-01

We constructed a new real-time PCR method to detect causative pathogens in cerebrospinal fluid (CSF) from patient due to bacterial meningitis. The eight pathogens targeted in the PCR are Streptococcus pneumoniae, Haemophilus influenzae, Streptococcus agalactiae, Staphylococcus aurues, Neisseria meningitides, Listeria monocytogenes, Esherichia coli, and Mycoplasma pneumoniae. The total time from DNA extraction from CSF to PCR analysis was 1.5 hour. The pathogens were detected in 72% of the CSF samples (n=115) by real-time PCR, but in only 48% by culture, although the microorganisms were completely concordant. The detection rate of pathogens with PCR was significantly better than that with cultures in patients with antibiotic administration.In conclusion, detection with real-time PCR is useful for rapidly identifying the causative pathogens of meningitis and for examining the clinical course of chemotherapy.

The Radioactivity Characteristics of the NPP Charcoal Sample Contaminated by Carbon-14 - 13531

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

Kim, Hee Reyoung

2013-07-01

The radioactivity of {sup 14}C-contaminated charcoal sample was analyzed by using a high temperature oxidation and liquid scintillation counting method. The radioactivity of the sample was monotonically increased according to the increase of the combustion time at each temperature where the experimental uncertainty was calculated in the 95 % confidence level. It showed that the {sup 14}C radioactivity was not completely extracted from the sample by simply increasing the combustion time unless the combustion temperature was high enough. The higher the combustion temperature was, the higher the recovery during the first 30 minutes was. The first 30 minute recoveries weremore » 100 % at a temperature equal to or greater than 450 deg. C. The ratios of the recovery during the first 30 minutes to the total recovery during whole duration were more than 90 % at each experiment temperature. It was understood that the temperature was a critical factor for the complete removal of the {sup 14}C from the waste sample. (authors)« less

Optimal pricing and replenishment policies for instantaneous deteriorating items with backlogging and trade credit under inflation

NASA Astrophysics Data System (ADS)

Sundara Rajan, R.; Uthayakumar, R.

2017-12-01

In this paper we develop an economic order quantity model to investigate the optimal replenishment policies for instantaneous deteriorating items under inflation and trade credit. Demand rate is a linear function of selling price and decreases negative exponentially with time over a finite planning horizon. Shortages are allowed and partially backlogged. Under these conditions, we model the retailer's inventory system as a profit maximization problem to determine the optimal selling price, optimal order quantity and optimal replenishment time. An easy-to-use algorithm is developed to determine the optimal replenishment policies for the retailer. We also provide optimal present value of profit when shortages are completely backlogged as a special case. Numerical examples are presented to illustrate the algorithm provided to obtain optimal profit. And we also obtain managerial implications from numerical examples to substantiate our model. The results show that there is an improvement in total profit from complete backlogging rather than the items being partially backlogged.

Electromagnetic scattering calculations on the Intel Touchstone Delta

NASA Technical Reports Server (NTRS)

Cwik, Tom; Patterson, Jean; Scott, David

1992-01-01

During the first year's operation of the Intel Touchstone Delta system, software which solves the electric field integral equations for fields scattered from arbitrarily shaped objects has been transferred to the Delta. To fully realize the Delta's resources, an out-of-core dense matrix solution algorithm that utilizes some or all of the 90 Gbyte of concurrent file system (CFS) has been used. The largest calculation completed to date computes the fields scattered from a perfectly conducting sphere modeled by 48,672 unknown functions, resulting in a complex valued dense matrix needing 37.9 Gbyte of storage. The out-of-core LU matrix factorization algorithm was executed in 8.25 h at a rate of 10.35 Gflops. Total time to complete the calculation was 19.7 h-the additional time was used to compute the 48,672 x 48,672 matrix entries, solve the system for a given excitation, and compute observable quantities. The calculation was performed in 64-b precision.

Correlative analysis of social support with anxiety and depression in men undergoing in vitro fertilization embryo transfer for the first time.

PubMed

Dong, Yue-Zhi; Yang, Xiao-Xia; Sun, Ying-Pu

2013-08-01

To explore the correlation between the level of social support and the extent of anxiety and depression in Chinese men undergoing in vitro fertilization embryo transfer (IVF-ET) for the first time, in order to provide a basis for male mental health counselling. Self-administered questionnaires covering general health status, anxiety (self-rating anxiety scale), depression (self-rating depression scale) and social support (social support rating scale) were completed by men undergoing their first round of IVF-ET. A total of 502 completed questionnaires were considered valid and were analysed. The anxiety, depression and social support scores for men undergoing their first round of IVF-ET were significantly higher than those for Chinese normative data. Social support was inversely correlated with anxiety and depression. These findings suggest that health care professionals should provide specific psychological counselling to Chinese men undergoing their first round of IVF-ET, in order to improve their psychological health and to facilitate increased levels of social support.

Using Videogame Apps to Assess Gains in Adolescents' Substance Use Knowledge: New Opportunities for Evaluating Intervention Exposure and Content Mastery.

PubMed

Montanaro, Erika; Fiellin, Lynn E; Fakhouri, Tamer; Kyriakides, Tassos C; Duncan, Lindsay R

2015-10-28

Videogame interventions are becoming increasingly popular as a means to engage people in behavioral interventions; however, strategies for examining data from such interventions have not been developed. The objective of this study was to describe how a technology-based intervention can yield meaningful, objective evidence of intervention exposure within a behavioral intervention. This study demonstrates the analysis of automatic log files, created by software from a videogame intervention, that catalog game play and, as proof of concept, the association of these data with changes in substance use knowledge as documented with standardized assessments. We analyzed 3- and 6-month follow-up data from 166 participants enrolled in a randomized controlled trial evaluating a videogame intervention, PlayForward: Elm City Stories (PlayForward). PlayForward is a videogame developed as a risk reduction and prevention program targeting HIV risk behaviors (substance use and sex) in young minority adolescents. Log files were analyzed to extract the total amount of time spent playing the videogame intervention and the total number of game levels completed and beaten by each player. Completing and beating more of the game levels, and not total game play time, was related to higher substance use knowledge scores at the 3- (P=.001) and 6-month (P=.001) follow-ups. Our findings highlight the potential contributions a videogame intervention can make to the study of health behavior change. Specifically, the use of objective data collected during game play can address challenges in traditional human-delivered behavioral interventions. Clinicaltrials.gov NCT01666496; https://clinicaltrials.gov/ct2/show/NCT01666496 (Archived by WebCite at http://www.webcitation.org/6cV9fxsOg).

Using Videogame Apps to Assess Gains in Adolescents’ Substance Use Knowledge: New Opportunities for Evaluating Intervention Exposure and Content Mastery

PubMed Central

2015-01-01

Background Videogame interventions are becoming increasingly popular as a means to engage people in behavioral interventions; however, strategies for examining data from such interventions have not been developed. Objective The objective of this study was to describe how a technology-based intervention can yield meaningful, objective evidence of intervention exposure within a behavioral intervention. This study demonstrates the analysis of automatic log files, created by software from a videogame intervention, that catalog game play and, as proof of concept, the association of these data with changes in substance use knowledge as documented with standardized assessments. Methods We analyzed 3- and 6-month follow-up data from 166 participants enrolled in a randomized controlled trial evaluating a videogame intervention, PlayForward: Elm City Stories (PlayForward). PlayForward is a videogame developed as a risk reduction and prevention program targeting HIV risk behaviors (substance use and sex) in young minority adolescents. Log files were analyzed to extract the total amount of time spent playing the videogame intervention and the total number of game levels completed and beaten by each player. Results Completing and beating more of the game levels, and not total game play time, was related to higher substance use knowledge scores at the 3- (P=.001) and 6-month (P=.001) follow-ups. Conclusions Our findings highlight the potential contributions a videogame intervention can make to the study of health behavior change. Specifically, the use of objective data collected during game play can address challenges in traditional human-delivered behavioral interventions. Trial Registration Clinicaltrials.gov NCT01666496; https://clinicaltrials.gov/ct2/show/NCT01666496 (Archived by WebCite at http://www.webcitation.org/6cV9fxsOg) PMID:26510775

Phase II Trial of Radiotherapy After Hyperbaric Oxygenation With Multiagent Chemotherapy (Procarbazine, Nimustine, and Vincristine) for High-Grade Gliomas: Long-Term Results

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

Ogawa, Kazuhiko, E-mail: kogawa@med.u-ryukyu.ac.jp; Ishiuchi, Shogo; Inoue, Osamu

2012-02-01

Purpose: To analyze the long-term results of a Phase II trial of radiotherapy given immediately after hyperbaric oxygenation (HBO) with multiagent chemotherapy in adults with high-grade gliomas. Methods and Materials: Patients with histologically confirmed high-grade gliomas were administered radiotherapy in daily 2 Gy fractions for 5 consecutive days per week up to a total dose of 60 Gy. Each fraction was administered immediately after HBO, with the time interval from completion of decompression to start of irradiation being less than 15 minutes. Chemotherapy consisting of procarbazine, nimustine, and vincristine and was administered during and after radiotherapy. Results: A total ofmore » 57 patients (39 patients with glioblastoma and 18 patients with Grade 3 gliomas) were enrolled from 2000 to 2006, and the median follow-up of 12 surviving patients was 62.0 months (range, 43.2-119.1 months). All 57 patients were able to complete a total radiotherapy dose of 60 Gy immediately after HBO with one course of concurrent chemotherapy. The median overall survival times in all 57 patients, 39 patients with glioblastoma and 18 patients with Grade 3 gliomas, were 20.2 months, 17.2 months, and 113.4 months, respectively. On multivariate analysis, histologic grade alone was a significant prognostic factor for overall survival (p < 0.001). During treatments, no patients had neutropenic fever or intracranial hemorrhage, and no serious nonhematologic or late toxicities were seen in any of the 57 patients. Conclusions: Radiotherapy delivered immediately after HBO with multiagent chemotherapy was safe, with virtually no late toxicities, and seemed to be effective in patients with high-grade gliomas.« less

Quality of Life, Coping Styles, Stress Levels, and Time Use in Mothers of Children with Autism Spectrum Disorders: Comparing Single Versus Coupled Households.

PubMed

McAuliffe, Tomomi; Cordier, Reinie; Vaz, Sharmila; Thomas, Yvonne; Falkmer, Torbjorn

2017-10-01

This study aimed to examine the influence of differences in household status on the parental stress, coping, time use and quality of life (QoL) among mothers of children with autism spectrum disorders. Forty-three single and 164 coupled mothers completed the survey. Data were analysed using multivariate logistic regression. We found that single mothers were 1.05 times more likely to report lower levels of environmental QoL. Whilst they were 1.73 times more likely to use acceptance coping style, this association did not persist after adjusting for total number of children, household income and employment status. There was no difference in time use and stress between these mothers. Possible environmental issues for single mothers and implications for future research are discussed.

Piezosurgery®-assisted periodontally accelerated osteogenic orthodontics.

PubMed

Pakhare, Vikas Vilas; Khandait, Chinmay Harishchandra; Shrivastav, Sunita Satish; Dhadse, Prasad Vijayrao; Baliga, Vidya Sudhindhra; Seegavadi, Vasudevan Dwarkanathan

2017-01-01

Periodontally accelerated osteogenic orthodontic procedure has become useful adjunct to reduce orthodontic treatment time as compared with conventional orthodontics. This case demonstrates the use of Piezosurgery ® to facilitate rapid tooth movement with relatively shorter treatment time. A 23-year-old male with Angles Class I malocclusion having spaced anterior teeth and protrusion requested orthodontic treatment with reduced time period. Before surgery, presurgical orthodontic treatment was done to do initial alignment of the teeth. This was followed by piezosurgical corticotomy and final space closure was achieved by active orthodontic tooth movement. The total treatment time required to complete the orthodontic treatment was 5 months. 1-year follow-up revealed no evidence of any adverse periodontal effects or relapse. Thus, Piezosurgery ® -assisted corticotomy may prove to be a noble and effective treatment approach to decrease the orthodontic treatment time.

Piezosurgery®-assisted periodontally accelerated osteogenic orthodontics

PubMed Central

Pakhare, Vikas Vilas; Khandait, Chinmay Harishchandra; Shrivastav, Sunita Satish; Dhadse, Prasad Vijayrao; Baliga, Vidya Sudhindhra; Seegavadi, Vasudevan Dwarkanathan

2017-01-01

Periodontally accelerated osteogenic orthodontic procedure has become useful adjunct to reduce orthodontic treatment time as compared with conventional orthodontics. This case demonstrates the use of Piezosurgery® to facilitate rapid tooth movement with relatively shorter treatment time. A 23-year-old male with Angles Class I malocclusion having spaced anterior teeth and protrusion requested orthodontic treatment with reduced time period. Before surgery, presurgical orthodontic treatment was done to do initial alignment of the teeth. This was followed by piezosurgical corticotomy and final space closure was achieved by active orthodontic tooth movement. The total treatment time required to complete the orthodontic treatment was 5 months. 1-year follow-up revealed no evidence of any adverse periodontal effects or relapse. Thus, Piezosurgery®-assisted corticotomy may prove to be a noble and effective treatment approach to decrease the orthodontic treatment time. PMID:29491592

Perceived barriers to completing an e-learning program on evidence-based medicine.

PubMed

Gagnon, Marie-Pierre; Légaré, France; Labrecque, Michel; Frémont, Pierre; Cauchon, Michel; Desmartis, Marie

2007-01-01

The Continuing Professional Development Center of the Faculty of Medicine at Laval University offers an internet-based program on evidence-based medicine (EBM). After one year, only three physicians out of the 40 who willingly paid to register had completed the entire program. This descriptive study aimed to identify physicians' beliefs regarding their completion of this online program. Using theoretical concepts from the Theory of Planned Behaviour, a semi-structured telephone interview guide was developed to assess respondents' attitudes, perceived subjective norms, perceived obstacles and facilitating conditions with respect to completing this internet-based program. Three independent reviewers performed content analysis of the interview transcripts to obtain an appropriate level of reliability. Findings were shared and organised according to theoretical categories of beliefs. A total of 35 physicians (88% response rate) were interviewed. Despite perceived advantages to completing the internet-based program, barriers remained, especially those related to physicians' perceptions of time constraints. Lack of personal discipline and unfamiliarity with computers were also perceived as important barriers. This study offers a theoretical basis to understand physicians' beliefs towards completing an internet-based continuing medical education (CME) program on EBM. Based upon respondents' insights, several modifications were carried out to enhance the uptake of the program by physicians and, therefore, its implementation.

Period changes of the long-period cataclysmic binary EX Draconis

NASA Astrophysics Data System (ADS)

Pilarčík, L.; Wolf, M.; Dubovský, P. A.; Hornoch, K.; Kotková, L.

2012-03-01

The cataclysmic variable star EX Dra is a relatively faint but frequently investigated eclipsing dwarf nova. In total 35 new eclipses were measured photometrically as part of our long-term monitoring of interesting eclipsing systems. Using published and new mid-eclipse times obtained between 2004 and 2011 we constructed the observed-minus-calculated diagram. The current data present 21 years of period modulation with a semi-amplitude of 2.5 min. The eclipse timings show significant deviations from the best sinusoidal fit, which indicates that this ephemeris is not a complete description of the data. The fractional period change is roughly ΔP/P = 3 × 10-6.

Quarterly progress report on Blowdown Heat Transfer Separate-Effects Program for January--March 1978. [PWR

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

Thomas, D.G.; Bohanan, R.E.; Clark, D.L.

1978-06-30

The Thermal-Hydraulic Test Facility (THTF) has completed 24 powered rod blowdowns through Mar. 9, 1978. Of these blowdowns, 5 were completed with all 49 rods powered, 2 were completed with 2 inactive rods, and 13 were completed with 4 inactive rods. Initial system pressure was approximately 15.5 MPa (approximately 2250 psi), test section inlet temperature was approximately 559/sup 0/K (approximately 547/sup 0/F), and break area was equivalent to a 200 percent break with the total area usually split between inlet and outlet in the ratio 0.40 : 0.60. Heater rod power was 80, 100, or 122 kW/rod, and the testmore » section outlet temperature was 607/sup 0/K (632/sup 0/F), 598/sup 0/K (617/sup 0/F), or 589/sup 0/K (600/sup 0/F). Mean time to CHF varied from 0.7 to 1.4 sec, with delayed CHF of approximately 2.5 sec occurring in the upper half of the bundle in some tests.« less

Delayed retropubic urethroplasty of completely transected urethra associated with pelvic fracture in girls.

PubMed

Hosseini, Jalil; Tavakkoli Tabassi, Kamyar; Razi, Abdollah

2009-01-01

The objective of the present study was to evaluate the results and the complications of delayed retropubic urethroplasty of completely transected urethra associated with pelvic fracture in girls. From 2002 to 2008, a total of 7 girls with complete urethral disruption after pelvic fracture were referred to our center and all of them underwent delayed retropubic urethroplasty with end-to-end anastomosis of the urethra. Seven female patients with a median age of 6 years old underwent delayed end-to-end anastomosis. The median time to surgery was 6 months from the trauma. Voiding was normal after catheter removal in all of the patients. The median follow-up was 36 months. Three patients had mild stress urinary incontinence after catheter removal. There are some different strategies for management of complete urethral avulsion in females who have sustained pelvic fracture, including early realignment, bladder flaps, and end-to-end anastomosis. The strategy of delayed end-to-end anastomosis urethroplasty with retropubic approach is sound and produces acceptable results. The use of flexible cystoscope and omental flap is effective in achieving continence after urethroplasty in such cases.

Delays in Referral and Enrolment Are Associated With Mitigated Benefits of Cardiac Rehabilitation After Coronary Artery Bypass Surgery.

PubMed

Marzolini, Susan; Blanchard, Chris; Alter, David A; Grace, Sherry L; Oh, Paul I

2015-11-01

Cardiac rehabilitation (CR) is recommended after coronary artery bypass graft surgery; however, the consequences of longer wait times to start CR have not been elucidated. Cardiopulmonary, demographic, and anthropometric assessments were conducted before and after 6 months of CR in consecutively enrolled patients from January 1995 to October 2012. Wait times were ascertained from referral forms and charts. Neighborhood characteristics were ascertained using census data and cross-referencing with patients' home geographic location. Among 6497 post- coronary artery bypass graft participants, mean and median total wait time (time from surgery to first exercise session) was 101.1±47.9 and 80 days, respectively. In multiple linear regression, correlates of longer total wait time and the 2 wait-time phases, time from surgery to CR referral and time from CR referral to first exercise session, were determined. Factors influencing longer wait times included female sex, greater age, being employed, less social support, longer drive time to CR, lower neighborhood socioeconomic status, higher systolic blood pressure, abdominal obesity, and a complex medical history. After adjusting for correlates of delayed entry, longer wait time for each of the total and 2 wait-time phases was significantly associated with less improvement in cardiopulmonary fitness (VO2peak; β=-0.165, P<0.001), body fat percentage (β=0.032, P<0.02), resting heart rate (β=0.066, P<0.001), and poorer attendance to CR classes (β=-0.081, P<0.001) and completion rate (β=2.741, P<0.001). Strategies for timely access to CR at each phase of the process are important given the negative impact that wait time has on key clinical outcomes. This is relevant because optimizing VO2peak and attendance to CR has been shown to confer a mortality advantage. © 2015 American Heart Association, Inc.

Physical, chemical and sensory characteristics of red guava (Psidium guajava) velva at different fruit ripening time

NASA Astrophysics Data System (ADS)

Ishartani, D.; Rahman, F. L. F.; Hartanto, R.; Utami, R.; Khasanah, L. U.

2018-01-01

This study purposed to determine the effect of red guava fruit ripening time on the physical (overrun and melting rate), chemical (vitamin C, pH, total dissolved solid) and sensory (color, taste, aroma, texture, and overall compare to control (without ripening) velva) characteristic of red guava velva. Red guava fruits were harvested at 90 days after flowering, ripened and then processed into velva. This research used Completely Randomized Design with fruit ripening time (without ripening, 4 days, and 6 days) as single factor. The research was conducted in triplicate. Chemical and physical characteristic data was analysed using One Way Analysis of Varian whether sensory characteristic data was analyzed using Independent Sample T-test. The result showed that fruit ripening time significantly affected the physical, chemical and sensory characteristic of the velva. Vitamin C, pH, and total solid of the velva were increased as the ripening time prolonged. In other hand, increasing of fruit ripening time decreased the overrun and melting rate of the velva. Red guava velva made from 6 days ripening had better sensory characteristics compared to velva made from red guava fruit without ripening or 4 day ripening. This research conclude that 6 days ripening time gives better chemical, physical and sensory characteristics of the velva compare to 4 days ripening time. Red guava fruits ripened for 6 days were recommended as raw material in velva making.

By-passing the sign-problem in Fermion Path Integral Monte Carlo simulations by use of high-order propagators

NASA Astrophysics Data System (ADS)

Chin, Siu A.

2014-03-01

The sign-problem in PIMC simulations of non-relativistic fermions increases in serverity with the number of fermions and the number of beads (or time-slices) of the simulation. A large of number of beads is usually needed, because the conventional primitive propagator is only second-order and the usual thermodynamic energy-estimator converges very slowly from below with the total imaginary time. The Hamiltonian energy-estimator, while more complicated to evaluate, is a variational upper-bound and converges much faster with the total imaginary time, thereby requiring fewer beads. This work shows that when the Hamiltonian estimator is used in conjunction with fourth-order propagators with optimizable parameters, the ground state energies of 2D parabolic quantum-dots with approximately 10 completely polarized electrons can be obtain with ONLY 3-5 beads, before the onset of severe sign problems. This work was made possible by NPRP GRANT #5-674-1-114 from the Qatar National Research Fund (a member of Qatar Foundation). The statements made herein are solely the responsibility of the author.

Estimation of gastric emptying time (GET) in clownfish (Amphiprion ocellaris) using X-radiography technique

NASA Astrophysics Data System (ADS)

Ling, Khoo Mei; Ghaffar, Mazlan Abd.

2014-09-01

This study examines the movement of food item and the estimation of gastric emptying time using the X-radiography techniques, in the clownfish (Amphiprion ocellaris) fed in captivity. Fishes were voluntarily fed to satiation after being deprived of food for 72 hours, using pellets that were tampered with barium sulphate (BaSO4). The movement of food item was monitored over different time of feeding. As a result, a total of 36 hours were needed for the food items to be evacuated completely from the stomach. Results on the modeling of meal satiation were also discussed. The size of satiation meal to body weight relationship was allometric, with the power value equal to 1.28.

Changes in dispositional empathy in American college students over time: a meta-analysis.

PubMed

Konrath, Sara H; O'Brien, Edward H; Hsing, Courtney

2011-05-01

The current study examines changes over time in a commonly used measure of dispositional empathy. A cross-temporal meta-analysis was conducted on 72 samples of American college students who completed at least one of the four subscales (Empathic Concern, Perspective Taking, Fantasy, and Personal Distress) of the Interpersonal Reactivity Index (IRI) between 1979 and 2009 (total N = 13,737). Overall, the authors found changes in the most prototypically empathic subscales of the IRI: Empathic Concern was most sharply dropping, followed by Perspective Taking. The IRI Fantasy and Personal Distress subscales exhibited no changes over time. Additional analyses found that the declines in Perspective Taking and Empathic Concern are relatively recent phenomena and are most pronounced in samples from after 2000.

Predictors of media multitasking in Chinese adolescents.

PubMed

Yang, Xiaohui; Zhu, Liqi

2016-12-01

We examined predictors of media multitasking in Chinese adolescents from 3 contexts: characteristics of the media user, types of media use and family media contexts. Three hundred and twenty adolescents, 11-18 years of age, completed questionnaires to measure media use, impulsivity, sensation seeking, time management disposition and family media environment. The results showed that media multitasking was positively correlated with age and total media use time. Participants with high levels of impulsivity and sensation seeking reported more multitasking behaviour. Multitasking was negatively correlated with time management. Children from media-oriented families often engage in more multitasking. What's more, social networking sites use and music use can mediate the effect of individual and family factors on media multitasking. © 2015 International Union of Psychological Science.

Estimation of gastric emptying time (GET) in clownfish (Amphiprion ocellaris) using X-radiography technique

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

Ling, Khoo Mei; Ghaffar, Mazlan Abd.

2014-09-03

This study examines the movement of food item and the estimation of gastric emptying time using the X-radiography techniques, in the clownfish (Amphiprion ocellaris) fed in captivity. Fishes were voluntarily fed to satiation after being deprived of food for 72 hours, using pellets that were tampered with barium sulphate (BaSO{sub 4}). The movement of food item was monitored over different time of feeding. As a result, a total of 36 hours were needed for the food items to be evacuated completely from the stomach. Results on the modeling of meal satiation were also discussed. The size of satiation meal tomore » body weight relationship was allometric, with the power value equal to 1.28.« less

Multi-ligament instability after early dislocation of a primary total knee replacement - case report.

PubMed

Sisak, Krisztian; Lloyd, John; Fiddian, Nick

2011-01-01

Peripheral nerve blocks have found increased popularity in providing prolonged post-operative analgesia following total knee replacement surgery. They generally provide effective analgesia with fewer complications than epidurals. This report describes an acute low-energy knee dislocation after a well balanced, fixed bearing, cruciate-retaining primary total knee replacement performed under a spinal anaesthetic with combined complimentary femoral and sciatic nerve blocks. The dislocation was not accompanied by neurovascular compromise. Due to the subsequent instability and injury to both collaterals, the posterior cruciate ligament and posterolateral corner structures, the knee was treated with a rotating-hinge revision total knee replacement. The dislocation occurred whilst the peripheral nerve blocks (PNB) were still working. We review our incidence of PNB related complications and conclude that PNB remain a safe and effective analgesia for total knee replacements. However, we advocate that ward staff and patients should be sufficiently educated to ensure that unaided post-operative mobilisation is prevented until such a time that patients have regained complete voluntary muscle control. Copyright © 2009 Elsevier B.V. All rights reserved.

Feasibility and preliminary efficacy of a web-based smoking cessation intervention for HIV-infected smokers: a randomized controlled trial.

PubMed

Shuter, Jonathan; Morales, Daniela A; Considine-Dunn, Shannon E; An, Lawrence C; Stanton, Cassandra A

2014-09-01

To evaluate the feasibility and preliminary efficacy of a Web-based tobacco treatment for persons living with HIV (PLWH). Prospective, randomized controlled trial. HIV-care center in the Bronx, New York. Eligibility criteria included HIV infection, current tobacco usage, interest in quitting, and access to a computer with internet. One hundred thirty-eight subjects enrolled, and 134 completed the study. Positively Smoke Free on the Web (PSFW), an 8-session, 7-week targeted tobacco treatment program for PLWH, was compared with standard care (brief advice to quit and self-help brochure). All subjects were offered nicotine patches. The main feasibility outcomes were number of sessions logged into, number of Web pages visited, number of interactive clicks, and total time logged in. The main efficacy outcome was biochemically verified, 7-day point prevalence abstinence 3 months after intervention. PSFW subjects logged into a mean of 5.5 of 8 sessions and 26.2 of 41 pages. They executed a mean of 10 interactive clicks during a mean total of 59.8 minutes logged in. Most required reminder phone calls to complete the sessions. Educational level, anxiety score, and home access of the Web site were associated with Web site usage. Ten percent of the PSFW group vs. 4.3% of controls achieved the abstinence end point. Among those who completed all 8 sessions, 17.9% were abstinent, and among women completers, 30.8% were abstinent. Web-based treatment is a feasible strategy for PLWH smokers, and preliminary findings suggest therapeutic efficacy.

Clinical impact and predictors of complete ST segment resolution after primary percutaneous coronary intervention: A subanalysis of the ATLANTIC Trial.

PubMed

Fabris, Enrico; van 't Hof, Arnoud; Hamm, Christian W; Lapostolle, Frédéric; Lassen, Jens F; Goodman, Shaun G; Ten Berg, Jurriën M; Bolognese, Leonardo; Cequier, Angel; Chettibi, Mohamed; Hammett, Christopher J; Huber, Kurt; Janzon, Magnus; Merkely, Béla; Storey, Robert F; Zeymer, Uwe; Cantor, Warren J; Tsatsaris, Anne; Kerneis, Mathieu; Diallo, Abdourahmane; Vicaut, Eric; Montalescot, Gilles

2017-08-01

In the ATLANTIC (Administration of Ticagrelor in the catheterization laboratory or in the Ambulance for New ST elevation myocardial Infarction to open the Coronary artery) trial the early use of aspirin, anticoagulation, and ticagrelor coupled with very short medical contact-to-balloon times represent good indicators of optimal treatment of ST-elevation myocardial infarction and an ideal setting to explore which factors may influence coronary reperfusion beyond a well-established pre-hospital system. This study sought to evaluate predictors of complete ST-segment resolution after percutaneous coronary intervention in ST-elevation myocardial infarction patients enrolled in the ATLANTIC trial. ST-segment analysis was performed on electrocardiograms recorded at the time of inclusion (pre-hospital electrocardiogram), and one hour after percutaneous coronary intervention (post-percutaneous coronary intervention electrocardiogram) by an independent core laboratory. Complete ST-segment resolution was defined as ≥70% ST-segment resolution. Complete ST-segment resolution occurred post-percutaneous coronary intervention in 54.9% ( n=800/1456) of patients and predicted lower 30-day composite major adverse cardiovascular and cerebrovascular events (odds ratio 0.35, 95% confidence interval 0.19-0.65; p<0.01), definite stent thrombosis (odds ratio 0.18, 95% confidence interval 0.02-0.88; p=0.03), and total mortality (odds ratio 0.43, 95% confidence interval 0.19-0.97; p=0.04). In multivariate analysis, independent negative predictors of complete ST-segment resolution were the time from symptoms to pre-hospital electrocardiogram (odds ratio 0.91, 95% confidence interval 0.85-0.98; p<0.01) and diabetes mellitus (odds ratio 0.6, 95% confidence interval 0.44-0.83; p<0.01); pre-hospital ticagrelor treatment showed a favorable trend for complete ST-segment resolution (odds ratio 1.22, 95% confidence interval 0.99-1.51; p=0.06). This study confirmed that post-percutaneous coronary intervention complete ST-segment resolution is a valid surrogate marker for cardiovascular clinical outcomes. In the current era of ST-elevation myocardial infarction reperfusion, patients' delay and diabetes mellitus are independent predictors of poor reperfusion and need specific attention in the future.

Jurassic-Cretaceous Composite Total Petroleum System and Geologic Assessment of Oil and Gas Resources of the North Cuba Basin, Cuba

USGS Publications Warehouse

,

2008-01-01

The purpose of the U.S. Geological Survey's (USGS) World Oil and Gas Assessment is to develop geologically based hypotheses regarding the potential for additions to oil and gas reserves in priority areas of the world. The U.S. Geological Survey (USGS) completed an assessment of the undiscovered oil and gas potential of the North Cuba Basin. The assessment is based on the geologic elements of the total petroleum system (TPS) defined in the province, including petroleum source rocks (source-rock maturation, generation, and migration), reservoir rocks (sequence stratigraphy and petrophysical properties), and petroleum traps (Trap formation and timing). Using this geologic framework, the USGS defined a Jurassic-Cretaceous Total Petroleum System in the North Cuba Basin Province. Within this TPS, three assessment units were defined and assessed for undiscovered oil and gas resources.

Internet addiction is related to attention deficit but not hyperactivity in a sample of high school students.

PubMed

Yılmaz, Savaş; Hergüner, Sabri; Bilgiç, Ayhan; Işık, Ümit

2015-03-01

To assess the effects of attention-deficit/hyperactivity disorder (ADHD) symptom dimensions on Internet addiction (IA) after controlling for Internet usage features among high school students. This study consisted of 640 students (331 females and 309 males) ranging from 14 to 19 years of age. The Internet Addiction Scale, the Conners-Wells' Adolescent Self-Report Scale-Short Form, and a personal information form were completed by the participants. Statistical analyses were conducted for both sexes and the total sample. According to the logistic regression analysis, attention deficit and playing online games were significant predictors of IA in both sexes. Other predictors of IA included behavioral problems for females, total weekly Internet usage time, and lifelong total Internet use for males. Hyperactivity and other Internet usage features did not predict IA. These results suggest that attention deficit and playing online games are important determinants of IA in this age group.

Liquid chromatography/quadrupole-time-of-flight mass spectrometry with metabolic profiling of human urine as a tool for environmental analysis of dextromethorphan.

PubMed

Thurman, E Michael; Ferrer, Imma

2012-10-12

We use the combination of liquid chromatography/quadrupole-time-of-flight mass spectrometry (LC/Q-TOF-MS) and urine metabolic profiling to find and identify the metabolites of dextromethorphan, a common over-the-counter (OTC) cough suppressant. Next, we use the combination of ion masses, their MS/MS fragmentation, and retention times to determine dextromethorphan and its metabolites in surface water impacted by wastewater. Prior to this study, neither dextromethorphan nor its metabolites have been reported in surface water; in spite of its common use in over 100 various OTC medications. We found that the concentration of the dextrorphan metabolite in surface water greatly exceeded the parent compound by factors of 5-10 times, which reflects the urine profile, where parent compound is approximately <2% of the total excreted drug based on ion intensities. Urine profiling also indicated that glucuronide metabolites are major phase 2 products (92% of the total) in urine and then are completely hydrolyzed in wastewater to dextrorphan and N-demethyldextrorphan, which are phase 1 metabolites-a "kind of reversal" of human metabolism. Copyright © 2012 Elsevier B.V. All rights reserved.

Specific features of the structure of microbial biomass in soils of annular mesodepressions in Lipetsk and Volgograd oblasts

NASA Astrophysics Data System (ADS)

Polyanskaya, L. V.; Sukhanova, N. I.; Chakmazyan, K. V.; Zvyagintsev, D. G.

2014-09-01

In the studied mesodepressions, the total microbial biomass in the gray forest and chernozemic soils decreases by two-three times under the impact of hydrogen flux from the subsoil horizons and soil waterlogging. The biomass decrease is especially pronounced in the lower soil horizons. The population density of bacteria in the soil samples subjected to the impact of hydrogen fluxes and temporary waterlogging decreases by two-three times in the upper horizons and by ten times in the lower horizons in comparison with that in the control samples. These factors also affect the length of fungal mycelium: it decreases by three-four times in the upper horizons and may completely disappear in the lower horizons. The reduction of the microbial biomass can be explained by the fact that hydrogen and waterlogging sharply decrease the soil redox potential, which retards the development of most microbes, except for methanogens and some other specialized groups of microorganisms. The domination of bacteria with diameter ≥0.23 and ≥0.38 μm and the decrease in the total number of bacteria have been found with the use of the cascade filtration method.

Automated Data Abstraction of Cardiopulmonary Resuscitation Process Measures for Complete Episodes of Cardiac Arrest Resuscitation.

PubMed

Lin, Steve; Turgulov, Anuar; Taher, Ahmed; Buick, Jason E; Byers, Adam; Drennan, Ian R; Hu, Samantha; J Morrison, Laurie

2016-10-01

Cardiopulmonary resuscitation (CPR) process measures research and quality assurance has traditionally been limited to the first 5 minutes of resuscitation due to significant costs in time, resources, and personnel from manual data abstraction. CPR performance may change over time during prolonged resuscitations, which represents a significant knowledge gap. Moreover, currently available commercial software output of CPR process measures are difficult to analyze. The objective was to develop and validate a software program to help automate the abstraction and transfer of CPR process measures data from electronic defibrillators for complete episodes of cardiac arrest resuscitation. We developed a software program to facilitate and help automate CPR data abstraction and transfer from electronic defibrillators for entire resuscitation episodes. Using an intermediary Extensible Markup Language export file, the automated software transfers CPR process measures data (electrocardiogram [ECG] number, CPR start time, number of ventilations, number of chest compressions, compression rate per minute, compression depth per minute, compression fraction, and end-tidal CO 2 per minute). We performed an internal validation of the software program on 50 randomly selected cardiac arrest cases with resuscitation durations between 15 and 60 minutes. CPR process measures were manually abstracted and transferred independently by two trained data abstractors and by the automated software program, followed by manual interpretation of raw ECG tracings, treatment interventions, and patient events. Error rates and the time needed for data abstraction, transfer, and interpretation were measured for both manual and automated methods, compared to an additional independent reviewer. A total of 9,826 data points were each abstracted by the two abstractors and by the software program. Manual data abstraction resulted in a total of six errors (0.06%) compared to zero errors by the software program. The mean ± SD time measured per case for manual data abstraction was 20.3 ± 2.7 minutes compared to 5.3 ± 1.4 minutes using the software program (p = 0.003). We developed and validated an automated software program that efficiently abstracts and transfers CPR process measures data from electronic defibrillators for complete cardiac arrest episodes. This software will enable future cardiac arrest studies and quality assurance programs to evaluate the impact of CPR process measures during prolonged resuscitations. © 2016 by the Society for Academic Emergency Medicine.

Independent and joint effects of sedentary time and cardiorespiratory fitness on all-cause mortality: the Cooper Center Longitudinal Study.

PubMed

Shuval, Kerem; Finley, Carrie E; Barlow, Carolyn E; Nguyen, Binh T; Njike, Valentine Y; Pettee Gabriel, Kelley

2015-11-01

To examine the independent and joint effects of sedentary time and cardiorespiratory fitness (fitness) on all-cause mortality. A prospective study of 3141 Cooper Center Longitudinal Study participants. Participants provided information on television (TV) viewing and car time in 1982 and completed a maximal exercise test during a 1-year time frame; they were then followed until mortality or through 2010. TV viewing, car time, total sedentary time and fitness were the primary exposures and all-cause mortality was the outcome. The relationship between the exposures and outcome was examined utilising Cox proportional hazard models. A total of 581 deaths occurred over a median follow-up period of 28.7 years (SD=4.4). At baseline, participants' mean age was 45.0 years (SD=9.6), 86.5% were men and their mean body mass index was 24.6 (SD=3.0). Multivariable analyses revealed a significant linear relationship between increased fitness and lower mortality risk, even while adjusting for total sedentary time and covariates (p=0.02). The effects of total sedentary time on increased mortality risk did not quite reach statistical significance once fitness and covariates were adjusted for (p=0.05). When examining this relationship categorically, in comparison to the reference category (≤10 h/week), being sedentary for ≥23 h weekly increased mortality risk by 29% without controlling for fitness (HR=1.29, 95% CI 1.03 to 1.63); however, once fitness and covariates were taken into account this relationship did not reach statistical significance (HR=1.20, 95% CI 0.95 to 1.51). Moreover, spending >10 h in the car weekly significantly increased mortality risk by 27% in the fully adjusted model. The association between TV viewing and mortality was not significant. The relationship between total sedentary time and higher mortality risk is less pronounced when fitness is taken into account. Increased car time, but not TV viewing, is significantly related to higher mortality risk, even when taking fitness into account, in this cohort. 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/

What are the cost savings associated with providing access to specialist care through the Champlain BASE eConsult service? A costing evaluation.

PubMed

Liddy, Clare; Drosinis, Paul; Deri Armstrong, Catherine; McKellips, Fanny; Afkham, Amir; Keely, Erin

2016-06-23

This study estimates the costs and potential savings associated with all eConsult cases completed between 1 April 2014 and 31 March 2015. Costing evaluation from the societal perspective estimating the costs and potential savings associated with all eConsults completed during the study period. Champlain health region in Eastern Ontario, Canada. Primary care providers and specialists registered to use the eConsult service. Costs included (1) delivery costs; (2) specialist remuneration; (3) costs associated with traditional (face-to-face) referrals initiated as a result of eConsult. Potential savings included (1) costs of traditional referrals avoided; (2) indirect patient savings through avoided travel and lost wages/productivity. Net potential societal cost savings were estimated by subtracting total costs from total potential savings. A total of 3487 eConsults were completed during the study period. In 40% of eConsults, a face-to-face specialist visit was originally contemplated but avoided as result of eConsult. In 3% of eConsults, a face-to-face specialist visit was not originally contemplated but was prompted as a result of the eConsult. From the societal perspective, total costs were estimated at $207 787 and total potential savings were $246 516. eConsult led to a net societal saving of $38 729 or $11 per eConsult. Our findings demonstrate potential cost savings from the societal perspective, as patients avoided the travel costs and lost wages/productivity associated with face-to-face specialist visits. Greater savings are expected once we account for other costs such as avoided tests and visits and potential improved health outcomes associated with shorter wait times. Our findings are valuable for healthcare delivery decision-makers as they seek solutions to improve care in a patient-centred and efficient manner. 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/

Which online format is most effective for assisting Baby Boomers to complete advance directives? A randomised controlled trial of email prompting versus online education module.

PubMed

Bradley, Sandra L; Tieman, Jennifer J; Woodman, Richard J; Phillips, Paddy A

2017-08-29

Completion of Advance Directives (ADs), being financial and healthcare proxy or instructional documents, is relatively uncommon in Australia. Efforts to increase completion rates include online education and prompting which past literature suggests may be effective. The aim of this randomized controlled trial was to assess computer-based online AD information and email prompting for facilitating completion of ADs by Australian Baby Boomers (b.1946-1965) as well as factors which may impede or assist completion of these documents by this generation when using the online environment. Two hundred eighty-two men and women aged 49-68 years at the time of the trial were randomly assigned to one of 3 intervention groups: education module only; email prompt only; email prompt and education module; and a control group with no education module and no email prompt. The randomized controlled trial was undertaken in participants' location of choice. Randomization and allocation to trial group were carried out by a central computer system. The primary analysis was based on a final total of 189 participants who completed the trial (n = 52 education module only; n = 44 email prompt only; n = 46 email prompt and education module; and n = 47 control). The primary outcome was the number of individuals in any group completing any of the 4 legal ADs in South Australia within 12 months or less from entry into the trial. Frequency analysis was conducted on secondary outcomes such as reasons for non-completion. Mean follow-up post-intervention at 12 months showed that 7% of overall participants completed one or more of the 4 legal ADs but without significant difference between groups (delta = 1%, p = .48 Prompt/Non-Prompt groups, delta = 5%, p = .44 education/non-education groups). Reasons offered for non-completion were too busy (26%) and/or it wasn't the right time (21%). Our results suggest that neither email prompting nor provision of additional educational material online were sufficient to significantly impact AD completion rates for this generational cohort. Research with this cohort over longer periods of time exploring online preferences for engagement with ADs as they age may provide better insight into using this environment for ADs with this group. Australian New Zealand Clinical Trials Registry ACTRN12616000425493 .

Efficiency of performing pulmonary procedures in a shared endoscopy unit: procedure time, turnaround time, delays, and procedure waiting time.

PubMed

Verma, Akash; Lee, Mui Yok; Wang, Chunhong; Hussein, Nurmalah B M; Selvi, Kalai; Tee, Augustine

2014-04-01

The purpose of this study was to assess the efficiency of performing pulmonary procedures in the endoscopy unit in a large teaching hospital. A prospective study from May 20 to July 19, 2013, was designed. The main outcome measures were procedure delays and their reasons, duration of procedural steps starting from patient's arrival to endoscopy unit, turnaround time, total case durations, and procedure wait time. A total of 65 procedures were observed. The most common procedure was BAL (61%) followed by TBLB (31%). Overall procedures for 35 (53.8%) of 65 patients were delayed by ≥ 30 minutes, 21/35 (60%) because of "spillover" of the gastrointestinal and surgical cases into the time block of pulmonary procedure. Time elapsed between end of pulmonary procedure and start of the next procedure was ≥ 30 minutes in 8/51 (16%) of cases. In 18/51 (35%) patients there was no next case in the room after completion of the pulmonary procedure. The average idle time of the room after the end of pulmonary procedure and start of next case or end of shift at 5:00 PM if no next case was 58 ± 53 minutes. In 17/51 (33%) patients the room's idle time was >60 minutes. A total of 52.3% of patients had the wait time >2 days and 11% had it ≥ 6 days, reason in 15/21 (71%) being unavailability of the slot. Most pulmonary procedures were delayed due to spillover of the gastrointestinal and surgical cases into the block time allocated to pulmonary procedures. The most common reason for difficulty encountered in scheduling the pulmonary procedure was slot unavailability. This caused increased procedure waiting time. The strategies to reduce procedure delays and turnaround times, along with improved scheduling methods, may have a favorable impact on the volume of procedures performed in the unit thereby optimizing the existing resources.

Testing the Accuracy of Aerial Surveys for Large Mammals: An Experiment with African Savanna Elephants (Loxodonta africana).

PubMed

Schlossberg, Scott; Chase, Michael J; Griffin, Curtice R

2016-01-01

Accurate counts of animals are critical for prioritizing conservation efforts. Past research, however, suggests that observers on aerial surveys may fail to detect all individuals of the target species present in the survey area. Such errors could bias population estimates low and confound trend estimation. We used two approaches to assess the accuracy of aerial surveys for African savanna elephants (Loxodonta africana) in northern Botswana. First, we used double-observer sampling, in which two observers make observations on the same herds, to estimate detectability of elephants and determine what variables affect it. Second, we compared total counts, a complete survey of the entire study area, against sample counts, in which only a portion of the study area is sampled. Total counts are often considered a complete census, so comparing total counts against sample counts can help to determine if sample counts are underestimating elephant numbers. We estimated that observers detected only 76% ± SE of 2% of elephant herds and 87 ± 1% of individual elephants present in survey strips. Detectability increased strongly with elephant herd size. Out of the four observers used in total, one observer had a lower detection probability than the other three, and detectability was higher in the rear row of seats than the front. The habitat immediately adjacent to animals also affected detectability, with detection more likely in more open habitats. Total counts were not statistically distinguishable from sample counts. Because, however, the double-observer samples revealed that observers missed 13% of elephants, we conclude that total counts may be undercounting elephants as well. These results suggest that elephant population estimates from both sample and total counts are biased low. Because factors such as observer and habitat affected detectability of elephants, comparisons of elephant populations across time or space may be confounded. We encourage survey teams to incorporate detectability analysis in all aerial surveys for mammals.

Testing the Accuracy of Aerial Surveys for Large Mammals: An Experiment with African Savanna Elephants (Loxodonta africana)

PubMed Central

Schlossberg, Scott; Chase, Michael J.; Griffin, Curtice R.

2016-01-01

Accurate counts of animals are critical for prioritizing conservation efforts. Past research, however, suggests that observers on aerial surveys may fail to detect all individuals of the target species present in the survey area. Such errors could bias population estimates low and confound trend estimation. We used two approaches to assess the accuracy of aerial surveys for African savanna elephants (Loxodonta africana) in northern Botswana. First, we used double-observer sampling, in which two observers make observations on the same herds, to estimate detectability of elephants and determine what variables affect it. Second, we compared total counts, a complete survey of the entire study area, against sample counts, in which only a portion of the study area is sampled. Total counts are often considered a complete census, so comparing total counts against sample counts can help to determine if sample counts are underestimating elephant numbers. We estimated that observers detected only 76% ± SE of 2% of elephant herds and 87 ± 1% of individual elephants present in survey strips. Detectability increased strongly with elephant herd size. Out of the four observers used in total, one observer had a lower detection probability than the other three, and detectability was higher in the rear row of seats than the front. The habitat immediately adjacent to animals also affected detectability, with detection more likely in more open habitats. Total counts were not statistically distinguishable from sample counts. Because, however, the double-observer samples revealed that observers missed 13% of elephants, we conclude that total counts may be undercounting elephants as well. These results suggest that elephant population estimates from both sample and total counts are biased low. Because factors such as observer and habitat affected detectability of elephants, comparisons of elephant populations across time or space may be confounded. We encourage survey teams to incorporate detectability analysis in all aerial surveys for mammals. PMID:27755570

The effectiveness of an intensive care quick reference checklist manual--a randomized simulation-based trial.

PubMed

Just, Katja S; Hubrich, Svenja; Schmidtke, Daniel; Scheifes, Andrea; Gerbershagen, Mark U; Wappler, Frank; Grensemann, Joern

2015-04-01

We aimed to test the effectiveness of checklists for emergency procedures on medical staff performance in intensive care crises. This is a prospective single-center randomized trial in a high-fidelity simulation center modeling an intensive care unit (ICU) in a tertiary care hospital in Germany. Teams consisted of 1 ICU resident and 2 ICU nurses (in total, n = 48). All completed 4 crisis scenarios, in which they were randomized to use checklists or to perform without any aid. In 2 of the scenarios, checklists could be used immediately (type 1 scenarios); and for the remaining, some further steps, for example, confirming diagnosis, were required first (type 2 scenarios). Outcome measurements were number of predefined items and time to completion of more than 50% and more than 75% of steps, respectively. When using checklists, participants initiated items faster and more completely according to appropriate treatment guidelines (9 vs 7 items with and without checklists, P < .05). Benefit of checklists was better in type 2 scenarios than in type 1 scenarios (2 vs 1 additional item, P < .05). In type 2 scenarios, time to complete 50% and 75% of items was faster with the use of checklists (P < .005). Use of checklists in ICU crises has a benefit on the completion of critical treatment steps. Within the type 2 scenarios, items were fulfilled faster with checklists. The implementation of checklists for intensive care crises is a promising approach that may improve patients' care. Copyright © 2014 Elsevier Inc. All rights reserved.

77 FR 58111 - Notice of Submission for OMB Review; Institute of Education Sciences; FAFSA Completion Project...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-19

... the National Center for Education Evaluation. The study will use a delayed- treatment control group... complete title of the information collection and OMB Control Number when making your request. Individuals... Control Number: Pending. Type of Review: New. Total Estimated Number of Annual Responses: 200. Total...

26 CFR 1.460-0 - Outline of regulations under section 460.

Code of Federal Regulations, 2013 CFR

2013-04-01

... total allocable contract costs. (iv) Pre-contracting-year costs. (v) Post-completion-year costs. (6) 10... improvements. (iv) Mixed use costs. (3) $10,000,000 gross receipts test. (i) In general. (ii) Single employer...) Computations. (3) Post-completion-year income. (4) Total contract price. (i) In general. (A) Definition. (B...

Stress and sleep disturbances in female college students.

PubMed

Lee, Shih-Yu; Wuertz, Caroline; Rogers, Rebecca; Chen, Yu-Ping

2013-11-01

To describe the sleep characteristics and examine the associations among perceived stress, sleep disturbances, depressive symptoms, and physical symptoms among female college students. A total of 103 students completed a battery of questionnaires. The students experienced high stress during the school year. The majority of them slept less than 6 hours during weekdays and experienced moderate fatigue. High stress levels are associated with sleep disturbances, less nocturnal total sleep time, higher fatigue severity, and more depressive symptoms. Perceived stress and sleep disturbances are significant predictors for depressive symptoms and physical symptoms. Compared to the good sleepers, the poor sleepers reported more daytime sleepiness, depressive symptoms, and physical symptoms. Interventions to reduce stress and improve sleep are critically needed in college education.

Total etch technique and cavity isolation.

PubMed

Fusayama, T

1992-01-01

In the total etch technique for chemically adhesive composite restorations, the phosphoric acid penetrates only 10 microns or less into the vital dentin with the dentinal tubules being filled with the odontoblast processes. The acid is completely removed by subsequent air-water jet spray washing. The tubule apertures are perfectly sealed by the protective bonding agent layer with the resin tags adhering to the tubule walls and the resin-impregnated dentin surface. Isolation of the cavity from moisture contamination is required for only less than a few seconds after drying the etched cavity until the bonding agent coating and after this coating until the composite resin placement. Such a short time for isolation is quite easy even without a rubber dam when a trained assistant is cooperating.

Radiation-Tolerant DC-DC Converters

NASA Technical Reports Server (NTRS)

Skutt, Glenn; Sable, Dan; Leslie, Leonard; Graham, Shawn

2012-01-01

A document discusses power converters suitable for space use that meet the DSCC MIL-PRF-38534 Appendix G radiation hardness level P classification. A method for qualifying commercially produced electronic parts for DC-DC converters per the Defense Supply Center Columbus (DSCC) radiation hardened assurance requirements was developed. Development and compliance testing of standard hybrid converters suitable for space use were completed for missions with total dose radiation requirements of up to 30 kRad. This innovation provides the same overall performance as standard hybrid converters, but includes assurance of radiation- tolerant design through components and design compliance testing. This availability of design-certified radiation-tolerant converters can significantly reduce total cost and delivery time for power converters for space applications that fit the appropriate DSCC classification (30 kRad).

Benefits, Harms, and Costs of Osteoporosis Screening in Male Veterans

DTIC Science & Technology

men; cost effectiveness analysis was not completed due to the overall lack of benefit of DXA testing. We conclude that current VADXA testing practices...and adherence in those meeting treatment thresholds (12 of follow-up time). Mortality was 21 lower in DXA tested men, also likely related to...VA guideline risk factors (0.91, 0.87-0.95);and high FRAX- BMI (0.90, 0.86-0.95). Total costs were slightly higher for DXA treated men than untested

Financial Management Regulation. Volume 7B. Military Pay Policy and Procedures for Retired Pay

DTIC Science & Technology

1995-06-01

3) Enlisted members are authorized to count double time for service beyond the continental limits of the United States between 1898 and 1912 while...and made a part of the Regular Army. a. The total number of enlisted men was limited to 12,000 voluntary enlisted natives of the Philippine Islands...not on promotion list. 12. Not on promotion list. Retirement subject to completion of 5 years’ service in grade. 13. Designated for limited duty

Analysis of the Exposure Levels and Potential Biologic Effects of the PAVE PAWS Radar System.

DTIC Science & Technology

1979-01-01

total body) yielded local SARs at hot spots (above the palate area and the upper part of the back of the neck) about 5 times the average values for the...increase the field intensity; whether the energy absorption is averaged over the entire body or over local areas, such as the head or particularly absorptive...animal. Full implications of the multibody effects on AAR are not completely understood, even though pilot experimental studies with anesthetized rats

Miniplate-Aided Mandibular Dentition Distalization as a Camouflage Treatment of a Class III Malocclusion in an Adult.

PubMed

Hakami, Zaki; Chen, Po Jung; Ahmida, Ahmad; Janakiraman, Nandakumar; Uribe, Flavio

2018-01-01

This case report describes orthodontic camouflage treatment for a 32-year-old African American male patient with Class III malocclusion. The treatment included nonextraction, nonsurgical orthodontic camouflage by en masse distalization of the mandibular teeth using skeletal anchorage devices. The total treatment time was 23 months. Normal overjet and overbite with Class I occlusion were obtained despite the compensated dentition to the skeletal malocclusion. His smile esthetics was significantly improved at the completion of his treatment.

Miniplate-Aided Mandibular Dentition Distalization as a Camouflage Treatment of a Class III Malocclusion in an Adult

PubMed Central

Chen, Po Jung; Ahmida, Ahmad; Janakiraman, Nandakumar; Uribe, Flavio

2018-01-01

This case report describes orthodontic camouflage treatment for a 32-year-old African American male patient with Class III malocclusion. The treatment included nonextraction, nonsurgical orthodontic camouflage by en masse distalization of the mandibular teeth using skeletal anchorage devices. The total treatment time was 23 months. Normal overjet and overbite with Class I occlusion were obtained despite the compensated dentition to the skeletal malocclusion. His smile esthetics was significantly improved at the completion of his treatment. PMID:29721340

VARTM Model Development and Verification

NASA Technical Reports Server (NTRS)

Cano, Roberto J. (Technical Monitor); Dowling, Norman E.

2004-01-01

In this investigation, a comprehensive Vacuum Assisted Resin Transfer Molding (VARTM) process simulation model was developed and verified. The model incorporates resin flow through the preform, compaction and relaxation of the preform, and viscosity and cure kinetics of the resin. The computer model can be used to analyze the resin flow details, track the thickness change of the preform, predict the total infiltration time and final fiber volume fraction of the parts, and determine whether the resin could completely infiltrate and uniformly wet out the preform.

Earth observations taken during the STS-59 mission

NASA Image and Video Library

1994-04-14

STS059-219-065 (9-20 April 1994) --- The narrow end of the island is to the north by northeast. This is one of several volcanic islands extending south by southwest between the southern tip of Kamchatka and Japan. The exposure was stopped down to provide extremely fine detail in the totally snow-covered landscape, at the same time making the dark sea look completely black. Compare to STS047-90-087, taken in September, which shows a green ground cover. Hasselblad photograph.

How many days of monitoring predict physical activity and sedentary behaviour in older adults?

PubMed Central

2011-01-01

Background The number of days of pedometer or accelerometer data needed to reliably assess physical activity (PA) is important for research that examines the relationship with health. While this important research has been completed in young to middle-aged adults, data is lacking in older adults. Further, data determining the number of days of self-reports PA data is also void. The purpose of this study was to examine the number of days needed to predict habitual PA and sedentary behaviour across pedometer, accelerometer, and physical activity log (PA log) data in older adults. Methods Participants (52 older men and women; age = 69.3 ± 7.4 years, range= 55-86 years) wore a Yamax Digiwalker SW-200 pedometer and an ActiGraph 7164 accelerometer while completing a PA log for 21 consecutive days. Mean differences each instrument and intensity between days of the week were examined using separate repeated measures analysis of variance for with pairwise comparisons. Spearman-Brown Prophecy Formulae based on Intraclass Correlations of .80, .85, .90 and .95 were used to predict the number of days of accelerometer or pedometer wear or PA log daily records needed to represent total PA, light PA, moderate-to-vigorous PA, and sedentary behaviour. Results Results of this study showed that three days of accelerometer data, four days of pedometer data, or four days of completing PA logs are needed to accurately predict PA levels in older adults. When examining time spent in specific intensities of PA, fewer days of data are needed for accurate prediction of time spent in that activity for ActiGraph but more for the PA log. To accurately predict average daily time spent in sedentary behaviour, five days of ActiGraph data are needed. Conclusions The number days of objective (pedometer and ActiGraph) and subjective (PA log) data needed to accurately estimate daily PA in older adults was relatively consistent. Despite no statistical differences between days for total PA by the pedometer and ActiGraph, the magnitude of differences between days suggests that day of the week cannot be completely ignored in the design and analysis of PA studies that involve < 7-day monitoring protocols for these instruments. More days of accelerometer data were needed to determine typical sedentary behaviour than PA level in this population of older adults. PMID:21679426

How many days of monitoring predict physical activity and sedentary behaviour in older adults?

PubMed

Hart, Teresa L; Swartz, Ann M; Cashin, Susan E; Strath, Scott J

2011-06-16

The number of days of pedometer or accelerometer data needed to reliably assess physical activity (PA) is important for research that examines the relationship with health. While this important research has been completed in young to middle-aged adults, data is lacking in older adults. Further, data determining the number of days of self-reports PA data is also void. The purpose of this study was to examine the number of days needed to predict habitual PA and sedentary behaviour across pedometer, accelerometer, and physical activity log (PA log) data in older adults. Participants (52 older men and women; age = 69.3 ± 7.4 years, range= 55-86 years) wore a Yamax Digiwalker SW-200 pedometer and an ActiGraph 7164 accelerometer while completing a PA log for 21 consecutive days. Mean differences each instrument and intensity between days of the week were examined using separate repeated measures analysis of variance for with pairwise comparisons. Spearman-Brown Prophecy Formulae based on Intraclass Correlations of .80, .85, .90 and .95 were used to predict the number of days of accelerometer or pedometer wear or PA log daily records needed to represent total PA, light PA, moderate-to-vigorous PA, and sedentary behaviour. Results of this study showed that three days of accelerometer data, four days of pedometer data, or four days of completing PA logs are needed to accurately predict PA levels in older adults. When examining time spent in specific intensities of PA, fewer days of data are needed for accurate prediction of time spent in that activity for ActiGraph but more for the PA log. To accurately predict average daily time spent in sedentary behaviour, five days of ActiGraph data are needed. The number days of objective (pedometer and ActiGraph) and subjective (PA log) data needed to accurately estimate daily PA in older adults was relatively consistent. Despite no statistical differences between days for total PA by the pedometer and ActiGraph, the magnitude of differences between days suggests that day of the week cannot be completely ignored in the design and analysis of PA studies that involve < 7-day monitoring protocols for these instruments. More days of accelerometer data were needed to determine typical sedentary behaviour than PA level in this population of older adults.

Reducing sedation time for thyroplasty with arytenoid adduction with sequential anesthetic technique.

PubMed

Saadeh, Charles K; Rosero, Eric B; Joshi, Girish P; Ozayar, Esra; Mau, Ted

2017-12-01

To determine the extent to which a sequential anesthetic technique 1) shortens time under sedation for thyroplasty with arytenoid adduction (TP-AA), 2) affects the total operative time, and 3) changes the voice outcome compared to TP-AA performed entirely under sedation/analgesia. Case-control study. A new sequential anesthetic technique of performing most of the TP-AA surgery under general anesthesia (GA), followed by transition to sedation/analgesia (SA) for voice assessment, was developed to achieve smooth emergence from GA. Twenty-five TP-AA cases performed with the sequential GA-SA technique were compared with 25 TP-AA controls performed completely under sedation/analgesia. The primary outcome measure was the time under sedation. Voice improvement, as assessed by Consensus Auditory-Perceptual Evaluation of Voice, and total operative time were secondary outcome measures. With the conventional all-SA anesthetic, the duration of SA was 209 ± 26.3 minutes. With the sequential GA-SA technique, the duration of SA was 79.0 ± 18.9 minutes, a 62.3% reduction (P < 0.0001). There was no significant difference in the total operative time (209.5 vs. 200.9 minutes; P = 0.42) or in voice outcome. This sequential anesthetic technique has been easily adopted by multiple anesthesiologists and nurse anesthetists at our institution. TP-AA is effectively performed under sequential GA-SA technique with a significant reduction in the duration of time under sedation. This allows the surgeon to perform the technically more challenging part of the surgery under GA, without having to contend with variability in patient tolerance for laryngeal manipulation under sedation. 3b. Laryngoscope, 127:2813-2817, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

The Relationship Between Soldier Performance on the Two-Mile Run and the 20-m Shuttle Run Test.

PubMed

Canino, Maria C; Cohen, Bruce S; Redmond, Jan E; Sharp, Marilyn A; Zambraski, Edward J; Foulis, Stephen A

2018-05-01

The 20-m shuttle run test (MSRT) is a common field test used to measure aerobic fitness in controlled environments. The U.S. Army currently assesses aerobic fitness with the two-mile run (TMR), but external factors may impact test performance. The aim of this study is to examine the relationship between the Army Physical Fitness Test TMR performance and the MSRT in military personnel. A group of 531 (403 males and 128 females) active duty soldiers (age: 24.0 ± 4.1 years) performed the MSRT in an indoor facility. Heart rate was monitored for the duration of the test. Post-heart rate and age-predicted maximal heart rate were utilized to determine near-maximal performance on the MSRT. The soldiers provided their most recent Army Physical Fitness Test TMR time (min). A Pearson correlation and multiple linear regression analyses were performed to examine the relationship between TMR time (min) and MSRT score (total number of shuttles completed). The study was approved by the Human Use Review Committee at the U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts. A significant, negative correlation exists between TMR time and MSRT score (r = -0.75, p < 0.001). Sex and MSRT score significantly predicted TMR time (adjusted R2 = 0.65, standard error of estimate = 0.97, p < 0.001) with a 95% ratio limits of agreement of ±12.6%. The resulting equation is: TMR = 17.736-2.464 × (sex) - 0.050 × (MSRT) - 0.026 × (MSRT × sex) for predicted TMR time. Males equal zero, females equal one, and MSRT score is the total number of shuttles completed. The MSRT is a strong predictor of the TMR and should be considered as a diagnostic tool when assessing aerobic fitness in active duty soldiers.

Consumer Participation in Quality Improvements for Chronic Disease Care: Development and Evaluation of an Interactive Patient-Centered Survey to Identify Preferred Service Initiatives

PubMed Central

Paul, Christine L; Bryant, Jamie; Roos, Ian A; Henskens, Frans A; Paul, David J

2014-01-01

Background With increasing attention given to the quality of chronic disease care, a measurement approach that empowers consumers to participate in improving quality of care and enables health services to systematically introduce patient-centered initiatives is needed. A Web-based survey with complex adaptive questioning and interactive survey items would allow consumers to easily identify and prioritize detailed service initiatives. Objective The aim was to develop and test a Web-based survey capable of identifying and prioritizing patient-centered initiatives in chronic disease outpatient services. Testing included (1) test-retest reliability, (2) patient-perceived acceptability of the survey content and delivery mode, and (3) average completion time, completion rates, and Flesch-Kincaid reading score. Methods In Phase I, the Web-based Consumer Preferences Survey was developed based on a structured literature review and iterative feedback from expert groups of service providers and consumers. The touchscreen survey contained 23 general initiatives, 110 specific initiatives available through adaptive questioning, and a relative prioritization exercise. In Phase II, a pilot study was conducted within 4 outpatient clinics to evaluate the reliability properties, patient-perceived acceptability, and feasibility of the survey. Eligible participants were approached to complete the survey while waiting for an appointment or receiving intravenous therapy. The age and gender of nonconsenters was estimated to ascertain consent bias. Participants with a subsequent appointment within 14 days were asked to complete the survey for a second time. Results A total of 741 of 1042 individuals consented to participate (71.11% consent), 529 of 741 completed all survey content (78.9% completion), and 39 of 68 completed the test-retest component. Substantial or moderate reliability (Cohen’s kappa>0.4) was reported for 16 of 20 general initiatives with observed percentage agreement ranging from 82.1%-100.0%. The majority of participants indicated the Web-based survey was easy to complete (97.9%, 531/543) and comprehensive (93.1%, 505/543). Participants also reported the interactive relative prioritization exercise was easy to complete (97.0%, 189/195) and helped them to decide which initiatives were of most importance (84.6%, 165/195). Average completion time was 8.54 minutes (SD 3.91) and the Flesch-Kincaid reading level was 6.8. Overall, 84.6% (447/529) of participants indicated a willingness to complete a similar survey again. Conclusions The Web-based Consumer Preferences Survey is sufficiently reliable and highly acceptable to patients. Based on completion times and reading level, this tool could be integrated in routine clinical practice and allows consumers to easily participate in quality evaluation. Results provide a comprehensive list of patient-prioritized initiatives for patients with major chronic conditions and delivers practice-ready evidence to guide improvements in patient-centered care. PMID:25532217

Hypocalcaemia after total thyroidectomy: incidence, control and treatment.

PubMed

Herranz González-Botas, Jesús; Lourido Piedrahita, Diana

2013-01-01

Hypocalcaemia, although usually transitory, is the most frequent complication after total thyroidectomy. To identify factors associated with a higher risk of hypoparathyroidism and related to aetiology and surgical procedure. A total of 254 total thyroidectomies were analysed for the incidence of transitory or permanent hypocalcaemia based on the relationship with etiological and surgical factors. Transient hypocalcaemia was present in 29.1% of the cases and permanent hypocalcemia was present in 4.7%. Postoperative hypocalcaemia was lower in patients with completion thyroidectomy than in patients that underwent total thyroidectomy in a single operation, 12% vs. 31%. Patients with Graves-Basedow disease developed postoperative hypocalcaemia in 50% of the cases. Mean recovery time of parathyroid function was 5.2 months, with 72.2% of the patients recovering before 6 months. Postoperative hypocalcaemia is a frequent complication of total thyroidectomy, but it is seldom permanent. Patients with Graves-Basedow disease have a higher incidence of postoperative hypocalcaemia and need closer follow-up. Postoperative calcium level analysis at 24 and 48 h after surgery is not useful for rapid identification of patients at high risk of hypocalcaemia. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Determinants of incubation period: do reptilian embryos hatch after a fixed total number of heart beats?

PubMed

Du, Wei-Guo; Radder, Rajkumar S; Sun, Bo; Shine, Richard

2009-05-01

The eggs of birds typically hatch after a fixed (but lineage-specific) cumulative number of heart beats since the initiation of incubation. Is the same true for non-avian reptiles, despite wide intraspecific variation in incubation period generated by variable nest temperatures? Non-invasive monitoring of embryo heart beat rates in one turtle species (Pelodiscus sinensis) and two lizards (Bassiana duperreyi and Takydromus septentrionalis) show that the total number of heart beats during embryogenesis is relatively constant over a wide range of warm incubation conditions. However, incubation at low temperatures increases the total number of heart beats required to complete embryogenesis, because the embryo spends much of its time at temperatures that require maintenance functions but that do not allow embryonic growth or differentiation. Thus, cool-incubated embryos allocate additional metabolic effort to maintenance costs. Under warm conditions, total number of heart beats thus predicts incubation period in non-avian reptiles as well as in birds (the total number of heart beats are also similar); however, under the colder nest conditions often experienced by non-avian reptiles, maintenance costs add significantly to total embryonic metabolic expenditure.

The Chandra Deep Wide-Field Survey: Completing the new generation of Chandra extragalactic surveys

NASA Astrophysics Data System (ADS)

Hickox, Ryan

2016-09-01

Chandra X-ray surveys have revolutionized our view of the growth of black holes across cosmic time. Recently, fundamental questions have emerged about the connection of AGN to their host large scale structures that clearly demand a wide, deep survey over a large area, comparable to the recent extensive Chandra surveys in smaller fields. We propose the Chandra Deep Wide-Field Survey (CDWFS) covering the central 6 sq. deg in the Bootes field, totaling 1.025 Ms (building on 550 ks from the HRC GTO program). CDWFS will efficiently probe a large cosmic volume, allowing us to carry out accurate new investigations of the connections between black holes and their large-scale structures, and will complete the next generation surveys that comprise a key part of Chandra's legacy.

Subsampling program for the estimation of fish impingement

NASA Astrophysics Data System (ADS)

Beauchamp, John J.; Kumar, K. D.

1984-11-01

Federal regulations require operators of nuclear and coal-fired power-generating stations to estimate the number of fish impinged on intake screens. During winter months, impingement may range into the hundreds of thousands for certain species, making it impossible to count all intake screens completely. We present graphs for determinig the appropriate“optimal” subsample that must be obtained to estimate the total number impinged. Since the number of fish impinged tends to change drastically within a short time period, the subsample size is determined based on the most recent data. This allows for the changing nature of the species-age composition of the impinged fish. These graphs can also be used for subsampling fish catches in an aquatic system when the size of the catch is too large to sample completely.

Assessment of critical thinking in pharmacy students.

PubMed

Cisneros, Robert M

2009-07-10

To determine whether changes occur over 1 academic year in pharmacy students' critical thinking skills and disposition to think critically. First, second, third, and fourth-year pharmacy students completed the California Critical Thinking Skills Test (CCTST) and the California Critical Thinking Disposition Inventory (CCTDI) at the beginning and end of 1 academic year. One hundred thirty-seven students completed the study. No significant changes occurred over the year in total scores on either instrument. However, scores in 3 of 12 subscale scores changed significantly and several significant correlations were found. Pharmacy students' scores on 2 critical thinking instruments showed no major improvements over 1 academic year but most scores were above average. Some areas of possible weakness were identified. Additional studies comparing scores over a longer period of time (eg, admission to graduation) are needed.

Classification of symmetry-protected phases for interacting fermions in two dimensions

NASA Astrophysics Data System (ADS)

Cheng, Meng; Bi, Zhen; You, Yi-Zhuang; Gu, Zheng-Cheng

2018-05-01

Recently, it has been established that two-dimensional bosonic symmetry-protected topological (SPT) phases with on-site unitary symmetry G can be completely classified by the group cohomology H3( G ,U (1 ) ) . Later, group supercohomology was proposed as a partial classification for SPT phases of interacting fermions. In this work, we revisit this problem based on the algebraic theory of symmetry and defects in two-dimensional topological phases. We reproduce the partial classifications given by group supercohomology, and we also show that with an additional H1(G ,Z2) structure, a complete classification of SPT phases for two-dimensional interacting fermion systems with a total symmetry group G ×Z2f is obtained. We also discuss the classification of interacting fermionic SPT phases protected by time-reversal symmetry.

Selected plantar pressure characteristics associated with the skating performance of national in-line speed skaters.

PubMed

Wu, Wen-Lan; Hsu, Hsiu-Tao; Chu, I-Hua; Tsai, Feng-Hua; Liang, Jing-Min

2017-06-01

In order to help coaches analyse the techniques of professional in-line speed skaters for making the required fine adjustments and corrections in their push-off work, this study analysed the specific plantar pressure characteristics during a 300-m time-trial test. Fourteen elite in-line speed skaters from the national team were recruited in this study. The total completion time of the 300-m time-trial test, duration of each skating phase, and plantar pressure distribution were measured. The correlation between plantar pressure distribution and skating performance was assessed using Pearson correlation analyses. The results showed that the contact time of the total foot and force-time integral (FTI) in the medial forefoot were significantly correlated with the duration of the start phase, and the FTIs in the medial forefoot of the gliding (left) leg and lateral forefoot of the pushing (right) leg were significantly correlated with the duration of the turning phase. The maximum force in the medial heel, medial forefoot, and median forefoot and the FTI in the medial heel and medial forefoot were significantly correlated with the duration of the linear acceleration phase. The results suggest that a correct plantar loading area and push-off strategy can enhance the skating performance.

Mortality in patients with TIMI 3 flow after PCI in relation to time delay to reperfusion.

PubMed

Vichova, Teodora; Maly, Marek; Ulman, Jaroslav; Motovska, Zuzana

2016-03-01

Percutaneous coronary intervention (PCI) performed within 12 h from symptom onset enables complete blood flow restoration in infarct-related artery in 90% of patients. Nevertheless, even with complete restoration of epicardial blood flow in culprit vessel (postprocedural Thrombolysis in Myocardial Infarction (TIMI) flow grade 3), myocardial perfusion at tissue level may be insufficient. We hypothesized that the outcome of patients with STEMI/bundle branch block (BBB)-myocardial infarction and post-PCI TIMI 3 flow is related to the time to reperfusion. Observational study based on a retrospective analysis of population of 635 consecutive patients with STEMI/BBB-MI and post-PCI TIMI 3 flow from January 2009 to December 2011 (mean age 63 years, 69.6% males). Mortality of patients was evaluated in relation to the time from symptom onset to reperfusion. A total of 83 patients (13.07%) with postprocedural TIMI 3 flow after PCI had died at 1-year follow-up. Median TD in patients who survived was 3.92 h (iqr 5.43), in patients who died 6.0 h (iqr 11.42), P = 0.004. Multiple logistic regression analysis identified time delay ≥ 9 h as significantly related to 1-year mortality of patients with STEMI/BBB-MI and post-PCI TIMI 3 flow (OR 1.958, P = 0.026). Other significant variables associated with mortality in multivariate regression analysis were: left ventricle ejection fraction < 30% (P = 0.006), age > 65 years (P < 0.001), Killip class >2 (P <0.001), female gender (P = 0.019), and creatinine clearance < 30 mL/min (P < 0.001). Time delay to reperfusion is significantly related to 1-year mortality of patients with STEMI/BBB-MI and complete restoration of epicardial blood flow in culprit vessel after PCI.

Functional Mobility Performance and Balance Confidence in Older Adults after Sensorimotor Adaptation Training

NASA Technical Reports Server (NTRS)

Buccello-Stout, Regina R.; Cromwell, Ronita L.; Bloomberg, Jacob J.; Weaver, G. D.

2010-01-01

Research indicates a main contributor of injury in older adults is from falling. The decline in sensory systems limits information needed to successfully maneuver through the environment. The objective of this study was to determine if prolonged exposure to the realignment of perceptual-motor systems increases adaptability of balance, and if balance confidence improves after training. A total of 16 older adults between ages 65-85 were randomized to a control group (walking on a treadmill while viewing a static visual scene) and an experimental group (walking on a treadmill while viewing a rotating visual scene). Prior to visual exposure, participants completed six trials of walking through a soft foamed obstacle course. Participants came in twice a week for 4 weeks to complete training of walking on a treadmill and viewing the visual scene for 20 minutes each session. Participants completed the obstacle course after training and four weeks later. Average time, penalty, and Activity Balance Confidence Scale scores were computed for both groups across testing times. The older adults who trained, significantly improved their time through the obstacle course F (2, 28) = 9.41, p < 0.05, as well as reduced their penalty scores F (2, 28) = 21.03, p < 0.05, compared to those who did not train. There was no difference in balance confidence scores between groups across testing times F (2, 28) = 0.503, p > 0.05. Although the training group improved mobility through the obstacle course, there were no differences between the groups in balance confidence.

Dynamic Resource Management for Parallel Tasks in an Oversubscribed Energy-Constrained Heterogeneous Environment

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

Imam, Neena; Koenig, Gregory A; Machovec, Dylan

2016-01-01

Abstract: The worth of completing parallel tasks is modeled using utility functions, which monotonically-decrease with time and represent the importance and urgency of a task. These functions define the utility earned by a task at the time of its completion. The performance of such a system is measured as the total utility earned by all completed tasks over some interval of time (e.g., 24 hours). To maximize system performance when scheduling dynamically arriving parallel tasks onto a high performance computing (HPC) system that is oversubscribed and energy-constrained, we have designed, analyzed, and compared different heuristic techniques. Four utility-aware heuristics (i.e.,more » Max Utility, Max Utility-per-Time, Max Utility-per-Resource, and Max Utility-per-Energy), three FCFS-based heuristics (Conservative Backfilling, EASY Backfilling, and FCFS with Multiple Queues), and a Random heuristic were examined in this study. A technique that is often used with the FCFS-based heuristics is the concept of a permanent reservation. We compare the performance of permanent reservations with temporary place-holders to demonstrate the advantages that place-holders can provide. We also present a novel energy filtering technique that constrains the maximum energy-per-resource used by each task. We conducted a simulation study to evaluate the performance of these heuristics and techniques in an energy-constrained oversubscribed HPC environment. With place-holders, energy filtering, and dropping tasks with low potential utility, our utility-aware heuristics are able to significantly outperform the existing FCFS-based techniques.« less

Association of Energy Intake With the Lack of in-Person Review of Household Dietary Records: Analysis of Japan National Health and Nutrition Surveys From 1997 to 2011.

PubMed

Ikeda, Nayu; Okuda, Nagako; Tsubota-Utsugi, Megumi; Nishi, Nobuo

2016-01-01

National surveys have demonstrated a long-term decrease in mean energy intake in Japan, despite the absence of a decrease in the prevalence of overweight and obesity. We aimed to examine whether total energy intake of survey respondents is associated with completion of an in-person review of dietary records and whether it affects the trend in mean energy intake. We pooled data from individuals aged 20-89 years from the National Nutrition Surveys of 1997-2002 and the National Health and Nutrition Surveys of 2003-2011. We conducted a linear mixed-effects regression to estimate the association between total energy intake and the lack of an in-person review of semi-weighed household dietary records with interviewers. As some respondents did not have their dietary data confirmed, we used regression coefficients to correct their total energy intake. Compared with respondents completing an in-person review, total energy intake was significantly inversely associated with respondents not completing a review across all sex and age groups (P < 0.001). After correction of total energy intake for those not completing a review, mean energy intake in each survey year significantly increased by 2.1%-3.9% in men and 1.3%-2.6% in women (P < 0.001), but the decreasing trend in mean energy intake was sustained. Total energy intake may be underestimated without an in-person review of dietary records. Further efforts to facilitate completion of a review may improve accuracy of these data. However, the increasing proportion of respondents missing an in-person review had little impact on the decreasing mean caloric intake.

Normative data for the Fototest from neurological patients with no cognitive impairment.

PubMed

Carnero Pardo, C; Carrera Muñoz, I; Triguero Cueva, L; López Alcalde, S; Vílchez Carrillo, R

2018-05-28

To contribute normative data for the Fototest from neurological patients with no cognitive impairment, including disaggregated data on each domain of the test (naming, free recall, total recall, and naming fluency). We performed a cross-sectional study in which neurological patients with no cognitive impairment were tested with the Fototest; we recorded total and domain scores. We performed a descriptive study of the total and domain scores, with data disaggregated by sex, age (over/under 65 years), and level of education (primary education completed/not completed; further study completed). We included a sample of 1,055 patients, who were mainly women (57.1%), aged over 65 (60.6%), and had a low level of education (38.6% had not completed primary education). Sex, age, and level of education influence total Fototest score (34.6 ± 5.3; P 10 : 28; P 5 : 27) and naming (5,9±0,3; 6; 5), free recall (8.5 ± 2.2; 6; 4), total recall (10.0 ± 1.5; 8; 7), and naming fluency scores (18.7 ± 4.9; 13; 12). For total score, the multivariate analysis revealed values of 1.5 ± 0.3 (ß ± SE) for sex (female), -2.4 ± 0.3 for age (> 65), and -1.6 ± 0.4 and 3.3 ± 0.4 for incomplete primary education and completed post-primary education, respectively (completed primary study was used as a reference). We provide normative data for total and domain Fototest results for each of the groups defined according to sex, age, and level of education. We also provide a percentile distribution of scores. We hope that these normative data will translate into increases in efficiency in Fototest administration in the clinical setting. Copyright © 2018 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Quality of Life and Migraine Disability among Female Migraine Patients in a Tertiary Hospital in Malaysia

PubMed Central

Shaik, Munvar Miya; Hassan, Norul Badriah; Gan, Siew Hua

2015-01-01

Background. Disability caused by migraine may be one of the main causes of burden contributing to poor quality of life (QOL) among migraine patients. Thus, this study aimed to measure QOL among migraine sufferers in comparison with healthy controls. Methods. Female diagnosed migraine patients (n= 100) and healthy controls (n=100) completed the Malay version of the World Health Organization QOL Brief (WHOQOL-BREF) questionnaire. Only migraine patients completed the Malay version of the Migraine Disability Assessment questionnaire. Results. Females with migraines had significantly lower total WHOQOL-BREF scores (84.3) than did healthy controls (91.9, P<0.001). Similarly, physical health (23.4 versus 27.7, P<0.001) and psychological health scores (21.7 versus 23.2, P< 0.001) were significantly lower than those for healthy controls. Seventy-three percent of patients experienced severe disability, with significantly higher number of days with headaches (13.8 days/3 months, P< 0.001) and pain scores (7.4, P< 0.013). Furthermore, migraine patients with lower total QOL scores had 1.2 times higher odds of having disability than patients with higher total QOL scores. Conclusions. The present study showed that migraine sufferers experienced significantly lower QOL than the control group from a similar population. Disability was severe and frequent and was associated with lower QOL among the migraine patients. PMID:25632394

Oral health-related quality of life in pediatric patients under general anesthesia: A prospective study.

PubMed

Li, Lanlan; Wang, Hongwei; Han, Xueping

2017-01-01

Our goal was to evaluate how dental treatments under general anesthesia (GA) affect the quality of life by a prospective pair-matched design. Pediatric patients, who had received dental treatments under GA, were enrolled and were asked to complete the Early Childhood Oral Health Impact Scale (ECOHIS) before the treatment and 1 month after the treatment. To shield the observed impacts, a pair-matched control group was performed. Patients in the control group were also required to complete the ECOHIS at these different points in time. In both groups, the items of troubled sleep and oral/dental pain scored highest, whereas avoiding smiling or laughing and avoiding talking scored lowest before the treatment. The total mean score in the 2 groups was 13.1 and 13.7, respectively, and there was no significant statistical difference (P > 0.05). However, the total mean score was 1.9 in the experimental group after the treatment and smaller compared with the control group (1.9 vs. 4.7, P < 0.001). The majority of the items in both groups had an apparent effect size and the total mean effect in the experimental group was greater than that in the control group (85.5% vs. 65.7%, P < 0.001). Therefore, dental treatment under GA could provide better quality of life restoration compared with treatment over multiple visits.

School-related expenses, living expenses, and income sources for graduate students in nurse anesthesia programs.

PubMed

Heikkila, Dianna

2002-02-01

Nurse anesthesia programs (NAPs) are the highest priced programs for graduate students compared with 7 other nursing master's degree programs. Not only are nurse anesthesia programs expensive, but also most students are encouraged by the policies within their individual programs to terminate full-time employment before matriculation. The purpose of this study was to determine school-related and living expenses, as well as the income and sources of income for graduate students in the second year of their NAP. To obtain the information, a student cost survey was designed and administered to participants attending NAPs across the United States during the 2001 school year. In addition, total degree costs were analyzed using a cost model assessing 4 components: educational costs, living expenses, net income foregone, and loan costs. The results showed that total degree costs incurred by graduate students in NAPs to complete their nurse anesthesia education totals $173,007. The analysis of the sources of income showed the following sources were used by respondents: guaranteed student loans; a spouse's income; agreements with future employers; stipends from universities, hospitals, and/or the military; grants; family support; and self-income. Completing a nurse anesthesia education program is expensive, although the expected return on the investment is high. Nevertheless, the expense may keep qualified graduate students from entering NAPs.

Examination of why some community pharmacists do not provide 72-hour emergency prescription drugs to Medicaid patients when prior authorization is not available.

PubMed

Shepherd, Marvin D

2013-09-01

Existing federal law requires that a 72-hour emergency supply of a prescription drug be dispensed to Medicaid patients when prior authorization (PA) is not available and the medication is needed without delay. The pharmacist's role is to contact prescribers and inform them that PA is needed. If the prescriber cannot be reached, the pharmacist can dispense a 72-hour emergency supply. To determine (a) the reasons why some community pharmacy owners/managers, staff pharmacists, and technicians are not compliant with the law; (b) how often the decision is made; and (c) estimate how often pharmacies do not dispense the 72-hour emergency supply when PA is not available. A questionnaire was mailed to selected Texas community pharmacies. The instrument was developed by the researcher and reviewed by the Texas Medicaid Vendor Drug Program staff. The University of Texas, Office of Survey Research collected the data in September and October of 2011 by mail and online. The data were forwarded to the researcher for analyses. A total of 788 identified community pharmacies were mailed a packet containing 3 questionnaires to be completed by the pharmacist-in-charge, a staff pharmacist, and a pharmacy technician. There were 2 mailings of the questionnaire packet and follow-up telephone calls to nonrespondents. A total of 653 questionnaires were completed and returned from 288 community pharmacies (36.7%) out of 788 pharmacies that were mailed the questionnaire packets. A total of 368 (57.5%) completed questionnaires came from chain store pharmacy respondents and 272 (42.5%) questionnaires from independent pharmacy respondents. A total of 21.3% (n = 134) of the respondents indicated that they were not aware of the federal and state requirement to dispense a 72-hour emergency supply of a prescription drug to Medicaid patients when prior authorization (PA) is not available. A greater proportion of the chain store respondents (26.6%) were unaware of the requirement compared with the independent pharmacy respondents (14.3%). A total of 77.7% of the respondents estimated that they make the decision of providing or not providing a 72-hour emergency supply of medication 6 or fewer times a month. A total of 14.6% indicated that they make the decision 6 to 11 times a month, and 7.7% make the decision more than 11 times a month. When asked how often respondents had seen a 72-hour emergency prescription not being dispensed for Texas Medicaid recipients when PA was not available, 49.1% answered "never"; however, 30.0% indicated once or twice a month, 16.5% indicated from 1 to 5 times a week, and another 4.5% indicated more than 5 times a week. The top 2 reasons for not dispensing a 72 hour-emergency drug supply were: "Reluctant to open a new 'unit-of-use' container (especially 30-day supply bottles)" and "The Rx will most likely be changed with the PA call, so why dispense a 72-hour supply of the originally prescribed drug?" The top categories of 72-hour emergency prescription drug products that respondents would "likely" dispense were antibiotics; inhaler canisters; products for nausea/vomiting, cough, and cold; antiseizure agents; and diabetic treatment products. The results show that there are many factors why pharmacists do not provide 72-hour emergency medications when PA is unavailable. The lack of awareness of the federal and state requirements was significantly related to the frequency of 72-hour medications not being dispensed. In addition, other factors inhibiting the process were the pharmacists' inability to reach physicians or the lack of cooperation with physicians, prescriptions for controlled substances, drug-packing limitations, and the financial risk involved with dispensing a 72-hour supply.

Patients recall worse preoperative pain after shoulder arthroplasty than originally reported: a study of recall accuracy using the American Shoulder and Elbow Surgeons score.

PubMed

Lowe, Jeremiah T; Li, Xinning; Fasulo, Sydney M; Testa, Edward J; Jawa, Andrew

2017-03-01

Patient-reported outcome measures (PROMs) are valuable tools for quantifying outcomes of orthopedic surgery. However, when baseline scores are not obtained, there is considerable controversy about whether PROMs can be administered retrospectively for patients to recall their preoperative state. We investigated the accuracy of patient recall after total shoulder arthroplasty (TSA) using the American Shoulder and Elbow Surgeons (ASES) assessment score. Recalled ASES scores were collected postoperatively at 6 weeks, 3 months, 6 months, and 12 months from 169 patients who previously completed baseline scores before TSA. The ASES total score was divided into its two subcomponents: functional ability and visual analog scale (VAS) for pain. We compared preoperative and recalled scores for each subcomponent and the total ASES score. Recalled ASES function scores were comparable to corresponding preoperative scores across all time points (analysis of variance, P = .21), but recalled VAS pain was significantly higher at all time points beyond 6 weeks after surgery (P = .0001 at 3 months; P = .005 at 6 months; and P = .001 at 12 months). As a result, the ASES total score was only comparable at 6 weeks after surgery (P = .39) and differed at all time points thereafter. Patients are able to recall preoperative function with considerable accuracy for up to 12 months after TSA. However, beyond 6 weeks postoperatively, patients recall having worse pain than they originally reported, and recalled ASES total scores are unreliable as a result. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Plantar loading during cutting while wearing a rigid carbon fiber insert.

PubMed

Queen, Robin M; Abbey, Alicia N; Verma, Ravi; Butler, Robert J; Nunley, James A

2014-01-01

Stress fractures are one of the most common injuries in sports, accounting for approximately 10% of all overuse injuries. Treatment of fifth metatarsal stress fractures involves both surgical and nonsurgical interventions. Fifth metatarsal stress fractures are difficult to treat because of the risks of delayed union, nonunion, and recurrent injuries. Most of these injuries occur during agility tasks, such as those performed in soccer, basketball, and lacrosse. To examine the effect of a rigid carbon graphite footplate on plantar loading during 2 agility tasks. Crossover study. Laboratory. A total of 19 recreational male athletes with no history of lower extremity injury in the past 6 months and no previous metatarsal stress fractures were tested. Seven 45° side-cut and crossover-cut tasks were completed in a shoe with or without a full-length rigid carbon plate. Testing order between the shoe conditions and the 2 cutting tasks was randomized. Plantar-loading data were recorded using instrumented insoles. Peak pressure, maximum force, force-time integral, and contact area beneath the total foot, the medial and lateral midfoot, and the medial, middle, and lateral forefoot were analyzed. A series of paired t tests was used to examine differences between the footwear conditions (carbon graphite footplate, shod) for both cutting tasks independently (α = .05). During the side-cut task, the footplate increased total foot and lateral midfoot peak pressures while decreasing contact area and lateral midfoot force-time integral. During the crossover-cut task, the footplate increased total foot and lateral midfoot peak pressure and lateral forefoot force-time integral while decreasing total and lateral forefoot contact area. Although a rigid carbon graphite footplate altered some aspects of the plantar-pressure profile during cutting in uninjured participants, it was ineffective in reducing plantar loading beneath the fifth metatarsal.

SLO blind data set inversion and classification using physically complete models

NASA Astrophysics Data System (ADS)

Shamatava, I.; Shubitidze, F.; Fernández, J. P.; Barrowes, B. E.; O'Neill, K.; Grzegorczyk, T. M.; Bijamov, A.

2010-04-01

Discrimination studies carried out on TEMTADS and Metal Mapper blind data sets collected at the San Luis Obispo UXO site are presented. The data sets included four types of targets of interest: 2.36" rockets, 60-mm mortar shells, 81-mm projectiles, and 4.2" mortar items. The total parameterized normalized magnetic source (NSMS) amplitudes were used to discriminate TOI from metallic clutter and among the different hazardous UXO. First, in object's frame coordinate, the total NSMS were determined for each TOI along three orthogonal axes from the training data provided by the Strategic Environmental Research and Development Program (SERDP) along with the referred blind data sets. Then the inverted total NSMS were used to extract the time-decay classification features. Once our inversion and classification algorithms were tested on the calibration data sets then we applied the same procedure to all blind data sets. The combined NSMS and differential evolution algorithm is utilized for determine the NSMS strengths for each cell. The obtained total NSMS time-decay curves were used to extract the discrimination features and perform classification using the training data as reference. In addition, for cross validation, the inverted locations and orientations from NSMS-DE algorithm were compared against the inverted data that obtained via the magnetic field, vector and scalar potentials (HAP) method and the combined dipole and Gauss-Newton approach technique. We examined the entire time decay history of the total NSMS case-by-case for classification purposes. Also, we use different multi-class statistical classification algorithms for separating the dangerous objects from non hazardous items. The inverted targets were ranked by target ID and submitted to SERDP for independent scoring. The independent scoring results are presented.

Recovery from Cyclophosphamide Overdose in a Dog.

PubMed

Finlay, Jessica Renee; Wyatt, Kenneth; North, Courtney

An adult female spayed dog was evaluated after inadvertently receiving a total dose of 1,750 mg oral cyclophosphamide, equivalent to 2,303 mg/m 2 , over 21 days (days -21 to 0). Nine days after the last dose of cyclophosphamide (day +9), the dog was evaluated at Perth Veterinary Specialists. Physical examination revealed mucosal pallor, a grade 2/6 systolic heart murmur, and severe hemorrhagic cystitis. Severe nonregenerative pancytopenia was detected on hematology. Broad spectrum antibiotics, two fresh whole blood transfusions, granulocyte colony stimulating factor, and tranexamic acid were administered. Five days after presentation (day +14), the peripheral neutrophil count had recovered, and by 12 days (day +21) the complete blood count was near normal. A second episode of thrombocytopenia (day +51) was managed with vincristine, prednisolone, and melatonin. The dog made a complete recovery with no long-term complications at the time of writing. To the author's knowledge, this is the highest inadvertently administered dose of cyclophosphamide to result in complete recovery.

Development and implementation of a virtual reality laparoscopic colorectal training curriculum.

PubMed

Wynn, Greg; Lykoudis, Panagis; Berlingieri, Pasquale

2017-12-12

Contemporary surgical training can be compromised by fewer practical opportunities. Simulation can fill this gap to optimize skills' development and progress monitoring. A structured virtual reality (VR) laparoscopic sigmoid colectomy curriculum is constructed and its validity and outcomes assessed. Parameters and thresholds were defined by analysing the performance of six expert surgeons completing the relevant module on the LAP Mentor simulator. Fourteen surgical trainees followed the curriculum, performance being recorded and analysed. Evidence of validity was assessed. Time to complete procedure, number of movements of right and left instrument, and total path length of right and left instrument movements demonstrated evidence of validity and clear learning curves, with a median of 14 attempts needed to complete the curriculum. A structured curriculum is proposed for training in laparoscopic sigmoid colectomy in a VR environment based on objective metrics in addition to expert consensus. Validity has been demonstrated for some key metrics. Copyright © 2017 Elsevier Inc. All rights reserved.

Prediction of Pseudoexfoliation Syndrome and Pseudoexfoliation Glaucoma by Using Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio.

PubMed

Ozgonul, Cem; Sertoglu, Erdim; Mumcuoglu, Tarkan; Ozge, Gokhan; Gokce, Gokcen

2016-12-01

To assess the levels of neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in patients with pseudoexfoliation syndrome (PEX) and to compare the NLR and PLR results of patients with PEX, PEX glaucoma (PXG), and healthy controls. In total, 34 patients with PEX, 29 patients with PXG, and 42 healthy subjects were enrolled in this retrospective study. Complete ophthalmologic examination and complete blood count measurements were performed of all subjects. Complete blood counts were performed within 2 h of blood collection. There was a significant difference in NLR between PEX and control groups (p = 0.012) and PXG and control groups (p = 0.003). Also, a significant difference was found in PLR values between control and PXG groups (p = 0.024). Our study for the first time provides evidence that PLR and NLR may be useful for predicting the prognosis of PEX patients and progression to PXG.

Media use and psychosocial adjustment in children and adolescents.

PubMed

Limtrakul, Nicha; Louthrenoo, Orawan; Narkpongphun, Atsawin; Boonchooduang, Nonglak; Chonchaiya, Weerasak

2018-03-01

Currently, television and new forms of media are readily available to children and adolescents in their daily lives. Excessive use of media can lead to negative physical and psychosocial health effects. This study aimed to describe children's media use, including media multitasking, as well as the associations between media use and their psychosocial adjustment. This study recruited 339 participants aged 10-15 years from an international school. The children and their care givers were asked to complete the Strengths and Difficulties Questionnaire independently to evaluate the psychosocial problems of the children. The mean age of the study participants was 12.4 ± 1.5 years, who were recruited from grades 5 to 9. Multitasking media use was reported in 59.3% of participants. The average total media exposure time was 7.0 h/day. The behavioural problem scores from self-reports were greater with increased media use time. After adjusting for confounding variables, the school report and sleep problems were among the factors associated with the total behavioural problem scores from the multiple linear regression analysis (P = 0.001 and <0.001, respectively), whereas age and average total media exposure time were significantly associated with the prosocial behaviour scores reported by the children (P = 0.004 and 0.02, respectively). Multitasking media use was not significantly associated with the total difficulties scores or the prosocial behaviour scores in this study. Increased media use time was significantly associated with decreased prosocial behaviour scores in children in this study. This can provide important information to parents regarding media use in children. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

Growth and enzymatic responses of phytopathogenic fungi to glucose in culture media and soil

PubMed Central

Costa, Beatriz de Oliveira; Nahas, Ely

2012-01-01

The effect of inoculation of Aspergillus flavus , Fusarium verticillioides , and Penicillium sp. in Dystrophic Red Latosol (DRL) and Eutroferric Red Latosol (ERL) soils with or without glucose on the total carbohydrate content and the dehydrogenase and amylase activities was studied. The fungal growth and spore production in culture medium with and without glucose were also evaluated. A completely randomized design with factorial arrangement was used. The addition of glucose in the culture medium increased the growth rate of A. flavus and Penicillium sp. but not of F. verticillioides . The number of spores increased 1.2 for F. verticillioides and 8.2 times for A. flavus in the medium with glucose, but was reduced 3.5 times for Penicillium sp. The total carbohydrates contents reduced significantly according to first and second degree equations. The consumption of total carbohydrates by A. flavus and Penicillium sp. was higher than the control or soil inoculated with F. verticillioides . The addition of glucose to soils benefited the use of carbohydrates, probably due to the stimulation of fungal growth. Dehydrogenase activity increased between 1.5 to 1.8 times ( p <0.05) in soils with glucose and inoculated with the fungi (except F. verticillioides ), in relation to soil without glucose. Amylase activity increased 1.3 to 1.5 times due to the addition of glucose in the soil. Increased amylase activity was observed in the DRL soil with glucose and inoculated with A. flavus and Penicillium sp. when compared to control. PMID:24031836

Computational aspects of real-time simulation of rotary-wing aircraft. M.S. Thesis

NASA Technical Reports Server (NTRS)

Houck, J. A.

1976-01-01

A study was conducted to determine the effects of degrading a rotating blade element rotor mathematical model suitable for real-time simulation of rotorcraft. Three methods of degradation were studied, reduction of number of blades, reduction of number of blade segments, and increasing the integration interval, which has the corresponding effect of increasing blade azimuthal advance angle. The three degradation methods were studied through static trim comparisons, total rotor force and moment comparisons, single blade force and moment comparisons over one complete revolution, and total vehicle dynamic response comparisons. Recommendations are made concerning model degradation which should serve as a guide for future users of this mathematical model, and in general, they are in order of minimum impact on model validity: (1) reduction of number of blade segments; (2) reduction of number of blades; and (3) increase of integration interval and azimuthal advance angle. Extreme limits are specified beyond which a different rotor mathematical model should be used.

Integrated production and distribution scheduling problems related to fixed delivery departure dates and weights of late orders.

PubMed

Li, Shanlin; Li, Maoqin

2015-01-01

We consider an integrated production and distribution scheduling problem faced by a typical make-to-order manufacturer which relies on a third-party logistics (3PL) provider for finished product delivery to customers. In the beginning of a planning horizon, the manufacturer has received a set of orders to be processed on a single production line. Completed orders are delivered to customers by a finite number of vehicles provided by the 3PL company which follows a fixed daily or weekly shipping schedule such that the vehicles have fixed departure dates which are not part of the decisions. The problem is to find a feasible schedule that minimizes one of the following objective functions when processing times and weights are oppositely ordered: (1) the total weight of late orders and (2) the number of vehicles used subject to the condition that the total weight of late orders is minimum. We show that both problems are solvable in polynomial time.

Integrated Production and Distribution Scheduling Problems Related to Fixed Delivery Departure Dates and Weights of Late Orders

PubMed Central

Li, Shanlin; Li, Maoqin

2015-01-01

We consider an integrated production and distribution scheduling problem faced by a typical make-to-order manufacturer which relies on a third-party logistics (3PL) provider for finished product delivery to customers. In the beginning of a planning horizon, the manufacturer has received a set of orders to be processed on a single production line. Completed orders are delivered to customers by a finite number of vehicles provided by the 3PL company which follows a fixed daily or weekly shipping schedule such that the vehicles have fixed departure dates which are not part of the decisions. The problem is to find a feasible schedule that minimizes one of the following objective functions when processing times and weights are oppositely ordered: (1) the total weight of late orders and (2) the number of vehicles used subject to the condition that the total weight of late orders is minimum. We show that both problems are solvable in polynomial time. PMID:25785285

Meta-RaPS Algorithm for the Aerial Refueling Scheduling Problem

NASA Technical Reports Server (NTRS)

Kaplan, Sezgin; Arin, Arif; Rabadi, Ghaith

2011-01-01

The Aerial Refueling Scheduling Problem (ARSP) can be defined as determining the refueling completion times for each fighter aircraft (job) on multiple tankers (machines). ARSP assumes that jobs have different release times and due dates, The total weighted tardiness is used to evaluate schedule's quality. Therefore, ARSP can be modeled as a parallel machine scheduling with release limes and due dates to minimize the total weighted tardiness. Since ARSP is NP-hard, it will be more appropriate to develop a pproimate or heuristic algorithm to obtain solutions in reasonable computation limes. In this paper, Meta-Raps-ATC algorithm is implemented to create high quality solutions. Meta-RaPS (Meta-heuristic for Randomized Priority Search) is a recent and promising meta heuristic that is applied by introducing randomness to a construction heuristic. The Apparent Tardiness Rule (ATC), which is a good rule for scheduling problems with tardiness objective, is used to construct initial solutions which are improved by an exchanging operation. Results are presented for generated instances.

Design and Construction of a Multi-wavelength, Micromirror Total Internal Reflectance Fluorescence Microscope

PubMed Central

Larson, Joshua; Kirk, Matt; Drier, Eric A.; O’Brien, William; MacKay, James F.; Friedman, Larry; Hoskins, Aaron

2015-01-01

Colocalization Single Molecule Spectroscopy (CoSMoS) has proven to be a useful method for studying the composition, kinetics, and mechanisms of complex cellular machines. Key to the technique is the ability to simultaneously monitor multiple proteins and/or nucleic acids as they interact with one another. Here we describe a protocol for constructing a CoSMoS micromirror Total Internal Reflection Fluorescence Microscope (mmTIRFM). Design and construction of a scientific microscope often requires a number of custom components and a significant time commitment. In our protocol, we have streamlined this process by implementation of a commercially available microscopy platform designed to accommodate the optical components necessary for a mmTIRFM. The mmTIRF system eliminates the need for machining custom parts by the end-user and facilitates optical alignment. Depending on the experience-level of the microscope builder, these time-savings and the following protocol can enable mmTIRF construction to be completed within two months. PMID:25188633

Design and construction of a multiwavelength, micromirror total internal reflectance fluorescence microscope.

PubMed

Larson, Joshua; Kirk, Matt; Drier, Eric A; O'Brien, William; MacKay, James F; Friedman, Larry J; Hoskins, Aaron A

2014-10-01

Colocalization single-molecule spectroscopy (CoSMoS) has proven to be a useful method for studying the composition, kinetics and mechanisms of complex cellular machines. Key to the technique is the ability to simultaneously monitor multiple proteins and/or nucleic acids as they interact with one another. Here we describe a protocol for constructing a CoSMoS micromirror total internal reflection fluorescence microscope (mmTIRFM). Design and construction of a scientific microscope often requires a number of custom components and a substantial time commitment. In our protocol, we have streamlined this process by implementation of a commercially available microscopy platform designed to accommodate the optical components necessary for an mmTIRFM. The mmTIRF system eliminates the need for machining custom parts by the end user and facilitates optical alignment. Depending on the experience level of the microscope builder, these time savings and the following protocol can enable mmTIRF construction to be completed within 2 months.

Effects of rotor model degradation on the accuracy of rotorcraft real time simulation

NASA Technical Reports Server (NTRS)

Houck, J. A.; Bowles, R. L.

1976-01-01

The effects are studied of degrading a rotating blade element rotor mathematical model to meet various real-time simulation requirements of rotorcraft. Three methods of degradation were studied: reduction of number of blades, reduction of number of blade segments, and increasing the integration interval, which has the corresponding effect of increasing blade azimuthal advance angle. The three degradation methods were studied through static trim comparisons, total rotor force and moment comparisons, single blade force and moment comparisons over one complete revolution, and total vehicle dynamic response comparisons. Recommendations are made concerning model degradation which should serve as a guide for future users of this mathematical model, and in general, they are in order of minimum impact on model validity: (1) reduction of number of blade segments, (2) reduction of number of blades, and (3) increase of integration interval and azimuthal advance angle. Extreme limits are specified beyond which the rotating blade element rotor mathematical model should not be used.

77 FR 67345 - Agency Information Collection Activities; Submission to the Office of Management and Budget for...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-09

... the application cycle. The total application projection for 2013-2014 is based upon two factors... submissions for the last completed or almost completed application cycle. The ABM is also based on the... applicants would result in an increase in burden of 347,945 hours. Accounting for both the increase in total...

Complete ? -decay pattern for the high-priority decay-heat isotopes I 137 and Xe 137 determined using total absorption spectroscopy

DOE PAGES

Rasco, B. C.; Rykaczewski, K. P.; Fijalkowska, A.; ...

2017-05-31

We measured the complete -decay intensities of 137I and 137Xe with the Modular Total Absorption Spectrometer at Oak Ridge National Laboratory. We describe a novel technique for measuring the -delayed neutron energy spectrum, which also provides a measurement of the -neutron branching ratio, P n.

Associations of Acculturation With Self-Report and Objective Physical Activity and Sedentary Behaviors Among Latinas.

PubMed

Perez, Lilian G; Chavez, Adrian; Marquez, David X; Soto, Sandra C; Haughton, Jessica; Arredondo, Elva M

2017-06-01

Less than 50% of Latinas meet physical activity (PA) recommendations. Acculturation is a complex cultural phenomenon that may influence health behaviors, but associations between acculturation and Latinas' activity and sedentary levels are unclear. To examine associations of acculturation with Latinas' domain-specific and total PA as well as sedentary time. We analyzed baseline data collected between 2011 and 2013 among 410 Latinas (18-65 years) from a PA promotion intervention in San Diego, CA ( Fe en Acción/ Faith in Action). Participants wore an accelerometer to assess moderate-to-vigorous PA (MVPA) and sedentary time and completed a survey assessing domain-specific PA, sociodemographics, and acculturation as measured by length of residence in the United States and the Bidimensional Acculturation Scale (BAS) for Hispanics. Higher acculturation was defined as longer residence in the United States or being either assimilated or bicultural as per scores on the Hispanic and Anglo domains of the BAS. Based on weekly averages from the accelerometer, Latinas spent 103 minutes in MVPA and 76% of total activity in sedentary time. Only 32% met MVPA recommendations via self-reported leisure-time and transportation PA. Longer residence in the United States was inversely associated with reporting any transportation or occupational PA and meeting MVPA recommendations. Assimilated/bicultural Latinas had significantly less accelerometer-based total MVPA and higher sedentary time than their lower acculturated counterparts. Overall, higher acculturation, based on either measure, was related to less activity. Our findings suggest interventions tailored to the acculturation levels of Latinas are needed to help reduce disparities in Latinas' PA and sedentary behaviors.

High dose urokinase for restoration of patency of occluded permanent central venous catheters in hemodialysis patients.

PubMed

Shavit, L; Lifschitz, M; Plaksin, J; Grenader, T; Slotki, I

2010-10-01

Catheter thrombosis is common and results in inadequate dialysis treatment and, frequently, in catheter loss. Since dialysis treatment runs on a strict schedule, occluded catheters need to be restored in a timely and cost effective manner. We present a new shortened protocol of urokinase infusion that allows hemodialysis to be performed within 90 minutes. To chronic hemodialysis patients, who developed complete catheter occlusion, urokinase was infused simultaneously through both lumens of the catheter (125,000 units to each lumen) over 90 minutes. Technical success was defined as restoring blood pump speed to at least 250 ml/min. We determined the average time from catheter placement to first clot event (primary patency PP), recurrent clot event after urokinase treatment (secondary patency SP), catheter salvage rate and cause for removal. 37 catheters developed total thrombosis and urokinase was used to restore patency one or more times (total 47 treatments). Catheter salvage rate was 97 %. The average time of PP was 152 ± 56 days (7 - 784 days). Nine patients (30%) developed recurrent occlusion and the average time of SP was 64 ± 34 days (2 - 364 days). One catheter was removed because of dysfunction due to thrombosis. Other catheters were removed due to infection, fistula maturation or fell out spontaneously. Hemodialysis was performed immediately after treatment with blood speed of 250 ml/min in all patients. Our protocol is highly effective, short, and allows to restore patency of totally occluded central venous catheters with minimal disruption of the dialysis session.

Assessing validity by comparing transition and static measures of dyspnea in patients with acute decompensated heart failure.

PubMed

Smithline, Howard A; Caglar, Selin; Blank, Fidela S J

2010-01-01

This study assessed the convergent validity of 2 dyspnea measures, the transition measure and the change measure, by comparing them with each other in patients admitted to the hospital with acute decompensated heart failure. Static measures of dyspnea were obtained at baseline (pre-static measure) and at time 1 hour and 4 hour (post-static measures). The change measure was calculated as the difference between the pre-static and post-static measures. Transition measures were obtained at time 1 hour and 4 hour. Visual analog scales and Likert scales were used. Both physicians and patients measured the dyspnea independently. A total of 112 patients had complete data sets at time 0 and 1 hour and 86 patients had complete data sets at all 3 time points. Correlations were calculated between the transition measures and static measures (pre-static, post-static, and change measure). Bland-Altman plots were generated and the mean difference and limits of agreement between the transition measures and the change measures were calculated. In general, short-term dyspnea assessment using transition measures and serial static measures can not be used to validate each other in this population of patients being admitted with acute decompensated heart failure. © 2010 Wiley Periodicals, Inc.

Cognitive Load Reduces Perceived Linguistic Convergence Between Dyads.

PubMed

Abel, Jennifer; Babel, Molly

2017-09-01

Speech convergence is the tendency of talkers to become more similar to someone they are listening or talking to, whether that person is a conversational partner or merely a voice heard repeating words. To elucidate the nature of the mechanisms underlying convergence, this study uses different levels of task difficulty on speech convergence within dyads collaborating on a task. Dyad members had to build identical LEGO® constructions without being able to see each other's construction, and with each member having half of the instructions required to complete the construction. Three levels of task difficulty were created, with five dyads at each level (30 participants total). Task difficulty was also measured using completion time and error rate. Listeners who heard pairs of utterances from each dyad judged convergence to be occurring in the Easy condition and to a lesser extent in the Medium condition, but not in the Hard condition. Amplitude envelope acoustic similarity analyses of the same utterance pairs showed that convergence occurred in dyads with shorter completion times and lower error rates. Together, these results suggest that while speech convergence is a highly variable behavior, it may occur more in contexts of low cognitive load. The relevance of these results for the current automatic and socially-driven models of convergence is discussed.

Hyper-resolution hydrological modeling: Completeness of Formulation, Appropriateness of Descritization, and Physical LImits of Predictability

NASA Astrophysics Data System (ADS)

Ogden, F. L.

2017-12-01

HIgh performance computing and the widespread availabilities of geospatial physiographic and forcing datasets have enabled consideration of flood impact predictions with longer lead times and more detailed spatial descriptions. We are now considering multi-hour flash flood forecast lead times at the subdivision level in so-called hydroblind regions away from the National Hydrography network. However, the computational demands of such models are high, necessitating a nested simulation approach. Research on hyper-resolution hydrologic modeling over the past three decades have illustrated some fundamental limits on predictability that are simultaneously related to runoff generation mechanism(s), antecedent conditions, rates and total amounts of precipitation, discretization of the model domain, and complexity or completeness of the model formulation. This latter point is an acknowledgement that in some ways hydrologic understanding in key areas related to land use, land cover, tillage practices, seasonality, and biological effects has some glaring deficiencies. This presentation represents a review of what is known related to the interacting effects of precipitation amount, model spatial discretization, antecedent conditions, physiographic characteristics and model formulation completeness for runoff predictions. These interactions define a region in multidimensional forcing, parameter and process space where there are in some cases clear limits on predictability, and in other cases diminished uncertainty.

Micro-Macro Coupling in Plasma Self-Organization Processes during Island Coalescence

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

Wan Weigang; Lapenta, Giovanni; Centrum voor Plasma-Astrofysica, Departement Wiskunde, Katholieke Universiteit Leuven, Celestijnenlaan 200B, 3001 Leuven

The collisionless island coalescence process is studied with particle-in-cell simulations, as an internal-driven magnetic self-organization scenario. The macroscopic relaxation time, corresponding to the total time required for the coalescence to complete, is found to depend crucially on the scale of the system. For small-scale systems, where the macroscopic scales and the dissipation scales are more tightly coupled, the relaxation time is independent of the strength of the internal driving force: the small-scale processes of magnetic reconnection adjust to the amount of the initial magnetic flux to be reconnected, indicating that at the microscopic scales reconnection is enslaved by the macroscopicmore » drive. However, for large-scale systems, where the micro-macro scale separation is larger, the relaxation time becomes dependent on the driving force.« less

Bi-Objective Flexible Job-Shop Scheduling Problem Considering Energy Consumption under Stochastic Processing Times.

PubMed

Yang, Xin; Zeng, Zhenxiang; Wang, Ruidong; Sun, Xueshan

2016-01-01

This paper presents a novel method on the optimization of bi-objective Flexible Job-shop Scheduling Problem (FJSP) under stochastic processing times. The robust counterpart model and the Non-dominated Sorting Genetic Algorithm II (NSGA-II) are used to solve the bi-objective FJSP with consideration of the completion time and the total energy consumption under stochastic processing times. The case study on GM Corporation verifies that the NSGA-II used in this paper is effective and has advantages to solve the proposed model comparing with HPSO and PSO+SA. The idea and method of the paper can be generalized widely in the manufacturing industry, because it can reduce the energy consumption of the energy-intensive manufacturing enterprise with less investment when the new approach is applied in existing systems.

Bi-Objective Flexible Job-Shop Scheduling Problem Considering Energy Consumption under Stochastic Processing Times

PubMed Central

Zeng, Zhenxiang; Wang, Ruidong; Sun, Xueshan

2016-01-01

This paper presents a novel method on the optimization of bi-objective Flexible Job-shop Scheduling Problem (FJSP) under stochastic processing times. The robust counterpart model and the Non-dominated Sorting Genetic Algorithm II (NSGA-II) are used to solve the bi-objective FJSP with consideration of the completion time and the total energy consumption under stochastic processing times. The case study on GM Corporation verifies that the NSGA-II used in this paper is effective and has advantages to solve the proposed model comparing with HPSO and PSO+SA. The idea and method of the paper can be generalized widely in the manufacturing industry, because it can reduce the energy consumption of the energy-intensive manufacturing enterprise with less investment when the new approach is applied in existing systems. PMID:27907163

Muscle enzyme release does not predict muscle function impairment after triathlon.

PubMed

Margaritis, I; Tessier, F; Verdera, F; Bermon, S; Marconnet, P

1999-06-01

We sought to determine the effects of a long distance triathlon (4 km swim, 120 km bike-ride, and 30 km run) on the four-day kinetics of the biochemical markers of muscle damage, and whether they were quantitatively linked with muscle function impairment and soreness. Data were collected from 2 days before until 4 days after the completion of the race. Twelve triathletes performed the triathlon and five did not. Maximal voluntary contraction (MVC), muscle soreness (DOMS) and total serum CK, CK-MB, LDH, AST and ALT activities were assessed. Significant changes after triathlon completion were found for all muscle damage indirect markers over time (p < 0.0001). MVC of the knee extensor and flexor muscles decreased over time (p < 0.05). There is disparity in the time point at which peak values where reached for DOMS, MVC and enzyme leakage. There is no correlation between serum enzyme leakage, DOMS and MVC impairment which occur after triathlon. Long distance triathlon race caused muscle damage, but extent, as well as muscle recovery cannot be evaluated by the magnitude of changes in serum enzyme activities. Muscle enzyme release cannot be used to predict the magnitude of the muscle function impairment caused by muscle damage.

Structuralized box-trainer laparoscopic training significantly improves performance in complex virtual reality laparoscopic tasks.

PubMed

Laski, Dariusz; Stefaniak, Tomasz J; Makarewicz, Wojciech; Proczko, Monika; Gruca, Zbigniew; Sledziński, Zbigniew

2012-03-01

In the era of flowering minimally invasive surgical techniques there is a need for new methods of teaching surgery and supervision of progress in skills and expertise. Virtual and physical box-trainers seem especially fit for this purpose, and allow for improvement of proficiency required in laparoscopic surgery. The study included 34 students who completed the authors' laparoscopic training on physical train-boxes. Progress was monitored by accomplishment of 3 exercises: moving pellets from one place to another, excising and clipping. Analysed parameters included time needed to complete the exercise and right and left hand movement tracks. Students were asked to do assigned tasks prior to, in the middle and after the training. The duration of the course was 28 h in total. Significant shortening of the time to perform each exercise and reduction of the left hand track were achieved. The right hand track was shortened only in exercise number 1. Exercises in the laboratory setting should be regarded as an important element of the process of skills acquisition by a young surgeon. Virtual reality laparoscopic training seems to be a new, interesting educational tool, and at the same time allows for reliable control and assessment of progress.

The management of peripheral facial nerve palsy: "paresis" versus "paralysis" and sources of ambiguity in study designs.

PubMed

Linder, Thomas E; Abdelkafy, Wael; Cavero-Vanek, Sandra

2010-02-01

Conservative management of idiopathic or herpetic acute peripheral facial palsy (herpes zoster oticus, HZO) often leads to a favorable outcome. However, recent multicenter studies have challenged the necessity of antivirals. Whereas large numbers of patients are required to reveal statistical differences in a disease with an overall positive outcome, surprisingly few studies differentiate between patients with paresis and paralysis. Analyzing our own prospective cohort of patients and reviewing the current literature on conservative treatment of Bell's palsy and HZO, we reveal the importance of initial baseline assessment of the disease course to predict the outcome and to validate the impact of medical treatment options. STUDY DESIGN AND DATA SOURCE: Prospective analysis of consecutive patients referred to 2 tertiary referral centers and research on the Cochrane Library for current updates of their previous reviews and search of MEDLINE (1976-2009) for randomized trials on conservative treatment of acute facial palsy were conducted. One hundred ninety-six patients with Bell's palsy or HZO were followed up prospectively until complete recovery or at least for 12 months. The numeric Fisch score (FS) was used to classify facial function, and patients were separated between incomplete palsy (=paresis) and complete paralysis. Electroneuronography (ENoG) was used to further subdivide patients with paralysis. The treatment protocol was independent of the ongoing investigation including prednisone and valacyclovir in most patients. A total of 250 previous studies on facial palsy outcome were evaluated regarding their distinction between different severity scores at baseline and its impact on treatment outcome. Trials not making the distinction between paresis and paralysis at baseline and with an insufficient follow-up of less than 12 months were excluded. In the Bell's and HZO paresis group, all except 1 patient recovered completely, most of them within 3 months, independent of the treatment regimen. In the Bell's paralysis group, 38 patients (70%) recovered completely after 1 year, including 94% of patients with a denervation by ENoG of less than 90%. Thirty percent of Bell's paralysis patients recovered incompletely, revealing the worst outcome in patients with a 100% denervation on ENoG. None of the 4 patients with HZO and ENoG denervation of more than 90% recovered to normal facial function. We found a highly significant difference regarding the time course and final outcome in patients with incomplete palsies versus total paralysis; however, only 3 of 250 studies make this distinction. The time course for improvement and the extent of recovery is significantly different in patients presenting with an incomplete facial nerve paresis compared with patients with a total paralysis. Whereas the term "palsy" includes both entities, the term "paralysis" should only be used to describe total loss of nerve function. Patients with incomplete acute Bell's palsy (paresis) should start to improve their facial function early (1-2 wk after onset) and are expected to recover completely within 3 months. These patients do not benefit from antiviral medications and most likely do not profit from systemic steroids. Mixing patients with different severity of palsies will always lead to controversial results.