[Incidence of non-communicable diseases and health risks due to potable water quality].

PubMed

Skudarnov, S E; Kurkatov, S V

2011-01-01

Iron and fluorine concentrations and water mineralization and hardness, which exceeded the maximum allowable concentrations, were found to cause an increase in overall morbidity and morbidity from skeletal-and-muscular, urogenital, and digestive system involvement in the population of the Krasnoyarsk Region. A quantitative relationship were found between the concentrations of iron, the hardness and dry residue of water and the incidence rates of urogenital, skeletal-and-muscular and digestive diseases. The consumption of potable water contaminated with chloroform and methane tetrachloride presents unacceptable carcinogenic risks to the population of the Krasnoyarsk Region.

Deviant Behavior in Higher Educational Institutions of the Central Federal District and the Northwestern Federal District: Causes, Scale, Varieties, and Prospects of Control and Prevention

ERIC Educational Resources Information Center

Talanov, S. L.

2014-01-01

Corruption and other forms of unacceptable behavior in Russian universities frequently is the result of poor conditions of work, low salaries, and inadequate administrative and oversight structures. A thorough reform and reorganization of institutions of higher education should go a long way to reducing the incidence of this behavior. [This…

Occurrence of Organic Wastewater Contaminants, Pharmaceuticals, and Personal Care Products in Selected Water Supplies, Cape Cod, Massachusetts, June 2004

DTIC Science & Technology

2005-01-01

previously detected high nitrate concen- trations. (Phenol and d- limonene , detected in equipment blanks at unacceptably high concentrations, are not...both tables, were not counted twice. (Phenol and d- limonene , detected in equipment blanks at unaccept- ably high concentrations, are not included in...The surrogate recoveries (not included in table 2) for the PPCP method were 101 and 102 percent. Three compounds, d- limonene , phenol, and

Pathway to care for drug resistant tuberculosis cases identified during a retrospective study conducted in high TB burden wards in Mumbai

PubMed Central

Lobo, Eunice; Shah, Shimoni; Rangan, Sheela; Dholakia, Yatin; Mistry, Nerges

2018-01-01

Background: Mumbai is witnessing a rising incidence of all forms of drug resistant tuberculosis (DR-TB). Methods: A population-based, retrospective study was conducted between April and July 2014, in 15 high TB burden wards in Mumbai, to capture the patient pathways to TB care. A total of 23 DR-TB patients were identified and their pathways to access DR-TB care were recorded using semi-structured interviews. Results: The total DR-TB pathway time of new patients (who did not report any past episode of TB) (180 days; IQR 123,346) was found to be more than twice that of retreatment patients (who reported a past episode of TB) (69 days; IQR 42,128). Conclusions: The unacceptable delay for diagnosis and treatment of DR-TB in Mumbai advocates for consistent implementation of early screening of patients using rapid gene-based technologies. PMID:29863175

Pathway to care for drug resistant tuberculosis cases identified during a retrospective study conducted in high TB burden wards in Mumbai.

PubMed

Lobo, Eunice; Shah, Shimoni; Rangan, Sheela; Dholakia, Yatin; Mistry, Nerges

2018-05-10

Background: Mumbai is witnessing a rising incidence of all forms of drug resistant tuberculosis (DR-TB). Methods: A population-based, retrospective study was conducted between April and July 2014, in 15 high TB burden wards in Mumbai, to capture the patient pathways to TB care. A total of 23 DR-TB patients were identified and their pathways to access DR-TB care were recorded using semi-structured interviews. Results: The total DR-TB pathway time of new patients (who did not report any past episode of TB) (180 days; IQR 123,346) was found to be more than twice that of retreatment patients (who reported a past episode of TB) (69 days; IQR 42,128). Conclusions: The unacceptable delay for diagnosis and treatment of DR-TB in Mumbai advocates for consistent implementation of early screening of patients using rapid gene-based technologies.

Incidence and Outcomes of Positive Donor Corneoscleral Rim Fungal Cultures after Keratoplasty.

PubMed

Vislisel, Jesse M; Goins, Kenneth M; Wagoner, Michael D; Schmidt, Gregory A; Aldrich, Benjamin T; Skeie, Jessica M; Reed, Cynthia R; Zimmerman, M Bridget; Greiner, Mark A

2017-01-01

To determine the incidence of positive corneoscleral donor rim fungal cultures after keratoplasty and to report clinical outcomes of grafts with culture-positive donor rims. Retrospective cohort study. Consecutive donor corneas and keratoplasty recipients at a single tertiary referral center over 20 years. Patient charts were reviewed to determine the incidence of positive donor rim fungal cultures and clinical outcomes of all grafts using contaminated tissue. The primary outcome measures were positive donor rim fungal culture results and the development of postkeratoplasty fungal infection using corresponding corneal tissue. The secondary outcome measure was the impact of postoperative prophylaxis on donor tissue-associated infections. A total of 3414 keratoplasty cases were included in the statistical analysis. Seventy-one cases (2.1%) were associated with a fungal culture-positive donor rim. Candida species were cultured in 40 cases (56.3%). There was a higher incidence of positive rim cultures over the last 5 years of the analytic period compared with the first 15 years (P = 0.018). Fungal keratitis developed in 4 cases (5.6%), and all patients required further surgical intervention to achieve cure. There were no cases of fungal endophthalmitis. Empiric antimycotic prophylaxis initiated at the time of positive culture result reduced the incidence of keratitis from 15.8% in untreated cases to 1.9% in treated cases (P = 0.056). Positive donor rim fungal cultures are uncommon, but carry an unacceptably high risk of postoperative fungal infection. This risk may be reduced with prophylactic antimycotic therapy when culture-positive donor rims are identified. Copyright © 2016 American Academy of Ophthalmology. All rights reserved.

NASA-ONERA Collaboration on Human Factors in Aviation Accidents and Incidents

NASA Technical Reports Server (NTRS)

Srivastava, Ashok N.; Fabiani, Patrick

2012-01-01

This is the first annual report jointly prepared by NASA and ONERA on the work performed under the agreement to collaborate on a study of the human factors entailed in aviation accidents and incidents, particularly focused on the consequences of decreases in human performance associated with fatigue. The objective of this agreement is to generate reliable, automated procedures that improve understanding of the levels and characteristics of flight-crew fatigue factors whose confluence will likely result in unacceptable crew performance. This study entails the analyses of numerical and textual data collected during operational flights. NASA and ONERA are collaborating on the development and assessment of automated capabilities for extracting operationally significant information from very large, diverse (textual and numerical) databases; much larger than can be handled practically by human experts.

Bioabsorbable poly-L/D-lactide (96/4) scaffold arthroplasty (RegJoint™) for trapeziometacarpal osteoarthritis: a 3-year follow-up study.

PubMed

Mattila, Simo; Ainola, Mari; Waris, Eero

2018-05-01

The poly-L/D-lactide joint scaffold (RegJoint™) has recently been associated with adverse tissue reactions and osteolysis after partial trapeziectomy for trapeziometacarpal osteoarthritis. Twenty-two of 23 patients previously operated on with this scaffold were re-examined at a mean follow-up of 3.3 years (range 36-53 months). Overall, the results showed an unacceptably high rate of adverse tissue reactions related to the degradation process of the implant, resulting in a revision procedure in three patients. At final follow-up, at which point the implant had completely degraded, there were no signs of ongoing adverse tissue reactions. There was a significant decrease in pain, increase in strength and subjective improvement in function at final follow-up compared with the pre-operative results in patients who had not undergone revision surgery. However, owing to the high incidence of adverse tissue reactions, the use of the implant has been discontinued in the treatment of trapeziometacarpal osteoarthritis. IV.

[A Systematic Review to Identify Unacceptable Intake Levels of Vitamin B6 among Patients Taking Levodopa].

PubMed

Sato, Yoko; Yasumiishi, Chiaki; Chiba, Tsuyoshi; Umegaki, Keizo

2017-01-01

The interaction of levodopa and vitamin B6 is a well-known issue. This study investigated the incidence of unacceptable intake levels of vitamin B6 among levodopa users by means of a systematic review. We searched two databases (PubMed and "Igaku Chuo Zasshi") for articles about adverse events due to the interaction of levodopa and vitamin B6 published up to August 2017. Of 98 citations retrieved, 11 studies met the selection criteria. The results indicated that a vitamin B6 intake level of more than 50 mg/day could reduce the efficacy of levodopa. The recommended intake of vitamin B6 for Japanese adults is 1.4 mg/day for men and 1.2 mg/day for women. Therefore, the acceptable intake of vitamin B6 for levodopa patients would be within the range of the recommended intake level, which is also within the usual range in foods in Japan, except for dietary supplements or health foods. Levodopa users should be cautious about taking dietary supplements and over-the-counter drugs.

Cascade aeroacoustics including steady loading effects

NASA Astrophysics Data System (ADS)

Chiang, Hsiao-Wei D.; Fleeter, Sanford

A mathematical model is developed to analyze the effects of airfoil and cascade geometry, steady aerodynamic loading, and the characteristics of the unsteady flow field on the discrete frequency noise generation of a blade row in an incompressible flow. The unsteady lift which generates the noise is predicted with a complex first-order cascade convected gust analysis. This model was then applied to the Gostelow airfoil cascade and variations, demonstrating that steady loading, cascade solidity, and the gust direction are significant. Also, even at zero incidence, the classical flat plate cascade predictions are unacceptable.

Road traffic injury on rural roads in Tanzania: measuring the effectiveness of a road safety program.

PubMed

Zimmerman, Karen; Jinadasa, Deepani; Maegga, Bertha; Guerrero, Alejandro

2015-01-01

Road traffic injuries (RTIs) are a major public health burden, especially in low- and middle-income countries. There is limited data on RTIs in low-volume, rural African settings. This study attempted to survey all individuals living in households within 200 m of two low-volume rural roads in Tanzania and to collect data on RTIs. Local communities and users of the Bago to Talawanda road (intervention site) and Kikaro to Mihuga road (control site) were targeted and received an intensive program of road safety measures tailored using the crash characteristics of the baseline sample. Demographic data on all household members were collected, and those individuals who suffered an RTI in the previous 3 months had comprehensive information collected about the crash characteristics and the socioeconomic impact. The follow-up data collection occurred nine months after the baseline data were collected. The majority of crashes that caused an RTI involved a motorcycle (71%) and the majority of victims were male (82%) with an average age of 27. Injuries to the legs (55%) were most common and the average length of time away from normal activity was 27 (±33) days. RTI incidence at the intervention site increased during the course of the study (incidence before vs. incidence after) and was unchanged in the community control (incidence before vs. incidence after). The incidence of RTIs in the low-volume rural setting is unacceptably high and most commonly associated with motorcycles. The change in incidence is unreliable due to logistic restraints of the project and more research is needed to quantify the impact of various RTI prevention strategies in this setting. This study provides insight into road traffic injuries on low-volume rural roads, areas where very little research has been captured. Additionally, it provides a replicable study design for those interested in collecting similar data on low-volume rural roads.

The spectrum of medical errors: when patients sue

PubMed Central

Kels, Barry D; Grant-Kels, Jane M

2012-01-01

Inarguably medical errors constitute a serious, dangerous, and expensive problem for the twenty-first-century US health care system. This review examines the incidence, nature, and complexity of alleged medical negligence and medical malpractice. The authors hope this will constitute a road map to medical providers so that they can better understand the present climate and hopefully avoid the “Scylla and Charybdis” of medical errors and medical malpractice. Despite some documented success in reducing medical errors, adverse events and medical errors continue to represent an indelible stain upon the practice, reputation, and success of the US health care industry. In that regard, what may be required to successfully attack the unacceptably high severity and volume of medical errors is a locally directed and organized initiative sponsored by individual health care organizations that is coordinated, supported, and guided by state and federal governmental and nongovernmental agencies. PMID:22924008

The future of mechanical circulatory support for advanced heart failure.

PubMed

Marinescu, Karolina K; Uriel, Nir; Adatya, Sirtaz

2016-05-01

Mechanical circulatory support (MCS) has become the main focus of heart replacement therapy for end stage heart failure patients. Advances in technology are moving towards miniaturization, biventricular support devices, complete internalization, improved hemocompatibility profiles, and responsiveness to cardiac loading conditions. This review will discuss the recent advances and investigational devices in MCS for advanced heart failure. The demand for both short-term and long-term durable devices for advanced heart failure is increasing. The current devices are still fraught with an unacceptably high incidence of gastrointestinal bleeding and thromboembolic and infectious complications. New devices are on the horizon focusing on miniaturization, versatility for biventricular support, improved hemocompatibility, use of alternate energy sources, and incorporation of continuous hemodynamic monitoring. The role for MCS in advanced heart replacement therapy is steadily increasing. With the advent of newer generation devices on the horizon, the potential exists for MCS to surpass heart transplantation as the primary therapy for advanced heart failure.

Effects of conversation interference on annoyance due to aircraft noise

NASA Technical Reports Server (NTRS)

Key, K. F.; Powell, C. A.

1980-01-01

The annoyance and interference effects of aircraft flyover noise on face to face conversation were investigated. Twenty 5 minute sessions, each composed of three flyovers, were presented to each of 20 pairs of female subjects in a simulated living room. Flyovers varied in peak noise level (55-79 dB, A-weighted) and spectrum (low or high frequency components). Subjects engaged in conversation for 10 sessions and in reverie for the other 10 sessions, and completed subjective ratings following every session. Annoyance was affected by noise level, but was not significantly different for the two activities of reverie and conversation. A noise level of 77 db was found unacceptable for conversation by 50 percent of the subjects. Conversation interference was assessed by incidence of increased vocal effort and/or interruption of conversation during flyovers. Although conversation interference increased with noise level, the conversation interference measures did not improve prediction of individual annoyance judgments.

The global response to HIV in men who have sex with men.

PubMed

Beyrer, Chris; Baral, Stefan D; Collins, Chris; Richardson, Eugene T; Sullivan, Patrick S; Sanchez, Jorge; Trapence, Gift; Katabira, Elly; Kazatchkine, Michel; Ryan, Owen; Wirtz, Andrea L; Mayer, Kenneth H

2016-07-09

Gay, bisexual, and other men who have sex with men (MSM) continue to have disproportionately high burdens of HIV infection in countries of low, middle, and high income in 2016. 4 years after publication of a Lancet Series on MSM and HIV, progress on reducing HIV incidence, expanding sustained access to treatment, and realising human rights gains for MSM remains markedly uneven and fraught with challenges. Incidence densities in MSM are unacceptably high in countries as diverse as China, Kenya, Thailand, the UK, and the USA, with substantial disparities observed in specific communities of MSM including young and minority populations. Although some settings have achieved sufficient coverage of treatment, pre-exposure prophylaxis (PrEP), and human rights protections for sexual and gender minorities to change the trajectory of the HIV epidemic in MSM, these are exceptions. The roll-out of PrEP has been notably slow and coverage nowhere near what will be required for full use of this new preventive approach. Despite progress on issues such as marriage equality and decriminalisation of same-sex behaviour in some countries, there has been a marked increase in anti-gay legislation in many countries, including Nigeria, Russia, and The Gambia. The global epidemic of HIV in MSM is ongoing, and global efforts to address it remain insufficient. This must change if we are ever to truly achieve an AIDS-free generation. Copyright © 2016 Elsevier Ltd. All rights reserved.

Mechanical Ventilation as a Therapeutic Tool to Reduce ARDS Incidence.

PubMed

Nieman, Gary F; Gatto, Louis A; Bates, Jason H T; Habashi, Nader M

2015-12-01

Trauma, hemorrhagic shock, or sepsis can incite systemic inflammatory response syndrome, which can result in early acute lung injury (EALI). As EALI advances, improperly set mechanical ventilation (MV) can amplify early injury into a secondary ventilator-induced lung injury that invariably develops into overt ARDS. Once established, ARDS is refractory to most therapeutic strategies, which have not been able to lower ARDS mortality below the current unacceptably high 40%. Low tidal volume ventilation is one of the few treatments shown to have a moderate positive impact on ARDS survival, presumably by reducing ventilator-induced lung injury. Thus, there is a compelling case to be made that the focus of ARDS management should switch from treatment once this syndrome has become established to the application of preventative measures while patients are still in the EALI stage. Indeed, studies have shown that ARDS incidence is markedly reduced when conventional MV is applied preemptively using a combination of low tidal volume and positive end-expiratory pressure in both patients in the ICU and in surgical patients at high risk for developing ARDS. Furthermore, there is evidence from animal models and high-risk trauma patients that superior prevention of ARDS can be achieved using preemptive airway pressure release ventilation with a very brief duration of pressure release. Preventing rather than treating ARDS may be the way forward in dealing with this recalcitrant condition and would represent a paradigm shift in the way that MV is currently practiced.

5 CFR 432.105 - Proposing and taking action based on unacceptable performance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... unacceptable performance. 432.105 Section 432.105 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PERFORMANCE BASED REDUCTION IN GRADE AND REMOVAL ACTIONS § 432.105 Proposing and taking action based on unacceptable performance. (a) Proposing action based on unacceptable performance...

Effect of biological type of cattle on the incidence of the dark, firm, and dry condition in the longissimus muscle.

PubMed

Shackelford, S D; Koohmaraie, M; Wheeler, T L; Cundiff, L V; Dikeman, M E

1994-02-01

The objectives of this experiment were to characterize longissimus muscle color, texture, and firmness for beef carcasses of diverse biological types and to determine the genetic parameters of lean color, texture, and firmness. The carcasses (n = 3,641) used in this experiment were from steers produced by mating Angus, Brahman, Braunvieh, Charolais, Chianina, Galloway, Gelbvieh, Hereford, Jersey, Limousin, Longhorn, Maine Anjou, Nellore, Piedmontese, Pinzgauer, Red Poll, Sahiwal, Salers, Shorthorn, Simmental, South Devon, and Tarentaise sires to Hereford and Angus dams. Steers were fed a corn-corn silage diet from weaning until slaughter at 356 to 575 d of age. Steers were slaughtered at commercial packing plants and longissimus muscle color, texture, and firmness were scored by trained carcass evaluators. Sire line least squares means for lean color, texture, and firmness ranged approximately one unit on a 7-point scale. Chianina crosses had darker-colored lean than all breed groups except Tarentaise and Simmental crosses (P < .05). Moreover, a higher percentage (P < .05) of Chianina crosses than of all other breed groups had unacceptably dark-colored ("dark red" or darker) lean. Bos indicus sire lines were not different from Bos taurus sire lines in frequency of carcasses with unacceptably dark-colored lean. However, Bos indicus crosses were more likely to be scored "very light cherry-red." Lean color and texture were lowly heritable, whereas lean firmness was moderately heritable. Thus, this experiment demonstrated that there is genetic variation in the incidence of the DFD condition; however, genetic variation was small relative to environmental variation.

40 CFR Appendix M to Subpart G - Unacceptable Substitutes Listed in the September 30, 2004 Final Rule, Effective November 29, 2004

Code of Federal Regulations, 2010 CFR

2010-07-01

... —Rigid polyurethane slabstock and other foams —Polystyrene extruded insulation boardstock and billet...—Unacceptable Substitutes Listed in the September 30, 2004 Final Rule, Effective November 29, 2004 Foam Blowing—Unacceptable Substitutes End-use Substitute Decision Comments All foam end-uses: HCFC-141b Unacceptable...

40 CFR Appendix M to Subpart G - Unacceptable Substitutes Listed in the September 30, 2004 Final Rule, Effective November 29, 2004

Code of Federal Regulations, 2012 CFR

2012-07-01

... —Rigid polyurethane slabstock and other foams —Polystyrene extruded insulation boardstock and billet...—Unacceptable Substitutes Listed in the September 30, 2004 Final Rule, Effective November 29, 2004 Foam Blowing—Unacceptable Substitutes End-use Substitute Decision Comments All foam end-uses: HCFC-141b Unacceptable...

40 CFR Appendix M to Subpart G - Unacceptable Substitutes Listed in the September 30, 2004 Final Rule, Effective November 29, 2004

Code of Federal Regulations, 2011 CFR

2011-07-01

... —Rigid polyurethane slabstock and other foams —Polystyrene extruded insulation boardstock and billet...—Unacceptable Substitutes Listed in the September 30, 2004 Final Rule, Effective November 29, 2004 Foam Blowing—Unacceptable Substitutes End-use Substitute Decision Comments All foam end-uses: HCFC-141b Unacceptable...

Development and Operation of Arrays of TES x-ray Microcalorimeters Suitable for Constellation-X

NASA Technical Reports Server (NTRS)

Kilbourne, C. A.; Bandler, S. R.; Brown, A. D.; Chervenak, J. A.; Eckart, M. E.; Finkbeiner, F. M.; Iyomoto, N.; Kelley, R. L.; Porter, F. S.; Smith, S. J.;

Maintenance and Testing of Fume Cupboard

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

Hussein, Falah H.; Al-Dahhan, Wedad H.; Al-Zuhairi, Ali Jassim

Scientists at universities across Iraq are actively working to report actual incidents and accidents occurring in their laboratories, as well as structural improvements made to improve safety and security, to raise awareness and encourage openness, leading to widespread adoption of robust Chemical Safety and Security (CSS) practices. This manuscript highlights the importance of periodic maintenance on fume cupboards, and is the fourth in a series of five case studies describing laboratory incidents, accidents, and laboratory improvements. In this study, we describe a situation in which the ventilation capacity of the fume cupboard in the undergraduate chemistry laboratories at Al-Nahrain Universitymore » had decreased to an unacceptable level. The CSS Committee investigated and found the ducting system had been blocked by plastic sheets and dead birds. All the ducts have since been cleaned, and four extra ventilation fans have been installed to further increase ventilation capacity. By openly sharing what happened along with the lessons learned from the accident, we hope to minimize the possibility of another researcher being injured in a similar incident in the future.« less

[Natural history of cholelithiasis and incidence of cholecystectomy in an urban and a Mapuche rural area].

PubMed

Pérez-Ayuso, Rosa María; Hernández, Verónica; González, Berta; Carvacho, Claudia; Navarrete, Carlos; Alvarez, Manuel; González, Robinson; Marshall, Guillermo; Miquel, Juan Francisco; Nervi, Flavio

2002-07-01

Cholelithiasis is the second cause of hospital admissions in Chile. To study the prevalence of symptomatic gallstone disease and opportunity of cholecystectomy in La Florida, Santiago and among Mapuche Indians in Huapi Island. In the period 2000-2001, we contacted to 71% (1127 subjects) and to 61% (145 subjects) patients of La Florida and Huapi Island, respectively, that had previously participated in an epidemiological study on cholelithiasis in 1993. We defined symptomatic gallstone patients as those with a history of biliary colic. Each patient was subjected to gallbladder ultrasound. In 1993, 30-35% of gallstone patients were symptomatic (approximately 70% women). During the lapse 1993-2001, only 50% of subjects from La Florida and 25% of patients from Huapi Island were cholecystectomized (p < 0.05). Fifty percent of cholecystectomies were emergency operations. In 38 symptomatic Mapuche Indians from Huapi, cholecystectomy was indicated in 2001. After five months of the indication, only one of these subjects had been operated. Laparoscopic cholecystectomy represented 40% of all cholecystectomies performed in the National Health Service Hospitals. This study demonstrates an unacceptable high prevalence of symptomatic gallstone patients remaining non-operated in both the urban and rural communities. This reciprocally correlates with the high frequency of emergency cholecystectomies and the high incidence of gallbladder cancer among Chileans. This study contrasts negatively with the situation of Scotland, where 73.5% of cholecystectomies were laparoscopic in 1998-1999. To reach Scotland standards, the Chilean Public Health System should increase the number of cholecystectomies from 27,000 in 2001 to 57,510

Characterizing the Benefits of Seismic Isolation for Nuclear Structures: A Framework for Risk-Based Decision Making

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

Bolisetti, Chandrakanth; Yu, Chingching; Coleman, Justin

This report provides a framework for assessing the benefits of seismic isolation and exercises the framework on a Generic Department of Energy Nuclear Facility (GDNF). These benefits are (1) reduction in the risk of unacceptable seismic performance and a dramatic reduction in the probability of unacceptable performance at beyond-design basis shaking, and (2) a reduction in capital cost at sites with moderate to high seismic hazard. The framework includes probabilistic risk assessment and estimates of overnight capital cost for the GDNF.

Fuel processor temperature monitoring and control

DOEpatents

Keskula, Donald H.; Doan, Tien M.; Clingerman, Bruce J.

2002-01-01

In one embodiment, the method of the invention monitors one or more of the following conditions: a relatively low temperature value of the gas stream; a relatively high temperature value of the gas stream; and a rate-of-change of monitored temperature. In a preferred embodiment, the rate of temperature change is monitored to prevent the occurrence of an unacceptably high or low temperature condition. Here, at least two temperatures of the recirculating gas stream are monitored over a period of time. The rate-of-change of temperature versus time is determined. Then the monitored rate-of-change of temperature is compared to a preselected rate-of-change of value. The monitoring of rate-of-change of temperature provides proactive means for preventing occurrence of an unacceptably high temperature in the catalytic reactor.

Sociodemographic and geographical inequalities in notifiable infectious diseases in Australia: a retrospective analysis of 21 years of national disease surveillance data.

PubMed

Gibney, Katherine B; Cheng, Allen C; Hall, Robert; Leder, Karin

2017-01-01

Australia is a high-income country with a well established and largely publicly funded health-care system. However, some populations within Australia have shorter life expectancy and worse health outcomes than others. We explored geographical variations and sociodemographic inequities in infectious disease notifications in Australia. In this retrospective study, we analysed National Notifiable Diseases Surveillance System (NNDSS) notifications from 1991-2011 (n=2·4 million). We assessed the effect of socioeconomic disadvantage and remoteness of residence on national notification incidence. We calculated Gini coefficients, adjusted relative risks (aRRs), population attributable fractions (PAFs), and attributable notifications. We reported aRRs for Indigenous status in three jurisdictions with more than 75% completeness of Indigenous status reporting from the Northern Territory, South Australia, and Western Australia. Of the eight most commonly notified diseases from Jan 1, 1991, to Dec 31, 2011, gonococcal infection was the most geographically unequal and campylobacteriosis was the most evenly distributed across the country. Overall, notification incidence was higher in remote and very remote areas than in major cities (aRR 3·37), and higher in the most socioeconomically disadvantaged quintiles compared with less disadvantaged quintiles (aRR 1·15). The PAF for socioeconomic disadvantage was high for blood-borne viral hepatitis but decreased in other disease groups. In 2011, sexually transmitted infections had 11 093 notifications attributed to remoteness and 5597 notifications attributable to socioeconomic disadvantage. Notification incidence was higher in Indigenous than in non-Indigenous Australians (aRR 5·3). All diseases had differing geographical concentration and sociodemographic risk. Overall, sociodemographic inequities in infectious disease notifications have decreased, but remain unacceptably high. National communicable disease control is complex, requiring both targeted and population-wide interventions. None. Copyright © 2017 Elsevier Ltd. All rights reserved.

A comparison of spacecraft penetration hazards due to meteoroids and manmade earth-orbiting objects

NASA Technical Reports Server (NTRS)

Brooks, D. R.

1976-01-01

The ability of a typical double-walled spacecraft structure to protect against penetration by high-velocity incident objects is reviewed. The hazards presented by meteoroids are compared to the current and potential hazards due to manmade orbiting objects. It is shown that the nature of the meteoroid number-mass relationship makes adequate protection for large space facilities a conceptually straightforward structural problem. The present level of manmade orbiting objects (an estimated 10,000 in early 1975) does not pose an unacceptable risk to manned space operations proposed for the near future, but it does produce penetration probabilities in the range of 1-10 percent for a 100-m diameter sphere in orbit for 1,000 days. The number-size distribution of manmade objects is such that adequate protection is difficult to achieve for large permanent space facilities, to the extent that future restrictions on such facilities may result if the growth of orbiting objects continues at its historical rate.

Mass-Produced, Assembly-Line Abortion—A Prime Example of Unethical, Unscientific Medicine

PubMed Central

Ford, James H.

1972-01-01

The incidence of psychologic sequelae associated with abortion cannot be established scientifically, and so continues to be disputed. Since there are no truly scientific criteria on which to make a prediction as to the psychologic outcome, it seems only proper that elective abortion be labeled “experimental,” rather than “therapeutic.” This uncertainty as to therapeutic benefit is compounded by the fact that adequate studies and information about physical sequelae are also lacking. Furthermore, preliminary statistics from the Population Council indicate that the morbidity rate of abortion performed even under proper medical auspices is unacceptably high. Viewed in this light and in relation to our own ethical code, the current practice of performing innumerable, mechanized, elective abortions can only be considered unethical. If it is argued that abortion can be ethically validated merely by surrounding it with the same controls used in other experimental procedures, then the medical profession should insist on such controls forthwith. PMID:4638411

Emotional distress in junior house officers.

PubMed Central

Firth-Cozens, J

1987-01-01

In a study of 170 junior house officers who were followed up from their fourth year in medical school mean levels of stress were higher than in other reported occupational groups, and the estimated prevalence of emotional disturbance was 50%, with 28% of the subjects showing evidence of depression. Nearly a fifth of the subjects reported occasional or frequent bouts of heavy drinking, a quarter took drugs for physical illness, and a few took drugs for recreation. Those who were emotionally distressed at the initial study and the follow up were more empathetic and more self critical than those who had low levels of stress on both occasions. Overwork was the most stressful aspect of their jobs, though the number of hours worked was not related to stress levels, unlike diet and sleep. The more stressed they were the more unfavourably they viewed aspects of their jobs. The incidence of distress is unacceptably high in junior house officers, and both they and the hospitals need to deal with the causes of the distress. PMID:3117213

40 CFR Appendix E to Subpart G of... - Unacceptable Substitutes Listed in the January 26, 1999 Final Rule, Effective January 26, 1999

Code of Federal Regulations, 2011 CFR

2011-07-01

... Refrigeration and Air-Conditioning Sector Unacceptable Substitutes End-use Substitute Decision Comments All refrigeration and air-conditioning end uses MT-31 Unacceptable Chemical contained in this blend presents...

40 CFR Appendix F to Subpart G of... - Unacceptable Substitutes Listed in the January 26, 1999 Final Rule, Effective January 26, 1999

Code of Federal Regulations, 2010 CFR

2010-07-01

... Refrigeration and Air-Conditioning Sector UnacceptabLe Substitutes End-use Substitute Decision Comments All refrigeration and air-conditioning end uses Hexafluoropropylene (HFP) and all HFP-containing blends Unacceptable...

40 CFR Appendix E to Subpart G of... - Unacceptable Substitutes Listed in the January 26, 1999 Final Rule, Effective January 26, 1999

Code of Federal Regulations, 2013 CFR

2013-07-01

... Refrigeration and Air-Conditioning Sector Unacceptable Substitutes End-use Substitute Decision Comments All refrigeration and air-conditioning end uses MT-31 Unacceptable Chemical contained in this blend presents...

40 CFR Appendix E to Subpart G of... - Unacceptable Substitutes Listed in the January 26, 1999 Final Rule, Effective January 26, 1999

Code of Federal Regulations, 2012 CFR

2012-07-01

... Refrigeration and Air-Conditioning Sector Unacceptable Substitutes End-use Substitute Decision Comments All refrigeration and air-conditioning end uses MT-31 Unacceptable Chemical contained in this blend presents...

40 CFR Appendix E to Subpart G of... - Unacceptable Substitutes Listed in the January 26, 1999 Final Rule, Effective January 26, 1999

Code of Federal Regulations, 2010 CFR

2010-07-01

... Refrigeration and Air-Conditioning Sector Unacceptable Substitutes End-use Substitute Decision Comments All refrigeration and air-conditioning end uses MT-31 Unacceptable Chemical contained in this blend presents...

40 CFR Appendix F to Subpart G of... - Unacceptable Substitutes Listed in the January 26, 1999 Final Rule, Effective January 26, 1999

Code of Federal Regulations, 2012 CFR

2012-07-01

... Refrigeration and Air-Conditioning Sector UnacceptabLe Substitutes End-use Substitute Decision Comments All refrigeration and air-conditioning end uses Hexafluoropropylene (HFP) and all HFP-containing blends Unacceptable...

40 CFR Appendix F to Subpart G of... - Unacceptable Substitutes Listed in the January 26, 1999 Final Rule, Effective January 26, 1999

Code of Federal Regulations, 2013 CFR

2013-07-01

... Refrigeration and Air-Conditioning Sector UnacceptabLe Substitutes End-use Substitute Decision Comments All refrigeration and air-conditioning end uses Hexafluoropropylene (HFP) and all HFP-containing blends Unacceptable...

40 CFR Appendix F to Subpart G of... - Unacceptable Substitutes Listed in the January 26, 1999 Final Rule, Effective January 26, 1999

Code of Federal Regulations, 2011 CFR

2011-07-01

... Refrigeration and Air-Conditioning Sector UnacceptabLe Substitutes End-use Substitute Decision Comments All refrigeration and air-conditioning end uses Hexafluoropropylene (HFP) and all HFP-containing blends Unacceptable...

40 CFR Appendix E to Subpart G of... - Unacceptable Substitutes Listed in the January 26, 1999 Final Rule, Effective January 26, 1999

Code of Federal Regulations, 2014 CFR

2014-07-01

... Refrigeration and Air-Conditioning Sector Unacceptable Substitutes End-use Substitute Decision Comments All refrigeration and air-conditioning end uses MT-31 Unacceptable Chemical contained in this blend presents...

40 CFR Appendix F to Subpart G of... - Unacceptable Substitutes Listed in the January 26, 1999 Final Rule, Effective January 26, 1999

Code of Federal Regulations, 2014 CFR

2014-07-01

... Refrigeration and Air-Conditioning Sector UnacceptabLe Substitutes End-use Substitute Decision Comments All refrigeration and air-conditioning end uses Hexafluoropropylene (HFP) and all HFP-containing blends Unacceptable...

Microbiological examination of cold ready-to-eat sliced meats from catering establishments in the United Kingdom.

PubMed

Gillespie, I; Little, C; Mitchell, R

2000-03-01

A microbiological study of cold, ready-to-eat sliced meats from 2579 catering establishments (public houses, hotels, cafés, restaurants, residential homes and other catering premises) found that 2587 of 3494 samples (74%) were of acceptable quality, 892 (26%) were of unsatisfactory quality and 15 (<1%) were of unacceptable quality. Unacceptable results were due to high levels of Escherichia coli, Staphylococcus aureus, Listeria species and/or Clostridium perfringens. Unsatisfactory results were mostly due to high Aerobic Plate Counts. The microbiological quality of cold, ready-to-eat meats was associated with meat type, premises type, management training, hygienic practices, meat supplier and length of storage. The relationship between food hygiene training and microbiological quality is discussed.

19 CFR 152.108 - Unacceptable bases of appraisement.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 19 Customs Duties 2 2013-04-01 2013-04-01 false Unacceptable bases of appraisement. 152.108 Section 152.108 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY... Merchandise § 152.108 Unacceptable bases of appraisement. For the purposes of this subpart, imported...

19 CFR 152.108 - Unacceptable bases of appraisement.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 2 2011-04-01 2011-04-01 false Unacceptable bases of appraisement. 152.108 Section 152.108 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY... Merchandise § 152.108 Unacceptable bases of appraisement. For the purposes of this subpart, imported...

19 CFR 152.108 - Unacceptable bases of appraisement.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 19 Customs Duties 2 2012-04-01 2012-04-01 false Unacceptable bases of appraisement. 152.108 Section 152.108 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY... Merchandise § 152.108 Unacceptable bases of appraisement. For the purposes of this subpart, imported...

19 CFR 152.108 - Unacceptable bases of appraisement.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 2 2010-04-01 2010-04-01 false Unacceptable bases of appraisement. 152.108 Section 152.108 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY... Merchandise § 152.108 Unacceptable bases of appraisement. For the purposes of this subpart, imported...

The characteristics of unacceptable/taboo thoughts in obsessive-compulsive disorder.

PubMed

Brakoulias, Vlasios; Starcevic, Vladan; Berle, David; Milicevic, Denise; Moses, Karen; Hannan, Anthony; Sammut, Peter; Martin, Andrew

2013-10-01

In the quest to unravel the heterogeneity of obsessive-compulsive disorder (OCD), an increasing number of factor analytic studies are recognising unacceptable/taboo thoughts as one of the symptom dimensions of OCD. This study aims to examine the characteristics associated with unacceptable/taboo thoughts. Using the Yale-Brown Obsessive-Compulsive Scale Symptom Checklist (YBOCS-SC) with 154 individuals with OCD, obsessive-compulsive symptoms were subjected to principal components analysis. The characteristics associated with the resulting symptom dimensions were then assessed using logistic and linear regression techniques. Unacceptable/taboo thoughts comprised of sexual, religious and impulsive aggressive obsessions, and mental rituals. Higher scores on an unacceptable/taboo thoughts symptom dimension were predicted by higher Y-BOCS obsession subscores, Y-BOCS time preoccupied by obsessions scores, Y-BOCS distress due to obsessions scores, importance of control of thought ratings, male gender, and having had treatment prior to entering into the study. Unacceptable/taboo thoughts were also predicted by greater levels of hostility, and a past history of non-alcohol substance dependence. An unacceptable/taboo thought symptom dimension of OCD is supported by a unique set of associated characteristics that should be considered in the assessment and treatment of individuals with these symptoms. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

Systematic review and meta-analysis: Multi-strain probiotics as adjunct therapy for Helicobacter pylori eradication and prevention of adverse events

PubMed Central

Huang, Ying; Wang, Lin; Malfertheiner, Peter

2015-01-01

Background Eradication rates with triple therapy for Helicobacter pylori infections have currently declined to unacceptable levels worldwide. Newer quadruple therapies are burdened with a high rate of adverse events. Whether multi-strain probiotics can improve eradication rates or diminish adverse events remains uncertain. Methods Relevant publications in which patients with H. pylori infections were randomized to a multi-strain probiotic or control were identified in PubMed, Cochrane Databases, and other sources from 1 January 1960–3 June 2015. Primary outcomes included eradication rates, incidence of any adverse event and the incidence of antibiotic-associated diarrhea. As probiotic efficacy is strain-specific, pooled relative risks and 95% confidence intervals were calculated using meta-analysis stratified by similar multi-strain probiotic mixtures. Results A total of 19 randomized controlled trials (20 treatment arms, n = 2730) assessing one of six mixtures of strains of probiotics were included. Four multi-strain probiotics significantly improved H. pylori eradication rates, five significantly prevented any adverse reactions and three significantly reduced antibiotic-associated diarrhea. Only two probiotic mixtures (Lactobacillus acidophilus/Bifidobacterium animalis and an eight-strain mixture) had significant efficacy for all three outcomes. Conclusions Our meta-analysis found adjunctive use of some multi-strain probiotics may improve H. pylori eradication rates and prevent the development of adverse events and antibiotic-associated diarrhea, but not all mixtures were effective. PMID:27536365

Scenario-targeted toxicity assessment through multiple endpoint bioassays in a soil posing unacceptable environmental risk according to regulatory screening values.

PubMed

Rodriguez-Ruiz, A; Etxebarria, J; Boatti, L; Marigómez, I

2015-09-01

Lanestosa is a chronically polluted site (derelict mine) where the soil (Lanestosa (LA) soil) exceeds screening values (SVs) of regulatory policies in force (Basque Country; Europe) for Zn, Pb and Cd. A scenario-targeted toxicity assessment was carried out on the basis of a multi-endpoint bioassay approach. Acute and chronic toxicity bioassays were conducted with selected test species (Vibrio fischeri, Dictyostelium discoideum, Lactuca sativa, Raphanus sativus and Eisenia fetida) in combination with chemical analysis of soils and elutriates and with bioaccumulation studies in earthworms. Besides, the toxicity profile was compared with that of the mine runoff (RO) soil and of a fresh artificially polluted soil (LAAPS) resembling LA soil pollutant profile. Extractability studies in LA soil revealed that Pb, Zn and Cd were highly available for exchange and/or release into the environment. Indeed, Pb and Zn were accumulated in earthworms and LA soil resulted to be toxic. Soil respiration, V. fischeri, vegetative and developmental cycles of D. discoideum and survival and juvenile production of E. fetida were severely affected. These results confirmed that LA soil had unacceptable environmental risk and demanded intervention. In contrast, although Pb and Zn concentrations in RO soil revealed also unacceptable risk, both metal extractability and toxicity were much lower than in LA soil. Thus, within the polluted site, the need for intervention varied between areas that posed dissimilar risk. Besides, since LAAPS, with a high exchangeable metal fraction, was the most toxic, ageing under in situ natural conditions seemingly contributed to attenuate LA soil risk. As a whole, combining multi-endpoint bioassays with scenario-targeted analysis (including leaching and ageing) provides reliable risk assessment in soils posing unacceptable environmental risk according to SVs, which is useful to optimise the required intervention measures.

Assignment of C1q-binding HLA antibodies as unacceptable HLA antigens avoids positive CDC-crossmatches prior to transplantation of deceased donor organs.

PubMed

Juhl, David; Marget, Matthias; Hallensleben, Michael; Görg, Siegfried; Ziemann, Malte

2017-03-01

Soon, a virtual crossmatch shall replace the complement-dependent cytotoxicity (CDC) allocation crossmatch in the Eurotransplant region. To prevent positive CDC-crossmatches in the recipient centre, careful definition of unacceptable antigens is necessary. For highly sensitized patients, this is difficult by CDC alone. Assignment of all antibodies detected by sensitive assays, however, could prevent organ allocation. To assess the usefulness of the Luminex C1q-assay to prevent positive CDC-crossmatches, all CDC-crossmatches performed prior to deceased kidney transplantation in a 16-month-period were reviewed. Sera causing positive crossmatches were investigated by the C1q-assay. 31 out of 1432 crossmatches (2.2%) were positive. Sera involved in 26 positive crossmatches were available. C1q-binding donor-specific antibodies were detected in 19 sera (73.1%). The other sera were from recipients without any HLA antibodies detectable by CDC or common solid phase assays. Three patients had known Non-HLA antibodies causing positive CDC-results. Four crossmatches were only weak positive. Therefore, avoidance of donors with HLA antigens against whom C1q-binding antibodies were detected would have prevented all positive crossmatches due to HLA antibodies. Provided that all HLA specificities against which antibodies are detected by the Luminex C1q-assay are considered as unacceptable antigens, CDC-crossmatches prior to transplantation might safely be omitted in many patients. They should be maintained in highly immunized patients, however, for whom assignment of all C1q-positive antibodies as unacceptable antigens could lead to a significant delay or even prevention of transplantation. Copyright © 2017 Elsevier B.V. All rights reserved.

21 CFR 1305.25 - Unaccepted and defective electronic orders.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Unaccepted and defective electronic orders. 1305... SCHEDULE I AND II CONTROLLED SUBSTANCES Electronic Orders § 1305.25 Unaccepted and defective electronic orders. (a) No electronic order may be filled if: (1) The required data fields have not been completed...

21 CFR 1305.25 - Unaccepted and defective electronic orders.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 9 2014-04-01 2014-04-01 false Unaccepted and defective electronic orders. 1305... SCHEDULE I AND II CONTROLLED SUBSTANCES Electronic Orders § 1305.25 Unaccepted and defective electronic orders. (a) No electronic order may be filled if: (1) The required data fields have not been completed...

The Effect of Distinguished Educators on Academic Gain of Louisiana Academically Unacceptable Schools

ERIC Educational Resources Information Center

Scroggins, Ruby C.

2012-01-01

The purpose of this study was to examine the degree of academic growth of Academically Unacceptable schools in Louisiana which have been assigned a Distinguished Educator. Distinguished Educators are external change agents who are placed in Academically Unacceptable schools in Louisiana. The data were generated from the Louisiana Department of…

An Experimental Evaluation of the Performance of Two Combination Pitot Pressure Probes

NASA Technical Reports Server (NTRS)

Arend, David J.; Saunders, John D.

2009-01-01

Experimental tests have been completed which recorded the ability of two combination steady state and high response time varying Pitot probe designs to accurately measure steady stagnation pressure at a single location in a flow field. Tests were conducted of double-barreled and coannular Prati probes in a 3.5 in. diameter free jet probe calibration facility from Mach 0.1 to 0.9. Geometric symmetry and pitch (-40 deg to 40 deg) and yaw (0 deg to 40 deg) angle actuation were used to fully evaluate the probes. These tests revealed that the double-barreled configuration induced error in its steady state measurement at zero incidence that increased consistently with jet Mach number to 1.1 percent at Mach 0.9. For all Mach numbers, the double-barreled probe nulled at a pitch angle of approximately 7.0 deg and provided inconsistent measurements when yawed. The double-barreled probe provided adequate measurements via both its steady state and high response tubes (within +/- 0.15 percent accuracy) over unacceptable ranges of biased pitch and inconsistent yaw angles which varied with Mach number. By comparison, the coannular probe provided accurate measurements (at zero incidence) for all jet Mach numbers as well as over a flow angularity range which varied from +/- 26.0 deg at Mach 0.3 deg to +/- 14.0 deg at Mach 0.9. Based on these results, the Prati probe is established as the preferred design. Further experimental tests are recommended to document the frequency response characteristics of the Prati probe.

Canine transurethral laser prostatectomy using a rotational technique

NASA Astrophysics Data System (ADS)

Cromeens, Douglas M.; Johnson, Douglas E.

1995-05-01

Conventional radical prostatectomy in the dog has historically been attended by unacceptably high incidence of urinary incontinence (80 - 100%). Ablation of the prostate can be accomplished in the dog by transurethral irradiation of the prostate with the Nd:YAG laser and a laterally deflecting fiber. Exposure has ranged between 40 and 60 watts for 60 seconds at 4 fixed locations. Although prostatectomies performed with the above described technique offers significant advantage over conventional prostatectomies, the high power density at each location can result in small submucosal explosions (`popcorn effect') that increase the potential for bleeding and rupture of the prostatic capsule. We describe a new technique in which the energy is applied continuously by a laser fiber rotating around a central point. Delivering 40 watts of Nd:YAG energy for 4 minutes using a new angle-delivery device (UrotekTM), we produced results comparable to those of other previously reported techniques in the canine model with two added advantages: (1) a more even application of heat resulting in no `popcorn' effect and (2) a more reliably predictable area of coagulative necrosis within a given axial plane. This technique should provide additional safety for the veterinary surgeon performing visual laser ablation of the prostate in the dog.

40 CFR Appendix M to Subpart G of... - Unacceptable Substitutes Listed in the September 30, 2004 Final Rule, Effective November 29, 2004

Code of Federal Regulations, 2014 CFR

2014-07-01

... refrigeration, and sandwich panels —Rigid polyurethane slabstock and other foams —Polystyrene extruded... 29, 2004 Foam Blowing—Unacceptable Substitutes End-use Substitute Decision Comments All foam end-uses: HCFC-141b Unacceptable Alternatives exist with lower or zero = ODP. —Rigid polyurethane and...

40 CFR Appendix M to Subpart G of... - Unacceptable Substitutes Listed in the September 30, 2004 Final Rule, Effective November 29, 2004

Code of Federal Regulations, 2013 CFR

2013-07-01

... refrigeration, and sandwich panels —Rigid polyurethane slabstock and other foams —Polystyrene extruded... 29, 2004 Foam Blowing—Unacceptable Substitutes End-use Substitute Decision Comments All foam end-uses: HCFC-141b Unacceptable Alternatives exist with lower or zero = ODP. —Rigid polyurethane and...

Catastrophic head injuries in high school and college football players.

PubMed

Boden, Barry P; Tacchetti, Robin L; Cantu, Robert C; Knowles, Sarah B; Mueller, Frederick O

2007-07-01

Catastrophic head injuries in football are rare but tragic events. To update the profile of catastrophic head injuries in high school and college football players and to describe relevant risk factors. Case series; Level of evidence, 4. We reviewed 94 incidents of severe football head injuries reported to the National Center for Catastrophic Sports Injury Research during 13 academic years (September 1989 through June 2002). In the study period there were an average of 7.23 (standard deviation = 2.05) direct high school and college catastrophic head injuries in scholastic football participants per year. There were 0.67 injuries per 100 000 (95% confidence interval: 0.54, 0.81 per 100 000) high school and 0.21 injuries per 100 000 (95% confidence interval: 0.0, 0.49 per 100 000) college participants for a risk ratio of 3.28 (95% confidence interval: 0.81, 13.3). The injuries resulted in subdural hematoma in 75 athletes, subdural hematoma with diffuse brain edema in 10 athletes, diffuse brain edema in 5 athletes, and arteriovenous malformation or aneurysm in 4 athletes. Fifty-nine percent of the contacts reported that the athlete had a history of a previous head injury, of which 71% occurred within the same season as the catastrophic event. Thirty-nine percent of the athletes (21 of 54) were playing with residual neurologic symptoms from the prior head injury. There were 8 (9%) deaths as a result of the injury, 46 (51%) permanent neurologic injuries, and 36 (40%) serious injuries with full recovery. Most players sustained a major impact to the head either from tackling or being tackled. The incidence of catastrophic head injuries in football has remained low since the advent of the modern day football helmet in the early 1970s. The incidence of catastrophic head injuries in football is dramatically higher at the high school level than at the college level. Although the reason for this discrepancy is unclear, an unacceptably high percentage of high school players were playing with residual symptoms from a prior head injury. Coaches, athletes, athletic trainers, and medical personnel need to adhere to the guideline that an athlete with any neurologic symptoms from a head injury should be strongly discouraged from returning to play.

21 CFR 1305.15 - Unaccepted and defective DEA Forms 222.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 9 2011-04-01 2011-04-01 false Unaccepted and defective DEA Forms 222. 1305.15... I AND II CONTROLLED SUBSTANCES DEA Form 222 § 1305.15 Unaccepted and defective DEA Forms 222. (a) A DEA Form 222 must not be filled if either of the following apply: (1) The order is not complete...

21 CFR 1305.15 - Unaccepted and defective DEA Forms 222.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Unaccepted and defective DEA Forms 222. 1305.15... I AND II CONTROLLED SUBSTANCES DEA Form 222 § 1305.15 Unaccepted and defective DEA Forms 222. (a) A DEA Form 222 must not be filled if either of the following apply: (1) The order is not complete...

Air and water cooled modulator

DOEpatents

Birx, Daniel L.; Arnold, Phillip A.; Ball, Don G.; Cook, Edward G.

1995-01-01

A compact high power magnetic compression apparatus and method for delivering high voltage pulses of short duration at a high repetition rate and high peak power output which does not require the use of environmentally unacceptable fluids such as chlorofluorocarbons either as a dielectric or as a coolant, and which discharges very little waste heat into the surrounding air. A first magnetic switch has cooling channels formed therethrough to facilitate the removal of excess heat. The first magnetic switch is mounted on a printed circuit board. A pulse transformer comprised of a plurality of discrete electrically insulated and magnetically coupled units is also mounted on said printed board and is electrically coupled to the first magnetic switch. The pulse transformer also has cooling means attached thereto for removing heat from the pulse transformer. A second magnetic switch also having cooling means for removing excess heat is electrically coupled to the pulse transformer. Thus, the present invention is able to provide high voltage pulses of short duration at a high repetition rate and high peak power output without the use of environmentally unacceptable fluids and without discharging significant waste heat into the surrounding air.

SDDOT : safety program

DOT National Transportation Integrated Search

2000-05-01

The current safety and loss control program for the South Dakota Department of Transportation is not reaching its full potential and does not adequately prevent accidents and injuries. The Department has experienced an unacceptably high number of acc...

Hewlett-Packard's Approaches to Full Color Reflective Displays

NASA Astrophysics Data System (ADS)

Gibson, Gary

2012-02-01

Reflective displays are desirable in applications requiring low power or daylight readability. However, commercial reflective displays are currently either monochrome or capable of only dim color gamuts. Low cost, high-quality color technology would be rapidly adopted in existing reflective display markets and would enable new solutions in areas such as retail pricing and outdoor digital signage. Technical breakthroughs are required to enable bright color gamuts at reasonable cost. Pixel architectures that rely on pure reflection from a single layer of side-by-side primary-color sub-pixels use only a fraction of the display area to reflect incident light of a given color and are, therefore, unacceptably dark. Reflective devices employing stacked color primaries offer the possibility of a somewhat brighter color gamut but can be more complex to manufacture. In this talk, we describe HP's successes in addressing these fundamental challenges and creating both high performance stacked-primary reflective color displays as well as inexpensive single layer prototypes that provide good color. Our stacked displays utilize a combination of careful light management techniques, proprietary high-contrast electro-optic shutters, and highly transparent active-matrix TFT arrays based on transparent metal oxides. They also offer the possibility of relatively low cost manufacturing through roll-to-roll processing on plastic webs. To create even lower cost color displays with acceptable brightness, we have developed means for utilizing photoluminescence to make more efficient use of ambient light in a single layer device. Existing reflective displays create a desired color by reflecting a portion of the incident spectrum while absorbing undesired wavelengths. We have developed methods for converting the otherwise-wasted absorbed light to desired wavelengths via tailored photoluminescent composites. Here we describe a single active layer prototype display that utilizes these materials along with an innovative optical out-coupling scheme. Further benefits of our approach include means for highly power-efficient back-lighting under low ambient light conditions and the possibility of video rate operation.

Review of HIV in the Caribbean: significant progress and outstanding challenges.

PubMed

Figueroa, J Peter

2014-06-01

This paper reviews the recent literature on HIV in the Caribbean and discusses the challenges faced. HIV incidence in the Caribbean has declined by 49 % in the past decade, coverage of persons living with HIV among those eligible for antiretroviral treatment as per national guidelines was 70 % in 2012, and some countries are meeting the target of virtual elimination of mother-to-child transmission. HIV prevalence in the Caribbean is 1 % with features of both a generalized and concentrated HIV epidemic. HIV prevalence among female sex workers has declined but remains unacceptably high among men who have sex with men. Social and cultural factors, gender norms, and strong stigma associated with HIV and homosexuality contribute to the continued spread of HIV. Caribbean countries and their partners have invested significant resources, creative effort and impressive research in strengthening the HIV response nationally and regionally. However, in order to control the HIV epidemic, leaders at all levels, and the people, must address fundamental structural barriers in society that deny marginalized persons their rights, undermine public health goals, and impede universal access to HIV prevention, treatment, and care.

Nonsurgical management of hypertrophic scars: evidence-based therapies, standard practices, and emerging methods.

PubMed

Atiyeh, Bishara S

2007-01-01

Hypertrophic scars, resulting from alterations in the normal processes of cutaneous wound healing, are characterized by proliferation of dermal tissue with excessive deposition of fibroblast-derived extracellular matrix proteins, especially collagen, over long periods, and by persistent inflammation and fibrosis. Hypertrophic scars are among the most common and frustrating problems after injury. As current aesthetic surgical techniques become more standardized and results more predictable, a fine scar may be the demarcating line between acceptable and unacceptable aesthetic results. However, hypertrophic scars remain notoriously difficult to eradicate because of the high recurrence rates and the incidence of side effects associated with available treatment methods. This review explores the various treatment methods for hypertrophic scarring described in the literature including evidence-based therapies, standard practices, and emerging methods, attempting to distinguish those with clearly proven efficiency from anecdotal reports about therapies of doubtful benefits while trying to differentiate between prophylactic measures and actual treatment methods. Unfortunately, the distinction between hypertrophic scar treatments and keloid treatments is not obvious in most reports, making it difficult to assess the efficacy of hypertrophic scar treatment.

Taking Bacteriophage Therapy Seriously: A Moral Argument

PubMed Central

Verbeken, Gilbert; Huys, Isabelle; Jennes, Serge; Chanishvili, Nina; Górski, Andrzej; De Vos, Daniel

2014-01-01

The excessive and improper use of antibiotics has led to an increasing incidence of bacterial resistance. In Europe the yearly number of infections caused by multidrug resistant bacteria is more than 400.000, each year resulting in 25.000 attributable deaths. Few new antibiotics are in the pipeline of the pharmaceutical industry. Early in the 20th century, bacteriophages were described as entities that can control bacterial populations. Although bacteriophage therapy was developed and practiced in Europe and the former Soviet republics, the use of bacteriophages in clinical setting was neglected in Western Europe since the introduction of traditional antibiotics. Given the worldwide antibiotic crisis there is now a growing interest in making bacteriophage therapy available for use in modern western medicine. Despite the growing interest, access to bacteriophage therapy remains highly problematic. In this paper, we argue that the current state of affairs is morally unacceptable and that all stakeholders (pharmaceutical industry, competent authorities, lawmakers, regulators, and politicians) have the moral duty and the shared responsibility towards making bacteriophage therapy urgently available for all patients in need. PMID:24868534

Pneumocystis jirovecii Pneumonia in Human Immunodeficiency Virus Infection.

PubMed

Siegel, Marc; Masur, Henry; Kovacs, Joseph

2016-04-01

The presentation of Pneumocystis pneumonia (PCP) in previously healthy men having sex with men (MSM) in San Francisco and New York City in 1981 heralded the beginning of the human immunodeficiency virus (HIV) pandemic. Despite a decreasing incidence of PCP among patients with HIV/AIDS (acquired immunodeficiency syndrome) since the advent of combination antiretroviral therapy in the mid-1990s, PCP remains one of the most common AIDS-defining opportunistic infections in the United States and Western Europe. Newer molecular diagnostic tests in conjunction with standard immunofluorescent or colorimetric tests have allowed for more rapid and accurate diagnosis. Although several effective oral and intravenous therapies exist to treat PCP, mortality rates in HIV-infected individuals remain unacceptably high, especially in those with advanced AIDS. The identification of specific mutations in Pneumocystis genes targeted by trimethoprim-sulfamethoxazole has raised concerns about the development of resistance to the drug of choice and may ultimately lead to greater utilization of alternative therapies to treat PCP in the future. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Federal High School Graduation Rate Policies and the Impact on Kansas

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Arkansas

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Alabama

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Connecticut

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Oregon

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Georgia

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Missouri

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Colorado

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on New Jersey

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Florida

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Illinois

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Ohio

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on New York

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Massachusetts

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Arizona

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on California

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Montana

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Kentucky

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Louisiana

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Maryland

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Alaska

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Idaho

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Maine

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Hawaii

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Oklahoma

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on New Hampshire

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on North Dakota

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on North Carolina

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Delaware

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Mississippi

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Indiana

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on New Mexico

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Minnesota

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Nebraska

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Nevada

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

Federal High School Graduation Rate Policies and the Impact on Michigan

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

A Comparison of Mission Statements of National Blue Ribbon Schools and Unacceptable Texas High Schools

ERIC Educational Resources Information Center

Perfetto, John Charles; Holland, Glenda; Davis, Rebecca; Fedynich, La Vonne

2013-01-01

This study was conducted to determine the themes present in the context of high schools, to determine any significant differences in themes for high and low performing high schools, and to determine if significant differences were present for the same sample of high schools based on school size. An analysis of the content of mission statements…

Federal Graduation Rate Policies and the Impact on Iowa

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2009

2009-01-01

In today's economy, employers increasingly demand that workers have a high school diploma, yet America's graduation rates are unacceptably low, particularly among poor and minority students. Nationally, only about 70 percent of students graduate from high school on time with a regular diploma; for African American and Hispanic students, this…

The Factorial Validity of the Piers-Harris Children's Self-Concept Scale for Each of Three Samples of Elementary, Junior High, and Senior High School Students in a Large Metropolitan School District

ERIC Educational Resources Information Center

Michael, William B.; And Others

1975-01-01

The scale yielded three major dimensions that were essentially invariant across the three samples: physical appearance, socially unacceptable (bad) behavior, and academic or school status. (Author/RC)

Socioeconomic Influences on the Educational and Career Paths of Kentucky High School Seniors.

ERIC Educational Resources Information Center

Rever, Philip R.; And Others

The report is a response to Kentucky Higher Education Assistance Authority's concern about limiting factors which constrain students' choices of paths to follow after leaving high school, specifically unacceptable factors that prohibit students (1) from pursuing postsecondary education and (2) from entering postsecondary institutions of their…

Junior High Student Responsibilities for Basic Skills.

ERIC Educational Resources Information Center

Parker, Charles C.

This paper advances the thesis that students should be trained to recognize acceptable and unacceptable performances in basic skill areas and should assume responsibility for attaining proficiency in these areas. Among the topics discussed are the value of having junior high school students check their own assignments, discover their errors, and…

[Babies with cranial deformity].

PubMed

Feijen, Michelle M W; Claessens, Edith A W M Habets; Dovens, Anke J Leenders; Vles, Johannes S; van der Hulst, Rene R W J

2009-01-01

Plagiocephaly was diagnosed in a baby aged 4 months and brachycephaly in a baby aged 5 months. Positional or deformational plagio- or brachycephaly is characterized by changes in shape and symmetry of the cranial vault. Treatment options are conservative and may include physiotherapy and helmet therapy. During the last two decades the incidence of positional plagiocephaly has increased in the Netherlands. This increase is due to the recommendation that babies be laid on their backs in order to reduce the risk of sudden infant death syndrome. We suggest the following: in cases of positional preference of the infant, referral to a physiotherapist is indicated. In cases of unacceptable deformity of the cranium at the age 5 months, moulding helmet therapy is a possible treatment option.

Preliminary Evidence Supports Modification of Retraction Technique to Prevent Needlestick Injuries

PubMed Central

Fa, Bernadette Alvear; Cuny, Eve

2016-01-01

A modified retraction technique was introduced into the DDS degree preclinical anesthesia course in 2011 with the goal of reducing needlestick exposure incidents. In numerous studies of dental exposures, injuries from dental anesthetic needles account for the highest proportion of all exposures. The purpose of this study was to assess the preliminary impact of a modified retraction technique on the incidence of blood and body fluids (BBF) exposure incidents associated with needles during injection. Data from evaluations of students from 2014 and 2015 were obtained and tracked to determine whether the modified retraction technique was “excellent,” “clinically acceptable,” or “clinically unacceptable.” Data were collected to determine if the patient perceived the modified retraction technique as “comfortable” or “correctable when addressed” to help improve student technique for future injections. Likewise, data from the blood-borne exposure database where all information related to BBF exposures is recorded were reviewed and the information separated by year and class. This study presents preliminary data only and because of the small sample size does not lend itself to validation by statistical analysis. However, the technique effectively removes the operator's hand from the field during injection, reducing the risk of accidental intraoral needlestick to the nondominant hand of the operator. PMID:27973940

Barriers to human papillomavirus vaccine acceptability in Israel.

PubMed

Fisher, William A; Laniado, Hila; Shoval, Hila; Hakim, Marwan; Bornstein, Jacob

2013-11-22

Barriers to human papillomavirus (HPV) vaccine acceptability in Israel include Israel's relatively low incidence of cervical cancer; the religiously-based 80% circumcision rate in Israel, which is regarded as contributing to the lower incidence of HPV infection in the country; the fact that HPV vaccine provides immunity against only few virus types; the vaccine's high cost; and the perception that HPV transmission is associated with unacceptable sexual relations. A recent survey has demonstrated that, following media two campaigns, Israeli's level of awareness of the vaccine increased but the actual vaccination rate remained low, at approximately 10%. Survey findings also indicated that an enduring barrier to HPV vaccination is the vaccine's high cost. Recent research on a convenience sample of Israeli undergraduate women 21 to 24 years of age showed that intentions to receive HPV vaccination in the coming year were a function of women's attitudes towards getting vaccinated and their perceptions of social support for doing so. Undergraduate women who intended to be vaccinated perceived the prevention of cervical cancer, avoidance of personal health threat, and avoidance of HPV infection per se to be the advantages of undergoing HPV vaccination. Disadvantages of getting vaccinated included fear of vaccine side effects, cost of the vaccine, and newness of the vaccine, doubts about vaccines, time required to undergo multiple vaccinations, and dislike of injections. Friends', mothers' and physicians' recommendations influenced women's intentions to be vaccinated in the coming year as well. This article forms part of a regional report entitled "Comprehensive Control of HPV Infections and Related Diseases in Israel" Vaccine Volume 31, Supplement 8, 2013. Updates of the progress in the field are presented in a separate monograph entitled "Comprehensive Control of HPV Infections and Related Diseases" Vaccine Volume 30, Supplement 5, 2012. Copyright © 2013 Elsevier Ltd. All rights reserved.

Intestinal Tissues Induce an SNP Mutation in Pseudomonas aeruginosa That Enhances Its Virulence: Possible Role in Anastomotic Leak

PubMed Central

Olivas, Andrea D.; Shogan, Benjamin D.; Valuckaite, Vesta; Zaborin, Alexander; Belogortseva, Natalya; Musch, Mark; Meyer, Folker; L.Trimble, William; An, Gary; Gilbert, Jack

2012-01-01

The most feared complication following intestinal resection is anastomotic leakage. In high risk areas (esophagus/rectum) where neoadjuvant chemoradiation is used, the incidence of anastomotic leaks remains unacceptably high (∼10%) even when performed by specialist surgeons in high volume centers. The aims of this study were to test the hypothesis that anastomotic leakage develops when pathogens colonizing anastomotic sites become in vivo transformed to express a tissue destroying phenotype. We developed a novel model of anastomotic leak in which rats were exposed to pre-operative radiation as in cancer surgery, underwent distal colon resection and then were intestinally inoculated with Pseudomonas aeruginosa, a common colonizer of the radiated intestine. Results demonstrated that intestinal tissues exposed to preoperative radiation developed a significant incidence of anastomotic leak (>60%; p<0.01) when colonized by P. aeruginosa compared to radiated tissues alone (0%). Phenotype analysis comparing the original inoculating strain (MPAO1- termed P1) and the strain retrieved from leaking anastomotic tissues (termed P2) demonstrated that P2 was altered in pyocyanin production and displayed enhanced collagenase activity, high swarming motility, and a destructive phenotype against cultured intestinal epithelial cells (i.e. apoptosis, barrier function, cytolysis). Comparative genotype analysis between P1 and P2 revealed a single nucleotide polymorphism (SNP) mutation in the mexT gene that led to a stop codon resulting in a non-functional truncated protein. Replacement of the mutated mexT gene in P2 with mexT from the original parental strain P1 led to reversion of P2 to the P1 phenotype. No spontaneous transformation was detected during 20 passages in TSB media. Use of a novel virulence suppressing compound PEG/Pi prevented P. aeruginosa transformation to the tissue destructive phenotype and prevented anastomotic leak in rats. This work demonstrates that in vivo transformation of microbial pathogens to a tissue destroying phenotype may have important implications in the pathogenesis of anastomotic leak. PMID:22952955

Defining acceptable levels for ecological indicators: an approach for considering social values.

PubMed

Smyth, Robyn L; Watzin, Mary C; Manning, Robert E

2007-03-01

Ecological indicators can facilitate an adaptive management approach, but only if acceptable levels for those indicators have been defined so that the data collected can be interpreted. Because acceptable levels are an expression of the desired state of the ecosystem, the process of establishing acceptable levels should incorporate not just ecological understanding but also societal values. The goal of this research was to explore an approach for defining acceptable levels of ecological indicators that explicitly considers social perspectives and values. We used a set of eight indicators that were related to issues of concern in the Lake Champlain Basin. Our approach was based on normative theory. Using a stakeholder survey, we measured respondent normative evaluations of varying levels of our indicators. Aggregated social norm curves were used to determine the level at which indicator values shifted from acceptable to unacceptable conditions. For seven of the eight indicators, clear preferences were interpretable from these norm curves. For example, closures of public beaches because of bacterial contamination and days of intense algae bloom went from acceptable to unacceptable at 7-10 days in a summer season. Survey respondents also indicated that the number of fish caught from Lake Champlain that could be safely consumed each month was unacceptably low and the number of streams draining into the lake that were impaired by storm water was unacceptably high. If indicators that translate ecological conditions into social consequences are carefully selected, we believe the normative approach has considerable merit for defining acceptable levels of valued ecological system components.

Defining Acceptable Levels for Ecological Indicators: An Approach for Considering Social Values

NASA Astrophysics Data System (ADS)

Smyth, Robyn L.; Watzin, Mary C.; Manning, Robert E.

2007-03-01

Ecological indicators can facilitate an adaptive management approach, but only if acceptable levels for those indicators have been defined so that the data collected can be interpreted. Because acceptable levels are an expression of the desired state of the ecosystem, the process of establishing acceptable levels should incorporate not just ecological understanding but also societal values. The goal of this research was to explore an approach for defining acceptable levels of ecological indicators that explicitly considers social perspectives and values. We used a set of eight indicators that were related to issues of concern in the Lake Champlain Basin. Our approach was based on normative theory. Using a stakeholder survey, we measured respondent normative evaluations of varying levels of our indicators. Aggregated social norm curves were used to determine the level at which indicator values shifted from acceptable to unacceptable conditions. For seven of the eight indicators, clear preferences were interpretable from these norm curves. For example, closures of public beaches because of bacterial contamination and days of intense algae bloom went from acceptable to unacceptable at 7-10 days in a summer season. Survey respondents also indicated that the number of fish caught from Lake Champlain that could be safely consumed each month was unacceptably low and the number of streams draining into the lake that were impaired by storm water was unacceptably high. If indicators that translate ecological conditions into social consequences are carefully selected, we believe the normative approach has considerable merit for defining acceptable levels of valued ecological system components.

Injury risk associated with ground hardness in junior cricket.

PubMed

Twomey, Dara M; White, Peta E; Finch, Caroline F

2012-03-01

To establish if there is an association between ground hardness and injury risk in junior cricket. Nested case-series of players who played matches on specific grounds with objective ground hardness measures, within a prospective cohort study of junior community club cricket players. Monitoring of injuries and playing exposure occurred during 434 matches over the 2007/2008 playing season. Objective assessment of the hardness of 38 grounds was undertaken using a Clegg hammer at 13 sites on 19 different junior cricket grounds on the match eve across the season. Hardness readings were classified from unacceptably low (<30 g) to unacceptably high (>120 g) and two independent raters assessed the likelihood of each injury being related to ground hardness. Injuries sustained on tested grounds were related to the ground hardness measures. Overall, 31 match injuries were reported; 6.5% were rated as likely to be related to ground hardness, 16.1% as possibly related and 74.2% as unlikely to be related and 3.2% unknown. The two injuries likely to be related to ground hardness were sustained whilst diving to catch a ball resulting, in a graze/laceration from contact with hard ground. Overall, 31/38 (82%) ground assessments were rated as having 'unacceptably high' hardness and all others as 'high/normal' hardness. Only one injury occurred on an objectively tested ground. It remains unclear if ground hardness is a contributing factor to the most common injury mechanism of being struck by the ball, and needs to be confirmed in future larger-scale studies. Copyright © 2011 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Air and water cooled modulator

DOEpatents

Birx, D.L.; Arnold, P.A.; Ball, D.G.; Cook, E.G.

1995-09-05

A compact high power magnetic compression apparatus and method are disclosed for delivering high voltage pulses of short duration at a high repetition rate and high peak power output which does not require the use of environmentally unacceptable fluids such as chlorofluorocarbons either as a dielectric or as a coolant, and which discharges very little waste heat into the surrounding air. A first magnetic switch has cooling channels formed therethrough to facilitate the removal of excess heat. The first magnetic switch is mounted on a printed circuit board. A pulse transformer comprised of a plurality of discrete electrically insulated and magnetically coupled units is also mounted on said printed board and is electrically coupled to the first magnetic switch. The pulse transformer also has cooling means attached thereto for removing heat from the pulse transformer. A second magnetic switch also having cooling means for removing excess heat is electrically coupled to the pulse transformer. Thus, the present invention is able to provide high voltage pulses of short duration at a high repetition rate and high peak power output without the use of environmentally unacceptable fluids and without discharging significant waste heat into the surrounding air. 9 figs.

Early maladaptive schemas and suicidal risk in an Iranian sample of patients with obsessive-compulsive disorder.

PubMed

Khosravani, Vahid; Sharifi Bastan, Farangis; Samimi Ardestani, Mehdi; Jamaati Ardakani, Razieh

2017-09-01

There are few studies on suicidal risk and its related factors in patients diagnosed with obsessive-compulsive disorder (OCD). This study investigated the associations of early maladaptive schemas, OC symptom dimensions, OCD severity, depression and anxiety with suicidality (i.e., suicidal ideation and suicide attempts) in OCD patients. Sixty OCD outpatients completed the Scale for Suicide Ideation (SSI), the Young Schema Questionnaire-Short Form (YSQ-SF), the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Dimensional Obsessive-Compulsive Scale (DOCS) and the Depression Anxiety Stress Scales (DASS-21). 51.7% of patients had lifetime suicide attempts and 75% had suicidal ideation. OCD patients with lifetime suicide attempts exhibited significantly higher scores on early maladaptive schemas than those without such attempts. Logistic regression analysis revealed that the mistrust/abuse schema and the OC symptom dimension of unacceptable thoughts explained lifetime suicide attempts. The mistrust/abuse schema, unacceptable thoughts and depression significantly predicted suicidal ideation. These findings indicated that the mistrust/abuse schema may contribute to high suicidality in OCD patients. Also, patients suffering from unacceptable thoughts need to be assessed more carefully for warning signs of suicide. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Risk management analysis for construction of Kutai Kartanegara bridge-East Kalimantan-Indonesia

NASA Astrophysics Data System (ADS)

Azis, Subandiyah

2017-11-01

Many sources of risk that may impede the achievement of the project objectives through either cost or quality and time, especially for bridges that have collapsed before, so when the implementation of possible hazard / high hazard so when should the possible hazard/high hazard be implemented The purpose of this research is to identify, to analyze risks by classifying the risks using the method of Risk Breakdown Structure (RBS) and managing the dominant risk of execution of the installation work to determine the handling of the steel frame in order to maximize the positive and minimize the incidence of adverse events. The results of this study indicate there are 15 sources of risks are identified, and there are 6 risk indicates the dominant risks. Mitigation performed on the dominant risks unacceptable i.e. Project factor that shows the delays in the arrival of materials due to locations, schedule of the arrival of materials should be tailored to the needs of the field and the amount of material that comes with the required field should also be evaluated. The result is expected to be a guideline for identifying risks and mitigation measures for further research. Subsequent researchers to pay attention on the security factor that implementation time does not affect the productivity of work in construction projects.

40 CFR Appendix A to Subpart G of... - Substitutes Subject to Use Restrictions and Unacceptable Substitutes

Code of Federal Regulations, 2011 CFR

2011-07-01

... characteristic of concern for PFCs is that they have long atmospheric lifetimes and high global warming potentials. Although actual contributions to global warming depend upon the quantities of PFCs emitted, the... characteristic of concern for PFCs is that they have long atmospheric lifetimes and high global warming...

40 CFR Appendix A to Subpart G of... - Substitutes Subject to Use Restrictions and Unacceptable Substitutes

Code of Federal Regulations, 2014 CFR

2014-07-01

... characteristic of concern for PFCs is that they have long atmospheric lifetimes and high global warming potentials. Although actual contributions to global warming depend upon the quantities of PFCs emitted, the... for PFCs is that they have long atmospheric lifetimes and high global warming potentials. Although...

40 CFR Appendix A to Subpart G of... - Substitutes Subject to Use Restrictions and Unacceptable Substitutes

Code of Federal Regulations, 2012 CFR

2012-07-01

... characteristic of concern for PFCs is that they have long atmospheric lifetimes and high global warming potentials. Although actual contributions to global warming depend upon the quantities of PFCs emitted, the... characteristic of concern for PFCs is that they have long atmospheric lifetimes and high global warming...

40 CFR Appendix A to Subpart G of... - Substitutes Subject to Use Restrictions and Unacceptable Substitutes

Code of Federal Regulations, 2013 CFR

2013-07-01

... characteristic of concern for PFCs is that they have long atmospheric lifetimes and high global warming potentials. Although actual contributions to global warming depend upon the quantities of PFCs emitted, the... characteristic of concern for PFCs is that they have long atmospheric lifetimes and high global warming...

HiveScience: A Citizen Science Project for Beekeepers##

EPA Science Inventory

Over the past decade, beekeepers have been experiencing unacceptably high colony losses while the demand for insect-pollinated crops has tripled during the same time period. Underscoring the need to develop reliable methods for predicting colony health, the United States Departme...

New Bedford Harbor Long Term Monitoring Program

EPA Science Inventory

New Bedford Harbor (NBH), located in southeastern Massachusetts, was designated as a Superfund site in 1983 due to unacceptably high levels of sediment contamination by polychlorinated biphenyls (PCBs). Based on human health and environmental concerns, the decision was made to d...

Addressing Uncertainty in Fecal Indicator Bacteria Dark Inactivation Rates

EPA Science Inventory

Fecal contamination is a leading cause of surface water quality degradation. Roughly 20% of all total maximum daily load assessments approved by the United States Environmental Protection Agency since 1995, for example, address water bodies with unacceptably high fecal indicator...

THERMODYNAMIC REACTION CONSTANTS FOR MODELING AQUEOUS ENVIRONMENTAL MERCURY SPECIATION

EPA Science Inventory

Unacceptably high fish tissue mercury residues are responsible for the majority of fish consumption advisories issued in 48 states of the United States of America. Mercury also has emerged as a transboundary contaminant of global concern. Although monomethylmercury is generally...

STREAM RESTORATION STRATEGIES FOR REDUCING RIVER NITROGEN LOADS

EPA Science Inventory

Despite decades of work implementing agricultural and urban best management practices to reduce the movement of excess nitrogen (N) from the land to aquatic ecosystems, the amount of N moving down streams and rivers remains unacceptably high in many watersheds. During this same ...

Failure analysis of blistered gold plating on spot welded electrical relays

NASA Technical Reports Server (NTRS)

Sokolowski, Witold; O'Donnell, Tim

1989-01-01

Gold-plated stainless-steel sideplates, part of a JPL Galileo spacecraft electronic-relay assembly, exhibited blistering after resistance spot welding. Unacceptable relays had heavy nonuniform gold electrodeposited layers with thicknesses 4.5-11.5 microns. SEM and metallographic investigations indicated much higher heat input generated during the resistance spot welding in unacceptable relays. The attributes of acceptable welded relays are contrasted with unacceptable relays; the possible mechanism of laminar formation of polymeric material in the gold plating is discussed; and some recommendations are provided to prevent similar problems.

Threats to information security of real-time disease surveillance systems.

PubMed

Henriksen, Eva; Johansen, Monika A; Baardsgaard, Anders; Bellika, Johan G

2009-01-01

This paper presents the main results from a qualitative risk assessment of information security aspects for a new real-time disease surveillance approach in general, and for the Snow surveillance system in particular. All possible security threats and acceptable solutions, and the implications these solutions had to the design of the system, were discussed. Approximately 30 threats were identified. None of these got an unacceptable high risk level originally, but two got medium risk level, of which one was concluded to be unacceptable after further investigation. Of the remaining low risk threats, some have severe consequence, thus requiring particular assessment. Since it is very important to identify and solve all security threats before real-time solutions can be used in a wide scale, additional investigations are needed.

Analysis for the amplitude oscillatory movements of the ship in response to the incidence wave

NASA Astrophysics Data System (ADS)

Chiţu, M. G.; Zăgan, R.; Manea, E.

2015-11-01

Event of major accident navigation near offshore drilling rigs remains unacceptably high, known as the complications arising from the problematic of the general motions of the ship sailing under real sea. Dynamic positioning system is an effective instrument used on board of the ships operating in the extraction of oil and gas in the continental shelf of the seas and oceans, being essential that the personnel on board of the vessel can maintain position and operating point or imposed on a route with high precision. By the adoption of a strict safety in terms of handling and positioning of the vessel in the vicinity of the drilling platform, the risk of accidents can be reduced to a minimum. Possibilities in anticipation amplitudes of the oscillatory movements of the ships navigating in real sea, is a challenge for naval architects and OCTOPUS software is a tool used increasingly more in this respect, complementing navigational facilities offered by dynamic positioning systems. This paper presents a study on the amplitudes of the oscillations categories of supply vessels in severe hydro meteorological conditions of navigation. The study provides information on the RAO (Response Amplitude Operator) response operator of the ship, for the amplitude of the roll movements, in some incident wave systems, interpreted using the energy spectrum Jonswap and whose characteristics are known (significant height of the wave, wave period, pulsation of the wave). Ship responses are analyzed according to different positioning of the ship in relation to the wave front (incident angle ranging from 10 to 10 degree from 0 to 180), highlighting the value of the ship roll motion amplitude. For the study, was used, as a tool for modeling and simulation, the features offered by OCTOPUS software that allows the study of the computerized behavior of the ship on the waves, in the real conditions of navigation. Program library was used for both the vessel itself and navigation modeling environment, for regular waves as well for the irregular waves which was modeled using Jonswap energy spectrum.

RENEB intercomparisons applying the conventional Dicentric Chromosome Assay (DCA).

PubMed

Oestreicher, Ursula; Samaga, Daniel; Ainsbury, Elizabeth; Antunes, Ana Catarina; Baeyens, Ans; Barrios, Leonardo; Beinke, Christina; Beukes, Philip; Blakely, William F; Cucu, Alexandra; De Amicis, Andrea; Depuydt, Julie; De Sanctis, Stefania; Di Giorgio, Marina; Dobos, Katalin; Dominguez, Inmaculada; Duy, Pham Ngoc; Espinoza, Marco E; Flegal, Farrah N; Figel, Markus; Garcia, Omar; Monteiro Gil, Octávia; Gregoire, Eric; Guerrero-Carbajal, C; Güçlü, İnci; Hadjidekova, Valeria; Hande, Prakash; Kulka, Ulrike; Lemon, Jennifer; Lindholm, Carita; Lista, Florigio; Lumniczky, Katalin; Martinez-Lopez, Wilner; Maznyk, Nataliya; Meschini, Roberta; M'kacher, Radia; Montoro, Alegria; Moquet, Jayne; Moreno, Mercedes; Noditi, Mihaela; Pajic, Jelena; Radl, Analía; Ricoul, Michelle; Romm, Horst; Roy, Laurence; Sabatier, Laure; Sebastià, Natividad; Slabbert, Jacobus; Sommer, Sylwester; Stuck Oliveira, Monica; Subramanian, Uma; Suto, Yumiko; Que, Tran; Testa, Antonella; Terzoudi, Georgia; Vral, Anne; Wilkins, Ruth; Yanti, LusiYanti; Zafiropoulos, Demetre; Wojcik, Andrzej

2017-01-01

Two quality controlled inter-laboratory exercises were organized within the EU project 'Realizing the European Network of Biodosimetry (RENEB)' to further optimize the dicentric chromosome assay (DCA) and to identify needs for training and harmonization activities within the RENEB network. The general study design included blood shipment, sample processing, analysis of chromosome aberrations and radiation dose assessment. After manual scoring of dicentric chromosomes in different cell numbers dose estimations and corresponding 95% confidence intervals were submitted by the participants. The shipment of blood samples to the partners in the European Community (EU) were performed successfully. Outside the EU unacceptable delays occurred. The results of the dose estimation demonstrate a very successful classification of the blood samples in medically relevant groups. In comparison to the 1st exercise the 2nd intercomparison showed an improvement in the accuracy of dose estimations especially for the high dose point. In case of a large-scale radiological incident, the pooling of ressources by networks can enhance the rapid classification of individuals in medically relevant treatment groups based on the DCA. The performance of the RENEB network as a whole has clearly benefited from harmonization processes and specific training activities for the network partners.

Modification of potato steroidal glycoalkaloids with silencing RNA constructs

USDA-ARS?s Scientific Manuscript database

Steroidal glycoalkaloids (SGAs), while found in many solanaceous plants, can accumulate to unacceptably high levels in potatoes. The two primary SGAs that occur in potatoes are the tri-glycosylated alkaloids, a-solanine and a-chaconine. The first glycosylation steps in their biosynthetic pathways ...

Assessment of variations in control of asthma over time.

PubMed

Combescure, C; Chanez, P; Saint-Pierre, P; Daurès, J P; Proudhon, H; Godard, P

2003-08-01

Control and severity of asthma are two different but complementary concepts. The severity of asthma could influence the control over time. The aim of this study was to demonstrate this relationship. A total 365 patients with persistent asthma (severity) were enrolled and followed-up prospectively. Data were analysed using a continuous time homogeneous Markov model of the natural history of asthma. Control of asthma was defined according to three health states which were qualified: optimal, suboptimal and unacceptable control (states 1, 2 and 3). Transition forces (denoted lambda(ij) from state i to state j) and transition probabilities between control states were assessed and the results stratified by asthma severity were compared. Models were validated by comparing expected and observed numbers of patients in the different states. Transition probabilities stabilised between 100-250 days and more rapidly in patients with mild-to-moderate asthma. Patients with mild-to-moderate asthma in suboptimal or unacceptable control had a high probability of transition directly to optimal control. Patients with severe asthma had a tendency to remain in unacceptable control. A Markov model is a useful tool to model the control of asthma over time. Severity modified clearly the health states. It could be used to compare the performance of different approaches to asthma management.

Transparent and Open Discussion of Errors Does Not Increase Malpractice Risk in Trauma Patients

PubMed Central

Stewart, Ronald M.; Corneille, Michael G.; Johnston, Joe; Geoghegan, Kathy; Myers, John G.; Dent, Daniel L.; McFarland, Marilyn; Alley, Joshua; Pruitt, Basil A.; Cohn, Stephen M.

2006-01-01

Objective: We set out to determine if there is an increased medical malpractice lawsuit rate when trauma patient cases are presented at an open, multidisciplinary morbidity and mortality conference (M&M). Introduction: Patient safety proponents emphasize the importance of transparency with respect to medical errors. In contrast, the tort system focuses on blame and punishment, which encourages secrecy. Our question: Can the goals of the patient safety movement be met without placing care providers and healthcare institutions at unacceptably high malpractice risk? Methods: The trauma registry, a risk management database, along with the written minutes of the trauma morbidity and mortality conference (M&M) were used to determine the number and incidence of malpractice suits filed following full discussion at an open M&M conference at an academic level I trauma center. Results: A total of 20,749 trauma patients were admitted. A total of 412 patients were discussed at M&M conference and a total of seven lawsuits were filed. Six of the patients were not discussed at M&M prior to the lawsuit being filed. One patient was discussed at M&M prior to the lawsuit being filed. The incidence of lawsuit was calculated in three groups: all trauma patients, all trauma patients with complications, and all patients presented at trauma M&M conference. The ratio of lawsuits filed to patients admitted and incidence in the three groups is as follows: All Patients, 7 lawsuits/20,479 patients (4.25 lawsuits/100,000 patients/year); M&M Presentation, 1 lawsuit/421 patients (29.6 lawsuits/100,000 patients/year); All Trauma Complications, 7 lawsuits/6,225 patients (14 lawsuits/100,000 patients/year). Patients with a complication were more likely to sue (P < 0.01); otherwise, there were no statistical differences between groups. Conclusions: A transparent discussion of errors, complications, and deaths does not appear to lead to an increased risk of lawsuit. PMID:16632999

47 CFR 22.878 - Obligation to abate unacceptable interference.

Code of Federal Regulations, 2010 CFR

2010-10-01

.... 22.878 Section 22.878 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Air-Ground Radiotelephone Service Commercial Aviation Air-Ground Systems § 22.878 Obligation to abate unacceptable interference. This section applies only to commercial...

Developing cold-chipping potato varieties by silencing the vacuolar invertase gene

USDA-ARS?s Scientific Manuscript database

Accumulation of reducing sugars during cold storage is a persistent and costly problem for the potato processing industry. High temperature processing of potato tubers with elevated amounts of reducing sugars results in potato chips, fries and other products that are unacceptable to consumers becaus...

Seed coat darkening in Cowpea bean

USDA-ARS?s Scientific Manuscript database

Seed coat of cowpea bean (Vigna unguiculata L. Walp) slowly browns to a darker color during storage. High temperature and humidity during storage might contribute to this color change. Variation in browning rate among seeds in a lot leads to a mixture of seed colors creating an unacceptable product...

[Ethical behavioral standards of medical students on examinations and studies].

PubMed

Tolkin, Lior; Glick, Shimon

2007-06-01

In recent years the medical literature has reflected an increasing interest in the medical ethics of physicians and medical students. Studies have shown that cheating in medical school is frequent enough to cause concern, that there is a positive correlation between students' ethical attitude and their ethical behavior and between cheating in school and cheating in patient care. This study aims to examine student attitudes towards cheating, their self-reported behavior, analyze cultural and sub-cultural differences, and to reach practical conclusions that might be incorporated into the teaching of ethics in medical schools. Anonymous questionnaires were distributed to 193 first and second year students of the Israeli and American programs at Ben-Gurion University. The questionnaire consisted of fifty three multiple choice questions. The students were asked to state their opinion on various cheating practices at medical school and dishonesty in patient care, to estimate how they would resolve various ethical dilemmas and to provide some demographic information. The results were analyzed using SPSS. T-tests, Chi-Square tests, one-way analysis of variance, and Pearson and Spearman's coefficients, all used as appropriate. Completed questionnaires were returned by 141 students (73%). The majority of the students regard cheating in an exam (93%) or on a final paper (85%) to be morally unacceptable behavior. Copying during an exam is regarded as more morally unacceptable than copying a homework exercise. The majority of the students consider faking a patient's laboratory results to be morally unacceptable behavior (98%). American students regard copying a homework exercise, reconstructing exam questions for the benefit of next year students and giving answers to a fellow student during an exam to be more morally unacceptable in comparison to the Israeli students. Married students consider cheating to be more morally unacceptable than unmarried students. A positive correlation was found between religiosity and the position that cheating is a morally negative practice. There is a positive correlation between cheating in high school and the position that cheating is morally acceptable. In addition, the more often a student cheated in high school the more that student claims that he or she would cheat if they were sure that they would not be caught. Amongst Israeli students, there was a correlation between the view that the faculty did not treat them well, and the position that cheating is morally acceptable, No correlation was found between cheating and gender, age, birth country of parents, army service, or type of high school. Students' attitude toward cheating is significantly determined by the cultural and sub-cultural characteristics of each student's background. Ethical discussions in which an ethical code would be formed, moral dilemmas analyzed and cultural differences addressed, may help improve the ethical behavior of students in medical school, and thus improve their ethical practice in patient care.

75 FR 3255 - Petitions for Modification

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-20

..., located in Barbour County, West Virginia. Regulation Affected: 30 CFR 75.1700 (Oil and gas wells... the immediate return. If mine air flows into the lateral as expected, or if gas inflow is acceptably... borehole plugging. If gas inflow from the well is unacceptably high (1.0% methane by volume, or higher, as...

Improving the Processing Quality of Existing Cultivars by Suppressing the Vacuolar Acid Invertase Gene

USDA-ARS?s Scientific Manuscript database

Storing potato tubers at low temperatures is highly advantageous in that it prevents sprouting, minimizes disease losses and increases the marketing window. Unfortunately, cold storage of existing cultivars causes an unacceptable accumulation of reducing sugars, a phenomenon referred to as cold-indu...

Predictive Modeling of Microbial Indicators for Timely Beach Notifications and Advisories at Marine Beaches

EPA Science Inventory

Marine beaches are occasionally contaminated by unacceptably high levels of fecal indicator bacteria (FIB) that exceed EPA water quality criteria. Here we describe application of a recent version of the software package Virtual Beach tool (VB 3.0.6) to build and evaluate multiple...

A Schoolwide Discipline Plan That Empowers Teachers and Gives Principals Time for Instructional Leadership.

ERIC Educational Resources Information Center

Borelli, Jan

1997-01-01

A high school principal explains her strategy for turning around a disorderly, gang-ridden middle school. Her discipline plan's success hinged on developing schoolwide expectations for behavior, developing positive consequences, compiling a list of unacceptable behaviors, and empowering teachers to administer consequences, including contacting…

The Effect of Empowerment and Self-Determination on Health Outcomes

ERIC Educational Resources Information Center

Garces-Ozanne, Arlene; Kalu, Edna Ikechi; Audas, Richard

2016-01-01

There remains a persistent gap in health outcomes between wealthy and poor countries. Basic measures such as life expectancy and infant and under-five mortality remain divergent, with preventable deaths being unacceptably high, despite significant efforts to reduce these disparities. We examine the impact of empowerment, measured by Freedom…

Implementation and Impact of the Check & Connect Mentoring Program

ERIC Educational Resources Information Center

Heppen, Jessica; O'Cummings, Mindee; Poland, Lindsay; Zeiser, Krissy; Mills, Nicholas

2015-01-01

High school graduation rates remain unacceptably low in the U.S., especially among disadvantaged youth (Chapman, Laird, Ifill, & KelalRamani, 2011; Stillwell, 2010), with troubling implications for future earnings and employment status (Bureau of Labor Statistics, 2012). Check & Connect (C&C) is an individualized program that pairs…

Western Australian High School Students' Attitudes towards Biotechnology Processes

ERIC Educational Resources Information Center

Dawson, Vaille; Schibeci, Renato

2003-01-01

This study reports on the attitudes towards biotechnology of 905, 15-16 year-old students from 11 Western Australian schools. Students were asked to read 15 statements about biotechnology processes and to draw a line to separate what they considered "acceptable" statements from those they considered "unacceptable". Overall, the…

40 CFR 231.2 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) OCEAN DUMPING SECTION 404(c) PROCEDURES...) Unacceptable adverse effect means impact on an aquatic or wetland ecosystem which is likely to result in... unacceptability of such impacts, consideration should be given to the relevant portions of the section 404(b)(1...

40 CFR 231.2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) OCEAN DUMPING SECTION 404(c) PROCEDURES...) Unacceptable adverse effect means impact on an aquatic or wetland ecosystem which is likely to result in... unacceptability of such impacts, consideration should be given to the relevant portions of the section 404(b)(1...

High incidence of non-random template strand segregation and asymmetric fate determination in dividing stem cells and their progeny.

PubMed

Conboy, Michael J; Karasov, Ariela O; Rando, Thomas A

2007-05-01

Decades ago, the "immortal strand hypothesis" was proposed as a means by which stem cells might limit acquiring mutations that could give rise to cancer, while continuing to proliferate for the life of an organism. Originally based on observations in embryonic cells, and later studied in terms of stem cell self-renewal, this hypothesis has remained largely unaccepted because of few additional reports, the rarity of the cells displaying template strand segregation, and alternative interpretations of experiments involving single labels or different types of labels to follow template strands. Using sequential pulses of halogenated thymidine analogs (bromodeoxyuridine [BrdU], chlorodeoxyuridine [CldU], and iododeoxyuridine [IdU]), and analyzing stem cell progeny during induced regeneration in vivo, we observed extraordinarily high frequencies of segregation of older and younger template strands during a period of proliferative expansion of muscle stem cells. Furthermore, template strand co-segregation was strongly associated with asymmetric cell divisions yielding daughters with divergent fates. Daughter cells inheriting the older templates retained the more immature phenotype, whereas daughters inheriting the newer templates acquired a more differentiated phenotype. These data provide compelling evidence of template strand co-segregation based on template age and associated with cell fate determination, suggest that template strand age is monitored during stem cell lineage progression, and raise important caveats for the interpretation of label-retaining cells.

40 CFR Appendix G to Subpart G of... - Substitutes Subject to Use Restrictions and Unacceptable Substitutes Listed in the March 3, 1999...

Code of Federal Regulations, 2010 CFR

2010-07-01

.... Refrigerants Unacceptable Substitutes End-use Substitute Decision Comments CFC-12, R-502, and HCFC-22 Household... gas emissions from direct release of refrigerant to the atmosphere. [64 FR 10378, Mar. 3, 1999] ...

40 CFR Appendix G to Subpart G of... - Substitutes Subject to Use Restrictions and Unacceptable Substitutes Listed in the March 3, 1999...

Code of Federal Regulations, 2011 CFR

2011-07-01

.... Refrigerants Unacceptable Substitutes End-use Substitute Decision Comments CFC-12, R-502, and HCFC-22 Household... gas emissions from direct release of refrigerant to the atmosphere. [64 FR 10378, Mar. 3, 1999] ...

Measuring Attitudes toward Acceptable and Unacceptable Parenting Practices

ERIC Educational Resources Information Center

Budd, Karen S.; Behling, Steven; Li, Yan; Parikshak, Sangeeta; Gershenson, Rachel A.; Feuer, Rachel; Danko, Christina M.

2012-01-01

This study investigated the properties of a new rating instrument, the Parenting Questionnaire (PQ), designed to measure attitudes about acceptable and unacceptable parenting practices. In Study 1, subject matter experts representing culturally diverse psychologists, parents, and college students were consulted to identify 110 items receiving high…

Toward optimizing patient-specific IMRT QA techniques in the accurate detection of dosimetrically acceptable and unacceptable patient plans

PubMed Central

McKenzie, Elizabeth M.; Balter, Peter A.; Stingo, Francesco C.; Jones, Jimmy; Followill, David S.; Kry, Stephen F.

2014-01-01

Purpose: The authors investigated the performance of several patient-specific intensity-modulated radiation therapy (IMRT) quality assurance (QA) dosimeters in terms of their ability to correctly identify dosimetrically acceptable and unacceptable IMRT patient plans, as determined by an in-house-designed multiple ion chamber phantom used as the gold standard. A further goal was to examine optimal threshold criteria that were consistent and based on the same criteria among the various dosimeters. Methods: The authors used receiver operating characteristic (ROC) curves to determine the sensitivity and specificity of (1) a 2D diode array undergoing anterior irradiation with field-by-field evaluation, (2) a 2D diode array undergoing anterior irradiation with composite evaluation, (3) a 2D diode array using planned irradiation angles with composite evaluation, (4) a helical diode array, (5) radiographic film, and (6) an ion chamber. This was done with a variety of evaluation criteria for a set of 15 dosimetrically unacceptable and 9 acceptable clinical IMRT patient plans, where acceptability was defined on the basis of multiple ion chamber measurements using independent ion chambers and a phantom. The area under the curve (AUC) on the ROC curves was used to compare dosimeter performance across all thresholds. Optimal threshold values were obtained from the ROC curves while incorporating considerations for cost and prevalence of unacceptable plans. Results: Using common clinical acceptance thresholds, most devices performed very poorly in terms of identifying unacceptable plans. Grouping the detector performance based on AUC showed two significantly different groups. The ion chamber, radiographic film, helical diode array, and anterior-delivered composite 2D diode array were in the better-performing group, whereas the anterior-delivered field-by-field and planned gantry angle delivery using the 2D diode array performed less well. Additionally, based on the AUCs, there was no significant difference in the performance of any device between gamma criteria of 2%/2 mm, 3%/3 mm, and 5%/3 mm. Finally, optimal cutoffs (e.g., percent of pixels passing gamma) were determined for each device and while clinical practice commonly uses a threshold of 90% of pixels passing for most cases, these results showed variability in the optimal cutoff among devices. Conclusions: IMRT QA devices have differences in their ability to accurately detect dosimetrically acceptable and unacceptable plans. Field-by-field analysis with a MapCheck device and use of the MapCheck with a MapPhan phantom while delivering at planned rotational gantry angles resulted in a significantly poorer ability to accurately sort acceptable and unacceptable plans compared with the other techniques examined. Patient-specific IMRT QA techniques in general should be thoroughly evaluated for their ability to correctly differentiate acceptable and unacceptable plans. Additionally, optimal agreement thresholds should be identified and used as common clinical thresholds typically worked very poorly to identify unacceptable plans. PMID:25471949

Toward optimizing patient-specific IMRT QA techniques in the accurate detection of dosimetrically acceptable and unacceptable patient plans.

PubMed

McKenzie, Elizabeth M; Balter, Peter A; Stingo, Francesco C; Jones, Jimmy; Followill, David S; Kry, Stephen F

2014-12-01

The authors investigated the performance of several patient-specific intensity-modulated radiation therapy (IMRT) quality assurance (QA) dosimeters in terms of their ability to correctly identify dosimetrically acceptable and unacceptable IMRT patient plans, as determined by an in-house-designed multiple ion chamber phantom used as the gold standard. A further goal was to examine optimal threshold criteria that were consistent and based on the same criteria among the various dosimeters. The authors used receiver operating characteristic (ROC) curves to determine the sensitivity and specificity of (1) a 2D diode array undergoing anterior irradiation with field-by-field evaluation, (2) a 2D diode array undergoing anterior irradiation with composite evaluation, (3) a 2D diode array using planned irradiation angles with composite evaluation, (4) a helical diode array, (5) radiographic film, and (6) an ion chamber. This was done with a variety of evaluation criteria for a set of 15 dosimetrically unacceptable and 9 acceptable clinical IMRT patient plans, where acceptability was defined on the basis of multiple ion chamber measurements using independent ion chambers and a phantom. The area under the curve (AUC) on the ROC curves was used to compare dosimeter performance across all thresholds. Optimal threshold values were obtained from the ROC curves while incorporating considerations for cost and prevalence of unacceptable plans. Using common clinical acceptance thresholds, most devices performed very poorly in terms of identifying unacceptable plans. Grouping the detector performance based on AUC showed two significantly different groups. The ion chamber, radiographic film, helical diode array, and anterior-delivered composite 2D diode array were in the better-performing group, whereas the anterior-delivered field-by-field and planned gantry angle delivery using the 2D diode array performed less well. Additionally, based on the AUCs, there was no significant difference in the performance of any device between gamma criteria of 2%/2 mm, 3%/3 mm, and 5%/3 mm. Finally, optimal cutoffs (e.g., percent of pixels passing gamma) were determined for each device and while clinical practice commonly uses a threshold of 90% of pixels passing for most cases, these results showed variability in the optimal cutoff among devices. IMRT QA devices have differences in their ability to accurately detect dosimetrically acceptable and unacceptable plans. Field-by-field analysis with a MapCheck device and use of the MapCheck with a MapPhan phantom while delivering at planned rotational gantry angles resulted in a significantly poorer ability to accurately sort acceptable and unacceptable plans compared with the other techniques examined. Patient-specific IMRT QA techniques in general should be thoroughly evaluated for their ability to correctly differentiate acceptable and unacceptable plans. Additionally, optimal agreement thresholds should be identified and used as common clinical thresholds typically worked very poorly to identify unacceptable plans.

47 CFR 22.877 - Unacceptable interference to Part 90 non-cellular 800 MHz licensees from commercial aviation air...

Code of Federal Regulations, 2010 CFR

2010-10-01

...-cellular 800 MHz licensees from commercial aviation air-ground systems. 22.877 Section 22.877 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Air-Ground Radiotelephone Service Commercial Aviation Air-Ground Systems § 22.877 Unacceptable interference...

Incidence of lingual nerve paraesthesia following mandibular third molar surgery

PubMed Central

Lata, Jeevan; Tiwari, Arunesh K.

2011-01-01

Context: The surgical removal of impacted mandibular third molar is associated with minor but expected complications like pain, swelling, bruising and trismus. The lingual nerve damage sometimes occurs after the removal of mandibular third molar producing impaired sensation or permanent sensory loss. This complication is usually unexpected and unacceptable for the patients particularly if no prior warning has been given. Aims: The aim of the present clinical prospective study was to determine the clinical incidence of lingual nerve injury following mandibular third molar removal and to analyze possible factors for the lingual nerve injury. Settings and Design: Clinical prospective study in the Department of Oral Surgery, Punjab Government Dental College and Hospital, Amritsar. Materials and Methods: Ninety patients were selected randomly, amongst the patients, who reported to our department from January 2009 to December 2009 for the surgical removal of impacted mandibular third molar. To minimize the risk of lingual nerve injury, the standard terence wards incision was made in all cases and only buccal flap was raised. Statistical Analysis: The small number of paraesthesia precluded statistical analysis. Results: Out of 90 patients, six patients were diagnosed with lingual nerve paraesthesia. The overall incidence rate of lingual nerve injury was 6.6%. Conclusions: It can be concluded that lingual nerve paraesthesia can occur with or without reflection of lingual flap in spite of all the measures taken to protect it. It may be contributed to the fact of anatomical variations of lingual nerve. PMID:22639500

Pulse compression using a tapered microstructure optical fiber.

PubMed

Hu, Jonathan; Marks, Brian S; Menyuk, Curtis R; Kim, Jinchae; Carruthers, Thomas F; Wright, Barbara M; Taunay, Thierry F; Friebele, E J

2006-05-01

We calculate the pulse compression in a tapered microstructure optical fiber with four layers of holes. We show that the primary limitation on pulse compression is the loss due to mode leakage. As a fiber's diameter decreases due to the tapering, so does the air-hole diameter, and at a sufficiently small diameter the guided mode loss becomes unacceptably high. For the four-layer geometry we considered, a compression factor of 10 can be achieved by a pulse with an initial FWHM duration of 3 ps in a tapered fiber that is 28 m long. We find that there is little difference in the pulse compression between a linear taper profile and a Gaussian taper profile. More layers of air-holes allows the pitch to decrease considerably before losses become unacceptable, but only a moderate increase in the degree of pulse compression is obtained.

Denver's Public Schools: Reforms, Challenges, and the Future

ERIC Educational Resources Information Center

Bray, Judy; Medler, Alex

2009-01-01

Denver is currently in the national education spotlight, largely because of its willingness to try a unique combination of major education reforms not seen in other large urban school districts. While many observers hold these reforms in high regard, a steep road lies ahead. Current student results are unacceptable by all measures. The time is…

Identification of Childhood Disability in Jamaica: The Ten Question Screen.

ERIC Educational Resources Information Center

Thorburn, Marigold; And Others

1992-01-01

This study evaluated use of the Ten Question Screen (TQ) to identify disability in a 2-stage population-based survey of 5,478 children aged 2-9 years in Clarendon, Jamaica. Findings indicated varied sensitivity by different subgroups (age, gender, and disability) and an unacceptably high false positive rate. (Author/DB)

The Relationship Between Repetition Priming and Skill Acquisition

DTIC Science & Technology

1993-01-01

hours of cognitive testing. Given that most measures were of response latency, it neemed unacceptable to include subjects with high error rates indicative...U Leaf Crude Oil Paper Bug Spray Hair Sea Water Plastic Shampoo Rock Blood Cement Ink IF the word is Food, THEN check if its Solid or Liquid LF its

"Getting a Job": Vocationalism, Identity Formation, and Critical Ethnographic Inquiry

ERIC Educational Resources Information Center

Down, Barry; Smyth, John

2012-01-01

This article examines the highly disputed policy nexus around what on the surface appears to be the helpful field of vocational education and training. Despite the promises of vocational education and training to deliver individual labour market success and global competitiveness, the reality is that it serves to residualise unacceptably large…

Why We Test Students for Drugs

ERIC Educational Resources Information Center

Brady, Lisa A.

2008-01-01

Today, there is a collective national awareness that an unacceptable number of teens are involved in the use of dangerous drugs such as methamphetamine, ecstasy, and heroin, and they have access to high-grade marijuana. Alcohol use, even more pervasive, results in risky sexual behaviors, automobile accidents, and even death. To the dismay of many…

The Importance of Tooth Decay Prevention in Children under Three

ERIC Educational Resources Information Center

Milgrom, Peter; Huebner, Colleen; Chi, Donald

2010-01-01

Tooth decay and tooth loss was once the norm but public health interventions have led to major improvements for most people. Nevertheless, not all children have benefited. Dental disease in young children is unacceptably high. Tooth decay is preventable. Early childhood educators are often the first to notice the problem. Professional…

A Critical Review of the Massachusetts Next Generation Science and Technology/Engineering Standards. Policy Brief

ERIC Educational Resources Information Center

Metzenberg, Stan

2015-01-01

Stan Metzenberg offers a critical analysis of the draft "Massachusetts Science and Technology/Engineering Standards," which are for pre-Kindergarten to Grade 8 and introductory high school courses. Metzenberg claims that the document reveals significant, unacceptable gaps in science content, as well as some notable errors and…

Human System Drivers for Exploration Missions

NASA Technical Reports Server (NTRS)

Kundrot, Craig E.; Steinberg, Susan; Charles, John B.

2010-01-01

Evaluation of DRM4 in terms of the human system includes the ability to meet NASA standards, the inclusion of the human system in the design trade space, preparation for future missions and consideration of a robotic precursor mission. Ensuring both the safety and the performance capability of the human system depends upon satisfying NASA Space Flight Human System Standards.1 These standards in turn drive the development of program-specific requirements for Near-earth Object (NEO) missions. In evaluating DRM4 in terms of these human system standards, the currently existing risk models, technologies and biological countermeasures were used. A summary of this evaluation is provided below in a structure that supports a mission architecture planning activities. 1. Unacceptable Level of Risk The duration of the DRM4 mission leads to an unacceptable level of risk for two aspects of human system health: A. The permissible exposure limit for space flight radiation exposure (a human system standard) would be exceeded by DRM4. B. The risk of visual alterations and abnormally high intracranial pressure would be too high. 1

T Cell-Replete Peripheral Blood Haploidentical Hematopoietic Cell Transplantation with Post-Transplantation Cyclophosphamide Results in Outcomes Similar to Transplantation from Traditionally Matched Donors in Active Disease Acute Myeloid Leukemia.

PubMed

How, Joan; Slade, Michael; Vu, Khoan; DiPersio, John F; Westervelt, Peter; Uy, Geoffrey L; Abboud, Camille N; Vij, Ravi; Schroeder, Mark A; Fehniger, Todd A; Romee, Rizwan

2017-04-01

Outcomes for patients with acute myeloid leukemia (AML) who fail to achieve complete remission remain poor. Hematopoietic cell transplantation (HCT) has been shown to induce long-term survival in AML patients with active disease. HCT is largely performed with HLA-matched unrelated or HLA-matched related donors. Recently, HCT with HLA-haploidentical related donors has been identified as a feasible option when HLA-matched donors are not immediately available. However, there are little data comparing outcomes for AML patients with active disease who receive haploidentical versus traditionally matched HCT. We retrospectively analyzed data from 99 AML patients with active disease undergoing allogeneic HCT at a single institution. Forty-three patients received unrelated donor HCT, 32 patients received matched related donor HCT, and 24 patients received peripheral blood haploidentical HCT with post-transplantation cyclophosphamide. We found no significant differences between treatment groups in terms of overall survival (OS), event-free survival, transplantation-related mortality, cumulative incidence of relapse, and cumulative incidence of acute and chronic graft-versus-host disease (GVHD). We performed univariate regression analysis of variables that modified OS in all patients and found only younger age at transplantation and development of chronic GVHD significantly improved outcome. Although limited by our relatively small sample size, these results indicate that haploidentical HCT in active AML patients have comparable outcomes to HCT with traditionally matched donors. Haploidentical HCT can be considered in this population of high-risk patients when matched donors are unavailable or when wait times for transplantation are unacceptably long. Copyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

Invasive Candidiasis in Various Patient Populations: Incorporating Non-Culture Diagnostic Tests into Rational Management Strategies

PubMed Central

Clancy, Cornelius J.; Shields, Ryan K.; Nguyen, M. Hong

2016-01-01

Mortality rates due to invasive candidiasis remain unacceptably high, in part because the poor sensitivity and slow turn-around time of cultures delay the initiation of antifungal treatment. β-d-glucan (Fungitell) and polymerase chain reaction (PCR)-based (T2Candida) assays are FDA-approved adjuncts to cultures for diagnosing invasive candidiasis, but their clinical roles are unclear. We propose a Bayesian framework for interpreting non-culture test results and developing rational patient management strategies, which considers test performance and types of invasive candidiasis that are most common in various patient populations. β-d-glucan sensitivity/specificity for candidemia and intra-abdominal candidiasis is ~80%/80% and ~60%/75%, respectively. In settings with 1%–10% likelihood of candidemia, anticipated β-d-glucan positive and negative predictive values are ~4%–31% and ≥97%, respectively. Corresponding values in settings with 3%–30% likelihood of intra-abdominal candidiasis are ~7%–51% and ~78%–98%. β-d-glucan is predicted to be useful in guiding antifungal treatment for wide ranges of populations at-risk for candidemia (incidence ~5%–40%) or intra-abdominal candidiasis (~7%–20%). Validated PCR-based assays should broaden windows to include populations at lower-risk for candidemia (incidence ≥~2%) and higher-risk for intra-abdominal candidiasis (up to ~40%). In the management of individual patients, non-culture tests may also have value outside of these windows. The proposals we put forth are not definitive treatment guidelines, but rather represent starting points for clinical trial design and debate by the infectious diseases community. The principles presented here will be applicable to other assays as they enter the clinic, and to existing assays as more data become available from different populations. PMID:29376927

Multicenter, dose-ranging study of efegatran sulfate versus heparin with thrombolysis for acute myocardial infarction: The Promotion of Reperfusion in Myocardial Infarction Evolution (PRIME) trial.

PubMed

2002-01-01

Adjunctive therapies that increase the incidence of normal reperfusion after thrombolysis for acute myocardial infarction (MI) could enhance clinical outcomes. Direct thrombin inhibitors may offer an advantage over standard adjunctive therapies. We randomized 336 patients with acute MI at 33 sites to receive 1 of 5 doses of efegatran sulfate, a direct thrombin inhibitor, or heparin for 72 to 96 hours, both with accelerated alteplase and aspirin. The primary end point was the incidence of thrombolytic failure (death, reinfarction, or TIMI grade 0-2 flow in the infarct artery from 90 minutes to discharge or 30 days, whichever occurred earlier). Significantly more patients randomized to efegatran had evidence of heart failure at admission. The lowest-dose efegatran arm was terminated at 15 patients because of unacceptably increased thrombolytic failure. The primary end point occurred in 53.0% of patients treated with heparin, in 53.8% of patients treated with efegatran overall (P =.90), and in 55.4% of patients given intermediate-dose efegatran (P =.74). These findings were unaffected after adjustment was done for baseline differences. Most bleeding was minor; major bleeding and the use of blood transfusions did not differ significantly by treatment. Three patients in the high-dose efegatran group had intracranial hemorrhage, as did 1 patient in the heparin group. Continuous ST monitoring showed a shorter time to recovery for the efegatran group (median 107 minutes) compared with the heparin group (154 minutes; P =.025). Efegatran sulfate appeared to offer no clear advantage over heparin as an adjunct to thrombolysis for acute myocardial infarction, although there may be a modest improvement in time to reperfusion.

Patterns of failure after postoperative radiotherapy for incompletely resected (R1) non-small cell lung cancer: implications for radiation target volume design.

PubMed

Olszyna-Serementa, Marta; Socha, Joanna; Wierzchowski, Marek; Kępka, Lucyna

2013-05-01

Overall survival (OS) and pattern of failure in R1-resected non-small cell lung cancer (NSCLC) patients treated with 3D-planned postoperative radiotherapy (PORT) was retrospectively evaluated. The outcomes and patterns of failure in patients with (+) and without (-) extracapsular nodal extension (ECE) were compared and analyzed with respect to the radiation target volume design. Eighty R1-resected (37 ECE+ and 43 ECE-) patients received PORT (60Gy, 2Gy daily) between 2002 and 2011. Patients with N2 disease received limited elective nodal irradiation (ENI); for pN0-1 disease the use of ENI was optional. Among ECE- (extranodal-R1) patients there were 35 pN0-1 and eight pN2 cases; in pN0-1 patients, patterns of failure and outcomes were analyzed with respect to the use of ENI. Loco-regional failure (LRF) was defined as in-field relapse; isolated nodal failure (INF) was defined as out-of-field regional nodal recurrence occurring without LRF, irrespective of distant metastases. The actuarial 3-year OS rate was 36.3% (median: 30 months). Three-year OS rates in the ECE- and ECE+ group were 40.4% and 31.4%, with median OS of 31 and 24 months, respectively (p=0.43). In multivariate analysis, the presence of ECE was correlated with OS (HR=3.02; 95% CI: 1.00-9.16; p=0.05). Three-year cumulative incidence of LRF (CILRF) was 14.5% and 15.5% in the ECE- and ECE+ groups, respectively (p=0.98). Three-year cumulative incidence of INF (CIINF) was 14.1% in the ECE- group and 11.1% in the ECE+ group (p=0.76). For pN0-1 patients treated with and without ENI (13 and 22 patients) 3-year CILRF rates were 7.7% and 20.8%, respectively (p=0.20); 3-year CIINF rates were 9.1% and 16.3%, respectively (p=0.65). PORT resulted in a relatively good survival of R1-resected NSCLC patients. Relatively high incidence of INF was found in both ECE+ and ECE- patients. For ECE+ patients, treated with limited ENI, distant failure remains a major concern, so the design of ENI fields seems of lesser importance. Omission of ENI in pN0-1 (extranodal-R1) patients resulted in an unacceptably high incidence of INF. We postulate the use of some form of ENI in this setting. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Parameters. US Army War College Quarterly. Volume 25. Number 1. Spring 1995,

DTIC Science & Technology

1995-01-01

major reason the fratricide rate remains so high is that imperfect human skills and judgment needed to employ weapon systems quickly degrade under...and rehearsals before the Desert Storm ground campaign, the residual rate of fratricide remained unacceptably high. Nor are the high rates at our combat...California State University, Fullerton. He is the editor and an author of The Search For Strategy: Politics and Strategic Vision. Spring 1995 31 Haiti, Peru

47 CFR 22.877 - Unacceptable interference to part 90 non-cellular 800 MHz licensees from commercial aviation air...

Code of Federal Regulations, 2014 CFR

2014-10-01

...-cellular 800 MHz licensees from commercial aviation air-ground systems. 22.877 Section 22.877...-Ground Radiotelephone Service Commercial Aviation Air-Ground Systems § 22.877 Unacceptable interference to part 90 non-cellular 800 MHz licensees from commercial aviation air-ground systems. The definition...

47 CFR 22.877 - Unacceptable interference to Part 90 non-cellular 800 MHz licensees from commercial aviation air...

Code of Federal Regulations, 2012 CFR

2012-10-01

...-cellular 800 MHz licensees from commercial aviation air-ground systems. 22.877 Section 22.877...-Ground Radiotelephone Service Commercial Aviation Air-Ground Systems § 22.877 Unacceptable interference to Part 90 non-cellular 800 MHz licensees from commercial aviation air-ground systems. The definition...

47 CFR 22.877 - Unacceptable interference to Part 90 non-cellular 800 MHz licensees from commercial aviation air...

Code of Federal Regulations, 2011 CFR

2011-10-01

...-cellular 800 MHz licensees from commercial aviation air-ground systems. 22.877 Section 22.877...-Ground Radiotelephone Service Commercial Aviation Air-Ground Systems § 22.877 Unacceptable interference to Part 90 non-cellular 800 MHz licensees from commercial aviation air-ground systems. The definition...

47 CFR 22.877 - Unacceptable interference to Part 90 non-cellular 800 MHz licensees from commercial aviation air...

Code of Federal Regulations, 2013 CFR

2013-10-01

...-cellular 800 MHz licensees from commercial aviation air-ground systems. 22.877 Section 22.877...-Ground Radiotelephone Service Commercial Aviation Air-Ground Systems § 22.877 Unacceptable interference to Part 90 non-cellular 800 MHz licensees from commercial aviation air-ground systems. The definition...

Pre-Crisis Intervention Strategies for Reducing Unacceptable Behaviors by Exceptional Students in a Public Elementary School.

ERIC Educational Resources Information Center

Levine-Brown, Linda S.

This report describes the implementation of a data-based program to reduce unacceptable student behaviors and decrease the number of administrative interventions with 21 students with severe emotional disturbances. A computerized database was developed to track classroom and transportation discipline infractions. Students met monthly to review…

Verification of Dose Distribution in Carbon Ion Radiation Therapy for Stage I Lung Cancer

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

Irie, Daisuke; Saitoh, Jun-ichi, E-mail: junsaito@gunma-u.ac.jp; Shirai, Katsuyuki

Purpose: To evaluate robustness of dose distribution of carbon-ion radiation therapy (C-ion RT) in non-small cell lung cancer (NSCLC) and to identify factors affecting the dose distribution by simulated dose distribution. Methods and Materials: Eighty irradiation fields for delivery of C-ion RT were analyzed in 20 patients with stage I NSCLC. Computed tomography images were obtained twice before treatment initiation. Simulated dose distribution was reconstructed on computed tomography for confirmation under the same settings as actual treatment with respiratory gating and bony structure matching. Dose-volume histogram parameters, such as %D95 (percentage of D95 relative to the prescribed dose), were calculated.more » Patients with any field for which the %D95 of gross tumor volume (GTV) was below 90% were classified as unacceptable for treatment, and the optimal target margin for such cases was examined. Results: Five patients with a total of 8 fields (10% of total number of fields analyzed) were classified as unacceptable according to %D95 of GTV, although most patients showed no remarkable change in the dose-volume histogram parameters. Receiver operating characteristic curve analysis showed that tumor displacement and change in water-equivalent pathlength were significant predictive factors of unacceptable cases (P<.001 and P=.002, respectively). The main cause of degradation of the dose distribution was tumor displacement in 7 of the 8 unacceptable fields. A 6-mm planning target volume margin ensured a GTV %D95 of >90%, except in 1 extremely unacceptable field. Conclusions: According to this simulation analysis of C-ion RT for stage I NSCLC, a few fields were reported as unacceptable and required resetting of body position and reconfirmation. In addition, tumor displacement and change in water-equivalent pathlength (bone shift and/or chest wall thickness) were identified as factors influencing the robustness of dose distribution. Such uncertainties should be regarded in planning.« less

Tobacco control environment: cross-sectional survey of policy implementation, social unacceptability, knowledge of tobacco health harms and relationship to quit ratio in 17 low-income, middle-income and high-income countries

PubMed Central

Corsi, Daniel J; Gilmore, Anna B; Kruger, Annamarie; Igumbor, Ehimario; Chifamba, Jephat; Yang, Wang; Wei, Li; Iqbal, Romaina; Mony, Prem; Gupta, Rajeev; Vijayakumar, Krishnapillai; Mohan, V; Kumar, Rajesh; Rahman, Omar; Yusoff, Khalid; Ismail, Noorhassim; Zatonska, Katarzyna; Altuntas, Yuksel; Rosengren, Annika; Bahonar, Ahmad; Yusufali, AfzalHussein; Dagenais, Gilles; Lear, Scott; Diaz, Rafael; Avezum, Alvaro; Lopez-Jaramillo, Patricio; Lanas, Fernando; Rangarajan, Sumathy; Teo, Koon; McKee, Martin; Yusuf, Salim

2017-01-01

Objectives This study examines in a cross-sectional study ‘the tobacco control environment’ including tobacco policy implementation and its association with quit ratio. Setting 545 communities from 17 high-income, upper-middle, low-middle and low-income countries (HIC, UMIC, LMIC, LIC) involved in the Environmental Profile of a Community's Health (EPOCH) study from 2009 to 2014. Participants Community audits and surveys of adults (35–70 years, n=12 953). Primary and secondary outcome measures Summary scores of tobacco policy implementation (cost and availability of cigarettes, tobacco advertising, antismoking signage), social unacceptability and knowledge were associated with quit ratios (former vs ever smokers) using multilevel logistic regression models. Results Average tobacco control policy score was greater in communities from HIC. Overall 56.1% (306/545) of communities had >2 outlets selling cigarettes and in 28.6% (154/539) there was access to cheap cigarettes (<5cents/cigarette) (3.2% (3/93) in HIC, 0% UMIC, 52.6% (90/171) LMIC and 40.4% (61/151) in LIC). Effective bans (no tobacco advertisements) were in 63.0% (341/541) of communities (81.7% HIC, 52.8% UMIC, 65.1% LMIC and 57.6% LIC). In 70.4% (379/538) of communities, >80% of participants disapproved youth smoking (95.7% HIC, 57.6% UMIC, 76.3% LMIC and 58.9% LIC). The average knowledge score was >80% in 48.4% of communities (94.6% HIC, 53.6% UMIC, 31.8% LMIC and 35.1% LIC). Summary scores of policy implementation, social unacceptability and knowledge were positively and significantly associated with quit ratio and the associations varied by gender, for example, communities in the highest quintile of the combined scores had 5.0 times the quit ratio in men (Odds ratio (OR) 5·0, 95% CI 3.4 to 7.4) and 4.1 times the quit ratio in women (OR 4.1, 95% CI 2.4 to 7.1). Conclusions This study suggests that more focus is needed on ensuring the tobacco control policy is actually implemented, particularly in LMICs. The gender-related differences in associations of policy, social unacceptability and knowledge suggest that different strategies to promoting quitting may need to be implemented in men compared to women. PMID:28363924

Sugar substitutes: their energy values, bulk characteristics, and potential health benefits.

PubMed

Levin, G V; Zehner, L R; Saunders, J P; Beadle, J R

1995-11-01

Restriction of dietary energy extends life and reduces incidences of disease in animals. These benefits would likely extend to humans. However, diet restriction in animals imposes reductions of 30-50% in food intake, which is probably unacceptable to humans. Low-energy sweeteners used in beverages offer minor reductions in energy intake. However, they lack the bulk required for baked goods and other sugar-rich foods. Full-bulk sweeteners providing about one-half the energy of sugar are under development for such uses. Laxation limits their acceptable dose. Even within such limitations, they can help achieve the health benefits for humans indicated by diet restriction. D-Tagatose, a new candidate sweetener, is nearly as sweet as sucrose and has the bulk of sucrose, yet provides zero available energy. We discuss its potential contribution to human diet restriction along with its specific effect in delaying the aging effects of glycosylation.

Environmental Health

NASA Technical Reports Server (NTRS)

Pierson, Duane; James, John; Russo, Dane; Limero, Thomas; Beck, Steve; Groves, Theron

1999-01-01

The Environmental Health activity for the Extended Duration Orbiter Medical Project (EDOMP) was formed to develop an overall strategy for safeguarding crew members from potential airborne hazards anticipated on missions of extended duration. These efforts were necessary because of major modifications to the air revitalization system of the U.S. Space Shuttle and an increased potential for environmental health risks associated with longer space flights. Degradation of air quality in the Shuttle during a space flight mission has the potential to affect the performance of the crew not only during piloting, landing, or egress, but also during space flight. It was anticipated that the risk of significant deterioration in air quality would increase with extended mission lengths and could result from: (1) a major chemical contamination incident, such as a thermodegradation event or toxic leak, (2) continual accumulation of volatile organic compounds to unacceptable levels, (3) excessive levels of airborne particles, (4) excessive levels of microorganisms, or (5) accumulation of airborne pathogens.

Cerebral oxygenation and hemodynamic changes during infant cardiac surgery: measurements by near infrared spectroscopy

NASA Astrophysics Data System (ADS)

du Plessis, Adre J.; Volpe, Joseph J.

1996-10-01

Despite dramatic advances in the survival rate among infants undergoing cardiac surgery for congenital heart disease, the incidence of brain injury suffered by survivors remains unacceptably high. This is largely due to our limited understanding of the complex changes in cerebral oxygen utilization and supply occurring during the intraoperative period as a result of hypothermia, neuroactive drugs, and profound circulatory changes. Current techniques for monitoring the adequacy of cerebral oxygen supply and utilization during hypothermic cardiac surgery are inadequate to address this complex problem and consequently to identify the infant at risk for such brain injury. Furthermore, this inability to detect imminent hypoxic- ischemic brain injury is likely to become all the more conspicuous as new neuroprotective strategies, capable of salvaging 'insulated' neuronal tissue form cell death, enter the clinical arena. Near infrared spectroscopy is a relatively new, noninvasive, and portable technique capable of interrogating the oxygenation and hemodynamics of tissue in vivo. These characteristics of the technique have generated enormous interest among clinicians in the ability of near infrared spectroscopy to elucidate the mechanisms of intraoperative brain injury and ultimately to identify infants oat risk for such injury. This paper reviews the experience with this technique to date during infant cardiac surgery.

Monte Carlo studies of ocean wind vector measurements by SCATT: Objective criteria and maximum likelihood estimates for removal of aliases, and effects of cell size on accuracy of vector winds

NASA Technical Reports Server (NTRS)

Pierson, W. J.

1982-01-01

The scatterometer on the National Oceanic Satellite System (NOSS) is studied by means of Monte Carlo techniques so as to determine the effect of two additional antennas for alias (or ambiguity) removal by means of an objective criteria technique and a normalized maximum likelihood estimator. Cells nominally 10 km by 10 km, 10 km by 50 km, and 50 km by 50 km are simulated for winds of 4, 8, 12 and 24 m/s and incidence angles of 29, 39, 47, and 53.5 deg for 15 deg changes in direction. The normalized maximum likelihood estimate (MLE) is correct a large part of the time, but the objective criterion technique is recommended as a reserve, and more quickly computed, procedure. Both methods for alias removal depend on the differences in the present model function at upwind and downwind. For 10 km by 10 km cells, it is found that the MLE method introduces a correlation between wind speed errors and aspect angle (wind direction) errors that can be as high as 0.8 or 0.9 and that the wind direction errors are unacceptably large, compared to those obtained for the SASS for similar assumptions.

Sabotage at Nuclear Power Plants

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

Purvis, James W.

1999-07-21

Recently there has been a noted worldwide increase in violent actions including attempted sabotage at nuclear power plants. Several organizations, such as the International Atomic Energy Agency and the US Nuclear Regulatory Commission, have guidelines, recommendations, and formal threat- and risk-assessment processes for the protection of nuclear assets. Other examples are the former Defense Special Weapons Agency, which used a risk-assessment model to evaluate force-protection security requirements for terrorist incidents at DOD military bases. The US DOE uses a graded approach to protect its assets based on risk and vulnerability assessments. The Federal Aviation Administration and Federal Bureau of Investigationmore » conduct joint threat and vulnerability assessments on high-risk US airports. Several private companies under contract to government agencies use formal risk-assessment models and methods to identify security requirements. The purpose of this paper is to survey these methods and present an overview of all potential types of sabotage at nuclear power plants. The paper discusses emerging threats and current methods of choice for sabotage--especially vehicle bombs and chemical attacks. Potential consequences of sabotage acts, including economic and political; not just those that may result in unacceptable radiological exposure to the public, are also discussed. Applicability of risk-assessment methods and mitigation techniques are also presented.« less

Integrated Environmental Risk Assessment and Whole-Process Management System in Chemical Industry Parks

PubMed Central

Shao, Chaofeng; Yang, Juan; Tian, Xiaogang; Ju, Meiting; Huang, Lei

2013-01-01

Chemical industry parks in China are considered high-risk areas because they present numerous risks that can damage the environment, such as pollution incidents. In order to identify the environmental risks and the principal risk factors in these areas, we have developed a simple physical model of a regional environmental risk field (ERF) using existing dispersal patterns and migration models. The regional ERF zoning was also conducted and a reference value for diagnostic methods was developed to determine risk-acceptable, risk-warning, and risk-mitigation zones, which can provide a risk source layout for chemical industry parks. In accordance with the environmental risk control requirements, this study focused on the three stages of control and management of environmental risk and established an environmental risk management system including risk source identification and assessment, environmental safety planning, early risk warning, emergency management, assessment of environmental effects, and environmental remediation of pollution accidents. By using this model, the environmental risks in Tianjin Binhai New Area, the largest chemical industry park in China, were assessed and the environmental risk zoning map was drawn, which suggested the existence of many unacceptable environmental risks in this area. Thus, relevant suggestions have been proposed from the perspective of the adjustment of risk source layout, intensified management of environmental risk control and so on. PMID:23603866

Integrated environmental risk assessment and whole-process management system in chemical industry parks.

PubMed

Shao, Chaofeng; Yang, Juan; Tian, Xiaogang; Ju, Meiting; Huang, Lei

2013-04-19

Chemical industry parks in China are considered high-risk areas because they present numerous risks that can damage the environment, such as pollution incidents. In order to identify the environmental risks and the principal risk factors in these areas, we have developed a simple physical model of a regional environmental risk field (ERF) using existing dispersal patterns and migration models. The regional ERF zoning was also conducted and a reference value for diagnostic methods was developed to determine risk-acceptable, risk-warning, and risk-mitigation zones, which can provide a risk source layout for chemical industry parks. In accordance with the environmental risk control requirements, this study focused on the three stages of control and management of environmental risk and established an environmental risk management system including risk source identification and assessment, environmental safety planning, early risk warning, emergency management, assessment of environmental effects, and environmental remediation of pollution accidents. By using this model, the environmental risks in Tianjin Binhai New Area, the largest chemical industry park in China, were assessed and the environmental risk zoning map was drawn, which suggested the existence of many unacceptable environmental risks in this area. Thus, relevant suggestions have been proposed from the perspective of the adjustment of risk source layout, intensified management of environmental risk control and so on.

Stars and stripes in pancreatic cancer: role of stellate cells and stroma in cancer progression

PubMed Central

Wilson, Jeremy S.; Pirola, Romano C.; Apte, Minoti V.

2014-01-01

Pancreatic cancer is a devastating disease with an unacceptably high mortality to incidence ratio. Traditional therapeutic approaches such as surgery in combination with chemo- or radiotherapy have had limited efficacy in improving the outcome of this disease. Up until just under a decade ago, the prominent desmoplastic reaction which is a characteristic of the majority of pancreatic ductal adenocarcinomas (PDAC) had been largely ignored. However, since the identification of the pancreatic stellate cell (PSC) as the key cell responsible for the production of the collagenous stroma in PDAC, increasing attention has been paid to the role of the stromal reaction in pancreatic cancer pathobiology. There is now compelling evidence that PSCs interact not only with cancer cells themselves, but with several other cell types in the stroma (endothelial cells, immune cells, and possibly neuronal cells) to promote cancer progression. This review summarizes current knowledge in the field about the influence of PSCs and the stromal microenvironment on cancer behavior and discusses novel therapeutic approaches which reflect an increasing awareness amongst clinicians and researchers that targeting cancer cells alone is no longer sufficient to improve patient outcome and that combinatorial treatments targeting the stroma as well as the cancer cells will be required to change the clinical course of this disease. PMID:24592240

EPs welcome new focus on reducing diagnostic errors.

PubMed

2015-12-01

Emergency medicine leaders welcome a major new report from the Institute of Medicine (IOM) calling on providers, policy makers, and government agencies to institute changes to reduce the incidence of diagnostic errors. The 369-page report, "Improving Diagnosis in Health Care," states that the rate of diagnostic errors in this country is unacceptably high and offers a long list of recommendations aimed at addressing the problem. These include large, systemic changes that involve improvements in multiple areas, including health information technology (HIT), professional education, teamwork, and payment reform. Further, of particular interest to emergency physicians are recommended changes to the liability system. The authors of the IOM report state that while most people will likely experience a significant diagnostic error in their lifetime, the importance of this problem is under-appreciated. According to conservative estimates, the report says 5% of adults who seek outpatient care each year experience a diagnostic error. The report also notes that research over many decades shows diagnostic errors contribute to roughly 10% of all.deaths. The report says more steps need to be taken to facilitate inter-professional and intra-professional teamwork throughout the diagnostic process. Experts concur with the report's finding that mechanisms need to be developed so that providers receive ongoing feedback on their diagnostic performance.

Long Duration Space Missions: Human Subsystem Risks and Requirements

NASA Technical Reports Server (NTRS)

Kundrot, Criag E.

2011-01-01

This viewgraph presentation reviews the human health and performance risks associated with long duration space flight beyond low earth orbit. The contents include: 1) Human Research Program; 2) Human Subsystem Risks; 3) Human Exploration Framework Team (HEFT) Architecture Elements; 4) Potentially Unacceptable Risks -1; 5) Potentially Unacceptable Risks-2; and 6) Major Mission Drivers of Risk.

Fuel cell flooding detection and correction

DOEpatents

DiPierno Bosco, Andrew; Fronk, Matthew Howard

2000-08-15

Method and apparatus for monitoring an H.sub.2 -O.sub.2 PEM fuel cells to detect and correct flooding. The pressure drop across a given H.sub.2 or O.sub.2 flow field is monitored and compared to predetermined thresholds of unacceptability. If the pressure drop exists a threshold of unacceptability corrective measures are automatically initiated.

47 CFR 22.970 - Unacceptable interference to part 90 non-cellular 800 MHz licensees from cellular radiotelephone...

Code of Federal Regulations, 2011 CFR

2011-10-01

...-cellular 800 MHz licensees from cellular radiotelephone or part 90-800 MHz cellular systems. 22.970 Section... MOBILE SERVICES Cellular Radiotelephone Service § 22.970 Unacceptable interference to part 90 non-cellular 800 MHz licensees from cellular radiotelephone or part 90-800 MHz cellular systems. (a) Definition...

The Perfect Place to Work? Australian Academic Libraries and Unacceptable Behaviour

ERIC Educational Resources Information Center

Moorcroft, Heather

2009-01-01

Despite the stereotype of libraries as peaceful retreats, unacceptable behaviour is a reality that desk staff have to deal with. This paper outlines the results of two surveys conducted at Charles Darwin University Library to investigate the extent to which this is a problem in Australian academic libraries. The first survey went to CAUL (Council…

47 CFR 22.970 - Unacceptable interference to part 90 non-cellular 800 MHz licensees from cellular radiotelephone...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 22.970 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Cellular Radiotelephone Service § 22.970 Unacceptable interference to part 90 non... −104 dBm or higher, as measured at the R.F. input of the receiver of a mobile unit; or (B) A median...

The Budget of the United States Government. Department of Defense Extract for Fiscal Year 1985

DTIC Science & Technology

1984-02-01

with real GNP rising over 6% and industrial production by 16%. Unemployment, though still unacceptably high , has declined by a record 2l/z...the administration will focus its legislative effort on three of those proposals, in modified form: cost-of-living adjustment (COLA) reform, a high 5...computer matching, adjusted payment schedules, contractor and grantee performance incentives, and a streamlined field structure. All of these efforts

Intercomparison of CO 2 measurements

NASA Astrophysics Data System (ADS)

Poisson, A.; Culkin, F.; Ridout, P.

1990-10-01

Seawater samples, of four different salinities, were analysed for total alkalinity, total CO 2, pH and pCO 2 by up to 12 laboratories. The results showthat although most laboratories are capable of high precision in these determinations, there is an unacceptably high disagreement between their analyses of the same samples. For global programmes involving studies of the CO 2 system in seawater, it is strongly recommended that standard reference materials be made widely available.

Shooting for Stars: Cross-Sector Lessons for Retaining High-Performing Educators. Building an Opportunity Culture for America's Teachers

ERIC Educational Resources Information Center

Ableidinger, Joe; Kowal, Julie

2010-01-01

As the United States continues to grapple with unacceptable education results, "a great teacher for every student" has risen to a national imperative. In response, many districts have increased retention efforts through teacher induction programs, professional development, mentoring, and other strategies. But education actually has lower…

Connecting Caring and Action through Responsive Teaching: How One Team Accomplished Success in a Struggling Middle School

ERIC Educational Resources Information Center

Strahan, David B.; Layell, Krystal

2006-01-01

In "Turning Points 2000," Jackson and Davis noted that "changes in middle grades practices have least often occurred where they are needed most: in high-poverty urban and rural communities where unacceptably poor student achievement is rampant". Even so, in many struggling schools, some teams have achieved success. Their…

Collection Development "Dog Care & Training": The Well-Behaved Dog

ERIC Educational Resources Information Center

Alpi, Kristine M.; Sherman, Barbara L.

2008-01-01

Dogs are indeed people's best friends. A majority of owners report that their dog is a "member of the family," and that acceptable canine behavior and optimal care are high priorities for them. The human-animal bond, the close connection between people and their pets, is forged by positive interactions, but unacceptable canine behaviors that…

Challenging Traditional Assumptions of High School Science through the Physics and Everyday Thinking Curriculum™

ERIC Educational Resources Information Center

Ross, Michael J.

2013-01-01

Science education in the U.S. has failed for over a century to bring the experience of scientific induction to classrooms, from elementary science to undergraduate courses. The achievement of American students on international comparisons of science proficiency is unacceptable, and the disparities between groups underrepresented in STEM and others…

EPA publishes notice to extend comment period to close 6/16/16 on proposal to list new substitutes and prohibit certain high-GWP HFCs as alternatives under SNAP

EPA Pesticide Factsheets

Proposed New Listings of Substitutes; Changes of Listing Status; and Reinterpretation of Unacceptability for Closed Cell Foam Products Under the Significant New Alternatives Policy Program; and Revision of Clean Air Act Section 608 Venting Prohibition for

Synchronous Half-Wave Rectifier

NASA Technical Reports Server (NTRS)

Rippel, Wally E.

1989-01-01

Synchronous rectifying circuit behaves like diode having unusually low voltage drop during forward-voltage half cycles. Circuit particularly useful in power supplies with potentials of 5 Vdc or less, where normal forward-voltage drops in ordinary diodes unacceptably large. Fabricated as monolithic assembly or as hybrid. Synchronous half-wave rectifier includes active circuits to attain low forward voltage drop and high rectification efficiency.

First Annual Report: NASA-ONERA Collaboration on Human Factors in Aviation Accidents and Incidents

NASA Technical Reports Server (NTRS)

Srivastava, Ashok; Fabiani, Patrick

2012-01-01

This is the first annual report jointly prepared by NASA and ONERA on the work performed under the agreement to collaborate on a study of the human factors entailed in aviation accidents and incidents particularly focused on consequences of decreases in human performance associated with fatigue. The objective of this Agreement is to generate reliable, automated procedures that improve understanding of the levels and characteristics of flight-crew fatigue factors whose confluence will likely result in unacceptable crew performance. This study entails the analyses of numerical and textual data collected during operational flights. NASA and ONERA are collaborating on the development and assessment of automated capabilities for extracting operationally significant information from very large, diverse (textual and numerical) databases much larger than can be handled practically by human experts. This report presents the approach that is currently expected to be used in processing and analyzing the data for identifying decrements in aircraft performance and examining their relationships to decrements in crewmember performance due to fatigue. The decisions on the approach were based on samples of both the numerical and textual data that will be collected during the four studies planned under the Human Factors Monitoring Program (HFMP). Results of preliminary analyses of these sample data are presented in this report.

Influence of season and type of restaurants on sashimi microbiota.

PubMed

Miguéis, S; Moura, A T; Saraiva, C; Esteves, A

2016-10-01

In recent years, an increase in the consumption of Japanese food in European countries has been verified, including in Portugal. These specialities made with raw fish, typical Japanese meals, have been prepared in typical and on non-typical restaurants, and represent a challenge to risk analysis on HACCP plans. The aim of this study was to evaluate the influence of the type of restaurant, season and type of fish used on sashimi microbiota. Sashimi samples (n = 114) were directly collected from 23 sushi restaurants and were classified as Winter and Summer Samples. They were also categorized according to the type of restaurant where they were obtained: as typical or non-typical. The samples were processed using international standards procedures. A middling seasonality influence was observed in microbiota using mesophilic aerobic bacteria, psychrotrophic microorganisms, Lactic acid bacteria, Pseudomonas spp., H 2 S positive bacteria, mould and Bacillus cereus counts parameters. During the Summer Season, samples classified as unacceptable or potentially Hazardous were observed. Non-typical restaurants had the most cases of Unacceptable/potentially hazardous samples 83.33%. These unacceptable results were obtained as a result of high values of pathogenic bacteria like Listeria monocytogenes and Staphylococcus aureus No significant differences were observed on microbiota counts from different fish species. The need to implement more accurate food safety systems was quite evident, especially in the warmer season, as well as in restaurants where other kinds of food, apart from Japanese meals, was prepared. © Crown copyright 2016.

Automated Weaning from Mechanical Ventilation after Off-Pump Coronary Artery Bypass Grafting.

PubMed

Fot, Evgenia V; Izotova, Natalia N; Yudina, Angelika S; Smetkin, Aleksei A; Kuzkov, Vsevolod V; Kirov, Mikhail Y

2017-01-01

The discontinuation of mechanical ventilation after coronary surgery may prolong and significantly increase the load on intensive care unit personnel. We hypothesized that automated mode using INTELLiVENT-ASV can decrease duration of postoperative mechanical ventilation, reduce workload on medical staff, and provide safe ventilation after off-pump coronary artery bypass grafting (OPCAB). The primary endpoint of our study was to assess the duration of postoperative mechanical ventilation during different modes of weaning from respiratory support (RS) after OPCAB. The secondary endpoint was to assess safety of the automated weaning mode and the number of manual interventions to the ventilator settings during the weaning process in comparison with the protocolized weaning mode. Forty adult patients undergoing elective OPCAB were enrolled into a prospective single-center study. Patients were randomized into two groups: automated weaning ( n  = 20) using INTELLiVENT-ASV mode with quick-wean option; and protocolized weaning ( n  = 20), using conventional synchronized intermittent mandatory ventilation (SIMV) + pressure support (PS) mode. We assessed the duration of postoperative ventilation, incidence and duration of unacceptable RS, and the load on medical staff. We also performed the retrospective analysis of 102 patients (standard weaning) who were weaned from ventilator with SIMV + PS mode based on physician's experience without prearranged algorithm. Realization of the automated weaning protocol required change in respiratory settings in 2 patients vs. 7 (5-9) adjustments per patient in the protocolized weaning group. Both incidence and duration of unacceptable RS were reduced significantly by means of the automated weaning approach. The FiO 2 during spontaneous breathing trials was significantly lower in the automated weaning group: 30 (30-35) vs. 40 (40-45) % in the protocolized weaning group ( p  < 0.01). The average time until tracheal extubation did not differ in the automated weaning and the protocolized weaning groups: 193 (115-309) and 197 (158-253) min, respectively, but increased to 290 (210-411) min in the standard weaning group. The automated weaning system after off-pump coronary surgery might provide postoperative ventilation in a more protective way, reduces the workload on medical staff, and does not prolong the duration of weaning from ventilator. The use of automated or protocolized weaning can reduce the duration of postoperative mechanical ventilation in comparison with non-protocolized weaning based on the physician's decision.

47 CFR 90.672 - Unacceptable interference to non-cellular 800 MHz licensees from 800 MHz cellular systems or part...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 5 2010-10-01 2010-10-01 false Unacceptable interference to non-cellular 800 MHz licensees from 800 MHz cellular systems or part 22 Cellular Radiotelephone systems, and within the 900 MHz Business/Industrial Land Transportation Pool. 90.672 Section 90.672 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY...

[Aspergillus species in hospital environments with pediatric patients in critical condition].

PubMed

Fernández, Mariana; Cattana, María; Rojas, Florencia; Sosa, María de Los Ángeles; Aguirre, Clarisa; Vergara, Marta; Giusiano, Gustavo

2014-01-01

Aspergillus is a group of opportunistic fungi that cause infections, with high morbimortality in immunosuppressed patients. Aspergillus fumigatus is the most frequent species in these infections, although the incidence of other species has increased in the last few years. To evaluate the air fungal load and the diversity of Aspergillus species in hospitals with pediatric patients in critical condition. The Intensive Care Unit and Burns Unit of a pediatric hospital were sampled every 15 days during the autumn and spring seasons. The air samples were collected with SAS Super 100(®) and the surface samples were collected by swab method. The UFC/m(3) counts found exceeded the acceptable levels. The UFC/m(3) and the diversity of Aspergillus species found in the Intensive Care Unit were higher than those found in the Burns Unit. The fungal load and the diversity of species within the units were higher than those in control environments. The use of both methods -SAS and swab- allowed the detection of a higher diversity of species, with 96 strains of Aspergillus being isolated and 12 species identified. The outstanding findings were Aspergillus sydowii, Aspergillus niger, Aspergillus flavus, Aspergillus terreus and Aspergillus parasiticus, due to their high frequency. Aspergillus fumigatus, considered unacceptable in indoor environments, was isolated in both units. Aspergillus was present with high frequency in these units. Several species are of interest in public health for being potential pathogenic agents. Air control and monitoring are essential in the prevention of these infections. Copyright © 2013 Revista Iberoamericana de Micología. Published by Elsevier Espana. All rights reserved.

Relating (Un)acceptability to Interpretation. Experimental Investigations on Negation

PubMed Central

Etxeberria, Urtzi; Tubau, Susagna; Deprez, Viviane; Borràs-Comes, Joan; Espinal, M. Teresa

2018-01-01

Although contemporary linguistic studies routinely use unacceptable sentences to determine the boundary of what falls outside the scope of grammar, investigations far more rarely take into consideration the possible interpretations of such sentences, perhaps because these interpretations are commonly prejudged as irrelevant or unreliable across speakers. In this paper we provide the results of two experiments in which participants had to make parallel acceptability and interpretation judgments of sentences presenting various types of negative dependencies in Basque and in two varieties of Spanish (Castilian Spanish and Basque Country Spanish). Our results show that acceptable sentences are uniformly assigned a single negation reading in the two languages. However, while unacceptable sentences consistently convey single negation in Basque, they are interpreted at chance in both varieties of Spanish. These results confirm that judgment data that distinguish between acceptable and unacceptable negative utterances can inform us not only about an adult’s grammar of his/her particular language but also about interesting cross-linguistic differences. We conclude that the acceptability and interpretation of (un)grammatical negative sentences can serve linguistic theory construction by helping to disentangle basic assumptions about the nature of various negative dependencies. PMID:29456515

Performance of life support breathing apparatus for under-ice diving operations.

PubMed

Lang, Michael A; Clarke, John R

2017-01-01

Single-hose scuba regulators dived in very cold water may suffer first- or second-stage malfunction, yielding complete occlusion of air flow or massive freeflow that rapidly expends a diver's air supply. This study, conducted in Antarctica, evaluated the under-ice performance of a sampling of commercially available regulators. Seventeen science divers logged a total of 305 dives in -1.86°C seawater under 6-meter-thick Antarctic fast-ice over two field seasons in 2008 and 2009. Dive profiles had an average depth of 30 msw and dive time of 29 minutes, including a mandatory three-minute safety stop at 6 msw. Sixty-nine unmodified regulator units (17 models) from 12 different manufacturers underwent standardized pre-dive regulator care and were randomly assigned to divers. Depths and times of onset of second-stage regulator freeflow were recorded. In 305 dives, there were 65 freeflows. The freeflows were not evenly distributed across the regulator brands. Regulator failure rates fell into two categories (⟨ 11% and ⟩ 26%). The regulators classified for the purpose of the test as "acceptable" (⟨ 11% failure rate: Dive-Rite Jetstream, Sherwood Maximus SRB3600, Poseidon Xstream Deep, Poseidon Jetstream, Sherwood Maximus SRB7600, Poseidon Cyklon, Mares USN22 Abyss) experienced only nine freeflows out of 146 exposures for a 6% overall freeflow incidence. Those classified as "unacceptable" (⟨ 26% failure rate) suffered 56 freeflows out of 159 exposures (35% freeflow incidence.). Contrary to expectations, the pooled incidences for the seven best performing regulators was significantly different by Chi-square test from the 10 remaining regulators (P ⟨ 0.001).

Self-Arrangement of Fleeting Student Pairs: A Web 2.0 Approach for Peer Tutoring

ERIC Educational Resources Information Center

Westera, Wim; de Bakker, Gijs; Wagemans, Leo

2009-01-01

This article presents a Web 2.0 approach for the arrangement of peer tutoring in online learning. In online learning environments, the learners' expectations of obtaining frequent, one-to-one support from their teachers tend to increase the teachers' workloads to unacceptably high levels. To address this problem of workload a self-organised peer…

Policy Responses to the Recent Poor Performance of the U.S. Labor Market

ERIC Educational Resources Information Center

Haveman, Robert; Heinrich, Carolyn; Smeeding, Timothy

2012-01-01

Since the onset of the Great Recession, the U.S. labor market has been reeling. Public concern has largely focused on the unemployment rate, which rose to double digits and has since been stalled at just over 9 percent. This rate is unacceptably high, and macroeconomic policy efforts have been unsuccessful in bringing it down. The overall…

The Preschool Nap as a Protective Factor in the Fight against Childhood Obesity: An Exploratory Study

ERIC Educational Resources Information Center

Kihm, Holly Spencer; Rolling, Peggy

2014-01-01

Although the prevalence of childhood obesity has not increased in recent years, it remains unacceptably high and warrants continued study. The purpose of this study was to explore the potential relationship between weight status and length of sleep (both daytime and nighttime) among preschool children. Special attention was given to the role…

When Will Our Values Finally Result in the Creation of New Pathways for Change--Change that We Can Believe In?

ERIC Educational Resources Information Center

Rusch, Frank R.; Wolfe, Pamela

2008-01-01

Despite efforts over the past several decades to improve the delivery of transition services for youth with disabilities, outcomes continue to be unacceptably dismal for most youth, including high rates of unemployment, residential independence, and financial dependence, concurrent with low rates of enrollment in college or other postsecondary…

Citation Help in Databases: The More Things Change, the More They Stay the Same

ERIC Educational Resources Information Center

Van Ullen, Mary; Kessler, Jane

2012-01-01

In 2005, the authors reviewed citation help in databases and found an error rate of 4.4 errors per citation. This article describes a follow-up study that revealed a modest improvement in the error rate to 3.4 errors per citation, still unacceptably high. The most problematic area was retrieval statements. The authors conclude that librarians…

Do Ethical Judgments Depend on the Type of Response Scale? Comparing Acceptability versus Unacceptability Judgments in the Case of Life-Ending Procedures

ERIC Educational Resources Information Center

Sastre, Maria Teresa Munoz; Gonzalez, Charlene; Lhermitte, Astrid; Sorum, Paul C.; Mullet, Etienne

2010-01-01

Using Functional Measurement (Anderson, 2008), Frileux, Lelievre, Munoz Sastre, Mullet, and Sorum (2003) examined the joint impact of several key factors on lay people's judgments of the acceptability of physicians' interventions to end patients' lives. The level of acceptability was high, and the information integration rule that best described…

Aspirations to Achievement: Men of Color and Community Colleges. A Special Report from the Center for Community College Student Engagement

ERIC Educational Resources Information Center

Center for Community College Student Engagement, 2014

2014-01-01

Consistently and unmistakably, data show a persistent gap separating Latinos and Black males from other student groups on measures of academic progress and college completion. These gaps exist across higher education. They are undeniable and unacceptable. Men of color have high aspirations when they begin higher education. Why are these…

40 CFR Appendix G to Subpart G of... - Substitutes Subject to Use Restrictions and Unacceptable Substitutes Listed in the March 3, 1999...

Code of Federal Regulations, 2012 CFR

2012-07-01

... Restrictions and Unacceptable Substitutes Listed in the March 3, 1999, Final rule, Effective April 2, 1999. G Appendix G to Subpart G of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Pt. 82, Subpt. G, App. G Appendix G to Subpart G of Part 82—Substitutes Subject to Use Restrictions...

40 CFR Appendix G to Subpart G of... - Substitutes Subject to Use Restrictions and Unacceptable Substitutes Listed in the March 3, 1999...

Code of Federal Regulations, 2013 CFR

2013-07-01

... Restrictions and Unacceptable Substitutes Listed in the March 3, 1999, Final rule, Effective April 2, 1999. G Appendix G to Subpart G of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Pt. 82, Subpt. G, App. G Appendix G to Subpart G of Part 82—Substitutes Subject to Use Restrictions...

40 CFR Appendix G to Subpart G of... - Substitutes Subject to Use Restrictions and Unacceptable Substitutes Listed in the March 3, 1999...

Code of Federal Regulations, 2014 CFR

2014-07-01

... Restrictions and Unacceptable Substitutes Listed in the March 3, 1999, Final rule, Effective April 2, 1999. G Appendix G to Subpart G of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Pt. 82, Subpt. G, App. G Appendix G to Subpart G of Part 82—Substitutes Subject to Use Restrictions...

40 CFR Appendix K to Subpart G of... - Substitutes Subject to Use Restrictions and Unacceptable Substitutes Listed in the July 22, 2002...

Code of Federal Regulations, 2010 CFR

2010-07-01

... Restrictions and Unacceptable Substitutes Listed in the July 22, 2002, Final Rule, Effective August 21, 2002 K Appendix K to Subpart G of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Pt. 82, Subpt. G, App. K Appendix K to Subpart G of Part 82—Substitutes Subject to Use Restrictions...

40 CFR Appendix K to Subpart G of... - Substitutes Subject to Use Restrictions and Unacceptable Substitutes Listed in the July 22, 2002...

Code of Federal Regulations, 2014 CFR

2014-07-01

... Restrictions and Unacceptable Substitutes Listed in the July 22, 2002, Final Rule, Effective August 21, 2002 K Appendix K to Subpart G of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Pt. 82, Subpt. G, App. K Appendix K to Subpart G of Part 82—Substitutes Subject to Use Restrictions...

40 CFR Appendix K to Subpart G of... - Substitutes Subject to Use Restrictions and Unacceptable Substitutes Listed in the July 22, 2002...

Code of Federal Regulations, 2012 CFR

2012-07-01

... Restrictions and Unacceptable Substitutes Listed in the July 22, 2002, Final Rule, Effective August 21, 2002 K Appendix K to Subpart G of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Pt. 82, Subpt. G, App. K Appendix K to Subpart G of Part 82—Substitutes Subject to Use Restrictions...

40 CFR Appendix K to Subpart G of... - Substitutes Subject to Use Restrictions and Unacceptable Substitutes Listed in the July 22, 2002...

Code of Federal Regulations, 2013 CFR

2013-07-01

... Restrictions and Unacceptable Substitutes Listed in the July 22, 2002, Final Rule, Effective August 21, 2002 K Appendix K to Subpart G of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Pt. 82, Subpt. G, App. K Appendix K to Subpart G of Part 82—Substitutes Subject to Use Restrictions...

40 CFR Appendix K to Subpart G of... - Substitutes Subject to Use Restrictions and Unacceptable Substitutes Listed in the July 22, 2002...

Code of Federal Regulations, 2011 CFR

2011-07-01

... Restrictions and Unacceptable Substitutes Listed in the July 22, 2002, Final Rule, Effective August 21, 2002 K Appendix K to Subpart G of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Pt. 82, Subpt. G, App. K Appendix K to Subpart G of Part 82—Substitutes Subject to Use Restrictions...

40 CFR Appendix C to Subpart G of... - Substitutes Subject to Use Restrictions and Unacceptable Substitutes Listed in the May 22, 1996...

Code of Federal Regulations, 2012 CFR

2012-07-01

... Restrictions and Unacceptable Substitutes Listed in the May 22, 1996 Final Rule, Effective June 21, 1996 C Appendix C to Subpart G of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Pt. 82, Subpt. G, App. C Appendix C to Subpart G of Part 82—Substitutes Subject to Use Restrictions...

40 CFR Appendix C to Subpart G of... - Substitutes Subject to Use Restrictions and Unacceptable Substitutes Listed in the May 22, 1996...

Code of Federal Regulations, 2014 CFR

2014-07-01

... Restrictions and Unacceptable Substitutes Listed in the May 22, 1996 Final Rule, Effective June 21, 1996 C Appendix C to Subpart G of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Pt. 82, Subpt. G, App. C Appendix C to Subpart G of Part 82—Substitutes Subject to Use Restrictions...

40 CFR Appendix C to Subpart G of... - Substitutes Subject to Use Restrictions and Unacceptable Substitutes Listed in the May 22, 1996...

Code of Federal Regulations, 2010 CFR

2010-07-01

... Restrictions and Unacceptable Substitutes Listed in the May 22, 1996 Final Rule, Effective June 21, 1996 C Appendix C to Subpart G of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Pt. 82, Subpt. G, App. C Appendix C to Subpart G of Part 82—Substitutes Subject to Use Restrictions...

Real-Time Pretreatment Review Limits Unacceptable Deviations on a Cooperative Group Radiation Therapy Technique Trial: Quality Assurance Results of RTOG 0933

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

Gondi, Vinai, E-mail: vgondi@chicagocancer.org; University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin; Cui, Yunfeng

2015-03-01

Purpose: RTOG 0933 was a phase II trial of hippocampal avoidance during whole brain radiation therapy for patients with brain metastases. The results demonstrated improvement in short-term memory decline, as compared with historical control individuals, and preservation of quality of life. Integral to the conduct of this trial were quality assurance processes inclusive of pre-enrollment credentialing and pretreatment centralized review of enrolled patients. Methods and Materials: Before enrolling patients, all treating physicians and sites were required to successfully complete a “dry-run” credentialing test. The treating physicians were credentialed based on accuracy of magnetic resonance imaging–computed tomography image fusion and hippocampal andmore » normal tissue contouring, and the sites were credentialed based on protocol-specified dosimetric criteria. Using the same criteria, pretreatment centralized review of enrolled patients was conducted. Physicians enrolling 3 consecutive patients without unacceptable deviations were permitted to enroll further patients without pretreatment review, although their cases were reviewed after treatment. Results: In all, 113 physicians and 84 sites were credentialed. Eight physicians (6.8%) failed hippocampal contouring on the first attempt; 3 were approved on the second attempt. Eight sites (9.5%) failed intensity modulated radiation therapy planning on the first attempt; all were approved on the second attempt. One hundred thirteen patients were enrolled in RTOG 0933; 100 were analyzable. Eighty-seven cases were reviewed before treatment; 5 (5.7%) violated the eligibility criteria, and 21 (24%) had unacceptable deviations. With feedback, 18 cases were approved on the second attempt and 2 cases on the third attempt. One patient was treated off protocol. Twenty-two cases were reviewed after treatment; 1 (4.5%) violated the eligibility criteria, and 5 (23%) had unacceptable deviations. Conclusions: Although >95% of the cases passed the pre-enrollment credentialing, the pretreatment centralized review disqualified 5.7% of reviewed cases, prevented unacceptable deviations in 24% of reviewed cases, and limited the final unacceptable deviation rate to 5%. Thus, pretreatment review is deemed necessary in future hippocampal avoidance trials and is potentially useful in other similarly challenging radiation therapy technique trials.« less

The relation of childhood trauma to suicide ideation in patients suffering from obsessive-compulsive disorder with lifetime suicide attempts.

PubMed

Khosravani, Vahid; Kamali, Zoleikha; Jamaati Ardakani, Razieh; Samimi Ardestani, Mehdi

2017-09-01

The aim of this study was to evaluate the relations of childhood trauma (CT) and obsessive-compulsive (OC) symptom dimensions to suicide ideation in patients with obsessive-compulsive disorder (OCD). Seventy OCD outpatients with lifetime suicide attempts and 60 controls were included. Participants completed the Scale for Suicide Ideation (SSI), the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Dimensional Obsessive-Compulsive Scale (DOCS) and the Depression Anxiety Stress Scales (DASS-21). Among OCD patients, 97.1% had current suicide ideation. OCD patients revealed higher scores on CT, suicide ideation, depression and anxiety than controls. The CT history of sexual abuse (SA) and OC symptom dimension of unacceptable thoughts explained suicide ideation. It was concluded that SA and unacceptable thoughts may contribute to high suicidality and have important implications for the assessment and treatment of suicide risk in OCD patients with lifetime suicide attempts. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Seismic performance assessment of base-isolated safety-related nuclear structures

USGS Publications Warehouse

Huang, Y.-N.; Whittaker, A.S.; Luco, N.

2010-01-01

Seismic or base isolation is a proven technology for reducing the effects of earthquake shaking on buildings, bridges and infrastructure. The benefit of base isolation has been presented in terms of reduced accelerations and drifts on superstructure components but never quantified in terms of either a percentage reduction in seismic loss (or percentage increase in safety) or the probability of an unacceptable performance. Herein, we quantify the benefits of base isolation in terms of increased safety (or smaller loss) by comparing the safety of a sample conventional and base-isolated nuclear power plant (NPP) located in the Eastern U.S. Scenario- and time-based assessments are performed using a new methodology. Three base isolation systems are considered, namely, (1) Friction Pendulum??? bearings, (2) lead-rubber bearings and (3) low-damping rubber bearings together with linear viscous dampers. Unacceptable performance is defined by the failure of key secondary systems because these systems represent much of the investment in a new build power plant and ensure the safe operation of the plant. For the scenario-based assessments, the probability of unacceptable performance is computed for an earthquake with a magnitude of 5.3 at a distance 7.5 km from the plant. For the time-based assessments, the annual frequency of unacceptable performance is computed considering all potential earthquakes that may occur. For both assessments, the implementation of base isolation reduces the probability of unacceptable performance by approximately four orders of magnitude for the same NPP superstructure and secondary systems. The increase in NPP construction cost associated with the installation of seismic isolators can be offset by substantially reducing the required seismic strength of secondary components and systems and potentially eliminating the need to seismically qualify many secondary components and systems. ?? 2010 John Wiley & Sons, Ltd.

Corrected Panel-Reactive Antibody Positivity Rates for Hypersensitized Patients in Turkish Population With Calculated Panel-Reactive Antibody Software.

PubMed

Karadeniz, S T; Akgul, S U; Ogret, Y; Ciftci, H S; Bayraktar, A; Bakkaloglu, H; Caliskan, Y; Yelekci, K; Turkmen, A; Aydin, A E; Oguz, F S; Carin, M; Aydin, F

2017-04-01

High rates of panel-reactive antibody (PRA) may decrease the chance of kidney transplantation and may result in long waiting periods before transplantation. The calculated PRA (cPRA) is performed based on unacceptable HLA antigens. These antigens are identified by a program that was created based on the antibodies that developed against the HLA antigens circulating in serum and on the risk of binding of these antibodies to antigens. The antigen profile of the population and antigen frequencies can be measured, and more realistic cPRA positivity rates may be obtained using this method. We developed a program based on the HLA antigens of 494 blood donors in 2 European Federation for Immunogenetics-accredited Tissue Typing Laboratories in Turkey. Next-generation sequencing-based tissue typing (HLA-A, -B, -C, -DR, -DQ, 4 digits) of the samples was performed. The PRA screening test was performed on 380 patients who were waiting for organ transplant from a cadaver in Istanbul Faculty of Medicine. The single antigen bead assay testing was performed to identify the antibody profiles on 48 hypersensitized patients. The PRA testing results using the current methods were 44.6% ± 18.5%, and the cPRA rate was 86.2% ± 5.1%. The mean PRA positivity of the sensitized patients using the current methods was 44.6%; however, the rate was 86.2% using the cPRA. cPRA shows the rate of the rejected donors according to all unacceptable antigens. The need for a list of unacceptable antigens in place of the PRA positivity rate is a real change in the sensitization-dependent calculation as cPRA positivity rate. In principal, implementation of cPRA will encourage many centers and laboratories to adopt a standard measurement of sensitization in Turkey. It will increase the chances of better donor match, particularly for hypersensitized patients, by the creation of an unacceptable mismatch program using cPRA software. Copyright © 2017 Elsevier Inc. All rights reserved.

2 Major incident triage and the implementation of a new triage tool, the MPTT-24.

PubMed

Vassallo, James; Smith, Jason

2017-12-01

Over the last decade, a number of European cities including London, have witnessed high profile terrorist attacks resulting in major incidents with large numbers of casualties. Triage, the process of categorising casualties on the basis of their clinical acuity, is a key principle in the effective management of major incidents.The Modified Physiological Triage Tool (MPTT) is a recently developed primary triage tool which in comparison to existing triage tools, including the 2013 UK NARU Sieve, demonstrates the greatest sensitivity at predicting need for life-saving intervention (LSI) within both military and civilian populations.To improve the applicability and usability of the MPTT we increased the upper respiratory rate threshold to 24 breaths per minute (MPTT-24), to make it divisible by four, and included an assessment of external catastrophic haemorrhage. The aim of this study was to conduct a feasibility analysis of the proposed MPTT-24 (figure 1).emermed;34/12/A860-b/F1F1F1Figure 1MPTT-24 METHODS: A retrospective review of the Joint Theatre Trauma Registry (JTTR) and Trauma Audit Research Network (TARN) databases was performed for all adult ( > 18 years) patients presenting between 2006-2013 (JTTR) and 2014 (TARN). Patients were defined as priority one (P1) if they had received one or more life-saving interventions.Using first recorded hospital physiology, patients were categorised as P1 or not-P1 by existing triage tools and both MPTT and MPTT-24. Performance characteristics were evaluated using sensitivity, specificity, under and over-triage with a McNemar test to determine statistical significance. Basic study characteristics are shown in Table 1. Both the MPTT and MPTT-24 outperformed all existing triage methods with a statistically significant (p<0.001) absolute reduction of between 25.5%-29.5% in under-triage when compared to existing UK civilian methods (NARU Sieve). In both populations the MPTT-24 demonstrated an absolute reduction in sensitivity with an increase in specificity when compared to the MPTT. A statistically significant difference was observed between the MPTT and MPTT-24 in the way they categorised TARN and JTTR cases as P1 (p<0.001).emermed;34/12/A860-b/T1F2T1Table 1Study characteristicsemermed;34/12/A860-b/T2F3T2Table 2Performance analysis CONCLUSION: Existing UK methods of primary major incident triage, including the NARU Sieve, are not fit for purpose, with unacceptably high rates of under-triage. When compared to the MPTT, the MPTT-24 allows for a more rapid triage assessment and continues to outperform existing triage tools at predicting need for life-saving intervention. Its use should be considered in civilian and military major incidents. © 2017, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Implications of insecticide resistance for malaria vector control with long-lasting insecticidal nets: a WHO-coordinated, prospective, international, observational cohort study.

PubMed

Kleinschmidt, Immo; Bradley, John; Knox, Tessa Bellamy; Mnzava, Abraham Peter; Kafy, Hmooda Toto; Mbogo, Charles; Ismail, Bashir Adam; Bigoga, Jude D; Adechoubou, Alioun; Raghavendra, Kamaraju; Cook, Jackie; Malik, Elfatih M; Nkuni, Zinga José; Macdonald, Michael; Bayoh, Nabie; Ochomo, Eric; Fondjo, Etienne; Awono-Ambene, Herman Parfait; Etang, Josiane; Akogbeto, Martin; Bhatt, Rajendra M; Chourasia, Mehul Kumar; Swain, Dipak K; Kinyari, Teresa; Subramaniam, Krishanthi; Massougbodji, Achille; Okê-Sopoh, Mariam; Ogouyemi-Hounto, Aurore; Kouambeng, Celestin; Abdin, Mujahid Sheikhedin; West, Philippa; Elmardi, Khalid; Cornelie, Sylvie; Corbel, Vincent; Valecha, Neena; Mathenge, Evan; Kamau, Luna; Lines, Jonathan; Donnelly, Martin James

2018-04-09

Scale-up of insecticide-based interventions has averted more than 500 million malaria cases since 2000. Increasing insecticide resistance could herald a rebound in disease and mortality. We aimed to investigate whether insecticide resistance was associated with loss of effectiveness of long-lasting insecticidal nets and increased malaria disease burden. This WHO-coordinated, prospective, observational cohort study was done at 279 clusters (villages or groups of villages in which phenotypic resistance was measurable) in Benin, Cameroon, India, Kenya, and Sudan. Pyrethroid long-lasting insecticidal nets were the principal form of malaria vector control in all study areas; in Sudan this approach was supplemented by indoor residual spraying. Cohorts of children from randomly selected households in each cluster were recruited and followed up by community health workers to measure incidence of clinical malaria and prevalence of infection. Mosquitoes were assessed for susceptibility to pyrethroids using the standard WHO bioassay test. Country-specific results were combined using meta-analysis. Between June 2, 2012, and Nov 4, 2016, 40 000 children were enrolled and assessed for clinical incidence during 1·4 million follow-up visits. 80 000 mosquitoes were assessed for insecticide resistance. Long-lasting insecticidal net users had lower infection prevalence (adjusted odds ratio [OR] 0·63, 95% CI 0·51-0·78) and disease incidence (adjusted rate ratio [RR] 0·62, 0·41-0·94) than did non-users across a range of resistance levels. We found no evidence of an association between insecticide resistance and infection prevalence (adjusted OR 0·86, 0·70-1·06) or incidence (adjusted RR 0·89, 0·72-1·10). Users of nets, although significantly better protected than non-users, were nevertheless subject to high malaria infection risk (ranging from an average incidence in net users of 0·023, [95% CI 0·016-0·033] per person-year in India, to 0·80 [0·65-0·97] per person year in Kenya; and an average infection prevalence in net users of 0·8% [0·5-1·3] in India to an average infection prevalence of 50·8% [43·4-58·2] in Benin). Irrespective of resistance, populations in malaria endemic areas should continue to use long-lasting insecticidal nets to reduce their risk of infection. As nets provide only partial protection, the development of additional vector control tools should be prioritised to reduce the unacceptably high malaria burden. Bill & Melinda Gates Foundation, UK Medical Research Council, and UK Department for International Development. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

An evaluation of flight path management automation in transport category aircraft

NASA Technical Reports Server (NTRS)

Chandra, D.; Bussolari, S. R.

1991-01-01

A desk-top simulation of a Boeing 757/767 Electronic Flight Instrumentation System (EFIS) and Control Display Unit (CDU) was used in an experiment to compare three modes of communication for the clearance amendment process: standard voice procedures, a textual delivery method, and a graphical delivery method. Eight qualified Boeing 757/767 pilots served as subjects. Each flew nine landing scenarios with three amendments given in each scenario. Both acceptable and unacceptable clearance amendments were presented in order to assess situational awareness. Times for comprehension and execution of the amendment were recorded along with workload ratings, responses to unacceptable amendments, and subjective impressions. The graphical mode was found to be superior in terms of the time measures and subjective ratings. No difference was found between the modes in the ability to detect unacceptable clearances.

Tobacco control environment: cross-sectional survey of policy implementation, social unacceptability, knowledge of tobacco health harms and relationship to quit ratio in 17 low-income, middle-income and high-income countries.

PubMed

Chow, Clara K; Corsi, Daniel J; Gilmore, Anna B; Kruger, Annamarie; Igumbor, Ehimario; Chifamba, Jephat; Yang, Wang; Wei, Li; Iqbal, Romaina; Mony, Prem; Gupta, Rajeev; Vijayakumar, Krishnapillai; Mohan, V; Kumar, Rajesh; Rahman, Omar; Yusoff, Khalid; Ismail, Noorhassim; Zatonska, Katarzyna; Altuntas, Yuksel; Rosengren, Annika; Bahonar, Ahmad; Yusufali, AfzalHussein; Dagenais, Gilles; Lear, Scott; Diaz, Rafael; Avezum, Alvaro; Lopez-Jaramillo, Patricio; Lanas, Fernando; Rangarajan, Sumathy; Teo, Koon; McKee, Martin; Yusuf, Salim

2017-03-31

This study examines in a cross-sectional study 'the tobacco control environment' including tobacco policy implementation and its association with quit ratio. 545 communities from 17 high-income, upper-middle, low-middle and low-income countries (HIC, UMIC, LMIC, LIC) involved in the Environmental Profile of a Community's Health (EPOCH) study from 2009 to 2014. Community audits and surveys of adults (35-70 years, n=12 953). Summary scores of tobacco policy implementation (cost and availability of cigarettes, tobacco advertising, antismoking signage), social unacceptability and knowledge were associated with quit ratios (former vs ever smokers) using multilevel logistic regression models. Average tobacco control policy score was greater in communities from HIC. Overall 56.1% (306/545) of communities had >2 outlets selling cigarettes and in 28.6% (154/539) there was access to cheap cigarettes (<5cents/cigarette) (3.2% (3/93) in HIC, 0% UMIC, 52.6% (90/171) LMIC and 40.4% (61/151) in LIC). Effective bans (no tobacco advertisements) were in 63.0% (341/541) of communities (81.7% HIC, 52.8% UMIC, 65.1% LMIC and 57.6% LIC). In 70.4% (379/538) of communities, >80% of participants disapproved youth smoking (95.7% HIC, 57.6% UMIC, 76.3% LMIC and 58.9% LIC). The average knowledge score was >80% in 48.4% of communities (94.6% HIC, 53.6% UMIC, 31.8% LMIC and 35.1% LIC). Summary scores of policy implementation, social unacceptability and knowledge were positively and significantly associated with quit ratio and the associations varied by gender, for example, communities in the highest quintile of the combined scores had 5.0 times the quit ratio in men (Odds ratio (OR) 5·0, 95% CI 3.4 to 7.4) and 4.1 times the quit ratio in women (OR 4.1, 95% CI 2.4 to 7.1). This study suggests that more focus is needed on ensuring the tobacco control policy is actually implemented, particularly in LMICs. The gender-related differences in associations of policy, social unacceptability and knowledge suggest that different strategies to promoting quitting may need to be implemented in men compared to women. 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/.

Toward the definition of specific protection goals for the environmental risk assessment of chemicals: A perspective on environmental regulation in Europe.

PubMed

Brown, A Ross; Whale, Graham; Jackson, Mathew; Marshall, Stuart; Hamer, Mick; Solga, Andreas; Kabouw, Patrick; Galay-Burgos, Malyka; Woods, Richard; Nadzialek, Stephanie; Maltby, Lorraine

2017-01-01

This critical review examines the definition and implementation of environmental protection goals for chemicals in current European Union (EU) legislation, guidelines, and international agreements to which EU countries are party. The European chemical industry is highly regulated, and prospective environmental risk assessments (ERAs) are tailored for different classes of chemical, according to their specific hazards, uses, and environmental exposure profiles. However, environmental protection goals are often highly generic, requiring the prevention of "unacceptable" or "adverse" impacts on "biodiversity" and "ecosystems" or the "environment as a whole." This review aims to highlight working examples, challenges, solutions, and best practices for defining specific protection goals (SPGs), which are seen to be essential for refining and improving ERA. Specific protection goals hinge on discerning acceptable versus unacceptable adverse effects on the key attributes of relevant, sensitive ecological entities (ranging from organisms to ecosystems). Some isolated examples of SPGs for terrestrial and aquatic biota can be found in prospective ERA guidance for plant protection products (PPPs). However, SPGs are generally limited to environmental or nature legislation that requires environmental monitoring and retrospective ERA. This limitation is due mainly to the availability of baselines, which define acceptable versus unacceptable environmental effects on the key attributes of sentinel species, populations and/or communities, such as reproductive status, abundance, or diversity. Nevertheless, very few regulatory case examples exist in which SPGs incorporate effect magnitude, spatial extent, and temporal duration. We conclude that more holistic approaches are needed for defining SPGs, particularly with respect to protecting population sustainability, ecosystem function, and integrity, which are implicit in generic protection goals and explicit in the International Programme for Chemical Safety (IPCS) definition of "adverse effect." A possible solution, which the chemical industry is currently assessing, is wider application of the ecosystem services approach proposed by the European Food Safety Authority (EFSA) for the risk assessment of PPPs. Integr Environ Assess Manag 2017;13:17-37. © 2016 SETAC. © 2016 SETAC.

Bias due to Preanalytical Dilution of Rodent Serum for Biochemical Analysis on the Siemens Dimension Xpand Plus

PubMed Central

Johns, Jennifer L.; Moorhead, Kaitlin A.; Hu, Jing; Moorhead, Roberta C.

2018-01-01

Clinical pathology testing of rodents is often challenging due to insufficient sample volume. One solution in clinical veterinary and exploratory research environments is dilution of samples prior to analysis. However, published information on the impact of preanalytical sample dilution on rodent biochemical data is incomplete. The objective of this study was to evaluate the effects of preanalytical sample dilution on biochemical analysis of mouse and rat serum samples utilizing the Siemens Dimension Xpand Plus. Rats were obtained from end of study research projects. Mice were obtained from sentinel testing programs. For both, whole blood was collected via terminal cardiocentesis into empty tubes and serum was harvested. Biochemical parameters were measured on fresh and thawed frozen samples run straight and at dilution factors 2–10. Dilutions were performed manually, utilizing either ultrapure water or enzyme diluent per manufacturer recommendations. All diluted samples were generated directly from the undiluted sample. Preanalytical dilution caused clinically unacceptable bias in most analytes at dilution factors four and above. Dilution-induced bias in total calcium, creatinine, total bilirubin, and uric acid was considered unacceptable with any degree of dilution, based on the more conservative of two definitions of acceptability. Dilution often caused electrolyte values to fall below assay range precluding evaluation of bias. Dilution-induced bias occurred in most biochemical parameters to varying degrees and may render dilution unacceptable in the exploratory research and clinical veterinary environments. Additionally, differences between results obtained at different dilution factors may confound statistical comparisons in research settings. Comparison of data obtained at a single dilution factor is highly recommended. PMID:29497614

A Comparison of Spectacles Purchased Online and in UK Optometry Practice.

PubMed

Alderson, Alison J; Green, Alison; Whitaker, David; Scally, Andrew J; Elliott, David B

2016-10-01

To compare spectacles bought online with spectacles from optometry practices. Thirty-three participants consisting of single vision spectacle wearers with either a low (N = 12, mean age 34 ± 14 years) or high prescription (N = 11, mean age 28 ± 9 years) and 10 presbyopic participants (mean age 59 ± 4 years) wearing progressive addition lenses (PALs) purchased 154 pairs of spectacles online and 154 from UK optometry practices. The spectacles were compared via participant-reported preference, acceptability, and safety; the assessment of lens, frame, and fit quality; and the accuracy of the lens prescriptions to international standard ISO 21987:2009. Participants preferred the practice spectacles (median ranking 4th, IQR 1-6) more than online (6th, IQR 4-8; Mann-Whitney U = 7345, p < 0.001) and practice PALs (median ranking 2nd, IQR 1-4) were particularly preferred (online 6.5th, IQR 4-9, Mann-Whitney U = 455, p < 0.001). Of those deemed unacceptable and unsafe, significantly more were bought online (unacceptable: online 43/154 vs. practice 15/154, Fisher's exact p = 0.0001; unsafe: online 14/154 vs. practice 5/154, Fisher's exact p = 0.03). Participants preferred spectacles from optometry practice rather than those bought online, despite lens quality and prescription accuracy being similar. A greater number of online spectacles were deemed unsafe or unacceptable because of poor spectacle frame fit, poor cosmetic appearance, and inaccurate optical centration. This seems particularly pertinent to PAL lenses, which are known to increase falls risk. Recommendations are made to improve both forms of spectacle provision.

One State's Systems Change Efforts to Reduce Child Care Expulsion: Taking the Pyramid Model to Scale

ERIC Educational Resources Information Center

Vinh, Megan; Strain, Phil; Davidon, Sarah; Smith, Barbara J.

2016-01-01

This article describes the efforts funded by the state of Colorado to address unacceptably high rates of expulsion from child care. Based on the results of a 2006 survey, the state of Colorado launched two complementary policy initiatives in 2009 to impact expulsion rates and to improve the use of evidence-based practices related to challenging…

Paying our way: thinking strategically to offset the cost of reducing fire hazard in western forests.

Treesearch

Rhonda Mazza

2008-01-01

The fire hazard in many western forests is unacceptably high, posing risks to human health and property, wildlife habitat, and air and water quality. Cost is an inhibiting factor for reducing hazardous fuel, given the amount of acreage needing treatment. Thinning overly dense forests is one way to reduce fuel loads. Much of the product removed during these treatments...

Sexual harassment of psychiatric trainees: experiences and attitudes.

PubMed

Morgan, J F; Porter, S

1999-07-01

A survey was carried out of psychiatric trainees' work-related experiences of unwanted sexual contact. A structured postal questionnaire was administered to 100 psychiatric trainees from senior house officer to specialist registrar level in a large psychiatric rotation. There was an 85% response rate; 86% (73) of the sample had experienced unwanted sexual contact, with 47% (40) experiencing deliberate touching, leaning over or cornering, and 18% (15) receiving letters, telephone calls or material of a sexual nature. Three-quarters (64) of respondents had experienced unwanted sexual contact from patients and 64% (54) from staff. Experiences and attitudes did not generally differ by gender, grade or training experience. Four out of 48 female respondents described stalking by patients. Of the 39 respondents who had reported harassment by patients, 31 felt supported by colleagues, while of the 13 who had reported harassment by colleagues, eight felt supported. Two-thirds of the respondents considered sexual harassment 'some-times' or 'frequently' a problem for the profession. Diagnoses of confusional states, mania or schizophrenia made subjects less likely to consider unwanted sexual behaviour to be 'sexual harassment' (86%, 80%, and 67%, respectively), but not for other diagnoses. Levels of threatening and intrusive sexual harassment are unacceptably high in this study group. Health trusts should adopt policies of 'zero tolerance' and all incidents should be reported. Psychological impact on victims should be acknowledged even when the behaviour of the perpetrator can be explained by diagnosis.

Comparison of illumigene Group A Streptococcus Assay with Culture of Throat Swabs from Children with Sore Throats in the New Zealand School-Based Rheumatic Fever Prevention Program.

PubMed

Upton, Arlo; Bissessor, Liselle; Farrell, Elizabeth; Shulman, Stanford T; Zheng, Xiaotian; Lennon, Diana

2016-01-01

Group A streptococcal (GAS) pharyngitis is a particularly important condition in areas of New Zealand where the incidence of acute rheumatic fever remains unacceptably high. Prompt diagnosis and treatment of GAS pharyngitis are cornerstones of the Rheumatic Fever Prevention Programme, but these are hindered by the turnaround time of culture. Tests with excellent performance and rapid turnaround times are needed. For this study, throat swabs (Copan ESwabs) were collected from schoolchildren self-identifying with a sore throat. Samples were tested by routine culture and the illumigene GAS assay using loop-mediated isothermal amplification. Discrepant results were resolved by retesting of the same specimen by an alternative molecular assay. Seven hundred fifty-seven throat swab specimens were tested by both methods. The performance characteristics of the illumigene assay using culture on blood agar as the "gold standard" and following discrepancy analysis were as follows: sensitivity, 82% and 87%, respectively; specificity, 93% and 98%, respectively; positive predictive value, 61% and 88%, respectively; and negative predictive value, 97% and 97%, respectively. In our unique setting of a school-based throat swabbing program, the illumigene assay did not perform quite as well as described in previous reports. Despite this, its improved sensitivity and rapid turnaround time compared with those of culture are appealing. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Rationale and pre-clinical efficacy of a novel anti-EMP2 antibody for the treatment of invasive breast cancer

PubMed Central

Fu, Maoyong; Maresh, Erin L.; Helguera, Gustavo F.; Kiyohara, Meagan; Qin, Yu; Ashki, Negin; Daniels-Wells, Tracy R.; Aziz, Najib; Gordon, Lynn K.; Braun, Jonathan; Elshimali, Yahya; Soslow, Robert A.; Penichet, Manuel L.; Goodglick, Lee; Wadehra, Madhuri

2014-01-01

Despite significant advances in biology and medicine, the incidence and mortality due to breast cancer world-wide is still unacceptably high. Thus, there is an urgent need to discover new molecular targets. In this paper, we show evidence for a novel target in human breast cancer, the tetraspan protein epithelial membrane protein-2 (EMP2). Using tissue tumor arrays, protein expression of EMP2 was measured and found to be minimal in normal mammary tissue, but it was upregulated in 63% of invasive breast cancer tumors and in 73% of triple negative tumors tested. To test the hypothesis that EMP2 may be a suitable target for therapy, we constructed a fully human IgG1 antibody specific for a conserved domain of human and murine EMP2. Treatment of breast cancer cells with the anti-EMP2 IgG1 significantly inhibited EMP2 mediated signaling, blocked FAK/Src signaling, inhibited invasion, and promoted apoptosis in vitro. In both human xenograft and syngeneic metastatic tumor monotherapy models, anti-EMP2 IgG1 retarded tumor growth without detectable systemic toxicity. This anti-tumor effect was in part attributable to a potent ADCC response as well as direct cytotoxicity induced by the monoclonal antibody. Together, these results identify EMP2 as a novel therapeutic target for invasive breast cancer. PMID:24448822

Rationale and preclinical efficacy of a novel anti-EMP2 antibody for the treatment of invasive breast cancer.

PubMed

Fu, Maoyong; Maresh, Erin L; Helguera, Gustavo F; Kiyohara, Meagan; Qin, Yu; Ashki, Negin; Daniels-Wells, Tracy R; Aziz, Najib; Gordon, Lynn K; Braun, Jonathan; Elshimali, Yahya; Soslow, Robert A; Penichet, Manuel L; Goodglick, Lee; Wadehra, Madhuri

2014-04-01

Despite significant advances in biology and medicine, the incidence and mortality due to breast cancer worldwide is still unacceptably high. Thus, there is an urgent need to discover new molecular targets. In this article, we show evidence for a novel target in human breast cancer, the tetraspan protein epithelial membrane protein-2 (EMP2). Using tissue tumor arrays, protein expression of EMP2 was measured and found to be minimal in normal mammary tissue, but it was upregulated in 63% of invasive breast cancer tumors and in 73% of triple-negative tumors tested. To test the hypothesis that EMP2 may be a suitable target for therapy, we constructed a fully human immunoglobulin G1 (IgG1) antibody specific for a conserved domain of human and murine EMP2. Treatment of breast cancer cells with the anti-EMP2 IgG1 significantly inhibited EMP2-mediated signaling, blocked FAK/Src signaling, inhibited invasion, and promoted apoptosis in vitro. In both human xenograft and syngeneic metastatic tumor monotherapy models, anti-EMP2 IgG1 retarded tumor growth without detectable systemic toxicity. This antitumor effect was, in part, attributable to a potent antibody-dependent cell-mediated cytotoxicity response as well as direct cytotoxicity induced by the monoclonal antibody. Together, these results identify EMP2 as a novel therapeutic target for invasive breast cancer.

Post-fabrication QAC-functionalized thermoplastic polyurethane for contact-killing catheter applications.

PubMed

Zander, Zachary K; Chen, Peiru; Hsu, Yen-Hao; Dreger, Nathan Z; Savariau, Laura; McRoy, Willie C; Cerchiari, Alec E; Chambers, Sean D; Barton, Hazel A; Becker, Matthew L

2018-05-11

The use of catheters is ubiquitous in medicine and the incidence of infection remains unacceptably high despite numerous advances in functional surfaces and drug elution. Herein we report the use of a thermoplastic polyurethane containing an allyl ether side-chain functionality (allyl-TPU) that allows for rapid and convenient surface modification with antimicrobial reagents, post-processing. This post-processing functionalization affords the ability to target appropriate TPU properties and maintain the functional groups on the surface of the device where they do not affect bulk properties. A series of quaternary ammonium thiol compounds (Qx-SH) possessing various hydrocarbon tail lengths (8-14 carbons) were synthesized and attached to the surface using thiol-ene "click" chemistry. A quantitative assessment of the amount of Qx-SH available on the surface was determined using fluorescence spectroscopy and X-ray photoelectron spectroscopy (XPS). Contact-killing assays note the Q8-SH composition has the highest antimicrobial activity, and a live/dead fluorescence assay reveals rapid contact-killing of Staphylococcus aureus (>75% in 5 min) and Escherichia coli (90% in 10 min) inocula. Scale-up and extrusion of allyl-TPU provides catheter prototypes for biofilm formation testing with Pseudomonas aeruginosa, and surface-functionalized catheters modified with Q8-SH demonstrate their ability to reduce biofilm formation. Copyright © 2018 Elsevier Ltd. All rights reserved.

Investigative techniques used to locate the liquid hydrogen leakage on the Space Shuttle Main Propulsion System

NASA Technical Reports Server (NTRS)

Hammock, William R., Jr.; Cota, Phillip E., Jr.; Rosenbaum, Bernard J.; Barrett, Michael J.

1991-01-01

Standard leak detection methods at ambient temperature have been developed in order to prevent excessive leakage from the Space Shuttle liquid oxygen and liquid hydrogen Main Propulsion System. Unacceptable hydrogen leakage was encountered on the Columbia and Atlantis flight vehicles in the summer of 1990 after the standard leak check requirements had been satisfied. The leakage was only detectable when the fuel system was exposed to subcooled liquid hydrogen during External Tank loading operations. Special instrumentation and analytical tools were utilized during a series of propellant tanking tests in order to identify the sources of the hydrogen leakage. After the leaks were located and corrected, the physical characteristics of the leak sources were analyzed in an effort to understand how the discrepancies were introduced and why the leakage had evaded the standard leak detection methods. As a result of the post-leak analysis, corrective actions and leak detection improvements have been implemented in order to preclude a similar incident.

[Analysis the relationship between the found ways and first diagnosis age for large vestibular aqueduct children].

PubMed

Yang, Yali; Huang, Lihui; Cheng, Xiaohua; Fu, Xinxing; Liu, Jiaxing; Ni, Tingting

2014-11-01

To explore the found ways and first diagnosis age of children with large vestibular aqueduct, and their relations with hearing loss. Medical histories of 122 cases of children diagnosed with large vestibular aqueduct by HRCT or MRI had been collected from January 2009 to April 2014 in our hospital children's hearing diagnosis center clinic. Found ways comprise of accepting universal newborn hearing screening (UNHS) group and unaccepting UNHS group. Accepting UNHS children were divided into two ears unpassing group, single ear unpassing group and passing group. The patients in unaccepting UNHS group were divided into not sensitive to sounds, speech stunting, sudden hearing loss, and other group. Analysis the relationship between the found ways and first diagnosis age and their relations with hearing loss. There are 84 cases (68.85%) accepting UNHS, the average age of first diagnosis was (17.24 ± 17.08) months; 37 cases (31.15%) are not accepting UNHS. The average age of first diagnosis was (30.92 ± 18.21) months. The average first diagnosis age of accepting UNHS group was more earlier than the unaccepting UNHS group. The difference was statistically signif- icant (P < 0.01). There were 57 cases (67.85%) whose two ears not pass UNHS; 15 cases (17.86%) single ear not pass; namely the referral rate was 85.71%; 12 cases (14.29%) pass the test. The first diagnosis age of passing UNHS group was more later than two ears unpassing group (P < 0.001). In the unaccepting UNHS group, the average first diagnosis age of not sensitive to sounds group (19.69 ± 11.16 months) was more earlier than words dysplasia group (37.13 ± 15.62 months) and sudden hearing loss group (47.40 ± 24.70 months) (P < 0.01). The difference in the degree of hearing loss between accepting UNHS and unaccepting UNHS group had no statistical significance (P > 0.05). In unaccepting UNHS group ,the average first diagnosis age of the mild-to-moderate hearing loss group was later than the very severe hearing loss group (P < 0.01). Most of large vestibular aqueduct children can be found and receive diagnosis early by UNHS. But part of these patients with late-onset or progressive hearing loss, especially these with mild-to-moderate hearing loss cannot be found early, which should arouse our attention.

Association between quality of care and complications after abdominal surgery.

PubMed

Bergman, Simon; Deban, Melina; Martelli, Vanessa; Monette, Michèle; Sourial, Nadia; Hamadani, Fadi; Teasdale, Debby; Holcroft, Christina; Zakrzewski, Helena; Fraser, Shannon

2014-09-01

Measuring the quality of surgical care is essential to identifying areas of weakness in the delivery of effective surgical care and to improving patient outcomes. Our objectives were to (1) assess the quality of surgical care delivered to adult patients; and (2) determine the association between quality of surgical care and postoperative complications. This retrospective, pilot, cohort study was conducted at a single university-affiliated institution. Using the institution's National Surgical Quality Improvement Program database (2009-2010), 273 consecutive patients ≥18 years of age who underwent elective major abdominal operations were selected. Adherence to 10 process-based quality indicators (QIs) was measured and quantified by calculating a patient quality score (no. of QIs passed/no. of QIs eligible). A pass rate for each individual QI was also calculated. The association between quality of surgical care and postoperative complications was assessed using an incidence rate ratio, which was estimated from a Poisson regression. The mean overall patient quality score was 67.2 ± 14.4% (range, 25-100%). The mean QI pass rate was 65.9 ± 26.1%, which varied widely from 9.6% (oral intake documentation) to 95.6% (prophylactic antibiotics). Poisson regression revealed that as the quality score increased, the incidence of postoperative complications decreased (incidence rate ratio, 0.19; P = .011). A sensitivity analysis revealed that this association was likely driven by the postoperative ambulation QI. Higher quality scores, mainly driven by early ambulation, were associated with fewer postoperative complications. QIs with unacceptably low adherence were identified as targets for future quality improvement initiatives. Copyright © 2014 Mosby, Inc. All rights reserved.

Recurrent venous thromboembolism and abnormal uterine bleeding with anticoagulant and hormone therapy use

PubMed Central

Lensing, Anthonie W. A.; Middeldorp, Saskia; Levi, Marcel; Beyer-Westendorf, Jan; van Bellen, Bonno; Bounameaux, Henri; Brighton, Timothy A.; Cohen, Alexander T.; Trajanovic, Mila; Gebel, Martin; Lam, Phuong; Wells, Philip S.; Prins, Martin H.

2016-01-01

Women receiving vitamin K antagonists (VKAs) require adequate contraception because of the potential for fetal complications. It is unknown whether the use of hormonal therapy, especially those containing estrogens, is associated with recurrent venous thromboembolism (VTE) during anticoagulation. Despite the absence of data, World Health Organization guidelines state that use of estrogen-containing contraceptives confers an “unacceptable health risk” during established anticoagulation for VTE. We compared the incidences of recurrent VTE and abnormal uterine bleeding with and without concomitant hormonal therapy in women aged <60 years who were receiving anticoagulation with rivaroxaban or enoxaparin/VKA for confirmed VTE. Incidence densities in percentage per year were computed for the on and off estrogen-containing or progestin-only therapy periods. Cox regression models were fitted, with hormonal therapy (on vs off) as a time-dependent variable to derive the hazard ratio (HR) for the effects on recurrent VTE and abnormal uterine bleeding. In total, 1888 women were included. VTE incidence densities on and off hormonal therapy were 3.7%/year and 4.7%/year (adjusted HR, 0.56; 95% confidence interval [CI], 0.23-1.39), respectively, and were 3.7%/year and 3.8%/year, respectively, for estrogen-containing and progestin-only therapy. The adjusted HR for all abnormal uterine bleeding (on vs off hormonal therapy) was 1.02 (95% CI, 0.66-1.57). Abnormal uterine bleeding occurred more frequently with rivaroxaban than with enoxaparin/VKA (HR, 2.13; 95% CI, 1.57-2.89). Hormonal therapy was not associated with an increased risk of recurrent VTE in women receiving therapeutic anticoagulation. The observed increased risk of abnormal uterine bleeding with rivaroxaban needs further exploration. PMID:26696010

Recurrent venous thromboembolism and abnormal uterine bleeding with anticoagulant and hormone therapy use.

PubMed

Martinelli, Ida; Lensing, Anthonie W A; Middeldorp, Saskia; Levi, Marcel; Beyer-Westendorf, Jan; van Bellen, Bonno; Bounameaux, Henri; Brighton, Timothy A; Cohen, Alexander T; Trajanovic, Mila; Gebel, Martin; Lam, Phuong; Wells, Philip S; Prins, Martin H

2016-03-17

Women receiving vitamin K antagonists (VKAs) require adequate contraception because of the potential for fetal complications. It is unknown whether the use of hormonal therapy, especially those containing estrogens, is associated with recurrent venous thromboembolism (VTE) during anticoagulation. Despite the absence of data, World Health Organization guidelines state that use of estrogen-containing contraceptives confers an "unacceptable health risk" during established anticoagulation for VTE. We compared the incidences of recurrent VTE and abnormal uterine bleeding with and without concomitant hormonal therapy in women aged <60 years who were receiving anticoagulation with rivaroxaban or enoxaparin/VKA for confirmed VTE. Incidence densities in percentage per year were computed for the on and off estrogen-containing or progestin-only therapy periods. Cox regression models were fitted, with hormonal therapy (on vs off) as a time-dependent variable to derive the hazard ratio (HR) for the effects on recurrent VTE and abnormal uterine bleeding. In total, 1888 women were included. VTE incidence densities on and off hormonal therapy were 3.7%/year and 4.7%/year (adjusted HR, 0.56; 95% confidence interval [CI], 0.23-1.39), respectively, and were 3.7%/year and 3.8%/year, respectively, for estrogen-containing and progestin-only therapy. The adjusted HR for all abnormal uterine bleeding (on vs off hormonal therapy) was 1.02 (95% CI, 0.66-1.57). Abnormal uterine bleeding occurred more frequently with rivaroxaban than with enoxaparin/VKA (HR, 2.13; 95% CI, 1.57-2.89). Hormonal therapy was not associated with an increased risk of recurrent VTE in women receiving therapeutic anticoagulation. The observed increased risk of abnormal uterine bleeding with rivaroxaban needs further exploration. © 2016 by The American Society of Hematology.

Energy spectrum control for modulated proton beams.

PubMed

Hsi, Wen C; Moyers, Michael F; Nichiporov, Dmitri; Anferov, Vladimir; Wolanski, Mark; Allgower, Chris E; Farr, Jonathan B; Mascia, Anthony E; Schreuder, Andries N

2009-06-01

In proton therapy delivered with range modulated beams, the energy spectrum of protons entering the delivery nozzle can affect the dose uniformity within the target region and the dose gradient around its periphery. For a cyclotron with a fixed extraction energy, a rangeshifter is used to change the energy but this produces increasing energy spreads for decreasing energies. This study investigated the magnitude of the effects of different energy spreads on dose uniformity and distal edge dose gradient and determined the limits for controlling the incident spectrum. A multilayer Faraday cup (MLFC) was calibrated against depth dose curves measured in water for nonmodulated beams with various incident spectra. Depth dose curves were measured in a water phantom and in a multilayer ionization chamber detector for modulated beams using different incident energy spreads. Some nozzle entrance energy spectra can produce unacceptable dose nonuniformities of up to +/-21% over the modulated region. For modulated beams and small beam ranges, the width of the distal penumbra can vary by a factor of 2.5. When the energy spread was controlled within the defined limits, the dose nonuniformity was less than +/-3%. To facilitate understanding of the results, the data were compared to the measured and Monte Carlo calculated data from a variable extraction energy synchrotron which has a narrow spectrum for all energies. Dose uniformity is only maintained within prescription limits when the energy spread is controlled. At low energies, a large spread can be beneficial for extending the energy range at which a single range modulator device can be used. An MLFC can be used as part of a feedback to provide specified energy spreads for different energies.

Test and Evaluation Master Plan (TEMP) for the Navy Occupational Health Information Management System (NOHIMS). Appendix A through Appendix U.

DTIC Science & Technology

1985-04-24

reliability/ downtime/ communication lines/ man-machine interface/ other: 2. A noticeable (to the user) failure happens about and that number has been...improving/ steady/ getting.worse. 3. The number of failures /errors for NOHIMS is acceptable/ somewhat acceptable/ somewhat unacceptable/ unacceptable...somewhat fast/ somewhat slow/ slow. 7. When a NWHIMS failure occurs, it affects the day-to-day provision of medical care because work procedures must

Beliefs about Emotions, Depression, Anxiety and Fatigue: A Mediational Analysis.

PubMed

Sydenham, Mia; Beardwood, Jennifer; Rimes, Katharine A

2017-01-01

Beliefs that it is unacceptable to experience or express negative emotions have been found to be associated with various clinical problems. It is unclear how such beliefs, which could be viewed as a form of unhelpful perfectionism about emotions, may contribute to symptomatology. This study investigated two hypotheses: a) greater endorsement of beliefs about the unacceptability of negative emotions will be associated with greater emotional avoidance and lower levels of support-seeking and self-compassion; b) these beliefs about emotions will be associated with higher levels of symptoms of depression, anxiety and fatigue and that this relationship will be mediated by social support-seeking, emotional avoidance and self-compassion. Online questionnaires were completed by 451 community participants. Mediational analyses were undertaken to investigate emotional avoidance, social support-seeking and self-compassion as mediators of the relationship between beliefs about emotions and symptoms of depression, anxiety and fatigue. Beliefs about the unacceptability of negative emotions were significantly associated with more emotional avoidance and less self-compassion and support-seeking. The relationships between beliefs about emotions and depression, anxiety and fatigue were significantly mediated by self-compassion and emotional avoidance but not social support-seeking. Future research should investigate whether interventions that pay particular attention to emotional avoidance and self-compassion, such as mindfulness-based therapy or modified forms of CBT, may be beneficial in reducing distress and fatigue associated with beliefs about the unacceptability of negative emotions.

The attitudes of dental students towards socially acceptable and unacceptable group working practices.

PubMed

Sisson, K; Newton, J

2007-08-01

To explore the attitudes of undergraduate dental students towards academically unacceptable behaviour. Three sets of vignettes were designed exploring; attitudes towards sharing essays which students present as their own work (set 1), attitudes towards purchasing an essay from a commercial website (set 2), and attitudes towards working in a group (set 3). Eighty-nine dental students read the vignettes, then indicated whether they felt the student depicted should engage in the behaviour, and whether any assessment of the work would be a fair assessment of the student's ability. In addition for the group working vignette, respondents were asked to indicate whether in that situation they would speak to the tutor about their own contribution to the group product. Twenty-one respondents (24%) reported that students should share essays, 11 (12%) felt that the essay would be a fair assessment; 13 (15%) felt that students should buy commercially produced essays, five (6%) felt it would be a fair assessment. For the vignettes involving group work, 31 (35%) respondents felt that group-based assessments were fair, 65 (73%) of respondents felt it unlikely that they would speak to the tutor about their individual contribution. A disturbing proportion of dental students report that cheating is acceptable, the majority feel that unacceptable academic practices are not a fair indication of students' ability. The respondents reported that they were unlikely to report the unacceptable working practices of fellow students.

Pediatric nurses' differentiations between acceptable and unacceptable parent discipline behaviors: a Q-study.

PubMed

Ho, Grace W K; Gross, Deborah A

2015-01-01

Nurses are mandated to report suspected cases of child maltreatment. However, it is unclear how nurses decide what constitutes child abuse or evidence for reporting. It is crucial to examine how nurses define various forms of child maltreatment, including child abuse and its differentiation from physical discipline, to enhance our services to families with young children. The present study examined pediatric nurses' views on acceptable versus unacceptable discipline behaviors to better understand parent behaviors that nurses are likely to deem reportable to child protective services. Using Q methodology, a convenience sample of 48 pediatric nurses from one urban medical center sorted 71 statements related to the behavior or outcome of punishing a child via the Internet application FlashQ. The statements were sorted on a predefined continuum ranging from "Most Unacceptable" to "Most Acceptable." By-person factor analysis was used to uncover groups of nurses with similar sorts and to generate a unique sort that represented the viewpoint of nurses in that group. Two distinct viewpoints were uncovered. Although there was consensus on what constitutes most acceptable and most unacceptable parent behaviors, nurses varied on their endorsement of using physical force as a form of discipline, suggesting a potential for discrepant tendencies to identify and report child abuse. Copyright © 2015 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

MRI-Guided Laser Interstitial Thermal Therapy for Epilepsy.

PubMed

North, Robert Y; Raskin, Jeffrey S; Curry, Daniel J

2017-10-01

MRI-guided laser interstitial thermal therapy for epilepsy (LITT-E) has become an established, minimally invasive alternative to traditional epilepsy surgery. LITT-E is particularly valuable in cases in which open surgery poses unacceptably high morbidity or patient preference precludes craniotomy. Here we present a focused review of technical details and application of LITT to both focal and generalized epilepsy. Copyright © 2017 Elsevier Inc. All rights reserved.

Comments on Economides and Ehlig-Economides,"Sequestering carbon dioxide in a closed underground volume," SPE 124430, October 2009

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

Oldenburg, Curt; Pruess, Karsten; Birkholzer, Jens

The paper examines the pressure increase resulting from injection of CO2 into a 1D radial system with closed boundaries. The finding is that unacceptably high pressures are obtained when only 1% or less of the pore volume is occupied by injected CO2. These results are used to make the general conclusion that large-scale CCS is not feasible.

Cardiac output and systemic vascular resistance: Clinical assessment compared with a noninvasive objective measurement in children with shock.

PubMed

Razavi, Asma; Newth, Christopher J L; Khemani, Robinder G; Beltramo, Fernando; Ross, Patrick A

2017-06-01

To evaluate physician assessment of cardiac output and systemic vascular resistance in patients with shock compared with an ultrasonic cardiac output monitor (USCOM). To explore potential changes in therapy decisions if USCOM data were available using physician intervention answers. Double-blinded, prospective, observational study in a tertiary hospital pediatric intensive care unit. Forty children (<18years) admitted with shock, requiring ongoing volume resuscitation or inotropic support. Two to 3 physicians clinically assessed cardiac output and systemic vascular resistance, categorizing them as high, normal, or low. An investigator simultaneously measured cardiac index (CI) and systemic vascular resistance index (SVRI) with USCOM categorized as high, normal, or low. Overall agreement between physician and USCOM for CI (48.5% [κ = 0.18]) and SVRI (45.9% [κ = 0.16]) was poor. Interobserver agreement was also poor for CI (58.7% [κ = 0.33]) and SVRI (52.3% [κ = 0.28]). Comparing theoretical physician interventions to "acceptable" or "unacceptable" clinical interventions, based on USCOM measurement, 56 (21%) physician interventions were found to be "unacceptable." There is poor agreement between physician-assessed CI and SVRI and USCOM, with significant interobserver variability among physicians. Objective measurement of CI and SVRI may reduce variability and improve diagnostic accuracy. Copyright © 2016 Elsevier Inc. All rights reserved.

[Sexual violence in Congo-Kinshasa: necessity of decriminalizing abortion].

PubMed

Kalonda, J C Omba

2012-01-01

The sexual violence's committed in the Democratic Republic of Congo (DRC) are from their scales and consequences on women, real public health, politico-legal, and socio-economical challenges. More than a million of women have been victims of sexual violence on a period of less than fifteen years. Systematic rapes of women were used as war weapon by different groups involved in the Congolese war. Sexual violence against women has impacted public health by spreading sexually transmissible diseases including HIV/AIDS, causing unwanted pregnancies, leading to the gynaecological complications of rape-related injuries, and inflicting psychological trauma on the victims. Despite high level of unwanted pregnancies observed, the Congolese law is very restrictive and interdict induced abortion. This paper presents three arguments which plead in favour of legalizing abortion in DRC: 1) a restrictive law on abortion forces women to use unsafe abortion and increase incidence of injuries and maternal mortality ; 2) DRC has ratified the universal Declaration of human rights, the African union charter, and has than to promote equality between sexes, in this is included women reproductive rights; 3) an unwanted birth is an additional financial charge for a woman, a factor increasing poverty and psychologically unacceptable in case of rape. From the politico-legal point of view, ending rape impunity and decriminalizing abortion are recommended. Decriminalizing abortion give women choice and save victims and pregnant women from risks related to the pregnancy, a childbirth, or an eventual unsafe abortion. These risks increase the maternal mortality already high in DRC (between 950 and 3000 for 100000 live births).

Vismodegib in patients with advanced basal cell carcinoma: Primary analysis of STEVIE, an international, open-label trial.

PubMed

Basset-Séguin, N; Hauschild, A; Kunstfeld, R; Grob, J; Dréno, B; Mortier, L; Ascierto, P A; Licitra, L; Dutriaux, C; Thomas, L; Meyer, N; Guillot, B; Dummer, R; Arenberger, P; Fife, K; Raimundo, A; Dika, E; Dimier, N; Fittipaldo, A; Xynos, I; Hansson, J

2017-11-01

The SafeTy Events in VIsmodEgib study (STEVIE, ClinicalTrials.gov, NCT01367665), assessed safety and efficacy of vismodegib-a first-in-class Hedgehog pathway inhibitor demonstrating clinical benefit in advanced basal cell carcinoma (BCC)-in a patient population representative of clinical practice. Primary analysis data are presented. Patients with locally advanced or metastatic BCC received oral vismodegib 150 mg/d until progressive disease, unacceptable toxicity, or withdrawal. Primary objective was safety. Efficacy variables were assessed as secondary end-points. Evaluable adult patients (N = 1215, 1119 locally advanced; 96 metastatic BCC) from 36 countries were treated; 147 patients (12%) remained on study at time of reporting. Median (range) treatment duration was 8.6 (0-44) months. Most patients (98%) had ≥1 treatment-emergent adverse event (TEAE). The incidence of the most common TEAEs was consistent with reports in previous analyses. No association between creatine phosphokinase (CPK) abnormalities and muscle spasm was observed. Serious TEAEs occurred in 289 patients (23.8%). Exposure ≥12 months did not lead to increased incidence or severity of new TEAEs. The majority of the most common TEAEs ongoing at time of treatment discontinuation resolved by 12 months afterwards, regardless of Gorlin syndrome status. Response rates (investigator-assessed) in patients with histologically confirmed measurable baseline disease were 68.5% (95% confidence interval (CI) 65.7-71.3) in patients with locally advanced BCC and 36.9% (95% CI 26.6-48.1) in patients with metastatic BCC. The primary analysis of STEVIE demonstrates that vismodegib is tolerable in typical patients in clinical practice; safety profile is consistent with that in previous reports. Long-term exposure was not associated with worsening severity/frequency of TEAEs. Investigator-assessed response rates showed high rate of tumour control. CLINICALTRIALS.GOV: NCT01367665. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Trends in organ donor management: 2002 to 2012.

PubMed

Callahan, Devon S; Kim, Dennis; Bricker, Scott; Neville, Angela; Putnam, Brant; Smith, Jennifer; Bongard, Frederic; Plurad, David

2014-10-01

Refinements in donor management have resulted in increased numbers and quality of grafts after neurologic death. We hypothesize that the increased use of hormone replacement therapy (HRT) has been accompanied by improved outcomes over time. Using the Organ Procurement and Transplant Network donor database, all brain-dead donors procured from July 1, 2001 to June 30, 2012 were studied. Hormone replacement therapy was identified by an infusion of thyroid hormone. An expanded criteria donor was defined as age 60 years or older. Incidence of HRT administration and number of donors and organs recovered were calculated. Using the Organ Procurement and Transplant Network thoracic recipient database transplant list, wait times were examined. There were 74,180 brain-dead donors studied. Hormone replacement therapy use increased substantially from 25.6% to 72.3% of donors. However, mean number of organs procured per donor remained static (3.51 to 3.50; p = 0.083), and the rate of high-yield donors decreased (46.4% to 43.1%; p < 0.001). Incidence of traumatic brain injury donors decreased (42.1% to 33.9%; p < 0.001) relative to an increased number of expanded criteria donors (22.1% to 26%). Despite this, there has been an increase in the raw number of donors (20,558 to 24,308; p < 0.001) and organs (5,857 to 6,945; p < 0.001). There has been an increase in organs per traumatic brain injury donor (4.02 to 4.12; p = 0.002) and a decrease in days on the waiting list (462.2 to 170.4 days; p < 0.001) for a thoracic transplant recipient. The marked increase in the use of HRT in the management of brain-dead donors has been accompanied by increased organ availability overall. Potential mechanisms might include successful conversion of previously unacceptable donors and improved recovery in certain subsets of donors. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

A Comparison of Spectacles Purchased Online and in UK Optometry Practice

PubMed Central

Alderson, Alison J.; Green, Alison; Whitaker, David; Scally, Andrew J.; Elliott, David B.

2016-01-01

ABSTRACT Purpose To compare spectacles bought online with spectacles from optometry practices. Methods Thirty-three participants consisting of single vision spectacle wearers with either a low (N = 12, mean age 34 ± 14 years) or high prescription (N = 11, mean age 28 ± 9 years) and 10 presbyopic participants (mean age 59 ± 4 years) wearing progressive addition lenses (PALs) purchased 154 pairs of spectacles online and 154 from UK optometry practices. The spectacles were compared via participant-reported preference, acceptability, and safety; the assessment of lens, frame, and fit quality; and the accuracy of the lens prescriptions to international standard ISO 21987:2009. Results Participants preferred the practice spectacles (median ranking 4th, IQR 1–6) more than online (6th, IQR 4–8; Mann-Whitney U = 7345, p < 0.001) and practice PALs (median ranking 2nd, IQR 1–4) were particularly preferred (online 6.5th, IQR 4–9, Mann-Whitney U = 455, p < 0.001). Of those deemed unacceptable and unsafe, significantly more were bought online (unacceptable: online 43/154 vs. practice 15/154, Fisher’s exact p = 0.0001; unsafe: online 14/154 vs. practice 5/154, Fisher’s exact p = 0.03). Conclusions Participants preferred spectacles from optometry practice rather than those bought online, despite lens quality and prescription accuracy being similar. A greater number of online spectacles were deemed unsafe or unacceptable because of poor spectacle frame fit, poor cosmetic appearance, and inaccurate optical centration. This seems particularly pertinent to PAL lenses, which are known to increase falls risk. Recommendations are made to improve both forms of spectacle provision. PMID:27536974

Predicting children's behaviour during dental treatment under oral sedation.

PubMed

Lourenço-Matharu, L; Papineni McIntosh, A; Lo, J W

2016-06-01

The primary aim of this study was to assess whether parents' own anxiety and their perception of their child's dental fear and child's general fear can predict preoperatively their child's behaviour during dental treatment under oral sedation. The secondary aim was to assess whether the child's age, gender and ASA classification grade are associated with a child's behaviour under oral sedation. Cross-sectional prospective study. The Corah's Dental Anxiety Scale (DAS), Children's Fear Survey Schedule Dental-Subscale (CFSS-DS) and Children's Fear Survey Schedule Short-Form (CFSS-SF) questionnaires were completed by parents of children undergoing dental treatment with oral midazolam. Behaviour was rated by a single clinician using the overall behaviour section of the Houpt-Scale and scores dichotomised into acceptable or unacceptable behaviour. Data were analysed using χ (2), t test and logistic regression analysis. In total 404 children (215 girls, 53 %) were included, with the mean age of 4.57 years, SD = 1.9. Behaviour was scored as acceptable in 336 (83 %) and unacceptable in 68 (17 %) children. The level of a child's dental fear, as perceived by their parent, was significantly associated with the behaviour outcome (p = 0.001). Logistic regression analysis revealed that if the parentally perceived child's dental fear (CFSS-DS) rating was high, the odds of the child exhibiting unacceptable behaviour under oral sedation was two times greater than if their parents scored them a low dental fear rating (OR 2.27, 95 % CI 1.33-3.88, p = 0.003). CFSS-DS may be used preoperatively to help predict behaviour outcome when children are treated under oral sedation and facilitate treatment planning.

The Effect of Soil Properties on Metal Bioavailability: Field Scale Validation to Support Regulatory Acceptance

DTIC Science & Technology

2014-06-01

unacceptable levels of the toxic metal(loid)s arsenic (As), cadmium (Cd), chromium (Cr), and lead (Pb). With the exception of Pb contaminated soils, human...remediation and closure. Lead (Pb), arsenic (As), chromium (Cr), and cadmium (Cd) are toxic (i.e., capable of producing an unwanted, deleterious effect...lagoon are contaminated with high concentrations of lead , chromium, and cadmium . 14 Deseret Chemical Depot: The Deseret Chemical Depot is

p16 Is Superior to ProEx C in Identifying High-grade Squamous Intraepithelial Lesions (HSIL) of the Anal Can

PubMed Central

Bala, Rajeev; Pinsky, Benjamin A.; Beck, Andrew H.; Kong, Christina S.; Welton, Mark L.; Longacre, Teri A.

2016-01-01

Although the incidence of human papillomavirus (HPV)-associated anal neoplasia is increasing, interobserver and intraobserver reproducibility in the grading of biopsy specimens from this area remains unacceptably low. Attempts to produce a more reproducible grading scheme have led to the use of biomarkers for the detection of high-risk HPV (HR-HPV). We evaluated the performance of standard morphology and biomarkers p16, ProEx C, and Ki-67 in a set of 75 lesions [17 nondysplastic lesions, 23 low-grade squamous intraepithelial lesions (LSIL)/condyloma, 20 high-grade squamous intraepithelial lesions (HSIL), 15 invasive squamous cell carcinomas] from the anal and perianal region in 65 patients and correlated these findings with HPV subtype on the basis of a type-specific multiplex real-time polymerase chain reaction assay designed to detect HR-HPV. A subset of cases with amplifiable HPV DNA was also sequenced. HSIL was typically flat (15/20), and only a minority (4/20) had koilocytes. In contrast, only 1 LSIL was flat (1/23), and the remainder were exophytic. The majority of LSIL had areas of koilocytic change (20/23). HR-HPV DNA was detected in the majority (89%) of invasive carcinomas and HSIL biopsies, 86% and 97% of which were accurately labeled by strong and diffuse block-positive p16 and ProEx C, respectively. LSIL cases, however, only infrequently harbored HR-HPV (13%); most harbored low-risk HPV (LR-HPV) types 6 and 11. Within the LSIL group, p16 outperformed ProEx C, resulting in fewer false-positive cases (5% vs. 75%). Ki-67 was also increased in HR-HPV-positive lesions, although biopsies with increased inflammation and reactive changes also showed higher Ki-67 indices. These data suggest that strong and diffuse block-positive nuclear and cytoplasmic labeling with p16 is a highly specific biomarker for the presence of HR-HPV in anal biopsies and that this finding correlates with high-grade lesions. PMID:23552383

Two-year evaluation indicates zirconia bridges acceptable alternative to PFMs.

PubMed

Perry, Ronald D; Kugel, Gerard; Sharma, Shradha; Ferreira, Susana; Magnuson, Britta

2012-01-01

The aim of this in-vivo study was to evaluate the 2-year clinical performance of zirconia computer-aided design/computer-aided manufacturing (CAD/CAM)-generated bridges. A total of 16 three- or four-unit Lava zirconia bridges were done on 15 subjects. The bridges were cemented using RelyX™ Unicem Self-Adhesive Universal Resin Cement. Evaluation was done at 6-month, 1-year, and 2-year recall visits. Evaluation criteria were color stability and matching, marginal integrity, marginal discoloration, incidence of caries, changes in restoration-tooth interface, changes in surface texture, postoperative sensitivity, maintenance of periodontal health, changes in proximal and opposing teeth, and maintenance of anatomic form. In each of these parameters, the bridges were rated in one of three possible categories: "A" (alpha)--ideal; "B" (bravo)--acceptable; and "C" (charlie)--unacceptable. After 2 years, 100% of the bridges were rated "A" for color stability and matching, marginal discoloration, incidence of caries, changes in restoration-tooth interface, changes in surface texture, postoperative sensitivity, and change in proximal or opposing teeth. In the parameter of marginal integrity, 6.25% of the bridges were rated "B;" the remaining 93.75% were rated "A." Maintenance of periodontal health was rated "B" for 6.25% of the bridges and "A" for 93.75%. At 2 years, 12.5% of the bridges rated "C" in maintenance of anatomic form and 87.5% rated "A." The overall clinical outcome was that the CAD/CAM-generated zirconia bridges were clinically acceptable.

Body Weight and Body Image

PubMed Central

Olmsted, Marion P; McFarlane, Traci

2004-01-01

Health Issue Body weight is of physical and psychological importance to Canadian women; it is associated with health status, physical activity, body image, and self-esteem. Although the problems associated with overweight and obesity are indeed serious, there are also problems connected to being underweight. Weight prejudice and the dieting industry intensify body image concerns for Canadian women and can have a major negative impact on self-esteem. Key Findings Women have lower BMIs than men, a lower incidence of being overweight and a higher incidence of being underweight. However, women across all weight categories are more dissatisfied with their bodies. Sixty percent of women are inactive, and women with a BMI of 27 or higher are more likely to be inactive than women with lower BMIs. The data show that women are aware of the health benefits of exercise, but there is a gap between knowledge and practice. When asked about barriers to health improvement, 39.7% of women cited lack of time and 39.2% lack of willpower. Data Gaps and Recommendations Weight prejudice must be made unacceptable and positive body image should be encouraged and diversity valued. Health policies should encourage healthy eating and healthy activity. Health curricula for young students should include information about healthy eating, active lifestyle, and self-esteem. Physical activities that mothers can participate in with their families should be encouraged. Research should be funded to elucidate the most effective methods of getting women to become and remain physically active without focusing on appearance. PMID:15345068

Quality Assurance in Trichiasis Surgery: a methodology

PubMed Central

Buchan, John C; Limburg, Hans; Burton, Matthew J

2013-01-01

SUMMARY Trachoma remains a significant cause of blindness in many parts of the world. The major route to blindness involves upper lid entropion leading to trachomatous trichiasis (TT) which promotes progressive corneal opacification. The provision of surgery to correct TT in the populations most severely affected is a major challenge for the global effort to eliminate Trachoma blindness by the year 2020. Most attention has been paid to increasing the quantity of TT surgery performed, and large numbers of non-doctor operators have been trained to this end. Surgical audit by those performing TT surgery is not a routine part of any national trachoma control programme, and no effective mechanism exists for identifying surgeons experiencing poor outcomes. We propose a methodology for surgical audit at the level of the individual surgeon based on Lot Quality Assurance. A set number of patients operated on previously for upper eyelid TT are examined to detect the recurrence of TT. The number of recurrent cases found will lead to categorisation of the TT surgeon to either “high recurrence” or “low recurrence” with reasonable confidence. The threshold of unacceptability can be set by individual programmes according to previous local studies of recurrence rates or those from similar settings. Identification of surgeons delivering unacceptably high levels of recurrent TT will guide managers on the need for remedial intervention such as re-training. PMID:20881027

Alcohol and hospitalized road traffic injuries in the Philippines.

PubMed

O'Connor, Lydia R; Ruiz, Roberto Andres Llanes

2014-09-01

Each year, there are approximately 1.24 million deaths due to road traffic injuries, the majority of which occur in low- and middle-income countries. Since 2008, 35 countries have passed legislation to implement road safety strategies. However, many countries have yet to pass comprehensive legislation while others lack adequate enforcement of current policies. The annual global mortality rate due to road trauma remains unacceptably high and reflects the need for governments to prioritize the passage and implementation of road safety legislation. Alcohol is a leading risk factor for road trauma globally and the leading cause of death and disability in the Western Pacific region. Despite the overwhelming evidence that strict enforcement of drunk-driving policies can lead to a drastic reduction in alcohol-related road incidents, many countries in the Western Pacific lack sufficient data that could facilitate the design of appropriate drunk-driving interventions. This paper provides an analysis of the current status of policies and attitudes related to alcohol and road injuries throughout the Western Pacific region, with a specific focus on the Philippines. Following the passage of drunk-driving legislation in 2013, a medical records review of alcohol-related road trauma patients in Manila Doctors Hospital was conducted. The findings of this pilot project further highlight the pervasive problem of missing or unreliable data regarding alcohol's role in road trauma. Assessing the burden of drunk driving is an important step in designing effective interventions and systematically changing attitudes about driving under the influence.

Prostate Cancer Information Available in Health-Care Provider Offices: An Analysis of Content, Readability, and Cultural Sensitivity.

PubMed

Choi, Seul Ki; Seel, Jessica S; Yelton, Brooks; Steck, Susan E; McCormick, Douglas P; Payne, Johnny; Minter, Anthony; Deutchki, Elizabeth K; Hébert, James R; Friedman, Daniela B

2018-07-01

Prostate cancer (PrCA) is the most common cancer affecting men in the United States, and African American men have the highest incidence among men in the United States. Little is known about the PrCA-related educational materials being provided to patients in health-care settings. Content, readability, and cultural sensitivity of materials available in providers' practices in South Carolina were examined. A total of 44 educational materials about PrCA and associated sexual dysfunction was collected from 16 general and specialty practices. The content of the materials was coded, and cultural sensitivity was assessed using the Cultural Sensitivity Assessment Tool. Flesch Reading Ease, Flesch-Kincaid Grade Level, and the Simple Measure of Gobbledygook were used to assess readability. Communication with health-care providers (52.3%), side effects of PrCA treatment (40.9%), sexual dysfunction and its treatment (38.6%), and treatment options (34.1%) were frequently presented. All materials had acceptable cultural sensitivity scores; however, 2.3% and 15.9% of materials demonstrated unacceptable cultural sensitivity regarding format and visual messages, respectively. Readability of the materials varied. More than half of the materials were written above a high-school reading level. PrCA-related materials available in health-care practices may not meet patients' needs regarding content, cultural sensitivity, and readability. A wide range of educational materials that address various aspects of PrCA, including treatment options and side effects, should be presented in plain language and be culturally sensitive.

Proceedings of the National Conference on Climate Change and Water Resources Management (1st) Held in Albuquerque, New Mexico on November 4-7, 1991

DTIC Science & Technology

1993-12-01

mean water temperatures are not much in excess of 25° C . From the global climate model predictions summarized in Figures 4 and 5, all the models suggest...that the mean diurnal water temperatures could exceed 25° C under high-summer conditions, with water temperatures rising to around 30’ C or more for some...allocation, C = 41,500 acre-feet, a 20 percent increase in the mean inflow produces what we consider a priori to be an unacceptably high flood

Cataract, cost: curious questions.

PubMed

Moran, D J

1999-02-01

An investigation of the pricing of implantable prosthetic devices in Australia reveals some alarming practices. A governmental mechanism exists to prop up the pricing of 7500 listed devices to levels that are unacceptably high by world standards. Private hospitals and doctors are able, legally, to profit by marking up the cost of these devices from the market price to this artificially inflated price. Even the open market prices of implantable prosthetic items, such as intra-ocular lenses, are high by international standards. In a time of budgetary constraint for health spending and rapidly increasing use of these devices, these issues urgently need to be addressed in Australia.

Nonproliferation Challenges in Space Defense Technology - PANEL

NASA Technical Reports Server (NTRS)

Houts, Michael G.

2016-01-01

The use of highly enriched uranium (HEU) almost always "helps" space fission systems. Nuclear Thermal Propulsion (NTP) and high power fission electric systems appear able to use < 20% enriched uranium with minimal / acceptable performance impacts. However, lower power, "entry level" systems may be needed for space fission technology to be developed and utilized. Low power (i.e. approx.1 kWe) fission systems may have an unacceptable performance penalty if LEU is used instead of HEU. Are there Ways to Support Non-Proliferation Objectives While Simultaneously Helping Enable the Development and Utilization of Modern Space Fission Power and Propulsion Systems?

Thermal Control Method for High-Current Wire Bundles by Injecting a Thermally Conductive Filler

NASA Technical Reports Server (NTRS)

Rodriguez-Ruiz, Juan; Rowles, Russell; Greer, Greg

2011-01-01

A procedure was developed to inject thermal filler material (a paste-like substance) inside the power wire bundle coming from solar arrays. This substance fills in voids between wires, which enhances the heat path and reduces wire temperature. This leads to a reduced amount of heat generated. This technique is especially helpful for current and future generation high-power spacecraft (1 kW or more), because the heat generated by the power wires is significant enough to cause unacceptable overheating to critical components that are in close contact with the bundle.

Damping Goes the Distance in Golf

NASA Technical Reports Server (NTRS)

2004-01-01

In the late 1980s, Dr. Benjamin Dolgin of NASA s Jet Propulsion Laboratory developed a concept for a high-damping graphite/viscoelastic material for the Strategic Defense Initiative (popularly referred to as "Star Wars"), as part of a space-based laser anti-missile program called "Asterix." Dolgin drummed up this concept with the intention of stabilizing weapons launch platforms in space, where there is no solid ground to firmly support these structures. Without the inclusion of high-damping material, the orbital platforms were said to vibrate for 20 minutes after force was applied - a rate deemed "unacceptable" by leaders of the Strategic Defense Initiative.

Intravenous Chemotherapy Compounding Errors in a Follow-Up Pan-Canadian Observational Study.

PubMed

Gilbert, Rachel E; Kozak, Melissa C; Dobish, Roxanne B; Bourrier, Venetia C; Koke, Paul M; Kukreti, Vishal; Logan, Heather A; Easty, Anthony C; Trbovich, Patricia L

2018-05-01

Intravenous (IV) compounding safety has garnered recent attention as a result of high-profile incidents, awareness efforts from the safety community, and increasingly stringent practice standards. New research with more-sensitive error detection techniques continues to reinforce that error rates with manual IV compounding are unacceptably high. In 2014, our team published an observational study that described three types of previously unrecognized and potentially catastrophic latent chemotherapy preparation errors in Canadian oncology pharmacies that would otherwise be undetectable. We expand on this research and explore whether additional potential human failures are yet to be addressed by practice standards. Field observations were conducted in four cancer center pharmacies in four Canadian provinces from January 2013 to February 2015. Human factors specialists observed and interviewed pharmacy managers, oncology pharmacists, pharmacy technicians, and pharmacy assistants as they carried out their work. Emphasis was on latent errors (potential human failures) that could lead to outcomes such as wrong drug, dose, or diluent. Given the relatively short observational period, no active failures or actual errors were observed. However, 11 latent errors in chemotherapy compounding were identified. In terms of severity, all 11 errors create the potential for a patient to receive the wrong drug or dose, which in the context of cancer care, could lead to death or permanent loss of function. Three of the 11 practices were observed in our previous study, but eight were new. Applicable Canadian and international standards and guidelines do not explicitly address many of the potentially error-prone practices observed. We observed a significant degree of risk for error in manual mixing practice. These latent errors may exist in other regions where manual compounding of IV chemotherapy takes place. Continued efforts to advance standards, guidelines, technological innovation, and chemical quality testing are needed.

Management of post-neurosurgical meningitis: narrative review.

PubMed

Hussein, K; Bitterman, R; Shofty, B; Paul, M; Neuberger, A

2017-09-01

Infections complicating neurosurgery pose unacceptable mortality and morbidity. To summarize what is known about the epidemiology, diagnosis and treatment of post-neurosurgical meningitis (PNM). PubMed, references of identified studies and reviews, and personal experience when evidence was lacking. The incidence and pathogen distribution of PNM is highly variable. A shift towards Gram-negative bacteria has been observed with use of antibiotic prophylaxis and antibiotic-coated devices directed mainly against Gram-positive bacteria. However, knowledge of the local epidemiology is necessary to treat PNM. The diagnosis of PNM is difficult because, unlike community-acquired meningitis, symptoms are less specific; patients are ill at baseline and many neurosurgical conditions mimic meningitis and cause cerebrospinal fluid (CSF) abnormalities. Pivotal CSF findings for diagnosis of PNM are the CSF glucose, CSF lactate and Gram stain. CSF leucocyte counts are not specific in PNM. Current diagnostic capabilities leave a non-negligible category of patients with microbiologically negative, uncertain diagnosis of PNM. There is no high-quality evidence on several cardinal issues in PNM management, including the effectiveness of intraventricular or intrathecal (IV/IT) antibiotics, effectiveness of dual antibiotic therapy for multidrug-resistant Gram-negative bacteria; clinical benefit of routine therapeutic drug monitoring; and safest timing of shunt replacement. Some data point to a potential benefit of IV/IT antibiotic treatment, mainly for PNM caused by carbapenem-resistant Gram-negative bacteria. Carbapenem-colistin combination therapy is suggested for PNM caused by carbapenem-resistant Gram-negative bacteria with a carbapenem MIC ≤8 mg/L. Guiding the optimal management of PNM will necessitate collaborative multicentre efforts and unique study designs. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

High-numerical aperture extreme ultraviolet scanner for 8-nm lithography and beyond

NASA Astrophysics Data System (ADS)

Schoot, Jan van; Setten, Eelco van; Rispens, Gijsbert; Troost, Kars Z.; Kneer, Bernhard; Migura, Sascha; Neumann, Jens Timo; Kaiser, Winfried

2017-10-01

Current extreme ultraviolet (EUV) projection lithography systems exploit a projection lens with a numerical aperture (NA) of 0.33. It is expected that these will be used in mass production in the 2018/2019 timeframe. By then, the most difficult layers at the 7-nm logic and the mid-10-nm DRAM nodes will be exposed. These systems are a more economical alternative to multiple-exposure by 193 argon fluoride immersion scanners. To enable cost-effective shrink by EUV lithography down to 8-nm half pitch, a considerably larger NA is needed. As a result of the increased NA, the incidence angles of the light rays at the mask increase significantly. Consequently, the shadowing and the variation of the multilayer reflectivity deteriorate the aerial image contrast to unacceptably low values at the current 4× magnification. The only solution to reduce the angular range at the mask is to increase the magnification. Simulations show that the magnification has to be doubled to 8× to overcome the shadowing effects. Assuming that the mask infrastructure will not change the mask form factor, this would inevitably lead to a field size that is a quarter of the field size of the current 0.33-NA step and scan systems and reduce the throughput (TPT) of the high-NA scanner to a value below 100 wafers per hour unless additional measures are taken. This paper presents an anamorphic step and scan system capable of printing fields that are half the field size of the current full field. The anamorphic system has the potential to achieve a TPT in excess of 150 wafers per hour by increasing the transmission of the optics, as well as increasing the acceleration of the wafer stage and mask stage. This makes it an economically viable lithography solution.

A Framework to Evaluate Wildlife Feeding in Research, Wildlife Management, Tourism and Recreation.

PubMed

Dubois, Sara; Fraser, David

2013-10-11

Feeding of wildlife occurs in the context of research, wildlife management, tourism and in opportunistic ways. A review of examples shows that although feeding is often motivated by good intentions, it can lead to problems of public safety and conservation and be detrimental to the welfare of the animals. Examples from British Columbia illustrate the problems (nuisance animal activity, public safety risk) and consequences (culling, translocation) that often arise from uncontrolled feeding. Three features of wildlife feeding can be distinguished: the feasibility of control, the effects on conservation and the effects on animal welfare. An evaluative framework incorporating these three features was applied to examples of feeding from the literature. The cases of feeding for research and management purposes were generally found to be acceptable, while cases of feeding for tourism or opportunistic feeding were generally unacceptable. The framework should allow managers and policy-makers to distinguish acceptable from unacceptable forms of wildlife feeding as a basis for policy, public education and enforcement. Many harmful forms of wildlife feeding seem unlikely to change until they come to be seen as socially unacceptable.

Perineal hygiene in patients with pelvic fractures.

PubMed

Hossain, Mohammad A; Pearce, Rachel; Bircher, Martin D

2008-08-01

At the tertiary referral Orthopaedic Unit of St. Georges Hospital, it was noted that there was an unacceptably high number of soiled perinea in patients transferred from Base Hospitals. This not only exposed the patients to increased infection [Jepsen O. The effectiveness of preoperative skin preparations: an integrated review of the literature. AORN J 1993;58:477-82; and Nix D, Ermer-Seltun J. A review of perineal skin care protocols and skin barrier product use. Ostomy Wound Manage 2004;50:59-67] but was also undignified and unacceptable for them. We decided to audit the problem with a view to finding out why this was happening and to improve the situation. A 2-year study was carried out over three distinct phases (phase 1: February-June 2004, phase 2: July-November 2004, phase 3: February-November 2005). Observations of soiling were recorded in a questionnaire by the surgeon prior to surgery. Key system and clinical guidelines were implemented during the second phase, and the audit process was repeated. The percentage of clean perinea in phase 1 was 32%, phase 2 68% and phase 3 99.5% indicating a clear improvement in the overall system.

Prevalence and predictors of postoperative pain after ear, nose, and throat surgery.

PubMed

Sommer, Michael; Geurts, José W J M; Stessel, Bjorn; Kessels, Alfons G H; Peters, Madelon L; Patijn, Jacob; van Kleef, Maarten; Kremer, Bernd; Marcus, Marco A E

2009-02-01

To determine postoperative pain in different types of ear, nose, and throat (ENT) surgery and their psychological preoperative predictors. Prospective cohort study. Academic hospital. A total of 217 patients undergoing ENT surgery. All ENT, neck, and salivary gland surgery. Postoperative pain and predictors for postoperative pain. Fifty percent of the patients undergoing surgery on the oral, pharyngeal, and laryngeal region and on the neck and salivary gland region had a visual analog scale score higher than 40 mm on day 1. In the patients who underwent oropharyngeal region operations the VAS score remained high on all 4 days. A VAS pain score higher than 40 mm was found in less than 30% of patients after endoscopic procedures and less than 20% after ear and nose surgery. After bivariate analysis, 6 variables--age, sex, preoperative pain, expected pain, short-term fear, and pain catastrophizing--had a predictive value. Multivariate analysis showed only preoperative pain, pain catastrophizing, and anatomical site of operation as independent predictors. Differences exist in the prevalence of unacceptable postoperative pain between ENT operations performed on different anatomical sites. A limited set of variables can be used to predict the occurrence of unacceptable postoperative pain after ENT surgery.

Variation in Acceptable Child Discipline Practices by Child Age: Perceptions of Community Norms by Medical and Legal Professionals

PubMed Central

Block, Stephanie D.; Poplin, Ashlee Burgess; Wang, Eric; Widaman, Keith F.; Runyan, Desmond K.

2016-01-01

Mandated child abuse reporters may judge specific disciplinary practices as unacceptable for young children, whereas child law professionals arbitrating allegations may be less inclusive. Do the views of these groups diverge, by child age, regarding physical discipline? Judgments of community norms across a wide range of children’s ages were obtained from 380 medical and legal professionals. Because the Parent-Child Conflict Tactics Scale (PC-CTS) can be used to assess the epidemiology of child disciplinary behaviors and as a proxy to examine the incidence or prevalence of child abuse, the disciplinary practices described on the PC-CTS were presented as triggers for questions. Significant child age effects were found for disciplinary practices classified as “harsh.” The consistencies between legal and medical professionals were striking. Both groups reflected changes in United States norms, as non-physical approaches were the most approved. We conclude that instruments estimating the prevalence of child maltreatment by parent-report should consider modifying how specific disciplinary practices are classified. PMID:27117603

[Stress urinary incontinence after radical cystectomy: neobladder construction and placement of the functional retrourethral sling].

PubMed

Mayer, M; Bauer, R M; Walther, S; Becker, A J; Stief, C G; Bastian, P J; Gozzi, C

2009-06-01

Stress urinary incontinence (SUI) following radical cystectomy and orthotopic ileal neobladder construction represents a challenging problem. The incidence of incontinence following this surgery is reported to be 30-60% and is - despite a better understanding of the male (and female) pelvic anatomy - still regarded as an adverse outcome of this surgery.Therapeutic options have been limited up until now and include pharmacological agents, surgical treatment and pelvic floor training with only moderate amelioration of the symptoms and often unacceptable side effects. Nevertheless, urinary continence is probably the most important key to patient satisfaction. Here we introduce the perineal approach of the functional retrourethral mesh as a new and innovative sling suspension based on a non-obstructive procedure in a patient with urinary stress incontinence after ileal neobladder. The sling adjusts the changed anatomy after radical cystectomy returning it to the former preoperative position and thus continence can be achieved again. The approach of the sling in a patient with ileal neobladder is safe and the good result concerning continence is promising.

Integrated controls for a new aircraft generation

NASA Technical Reports Server (NTRS)

Mace, W. D.; Howell, W. E.

1978-01-01

Many of the commercial aircraft now flying will have to be phased out in the early 1980s because of fuel inefficiency and unacceptable noise levels. This paper discusses the role of new digital technology in making aircraft more fuel efficient, more reliable, and quieter. Attention is given to the integration of sensing and control functions in an aircraft in order to provide a simple, lightweight, and high-redundancy system. Technology under development now is expected to come on-line in the 1990s.

Behavior of hydrogen in alpha-iron at lower temperatures

NASA Technical Reports Server (NTRS)

Weizer, V. G.

1973-01-01

Evidence is presented that the low temperature anomalies in the hydrogen occlusive behavior of alpha iron can be explained by means of a molecular occlusion theory. This theory proposes that the stable state of the absorbed hydrogen changes from atomic at high temperatures to molecular as the temperature is lowered below a critical value. Theories proposing to explain the anomalous behavior as being due to the capture, at lower temperatures, of hydrogen in traps are shown to be unacceptable.

Universal Health Coverage - The Critical Importance of Global Solidarity and Good Governance Comment on "Ethical Perspective: Five Unacceptable Trade-offs on the Path to Universal Health Coverage".

PubMed

Reis, Andreas A

2016-06-07

This article provides a commentary to Ole Norheim' s editorial entitled "Ethical perspective: Five unacceptable trade-offs on the path to universal health coverage." It reinforces its message that an inclusive, participatory process is essential for ethical decision-making and underlines the crucial importance of good governance in setting fair priorities in healthcare. Solidarity on both national and international levels is needed to make progress towards the goal of universal health coverage (UHC). © 2016 by Kerman University of Medical Sciences.

Alexithymia and perfectionism traits are associated with suicidal risk in patients with obsessive-compulsive disorder.

PubMed

Kim, Heeyeon; Seo, Jiwoo; Namkoong, Kee; Hwang, Eun Hee; Sohn, Sung Yun; Kim, Se Joo; Kang, Jee In

2016-03-01

There is limited evidence on suicidality and its associated factors in patients with obsessive-compulsive disorder (OCD). The present study investigated the potential contributing traits such as alexithymia and perfectionism and clinical risk factors including symptom dimensions associated with high suicidality in OCD patients. A total of 81 patients with OCD were included (mean age: 28.89 years, SD=7.95 years, 62% men). Suicidal risk was assessed using the Scale for Suicide Ideation and history taking. To assess alexithymia and perfectionism, the Toronto Alexithymia Scale-20 and the Measure of Constructs Underlying Perfectionism were applied. Clinical characteristics of OCD were assessed with the Yale-Brown Obsessive-Compulsive Scale, the Dimensional Obsessive-Compulsive Scale, and the Montgomery-Asberg Depression Rating Scale. Among OCD patients, 37% had a history of previous suicidal attempt, and 56.8% had current suicidal ideation. Those with lifetime suicide attempts scored significantly higher for alexithymia and ego-dystonic perfectionism than those without such history. In the binary logistic regression analysis, high score for alexithymia and the responsibility for harm, injury, or bad luck were significant determinants for lifetime suicide attempts. As for current suicide ideation, ego-dystonic perfectionism and the dimension of unacceptable thought were significant predictors of suicidal risk. The classification of suicidal risk and personality traits relied on self-report measures. The present findings indicate that personality traits such as alexithymia and perfectionism may contribute to high suicidality in patients with OCD, and patients suffering with unacceptable thoughts need to be assessed more carefully for warning signs of suicide. Copyright © 2015 Elsevier B.V. All rights reserved.

Positive-pressure ventilation during transport: a randomized crossover study of self-inflating and flow-inflating resuscitators in a simulation model.

PubMed

Lucy, Malcolm J; Gamble, Jonathan J; Daku, Brian L; Bryce, Rhonda D; Rana, Masud

2014-12-01

Positive-pressure ventilation during transport of intubated patients is generally delivered via a hand-pressurized device. Of these devices, self-inflating resuscitators (SIR) and flow-inflating resuscitators (FIR) constitute the two major types used. Selection of a particular device for transport, however, remains largely an institutional practice. To evaluate the hypothesis that transport ventilation goals of intubated pediatric patients are better achieved using an FIR compared to an SIR. This randomized crossover simulation study compared the performance of SIR and FIR among anesthesia providers in a pediatric transport scenario. Subjects hand-ventilated a test lung while simultaneously maneuvering a stretcher bed to simulate patient transport. Hand ventilation was carried out using a Jackson-Rees circuit (FIR) and a Laerdal pediatric silicone resuscitator (SIR). The primary outcome was the proportion of total breaths delivered within the predefined target PIP/PEEP range (30+/- 3, 10+/- 3 cm H2O). Secondary outcomes included proportion of total breaths delivered with operationally defined unacceptable breath variables (PIP > 35 cm H2O or PEEP < 5 cm H2O). Overall, participants were four times more likely to deliver target breaths and one-third less likely to deliver unacceptable breaths using the FIR compared to the SIR. When comparing device performance, a 44% increase in the proportions of target breaths and a 40.4% decrease in unacceptable breaths using the FIR were observed (P < 0.0001 for both). Hand ventilation during patient transport is superior using the FIR compared to the SIR to achieve target ventilatory goals and avoid unacceptable ventilatory cycles. © 2014 John Wiley & Sons Ltd.

The normative dimension and legal meaning of endangered and recovery in the U.S. Endangered Species Act.

PubMed

Vucetich, John A; Nelson, Michael P; Phillips, Michael K

2006-10-01

The ethical, legal, and social significance of the U.S. Endangered Species Act of 1973 (ESA) is widely appreciated. Much of the significance of the act arises from the legal definitions that the act provides for the terms threatened species and endangered species. The meanings of these terms are important because they give legal meaning to the concept of a recovered species. Unfortunately, the meanings of these terms are often misapprehended and rarely subjected to formal analysis. We analyzed the legal meaning of recovered species and illustrate key points with details from "recovery" efforts for the gray wolf (Canis lupus). We focused on interpreting the phrase "significant portion of its range," which is part of the legal definition of endangered species. We argue that recovery and endangerment entail a fundamentally normative dimension (i.e., specifying conditions of endangerment) and a fundamentally scientific dimension (i.e., determining whether a species meets the conditions of endangerment). Specifying conditions for endangerment is largely normative because it judges risks of extinction to be either acceptable or unacceptable. Like many other laws that specify what is unacceptable, the ESA largely specifies the conditions that constitute unacceptable extinction risk. The ESA specifies unacceptable risks of extinction by defining endangered species in terms of the portion of a species' range over which a species is "in danger of extinction." Our analysis indicated that (1) legal recovery entails much more than the scientific notion of population viability, (2) most efforts to recover endangered species are grossly inadequate, and (3) many unlisted species meet the legal definition of an endangered or threatened species.

Rotordynamic Characteristics of the HPOTP (High Pressure Oxygen Turbopump) of the SSME (Space Shuttle Main Engine)

NASA Technical Reports Server (NTRS)

Childs, D. W.

1984-01-01

Rotational stability of turbopump components in the space shuttle main engine was studied via analysis of component and structural dynamic models. Subsynchronous vibration caused unacceptable migration of the rotor/housing unit with unequal load sharing of the synchronous bearings that resulted in the failure of the High Pressure Oxygen Turbopump. Linear analysis shows that a shrouded inducer eliminates the second critical speed and the stability problem, a stiffened rotor improves the rotordynamic characteristics of the turbopump, and installing damper boost/impeller seals reduces bearing loads. Nonlinear analysis shows that by increasing the "dead band' clearances, a marked reduction in peak bearing loads occurs.

Dross treatment in a rotary arc furnace with graphite electrodes

NASA Astrophysics Data System (ADS)

Drouet, Michel G.; Handfield, My; Meunier, Jean; Laflamme, Claude B.

1994-05-01

Aluminum baths are always covered with a layer of dross resulting from the aluminum surface oxidation. This dross represents 1-10% of the melt and may contain up to 75wt.% aluminum. Since aluminum production is highly energy intensive, dross recycling is very attractive from both energy and economic standpoints. The conventional recycling process using salt rotary furnaces is thermally inefficient and environmentally unacceptable because of the production of salt slags. Hydro-Quebec has developed a new technology using a rotary arc furnace with graphite electrodes. This process provides aluminum recovery rates of 80-90%, using a highly energy efficient, environmentally sound production method.

The elimination of scabies: a task for our generation.

PubMed

McLean, Florence E

2013-10-01

Scabies prevalence remains unacceptably high in many regions throughout the world. Infestation with scabies significantly impacts quality of life and is linked to pyoderma and consequently to severe long-term sequelae such as post-streptococcal glomerulonephritis. In the past, control programs using topical treatments have met with poor compliance; however, the highly effective oral agent ivermectin may offer a new paradigm in scabies management. Problems still exist with insensitive diagnostic tests, questions concerning mite reservoirs, and restrictions on who can receive ivermectin. Despite these difficulties, the elimination of scabies in communities worst affected may soon be possible. © 2013 The International Society of Dermatology.

Cognitive Support During High-Consequence Episodes of Care in Cardiovascular Surgery.

PubMed

Conboy, Heather M; Avrunin, George S; Clarke, Lori A; Osterweil, Leon J; Christov, Stefan C; Goldman, Julian M; Yule, Steven J; Zenati, Marco A

2017-03-01

Despite significant efforts to reduce preventable adverse events in medical processes, such events continue to occur at unacceptable rates. This paper describes a computer science approach that uses formal process modeling to provide situationally aware monitoring and management support to medical professionals performing complex processes. These process models represent both normative and non-normative situations, and are validated by rigorous automated techniques such as model checking and fault tree analysis, in addition to careful review by experts. Context-aware Smart Checklists are then generated from the models, providing cognitive support during high-consequence surgical episodes. The approach is illustrated with a case study in cardiovascular surgery.

Heavy metals contamination and human health risk assessment around Obuasi gold mine in Ghana.

PubMed

Bempah, Crentsil Kofi; Ewusi, Anthony

2016-05-01

Gold mining has increased the prevalence and occurrence of heavy metals contamination at the Earth's surface and is causing major concern due to the potential risk involved. This study investigated the impact of gold mine on heavy metals (As, Cd, Cr, Cu, Pb, Hg, Ni, Fe, Mn, and Zn) pollution and evaluated the potential health risks to local residents via consumption of polluted groundwater, agricultural soils, and vegetable crops grown at three community farms surrounding the mine at Obuasi municipality of Ghana. The results showed levels of As, Cd, Cr, Hg, Fe, and Mn higher than the allowable drinking water standards. The vegetable samples analyzed showed high accumulation of As and Ni above the normal value. Bioaccumulation factors of heavy metals were significantly higher for vegetables grown in the Sanso soils. Estimated average daily intake and hazard quotient for As in drinking water as well as As, Pb, and Hg in vegetable samples exceeded permissible limit. Unacceptable non-cancer health risk levels were found in vegetable samples analyzed for As, Pb, and Hg. An unacceptable cancer risk was found via drinking of groundwater, in consumption of vegetables, and in soil. The hazard index for vegetables was higher than 1, indicating very high health risk to heavy metals contamination through consumption of vegetables grown around the sampling sites. The results recommend the need for regular monitoring of groundwater and food crops to protect consumers' health.

How much would each researcher receive if competitive government research funding were distributed equally among researchers?

PubMed Central

Katzav, Joel

2017-01-01

Scientists are increasingly dissatisfied with funding systems that rely on peer assessment and, accordingly, have suggested several proposals for reform. One of these proposals is to distribute available funds equally among all qualified researchers, with no interference from peer review. Despite its numerous benefits, such egalitarian sharing faces the objection, among others, that it would lead to an unacceptable dilution of resources. The aim of the present paper is to assess this particular objection. We estimate (for the Netherlands, the U.S. and the U.K.) how much researchers would receive were they to get an equal share of the government budgets that are currently allocated through competitive peer assessment. For the Netherlands, we furthermore estimate what researchers would receive were we to differentiate between researchers working in low-cost, intermediate-cost and high-cost disciplines. Given these estimates, we then determine what researchers could afford in terms of PhD students, Postdocs, travel and equipment. According to our results, researchers could, on average, maintain current PhD student and Postdoc employment levels, and still have at their disposal a moderate (the U.K.) to considerable (the Netherlands, U.S.) budget for travel and equipment. This suggests that the worry that egalitarian sharing leads to unacceptable dilution of resources is unjustified. Indeed, our results strongly suggest that there is room for far more egalitarian distribution of funds than happens in the highly competitive funding schemes so prevalent today. PMID:28886054

How much would each researcher receive if competitive government research funding were distributed equally among researchers?

PubMed

Vaesen, Krist; Katzav, Joel

2017-01-01

Scientists are increasingly dissatisfied with funding systems that rely on peer assessment and, accordingly, have suggested several proposals for reform. One of these proposals is to distribute available funds equally among all qualified researchers, with no interference from peer review. Despite its numerous benefits, such egalitarian sharing faces the objection, among others, that it would lead to an unacceptable dilution of resources. The aim of the present paper is to assess this particular objection. We estimate (for the Netherlands, the U.S. and the U.K.) how much researchers would receive were they to get an equal share of the government budgets that are currently allocated through competitive peer assessment. For the Netherlands, we furthermore estimate what researchers would receive were we to differentiate between researchers working in low-cost, intermediate-cost and high-cost disciplines. Given these estimates, we then determine what researchers could afford in terms of PhD students, Postdocs, travel and equipment. According to our results, researchers could, on average, maintain current PhD student and Postdoc employment levels, and still have at their disposal a moderate (the U.K.) to considerable (the Netherlands, U.S.) budget for travel and equipment. This suggests that the worry that egalitarian sharing leads to unacceptable dilution of resources is unjustified. Indeed, our results strongly suggest that there is room for far more egalitarian distribution of funds than happens in the highly competitive funding schemes so prevalent today.

Low immunisation uptake: Is the process the problem?

PubMed Central

Harrington, P.; Woodman, C.; Shannon, W.

2000-01-01

OBJECTIVE—To examine mothers' satisfaction with the process of immunisation and its possible contribution to suboptimal immunisation uptake.
DESIGN—In depth interviews with mothers.
SETTING—Two Community Care Areas, Dublin city, Ireland.
PARTICIPANTS—In depth interviews of 23 mothers of children 1-2 years old, recruited purposively from a birth cohort born in 1994.
MAIN RESULTS—Mothers preferred general practice to Health Centre immunisation (11:5) for predominantly emotional compared with practical reasons (4:1). Health Centre immunisation was seen, at times, as unacceptably rough and inhuman. Many mothers experienced severe emotional distress at the prospect of inflicting the pain of immunisation on their babies. The non-empathic stance of some immunising doctors was unacceptable to mothers. They valued attempts by health professionals to acknowledge the pain of immunisation and to engage with their baby. Adverse experiences contributed to deferral of future visits and to defaulting behaviour.
CONCLUSIONS—Low empathy mass immunisation in clinic type settings may be unacceptable to mothers in the 1990s, and may in part explain suboptimal uptake in health care systems that use such clinics.


Keywords: immunisation; health behaviour; immunisation uptake PMID:10814662

Effect of sexual excitation on testosterone and nitric oxide levels of water buffalo bulls (Bubalus bubalis) with different categories of sexual behavior and their correlation with each other.

PubMed

Swelum, Ayman Abdel-Aziz; Saadeldin, Islam M; Zaher, Hany A; Alsharifi, Sawsan A M; Alowaimer, Abdullah N

2017-06-01

We studied the effect of sexual excitation on serum testosterone and nitric oxide (NO) levels in water buffalo bulls with different categories of sexual behavior and their correlation with each other. Buffalo bulls were classified according to their sexual behavior (including reaction time, sexual aggressiveness and mating ability): acceptable (good to excellent) (n=5), fair (n=5), and unacceptable (poor) (n=5) sexual behavior. Blood samples were collected from all animals immediately before and after sexual teasing and/or mounting to estimate the testosterone and NO levels using a commercial radioimmunoassay kit and Griess reaction test, respectively. Comparisons among groups were evaluated using a mixed-design analysis of variance. Pearson's correlation coefficients were calculated to determine the relationship between testosterone and NO levels before and after sexual excitation besides sexual behavior. The level of testosterone before sexual excitation was higher (p≤0.05) in bulls with acceptable and fair sexual behavior than in bulls with unacceptable sexual behavior (0.86±0.01, 0.69±0.02, and 0.29±0.02ng/mL, respectively). The level of NO was higher (p≤0.05) in bulls with acceptable and fair sexual behavior than in bulls with unacceptable sexual behavior (8.00±0.03, 7.66±0.19, and 6.29±0.33μM, respectively). Sexual excitation significantly (p<0.05) increase testosterone and NO levels in bulls with acceptable (1.45±0.01ng/mL and 19.04±0.32μM, respectively) or fair (0.92±0.02ng/mL and 14.95±0.34μM, respectively) sexual behavior, but not in bulls with unacceptable sexual behavior. The unacceptable sexual behavior bulls had significantly lower testosterone and NO levels than the other bulls. There was a strong correlation and association between serum testosterone and NO levels besides sexual behavior of buffalo bulls. In conclusion, the alteration in the testosterone and NO levels after sexual excitation depends on the sexual behavior category of buffalo-bull. Testosterone and NO can be used to create a sexual behavior score. The testosterone and NO levels of can be predicted via evaluation of sexual behavior of buffalo bull. Copyright © 2017 Elsevier B.V. All rights reserved.

[Helicobacter pylori-associated diseases].

PubMed

Gisbert, Javier P

2015-09-01

This article summarizes the main conclusions of the studies presented at Digestive Disease Week this year (2015) related to Helicobacter pylori infection. Despite the undeniable widespread reduction in the prevalence of H. pylori infection, developing countries continue to have substantial infection rates. The prevalence of clarithromycin, metronidazole and quinolone resistance is markedly higher in most countries and continues to rise. Although H. pylori eradication reduces the incidence of gastric adenocarcinoma, it does not completely prevent its development; the presence of precancerous lesions--intestinal atrophy and metaplasia--is associated with a higher risk of developing this neoplasm, despite H. pylori eradication. The use of molecular diagnostic methods (polymerase chain reaction) in faecal samples could allow non-invasive evaluation of the antibiotic susceptibility of H. pylori. The effectiveness of standard triple therapy is clearly insufficient and continues to decrease. The effectiveness of sequential therapy in recent studies is lower than initially described and consequently this treatment cannot be recommended in clinical practice. Concomitant therapy is more effective and simpler than sequential therapy. In penicillin-allergic patients, quadruple therapy with bismuth is the treatment of choice in our environment. After the failure of standard triple therapy, second-line therapy with levofloxacin is effective and, moreover, is simpler and better tolerated than quadruple therapy with bismuth. Quadruple therapy with a proton pump inhibitor, bismuth, levofloxacin and amoxicillin is an effective (≥ 90% eradication), simple and safe second-line therapy if triple or quadruple therapy without bismuth (sequential or concomitant) fails to eradicate the infection. The new-generation quinolones, such as moxifloxacin or sitafloxacin, could be useful in second- or third-line rescue eradication therapy. Even after the failure of 3 eradication treatments, a fourth empirical rescue therapy (with rifabutin) can be effective. The management of H. pylori infection by European gastroenterologists is widely heterogeneous, and their eradication rates are generally unacceptable. In addition, there is a clear discrepancy between consensus document recommendations and clinical practice in primary care. The incidence of H. pylori reinfection is very low in the most developed regions, but is high in developing countries. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Traditional and MLC based dose compensator design for patients with hip prostheses undergoing pelvic radiation therapy.

PubMed

Alecu, R; Alecu, M; Loomis, T; Ochran, T; He, T

1999-01-01

Perturbations in the dose distribution caused by a hip prosthesis when treating pelvic malignancies can result in unacceptable dose inhomogeneities within the target volume. Our results, obtained by in vivo exit dose measurements with diodes, showed a 55% reduction in the dose at the exit dmax of a lateral 15 MV photon beam after passing through a bilateral cobalt-chrome alloy hip prosthesis. Such an inhomogeneous dose distribution may decrease the curability. Solutions such as treatment techniques to avoid the prosthesis are often not the best choice as the dose to the rectum may be unacceptably high. In this work an alternative method of dose compensator is presented. Two types of dose compensators were designed based on a 3-D treatment planning system and CT images of a pelvic phantom containing a hip prosthesis: one was fabricated from a polyethylene-lead slab in the representation of step fringes and placed on a tray in the path of the beam while the other was produced by the use of several fields shaped with a multileaf collimator. The calculation procedures developed by the authors for generating the compensators are described. Results of film measurements performed in a phantom with and without the compensators in place are discussed.

The challenges for scientific publishing, 60 years on.

PubMed

Hausmann, Laura; Murphy, Sean P

2016-10-01

The most obvious difference in science publishing between 'then' and 'now' is the dramatic change in the communication of data and in their interpretation. The democratization of science via the Internet has brought not only benefits but also challenges to publishing including fraudulent behavior and plagiarism, data and statistics reporting standards, authorship confirmation and other issues which affect authors, readers, and publishers in different ways. The wide accessibility of data on a global scale permits acquisition and meta-analysis to mine for novel synergies, and has created a highly commercialized environment. As we illustrate here, identifying unacceptable practices leads to changes in the standards for data reporting. In the past decades, science publishing underwent dramatic changes in the communication of data and in their interpretation, in the increasing pressure and commercialization, and the democratization of science on a global scale via the Internet. This article reviews the benefits and challenges to publishing including fraudulent behavior and plagiarism, data and statistics reporting standards, authorship confirmation and other issues, with the aim to provide readers with practical examples and hands-on guidelines. As we illustrate here, identifying unacceptable practices leads to changes in the standards for data reporting. This article is part of the 60th Anniversary special issue. © 2016 International Society for Neurochemistry.

Prevalence of apical periodontitis and quality of root canal treatment in an adult Palestinian sub-population

PubMed Central

Mukhaimer, Raed; Hussein, Emad; Orafi, Ibtesam

2012-01-01

Purpose The aim of this study was to determine the prevalence of apical periodontitis and the technical quality of root canal fillings in a Palestinian sub-population. Methods The panoramic radiographs of 258 patients (142 females, 116 males) attending dental clinics in 2010 were examined to identify the presence of apical lesions associated with any remaining teeth, excluding third molars. The technical quality of root canal fillings was also evaluated by assessing apical extension from the radiographic apex. The panoramic radiographs were taken by a well-trained radiology assistant and evaluated by a radiologist and an endodontist. Statistical analysis was performed with the chi-square test with a significant level set at P < 0.05%. Results Of 6482 teeth examined radiographically, 978 (15.1%) had radiographic signs of apical periodontitis (AP). The prevalence of AP was 8.3% in teeth without filled roots and 59.5% (509/855) in root canal-treated teeth. The prevalence of AP and endodontic treatment increased with age and differed significantly (p < 0.05) between males and females. The majority (74.5%) of root canal fillings was performed inadequately, and most (77.2%) inadequate fillings were >2 mm short of the radiographic apex. The presence of AP was correlated significantly with poorly executed root canal fillings (p < 0.05). Conclusions The present study found a high prevalence and incidence of AP in association with root-filled teeth. The technical quality of many root canal treatments was unacceptable. PMID:23960544

Results of Surgery for Low-Grade Brain Arteriovenous Malformation Resection by Early Career Neurosurgeons: An Observational Study.

PubMed

Patel, Nirav J; Bervini, David; Eftekhar, Behzad; Davidson, Andrew Stewart; Walsh, Daniel C; Assaad, Nazih N; Morgan, Michael Kerin

2018-03-28

For sustainability of arteriovenous malformation (AVM) surgery, results from early career cerebrovascular neurosurgeons (ECCNs) must be acceptably safe. To determine whether ECCNs performance of Spetzler-Ponce Class A AVM (SPC A) resection can be acceptably safe. ECCNs completing a cerebrovascular fellowship (2004-2015) with the last author were included. Inclusion of the ECCN cases occurred if they: had a prospective database of all AVM cases since commencing independent practice; were the primary surgeon on SPC A; and had made the significant management decisions. All SPC A surgical cases from the beginning of the ECCN's independent surgical practice to a maximum of 8 yr were included. An adverse outcome was considered a complication of surgery leading to a new permanent neurological deficit with a last modified Rankin Scale score >1. A cumulative summation (Cusum) plot examined the performance of each surgery. The highest acceptable level of adverse outcomes for the Cusum was 3.3%, derived from the upper 95% confidence interval of the last author's reported series. Six ECCNs contributed 110 cases for analysis. The median number of SPC A cases operated by each ECCN was 16.5 (range 4-40). Preoperative embolization was performed in 5 (4.5%). The incidence of adverse outcomes was 1.8% (95% confidence interval: <0.01%-6.8%). At no point during the accumulated series did the combined cohort become unacceptable by the Cusum plot. ECCNs with appropriate training appointed to large-volume cerebrovascular centers can achieve results for surgery for SPC A that are not appreciably worse than those published from high-volume neurosurgeons.

[Survey of sexually transmitted diseases in the region of Rio Cuarto].

PubMed

Barberis, I L; Pájaro, M C; Godino, S; Pascual, L; Rodríguez, I; Agüero, M; Ordóñez, C

1998-01-01

Sexually transmitted diseases (STD) are acquired mainly through sexual intercourse, being one of the most frequent groups of infectious diseases worldwide and consequently an important public health problem. The aim of this paper was to determine the current state of STD and to compare different diagnostic methods in the population studied. A total of 1060 samples from vaginal flows, endocervical material and urethral discharge were studied during 3 years. Of the total samples, 583 were positive, 493 in women and 90 in men. Microorganisms found in women were: Gardnerella vaginalis (39.3%), Candida albicans (21.1%), Trichomonas vaginalis (17.3%), Candida trachomatis (11.3%), Neisseria gonorrhoeae (3.2%): Mycoplasma hominis and Ureaplasma urelyticum (6.5%) and Treponema pallidum (1.4%), the associations found were, Gardnerella vaginalis with Trichomonas vaginalis 5.5%; Gardnerella vaginalis with Candida albicans 4.9%; Trichomonas vaginalis with Neisseria gonorrhoeae (2.2%) and Gardnerella vaginalis with Chlamydia trachomatis (1.9%). In men, gonococcal urethritis (UG) represented 37.7% non UG 55.6% and Treponema pallidum 6.7%. These results indicate a decrease in sifilis and in UG when compared to previous studies showing that gonococcal cervicitis had also decreased. We found an important increase in the prevalence of urethritis and non gonococcal cervicitis in agreement with world statistics which consider these diseases as the most common venereal ones. It is necessary to increase the search for Chlamydia trachomatis in pregnant women due to vertical transmission. It should be noted that, in spite of certain fluctuations, the incidence of the STD in our area is still unacceptably high.

The status of academic integrity amongst nursing students at a nursing education institution in the Western Cape.

PubMed

Theart, Cecilia J; Smit, Ilze

2012-06-20

Honesty is regarded as a basic ethical value in all educational programmes, and academic integrity is of undisputed importance in educational environments. The literature reviewed revealed that academic dishonesty is wide-ranging and also encountered in the nursing education environment. This phenomenon is of concern to the nursing fraternity because of the proven positive correlation between unethical academic practices and future unethical professional behaviour. Limited research data regarding academic dishonesty at nursing education institutions in South Africa and this correlation motivated the present study. The purpose was to examine the status of academic integrity amongst nursing students at a nursing education institution in the Western Cape. Formulated objectives guided investigation of several variables which impact upon academic integrity, for example the incidence of and student perceptions around academic dishonesty. A quantitative, descriptive survey design was used, with a self-reported questionnaire (based on literature review and study objectives) designed to obtain information about academic dishonesty. Provision was also made for qualitative input from the respondents by including three open-ended questions. It was found that academic dishonesty was a reality at the nursing education institution where this study was done. Cheating associated with plagiarism and assignments was identified as the main problem area. An unacceptably high level of dishonesty in completion of practical records was also an area of concern. The main recommendations are development and implementation of a code of honour and implementation of comprehensive academic integrity policies at the nursing education institution, with practical measures aimed at combating cheating in tests and examinations.

Site-specific probabilistic ecological risk assessment of a volatile chlorinated hydrocarbon-contaminated tidal estuary.

PubMed

Hunt, James; Birch, Gavin; Warne, Michael St J

2010-05-01

Groundwater contaminated with volatile chlorinated hydrocarbons (VCHs) was identified as discharging to Penrhyn Estuary, an intertidal embayment of Botany Bay, New South Wales, Australia. A screening-level hazard assessment of surface water in Penrhyn Estuary identified an unacceptable hazard to marine organisms posed by VCHs. Given the limitations of hazard assessments, the present study conducted a higher-tier, quantitative probabilistic risk assessment using the joint probability curve (JPC) method that accounted for variability in exposure and toxicity profiles to quantify risk (delta). Risk was assessed for 24 scenarios, including four areas of the estuary based on three exposure scenarios (low tide, high tide, and both low and high tides) and two toxicity scenarios (chronic no-observed-effect concentrations [NOEC] and 50% effect concentrations [EC50]). Risk (delta) was greater at low tide than at high tide and varied throughout the tidal cycle. Spatial distributions of risk in the estuary were similar using both NOEC and EC50 data. The exposure scenario including data combined from both tides was considered the most accurate representation of the ecological risk in the estuary. When assessing risk using data across both tides, the greatest risk was identified in the Springvale tributary (delta=25%)-closest to the source area-followed by the inner estuary (delta=4%) and the Floodvale tributary (delta=2%), with the lowest risk in the outer estuary (delta=0.1%), farthest from the source area. Going from the screening level ecological risk assessment (ERA) to the probabilistic ERA changed the risk from unacceptable to acceptable in 50% of exposure scenarios in two of the four areas within the estuary. The probabilistic ERA provided a more realistic assessment of risk than the screening-level hazard assessment. Copyright (c) 2010 SETAC.

Comparison between auricular and standard rectal thermometers for the measurement of body temperature in dogs

PubMed Central

Sousa, Marlos G.; Carareto, Roberta; Pereira-Junior, Valdo A.; Aquino, Monally C.C.

2011-01-01

Although the rectal mucosa remains the traditional site for measuring body temperature in dogs, an increasing number of clinicians have been using auricular temperature to estimate core body temperature. In this study, 88 mature healthy dogs had body temperatures measured with auricular and rectal thermometers. The mean temperature and confidence intervals were similar for each method, but Bland-Altman plots showed high biases and limits of agreement unacceptable for clinical purposes. The results indicate that auricular and rectal temperatures should not be interpreted interchangeably. PMID:21731094

Comparison between auricular and standard rectal thermometers for the measurement of body temperature in dogs.

PubMed

Sousa, Marlos G; Carareto, Roberta; Pereira-Junior, Valdo A; Aquino, Monally C C

2011-04-01

Although the rectal mucosa remains the traditional site for measuring body temperature in dogs, an increasing number of clinicians have been using auricular temperature to estimate core body temperature. In this study, 88 mature healthy dogs had body temperatures measured with auricular and rectal thermometers. The mean temperature and confidence intervals were similar for each method, but Bland-Altman plots showed high biases and limits of agreement unacceptable for clinical purposes. The results indicate that auricular and rectal temperatures should not be interpreted interchangeably.

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

Fox, K. M.; Johnson, F. C.

Increased loading of high level waste in glass can lead to crystallization within the glass. Some crystalline species, such as spinel, have no practical impact on the chemical durability of the glass, and therefore may be acceptable from both a processing and a product performance standpoint. In order to operate a melter with a controlled amount of crystallization, options must be developed for remediating an unacceptable accumulation of crystals. This report describes preliminary experiments designed to evaluate the ability to dissolve spinel crystals in simulated waste glass melts via the addition of glass forming chemicals (GFCs).

Chemical and chemically-related considerations associated with sluicing tank C-106 waste to tank AY-102

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

Reynolds, D.A.

1997-04-04

New data on tank 241-C-106 were obtained from grab sampling and from compatibility testing of tank C-106 and tank AY-102 wastes. All chemistry-associated and other compatibility Information compiled in this report strongly suggests that the sluicing of the contents of tank C-106, in accord with appropriate controls, will pose no unacceptable risk to workers, public safety, or the environment. In addition, it is expected that the sluicing operation will successfully resolve the High-Heat Safety Issue for tank C-106.

Loss aversion, large deviation preferences and optimal portfolio weights for some classes of return processes

NASA Astrophysics Data System (ADS)

Duffy, Ken; Lobunets, Olena; Suhov, Yuri

2007-05-01

We propose a model of a loss averse investor who aims to maximize his expected wealth under certain constraints. The constraints are that he avoids, with high probability, incurring an (suitably defined) unacceptable loss. The methodology employed comes from the theory of large deviations. We explore a number of fundamental properties of the model and illustrate its desirable features. We demonstrate its utility by analyzing assets that follow some commonly used financial return processes: Fractional Brownian Motion, Jump Diffusion, Variance Gamma and Truncated Lévy.

Materials interactions between the thermoelectric converter and the 5kwe reactor system

NASA Technical Reports Server (NTRS)

Ferry, P. B.

1973-01-01

The integration of a compact thermoelectric converter with a 5-kwe reactor system is described. Material interaction uncertainties study is also presented. This includes degradation of the required austenitic - refractory metal transition joint during operation at high temperatures; loss of corrosion resistance; embrittlement by the presence of hydrogen; and loss of design margin by transport of interstitial elements. Analysis and limited experimental evidence indicate that these potential materials interactions can be adequately controlled. Group 5-2 refractory metals can be utilized without unacceptable adverse effect on system reliability.

Evaluation of hydrogen as a cryogenic wind tunnel test gas

NASA Technical Reports Server (NTRS)

Haut, R. C.

1977-01-01

The nondimensional ratios used to describe various flow situations in hydrogen were determined and compared with the corresponding ideal diatomic gas ratios. The results were used to examine different inviscid flow configurations. The relatively high value of the characteristic rotational temperature causes the behavior of hydrogen, under cryogenic conditions, to deviate substantially from the behavior of an ideal diatomic gas in the compressible flow regime. Therefore, if an idea diatomic gas is to be modeled, cryogenic hydrogen is unacceptable as a wind tunnel test gas in a compressible flow situation.

The Hybrid Propellant Module (HPM): A New Concept for Space Transfer in the Earth's Neighborhood and Beyond

NASA Technical Reports Server (NTRS)

Mankins, John C.; Mazanek, Daniel D.

2001-01-01

The safe, affordable and effective transfer of ever-larger payloads and eventually personnel beyond Low Earth Orbit (LEO) is a major challenge facing future commercial development and human exploration of space. Without reusable systems, sustained exploration or large scale development beyond LEO appears to be economically non-viable. However, reusable systems must be capable of both good fuel efficiency and "high utilization of capacity", or else economic costs will remain unacceptably high. Various options exist that can provide high fuel efficiency - for example, Solar Electric Propulsion Systems (SEPS) - but only at the cost of low thrust and concomitant long transit times. Chemical propulsion systems offer the potential for high thrust and short transit times - including both cryogenic and non-cryogenic options - but only at the cost of relatively low specific impulse (Isp). Nuclear thermal propulsion systems offer relatively good thrust-to-weight and Isp - but involve public concerns that may be insurmountable for all except the most-critical of public purposes. Fixed infrastructures have been suggested as one approach to solving this challenge; for example, rotating tether approaches. However, these systems tend to suffer from high initial costs or unacceptable operational constraints. A new concept has been identified - the Hybrid Propellant Module (HPM) - that integrates the best features of both chemical and solar electric transportation architectures. The HPM approach appears to hold promise of solving the issues associated with other approaches, opening a new family of capabilities for future space exploration and development of near-Earth space and beyond. This paper provides a summary overview of the challenge of Earth neighborhood transportation and discusses how various systems concepts might be applied to meet the needs of these architectures. The paper describes a new approach, the HPM, and illustrates the application of the concept for a typical mission concept. The paper concludes with a discussion of needed technologies and a possible timeline for the development and evolution of this class of systems concepts.

CT Scan Screening for Lung Cancer: Risk Factors for Nodules and Malignancy in a High-Risk Urban Cohort

PubMed Central

Greenberg, Alissa K.; Lu, Feng; Goldberg, Judith D.; Eylers, Ellen; Tsay, Jun-Chieh; Yie, Ting-An; Naidich, David; McGuinness, Georgeann; Pass, Harvey; Tchou-Wong, Kam-Meng; Addrizzo-Harris, Doreen; Chachoua, Abraham; Crawford, Bernard; Rom, William N.

2012-01-01

Background Low-dose computed tomography (CT) for lung cancer screening can reduce lung cancer mortality. The National Lung Screening Trial reported a 20% reduction in lung cancer mortality in high-risk smokers. However, CT scanning is extremely sensitive and detects non-calcified nodules (NCNs) in 24–50% of subjects, suggesting an unacceptably high false-positive rate. We hypothesized that by reviewing demographic, clinical and nodule characteristics, we could identify risk factors associated with the presence of nodules on screening CT, and with the probability that a NCN was malignant. Methods We performed a longitudinal lung cancer biomarker discovery trial (NYU LCBC) that included low-dose CT-screening of high-risk individuals over 50 years of age, with more than 20 pack-year smoking histories, living in an urban setting, and with a potential for asbestos exposure. We used case-control studies to identify risk factors associated with the presence of nodules (n = 625) versus no nodules (n = 557), and lung cancer patients (n = 30) versus benign nodules (n = 128). Results The NYU LCBC followed 1182 study subjects prospectively over a 10-year period. We found 52% to have NCNs >4 mm on their baseline screen. Most of the nodules were stable, and 9.7% of solid and 26.2% of sub-solid nodules resolved. We diagnosed 30 lung cancers, 26 stage I. Three patients had synchronous primary lung cancers or multifocal disease. Thus, there were 33 lung cancers: 10 incident, and 23 prevalent. A sub-group of the prevalent group were stable for a prolonged period prior to diagnosis. These were all stage I at diagnosis and 12/13 were adenocarcinomas. Conclusions NCNs are common among CT-screened high-risk subjects and can often be managed conservatively. Risk factors for malignancy included increasing age, size and number of nodules, reduced FEV1 and FVC, and increased pack-years smoking. A sub-group of screen-detected cancers are slow-growing and may contribute to over-diagnosis and lead-time biases. PMID:22768300

Self-healing failures in the aerial plant

NASA Astrophysics Data System (ADS)

Kiss, Gabor D.

1994-03-01

This account begins in the wee hours of a bitterly cold night in the winter of '92 - '93. A fiber optic transmission system starts to incur unacceptable errors and switches to a protect channel. The system is being run at 1550 nm because it is a route which is long enough to otherwise require a repeater at 1310 nm. OTDR measurement shows high splice losses. By dawn the high-loss splices have partially recovered so the system is switched back to the original fibers. Failure of the mechanical splices is suspected, the RBOC requests post-mortem assistance from Bellcore, and a team is dispatched immediately to work with RBOC personnel in determining the cause of the failure.

Associations between tobacco control policy awareness, social acceptability of smoking and smoking cessation. Findings from the International Tobacco Control (ITC) Europe Surveys.

PubMed

Rennen, Els; Nagelhout, Gera E; van den Putte, Bas; Janssen, Eva; Mons, Ute; Guignard, Romain; Beck, François; de Vries, Hein; Thrasher, James F; Willemsen, Marc C

2014-02-01

This study examined whether awareness of tobacco control policies was associated with social unacceptability of smoking and whether social unacceptability had an effect on smoking cessation in three European countries. Representative samples (n = 3865) of adult smokers in France, the Netherlands and Germany were used from two survey waves of the longitudinal International Tobacco Control Europe Surveys. Associations were examined of aspects of social unacceptability of smoking (i.e. feeling uncomfortable, important people disapproval and societal disapproval) with tobacco policy awareness (i.e. awareness of warning labels, anti-tobacco information and smoking restrictions at work) and smoking cessation. Only the positive association of awareness of anti-tobacco information with feeling uncomfortable about smoking was significant in each of the three countries. Important people disapproval predicted whether smokers attempted to quit, although this did not reach significance in the French and German samples in multivariate analyses. Our findings suggest that anti-tobacco information campaigns about the dangers of second-hand smoke in France and about smoking cessation in the Netherlands and Germany might have reduced the social acceptability of smoking in these countries. However, campaigns that influence the perceived disapproval of smoking by important people may be needed to ultimately increase attempts to quit smoking.

Associations between tobacco control policy awareness, social acceptability of smoking and smoking cessation. Findings from the International Tobacco Control (ITC) Europe Surveys

PubMed Central

Rennen, Els; Nagelhout, Gera E.; van den Putte, Bas; Janssen, Eva; Mons, Ute; Guignard, Romain; Beck, François; de Vries, Hein; Thrasher, James F.; Willemsen, Marc C.

2014-01-01

This study examined whether awareness of tobacco control policies was associated with social unacceptability of smoking and whether social unacceptability had an effect on smoking cessation in three European countries. Representative samples (n = 3865) of adult smokers in France, the Netherlands and Germany were used from two survey waves of the longitudinal International Tobacco Control Europe Surveys. Associations were examined of aspects of social unacceptability of smoking (i.e. feeling uncomfortable, important people disapproval and societal disapproval) with tobacco policy awareness (i.e. awareness of warning labels, anti-tobacco information and smoking restrictions at work) and smoking cessation. Only the positive association of awareness of anti-tobacco information with feeling uncomfortable about smoking was significant in each of the three countries. Important people disapproval predicted whether smokers attempted to quit, although this did not reach significance in the French and German samples in multivariate analyses. Our findings suggest that anti-tobacco information campaigns about the dangers of second-hand smoke in France and about smoking cessation in the Netherlands and Germany might have reduced the social acceptability of smoking in these countries. However, campaigns that influence the perceived disapproval of smoking by important people may be needed to ultimately increase attempts to quit smoking. PMID:23861478

Models of Mass Transport During Microgravity Crystal Growth of Alloyed Semiconductors in a Magnetic Field

NASA Technical Reports Server (NTRS)

Ma, Nancy

2003-01-01

Alloyed semiconductor crystals, such as germanium-silicon (GeSi) and various II-VI alloyed crystals, are extremely important for optoelectronic devices. Currently, high-quality crystals of GeSi and of II-VI alloys can be grown by epitaxial processes, but the time required to grow a certain amount of single crystal is roughly 1,000 times longer than the time required for Bridgman growth from a melt. Recent rapid advances in optoelectronics have led to a great demand for more and larger crystals with fewer dislocations and other microdefects and with more uniform and controllable compositions. Currently, alloyed crystals grown by bulk methods have unacceptable levels of segregation in the composition of the crystal. Alloyed crystals are being grown by the Bridgman process in space in order to develop successful bulk-growth methods, with the hope that the technology will be equally successful on earth. Unfortunately some crystals grown in space still have unacceptable segregation, for example, due to residual accelerations. The application of a weak magnetic field during crystal growth in space may eliminate the undesirable segregation. Understanding and improving the bulk growth of alloyed semiconductors in microgravity is critically important. The purpose of this grant to to develop models of the unsteady species transport during the bulk growth of alloyed semiconductor crystals in the presence of a magnetic field in microgravity. The research supports experiments being conducted in the High Magnetic Field Solidification Facility at Marshall Space Flight Center (MSFC) and future experiments on the International Space Station.

Sternal approximation for bilateral anterolateral transsternal thoracotomy for lung transplantation.

PubMed

McGiffin, David C; Alonso, Jorge E; Zorn, George L; Kirklin, James K; Young, K Randall; Wille, Keith M; Leon, Kevin; Hart, Katherine

2005-02-01

The traditional incision for bilateral sequential lung transplantation is the bilateral anterolateral transsternal thoracotomy with approximation of the sternal fragments with interrupted stainless steel wire loops; this technique may be associated with an unacceptable incidence of postoperative sternal disruption causing chronic pain and deformity. Approximation of the sternal ends was achieved with peristernal cables that passed behind the sternum two intercostal spaces above and below the sternal division, which were then passed through metal sleeves in front of the sternum, the cables tensioned, and the sleeves then crimped. Forty-seven patients underwent sternal closure with this method, and satisfactory bone union occurred in all patients. Six patients underwent removal of the peristernal cables: 1 for infection (with satisfactory bone union after the removal of the cables), 3 for cosmetic reasons, 1 during the performance of a median sternotomy for an aortic valve replacement, and 1 in a patient who requested removal before commencing participation in football. This technique of peristernal cable approximation of sternal ends has successfully eliminated the problem of sternal disruption associated with this incision and is a useful alternative for preventing this complication after bilateral lung transplantation.

[The nature, extent and judicial response to aggression and violence directed against care workers in psychiatry].

PubMed

Harte, J M; van Leeuwen, M E; Theuws, R

2013-01-01

The Dutch government and the Council for public prosecutions consider aggression against and violence directed against public officers and care workers as unacceptable. But what is the attitude of these official bodies to violence directed against mental health care workers? To examine the nature and the prevalence of violence against mental health care professionals and the possible judicial consequences of this violence. Dutch mental health professionals who work in the psychiatric hospitals and clinics were asked to fill in an online questionnaire about their experiences, over the past five years, of violence perpetrated by patients. The 1534 respondents had encountered violence regularly in the course of their work. Some of the violence was of a very serious nature and sometimes had severe consequences. Only a small number of the violent incidents were reported to the police and ultimately brought to court. The victims were poorly informed about the possible judicial consequences of the violence they had encountered. Not only should the mental health institutes counsel and inform the employees who have been victims of violence, they should also promote the development and implementation of an effective prosecution policy.

External rhinoplasty: a critical analysis of 500 cases.

PubMed

Foda, Hossam M T

2003-06-01

The study presents a comprehensive statistical analysis of a series of 500 consecutive rhinoplasties of which 380 (76 per cent) were primary and 120 (24 per cent) were secondary cases. All cases were operated upon using the external rhinoplasty technique; simultaneous septal surgery was performed in 350 (70 per cent) of the cases. Deformities of the upper two-thirds of the nose that occurred significantly more in the secondary cases included; dorsal saddling, dorsal irregularities, valve collapse, open roof and pollybeak deformities. In the lower third of the nose; secondary cases showed significantly higher incidences of depressed tip, tip over-rotation, tip asymmetry, retracted columella, and alar notching. Suturing techniques were used significantly more in primary cases, while in secondary cases grafting techniques were used significantly more. The complications encountered intra-operatively included; septal flap tears (2.8 per cent) and alar cartilage injury (1.8 per cent), while post-operative complications included; nasal trauma (one per cent), epistaxis (two per cent), infection (2.4 per cent), prolonged oedema (17 per cent), and nasal obstruction (0.8 per cent). The overall patient satisfaction rate was 95.6 per cent and the transcolumellar scar was found to be unacceptable in only 0.8 per cent of the patients.

Cost-effectiveness of two operational models at industrial wastewater treatment plants in China: a case study in Shengze town, Suzhou City.

PubMed

Yuan, Zengwei; Jiang, Weili; Bi, Jun

2010-10-01

The widespread illegal discharge of industrial wastewater in China has posed significant challenges to the effective management of industrial wastewater treatment plants (IWTPs) and caused or exacerbated critical social issues such as trans-boundary environmental pollution. This study examines two operational strategies, decentralized model and an innovative integrated model, that have been used in the industrial town of Shengze (located in Suzhou City) over the past two decades at IWTPs handling wastewater from the city's dyeing industry. Our cost-effectiveness analysis shows that, although the operational cost of IWTPs under the integrated model is higher than under the original decentralized model, the integrated model has significantly improved IWTP performance and effectively reduced illegal discharge of industrial wastewater. As a result, the number of reported incidents of unacceptable pollution in local receiving water bodies had declined from 13 in 2000-1 in 2008. Key factors contributing to the success of the innovative integrated model are strong support from municipal and provincial leaders, mandatory ownership transfer of IWTPs to a centralized management body, strong financial incentives for proper plant management, and geographically-clustered IWTPs. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

Gynecologic Oncology Group quality assurance audits: analysis and initiatives for improvement.

PubMed

Blessing, John A; Bialy, Sally A; Whitney, Charles W; Stonebraker, Bette L; Stehman, Frederick B

2010-08-01

The Gynecologic Oncology Group (GOG) is a multi-institution, multi-discipline Cooperative Group funded by the National Cancer Institute (NCI) to conduct clinical trials which investigate the treatment, prevention, control, quality of survivorship, and translational science of gynecologic malignancies. In 1982, the NCI initiated a program of on-site quality assurance audits of participating institutions. Each is required to be audited at least once every 3 years. In GOG, the audit mandate is the responsibility of the GOG Quality Assurance Audit Committee and it is centralized in the Statistical and Data Center (SDC). Each component (Regulatory, Investigational Drug Pharmacy, Patient Case Review) is classified as Acceptable, Acceptable, follow-up required, or Unacceptable. To determine frequently occurring deviations and develop focused innovative solutions to address them. A database was created to examine the deviations noted at the most recent audit conducted at 57 GOG parent institutions during 2004-2007. Cumulatively, this involved 687 patients and 306 protocols. The results documented commendable performance: Regulatory (39 Acceptable, 17 Acceptable, follow-up, 1 Unacceptable); Pharmacy (41 Acceptable, 3 Acceptable, follow-up, 1 Unacceptable, 12 N/A): Patient Case Review (31 Acceptable, 22 Acceptable, follow-up, 4 Unacceptable). The nature of major and lesser deviations was analyzed to create and enhance initiatives for improvement of the quality of clinical research. As a result, Group-wide proactive initiatives were undertaken, audit training sessions have emphasized recurring issues, and GOG Data Management Subcommittee agendas have provided targeted instruction and training. The analysis was based upon parent institutions only; affiliate institutions and Community Clinical Oncology Program participants were not included, although it is assumed their areas of difficulty are similar. The coordination of the GOG Quality Assurance Audit program in the SDC has improved data quality by enhancing our ability to identify frequently occurring deviations and develop innovative solutions to avoid or minimize their occurrence in the future.

Radiation Hardened, Modulator ASIC for High Data Rate Communications

NASA Technical Reports Server (NTRS)

McCallister, Ron; Putnam, Robert; Andro, Monty; Fujikawa, Gene

2000-01-01

Satellite-based telecommunication services are challenged by the need to generate down-link power levels adequate to support high quality (BER approx. equals 10(exp 12)) links required for modem broadband data services. Bandwidth-efficient Nyquist signaling, using low values of excess bandwidth (alpha), can exhibit large peak-to-average-power ratio (PAPR) values. High PAPR values necessitate high-power amplifier (HPA) backoff greater than the PAPR, resulting in unacceptably low HPA efficiency. Given the high cost of on-board prime power, this inefficiency represents both an economical burden, and a constraint on the rates and quality of data services supportable from satellite platforms. Constant-envelope signals offer improved power-efficiency, but only by imposing a severe bandwidth-efficiency penalty. This paper describes a radiation- hardened modulator which can improve satellite-based broadband data services by combining the bandwidth-efficiency of low-alpha Nyquist signals with high power-efficiency (negligible HPA backoff).

Toward an image compression algorithm for the high-resolution electronic still camera

NASA Technical Reports Server (NTRS)

Nerheim, Rosalee

1989-01-01

Taking pictures with a camera that uses a digital recording medium instead of film has the advantage of recording and transmitting images without the use of a darkroom or a courier. However, high-resolution images contain an enormous amount of information and strain data-storage systems. Image compression will allow multiple images to be stored in the High-Resolution Electronic Still Camera. The camera is under development at Johnson Space Center. Fidelity of the reproduced image and compression speed are of tantamount importance. Lossless compression algorithms are fast and faithfully reproduce the image, but their compression ratios will be unacceptably low due to noise in the front end of the camera. Future efforts will include exploring methods that will reduce the noise in the image and increase the compression ratio.

Electrostatic antenna space environment interaction study

NASA Technical Reports Server (NTRS)

Katz, I.

1981-01-01

The interactions of the electrostatic antenna with the space environment in both low Earth orbit and geosynchronous orbit are investigated. It is concluded that the electrostatically controlled membrane mirror is a viable concept for space applications. However, great care must be taken to enclose the high voltage electrodes in a Faraday cage structure to separate the high voltage region from the ambient plasma. For this reason, metallized cloth is not acceptable as a membrane material. Conventional spacecraft charging at geosynchronous orbit should not be a problem provided ancillary structures (such as booms) are given nonnegligible conductivity and adequate grounding. Power loss due to plasma electrons entering the high field region is a potentially serious problem. In low earth orbit any opening whatever in the Faraday cage is likely to produce an unacceptable power drain.

The microbiological quality of ready-to-eat foods with added spices.

PubMed

Little, C L; Omotoye, R; Mitchell, R T

2003-03-01

A microbiological study of ready-to-eat foods with added spices or spice ingredients was undertaken to identify any risk factors in the production, storage and display of this product and to establish their effect on microbiological quality. Examination of 1946 ready-to-eat foods from sandwich bars, cafés, public houses, restaurants, specialist sandwich producers, bakers, delicatessens, market stalls and mobile vendors found that 1291 (66%) were of satisfactory/acceptable microbiological quality, 609 (32%) were of unsatisfactory quality, and 46 (2%) were of unacceptable quality. Unacceptable results were due to high levels of B. cereus and/or other Bacillus spp. (>/=10(5) cfu g(-1)). Unsatisfactory results were mostly due to high Aerobic Colony Counts (up to >/=10(7) cfu g(-1)), Enterobacteriaceae (>/=10(4) cfu g(-1)), Escherichia coli (>/=10(2) cfu g(-1)), and Bacillus spp (>/=10(4) cfu g(-1)). Examination of 750 spices and spice ingredients revealed that B. cereus were present in 142 (19%) samples, other Bacillus spp. in 399 (53%) samples, and Salmonella spp. (S. enteritidis PT 11) in one (<1%) sample. Approximately a third (222) of spice and spice ingredients examined contained high counts (>/=10(4) cfu g(-1)) of B. cereus and/or other Bacillus spp., and appeared to be associated with the corresponding ready-to-eat foods containing similar high counts of these organisms (P<0.0001). Acceptable microbiological quality of ready-to-eat foods to which spices or spice ingredients have been added was associated with premises that had management food hygiene training and hazard analysis in place. Poor microbiological quality was associated with preparation on the premises, premises type, little or no confidence in the food business management of food hygiene, and small premises as indicated by local authority inspectors' confidence in management and consumer at risk scores.

A method for safely resecting anterior butterfly gliomas: the surgical anatomy of the default mode network and the relevance of its preservation.

PubMed

Burks, Joshua D; Bonney, Phillip A; Conner, Andrew K; Glenn, Chad A; Briggs, Robert G; Battiste, James D; McCoy, Tressie; O'Donoghue, Daniel L; Wu, Dee H; Sughrue, Michael E

2017-06-01

OBJECTIVE Gliomas invading the anterior corpus callosum are commonly deemed unresectable due to an unacceptable risk/benefit ratio, including the risk of abulia. In this study, the authors investigated the anatomy of the cingulum and its connectivity within the default mode network (DMN). A technique is described involving awake subcortical mapping with higher attention tasks to preserve the cingulum and reduce the incidence of postoperative abulia for patients with so-called butterfly gliomas. METHODS The authors reviewed clinical data on all patients undergoing glioma surgery performed by the senior author during a 4-year period at the University of Oklahoma Health Sciences Center. Forty patients were identified who underwent surgery for butterfly gliomas. Each patient was designated as having undergone surgery either with or without the use of awake subcortical mapping and preservation of the cingulum. Data recorded on these patients included the incidence of abulia/akinetic mutism. In the context of the study findings, the authors conducted a detailed anatomical study of the cingulum and its role within the DMN using postmortem fiber tract dissections of 10 cerebral hemispheres and in vivo diffusion tractography of 10 healthy subjects. RESULTS Forty patients with butterfly gliomas were treated, 25 (62%) with standard surgical methods and 15 (38%) with awake subcortical mapping and preservation of the cingulum. One patient (1/15, 7%) experienced postoperative abulia following surgery with the cingulum-sparing technique. Greater than 90% resection was achieved in 13/15 (87%) of these patients. CONCLUSIONS This study presents evidence that anterior butterfly gliomas can be safely removed using a novel, attention-task based, awake brain surgery technique that focuses on preserving the anatomical connectivity of the cingulum and relevant aspects of the cingulate gyrus.

[Sexual harassment of medical students during their period of work placement].

PubMed

van den Muijsenbergh, M E T C; Lagro-Janssen, A L M

2005-04-02

To investigate the incidence, type and consequences of sexual harassment of medical students at the Radboud University in Nijmegen, the Netherlands, during their period of work placement, as well as the students' need for care thereafter. Questionnaire. During the period from 1 July to 31 December 2003, 5th and 6th year medical students were asked about their experiences with sexual harassment by means of a questionnaire. Sexual harassment was defined as unwelcome, sexually-coloured attention. Of the 183 questionnaires distributed, 113 (62%) were returned. 15 (20%) of the 75 female students and none of the 38 male students had experienced sexual harassment. The offenders included 9 patients and 6 doctors (54 men and 1 woman). In 7 of the 15 cases the harassment consisted of combinations of unwanted behaviour and unwanted sexually-coloured remarks. 9 of the 15 students had discussed their experiences with their peers, 7 with a supervisor and 3 with nobody. The most important reason to discuss it first in their peer group was that, despite the fact that the students were convinced that the offender's behaviour was unacceptable, they still doubted their own judgement. 5 students felt inhibited in their contacts with patients after the incident. 8 of the 15 offenders were not confronted with their behaviour. 6 of the 15 students were not satisfied with the way their case was handled. The problem of sexual harassment of medical students during their period of work placement should not be underestimated. It has a negative impact on the personal and professional conduct of future doctors. This subject should be part of the training of both medical students and their supervisors.

Microbiological safety of retail vacuum-packed and modified-atmosphere-packed cooked meats at end of shelf life.

PubMed

Sagoo, S K; Little, C L; Allen, G; Williamson, K; Grant, K A

2007-04-01

A study of retail modified-atmosphere-packed and vacuum-packed cooked ready-to-eat meats was undertaken from September through mid-November 2003 to determine the microbiological quality at the end of shelf life and to establish any risk factors in the production, storage, and display of this product. Examination of 2,981 samples using Microbiological Guidelines criteria revealed that 66% were of satisfactory or acceptable microbiology quality, 33% were of unsatisfactory quality mainly due to high aerobic colony counts and Enterobacteriaceae concentrations, and 1% were of unacceptable quality due to the presence of Listeria monocytogenes at 100 CFU/g or higher (27 samples; range of 10(2) to 106 CFU/g) and Campylobacter jejuni (1 sample), indicating a risk to health. All samples at the end of the shelf life had satisfactory (<20 CFU/g) and/or acceptable (<102 CFU/g) levels of Staphylococcus aureus and Clostridium perfringens, four samples (<1%) had unsatisfactory levels of Escherichia coli (range of 102 to 106 CFU/g) and 5.5% of the samples contained L. monocytogenes at <20 CFU/g (4.8%) or between 20 and 100 CFU/g (0.7%). More samples of chicken (45%; 224 of 495 samples), beef (43%; 160 of 371 samples), and turkey (41%; 219 of 523 samples) were of unsatisfactory or unacceptable quality compared with ham (23%; 317 of 1,351 samples) or pork (32%; 67 of 206 samples). Twelve different L. monocytogenes typing characters (serotype-amplified fragment length polymorphism type-phage type) were evaluated for isolates recovered from samples of unacceptable quality, and the 1/2-IX-NT type was recovered from almost half (48%) of these samples. Salmonella was not detected in any samples examined. Risk factors identified for cooked meats that were microbiologically contaminated more frequently included vacuum packaging, packaging on retail premises, slicing, temperature not monitored in display units, and no hazard analysis system in place. Results from this study also suggest that the shelf life assigned to some modified-atmosphere-packed and vacuum-packed meats may not be appropriate.

Adjuvant Sunitinib in High-Risk Renal-Cell Carcinoma after Nephrectomy.

PubMed

Ravaud, Alain; Motzer, Robert J; Pandha, Hardev S; George, Daniel J; Pantuck, Allan J; Patel, Anup; Chang, Yen-Hwa; Escudier, Bernard; Donskov, Frede; Magheli, Ahmed; Carteni, Giacomo; Laguerre, Brigitte; Tomczak, Piotr; Breza, Jan; Gerletti, Paola; Lechuga, Mariajose; Lin, Xun; Martini, Jean-Francois; Ramaswamy, Krishnan; Casey, Michelle; Staehler, Michael; Patard, Jean-Jacques

2016-12-08

Sunitinib, a vascular endothelial growth factor pathway inhibitor, is an effective treatment for metastatic renal-cell carcinoma. We sought to determine the efficacy and safety of sunitinib in patients with locoregional renal-cell carcinoma at high risk for tumor recurrence after nephrectomy. In this randomized, double-blind, phase 3 trial, we assigned 615 patients with locoregional, high-risk clear-cell renal-cell carcinoma to receive either sunitinib (50 mg per day) or placebo on a 4-weeks-on, 2-weeks-off schedule for 1 year or until disease recurrence, unacceptable toxicity, or consent withdrawal. The primary end point was disease-free survival, according to blinded independent central review. Secondary end points included investigator-assessed disease-free survival, overall survival, and safety. The median duration of disease-free survival was 6.8 years (95% confidence interval [CI], 5.8 to not reached) in the sunitinib group and 5.6 years (95% CI, 3.8 to 6.6) in the placebo group (hazard ratio, 0.76; 95% CI, 0.59 to 0.98; P=0.03). Overall survival data were not mature at the time of data cutoff. Dose reductions because of adverse events were more frequent in the sunitinib group than in the placebo group (34.3% vs. 2%), as were dose interruptions (46.4% vs. 13.2%) and discontinuations (28.1% vs. 5.6%). Grade 3 or 4 adverse events were more frequent in the sunitinib group (48.4% for grade 3 events and 12.1% for grade 4 events) than in the placebo group (15.8% and 3.6%, respectively). There was a similar incidence of serious adverse events in the two groups (21.9% for sunitinib vs. 17.1% for placebo); no deaths were attributed to toxic effects. Among patients with locoregional clear-cell renal-cell carcinoma at high risk for tumor recurrence after nephrectomy, the median duration of disease-free survival was significantly longer in the sunitinib group than in the placebo group, at a cost of a higher rate of toxic events. (Funded by Pfizer; S-TRAC ClinicalTrials.gov number, NCT00375674 .).

A design for integration.

PubMed

Fenna, D

1977-09-01

For nearly two decades, the development of computerized information systems has struggled for acceptable compromises between the unattainable "total system" and the unacceptable separate applications. Integration of related applications is essential if the computer is to be exploited fully, yet relative simplicity is necessary for systems to be implemented in a reasonable time-scale. This paper discusses a system being progressively developed from minimal beginnings but which, from the outset, had a highly flexible and fully integrated system basis. The system is for batch processing, but can accommodate on-line data input; it is similar in its approach to many transaction-processing real-time systems.

Managing toxic shock syndrome with antibiotics.

PubMed

Annane, Djillali; Clair, Bernard; Salomon, Jérôme

2004-08-01

Toxic shock syndrome (TSS) is a serious disorder with a worldwide prevalence of approximately 3/100,000 persons. TSS is mainly caused by Streptococcus pyogenes or Staphylococcus aureus. Thus, beta-lactam and lincosamides, such as clindamycin, are the first-line drugs. Yet, the mortality rate remains unacceptably high; highlighting the role of bacterial toxin-mediated activation of the inflammatory cascade in TSS pathogenesis. Further strategies should be targeted towards interfering with the interaction between bacterial toxins and host T cells. This paper aims to provide an overview of the epidemiology, pathomechanisms, and clinical presentation of TSS, and criteria for selecting drugs among available antibiotics.

Midwives, gender equality and feminism.

PubMed

Walsh, Denis

2016-03-01

Gender inequality and the harmful effects of patriarchy are sustaining the wide spread oppression of women across the world and this is also having an impact on maternity services with unacceptable rates of maternal mortality, the continued under investment in the midwifery profession and the limiting of women's place of birth options. However alongside these effects, the current zeitgeist is affirming an alignment of feminism and gender equality such that both have a high profile in public discourse. This presents a once in a generation opportunity for midwives to self-declare as feminists and commit to righting the wrongs of this most pernicious form of discrimination.

Noninvasive sensors in critical care medicine: near-infrared spectroscopy for the detection of altered microvascular blood flow in severe sepsis and septic shock

NASA Astrophysics Data System (ADS)

Walz, J. Matthias; Soller, Babs; Soyemi, Olusola; Yang, Ye; Landry, Michelle; Heard, Stephen O.

2006-10-01

It is estimated that 750,000 cases of severe sepsis occur in the United States annually, at least 225,000 of which are fatal, resulting in significant utilization of healthcare resources and expenses. Significant progress in the understanding of pathophysiology and treatment of this condition has been made lately. Among the newer treatment strategies for critically ill patients are the administration of early goal directed therapy, and Recombinant Human Activated Protein C (Drotrecogrin alfa (activated) [DTAA]) for severe sepsis. However, mortality remains unacceptably high.

STEWARDSHIP: A Conceptual Imperative For Managerial Effectiveness In The Nigerian Health System

PubMed Central

2007-01-01

Unacceptable health status indicators such as high infant and maternal mortality rates and low life expectancy have continued unabated inspite of government efforts to change it. This paper espouses the concept of stewardship as a selfless, ethical, cost effective and outcome oriented approach to governance. It is believed that through stewardship approach governments would improve the health status of their populations considerably. The paper implores not only government and health care managers but the Nigerian society also to imbibe the concept of stewardship to make the development of a result-oriented health system easy. PMID:25161436

STEWARDSHIP: A Conceptual Imperative For Managerial Effectiveness In The Nigerian Health System.

PubMed

2007-12-01

Unacceptable health status indicators such as high infant and maternal mortality rates and low life expectancy have continued unabated inspite of government efforts to change it. This paper espouses the concept of stewardship as a selfless, ethical, cost effective and outcome oriented approach to governance. It is believed that through stewardship approach governments would improve the health status of their populations considerably. The paper implores not only government and health care managers but the Nigerian society also to imbibe the concept of stewardship to make the development of a result-oriented health system easy.

77 FR 32006 - Special Conditions: Gulfstream Model GVI Airplane; High Incidence Protection

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-31

... Special Conditions No. 25-423-SC] Special Conditions: Gulfstream Model GVI Airplane; High Incidence... pertaining to a high incidence protection system that replaces the stall warning system during normal... V SR and not greater than 1.3 V SR . (6) The high incidence protection function disabled, or...

Sigma metric analysis for performance of creatinine with fresh frozen serum.

PubMed

Kang, Fengfeng; Zhang, Chuanbao; Wang, Wei; Wang, Zhiguo

2016-01-01

Six sigma provides an objective and quantitative methodology to describe the laboratory testing performance. In this study, we conducted a national trueness verification scheme with fresh frozen serum (FFS) for serum creatinine to evaluate its performance in China. Two different concentration levels of FFS, targeted with reference method, were sent to 98 laboratories in China. Imprecision and bias of the measurement procedure were calculated for each participant to further evaluate the sigma value. Quality goal index (QGI) analysis was used to investigate the reason of unacceptable performance for laboratories with σ < 3. Our study indicated that the sample with high concentration of creatinine had preferable sigma values. For the enzymatic method, 7.0% (5/71) to 45.1% (32/71) of the laboratories need to improve their measurement procedures (σ < 3). And for the Jaffe method, the percentages were from 11.5% (3/26) to 73.1% (19/26). QGI analysis suggested that most of the laboratories (62.5% for the enzymatic method and 68.4% for the Jaffe method) should make an effort to improve the trueness (QGI > 1.2). Only 3.1-5.3% of the laboratories should improve both of the precision and trueness. Sigma metric analysis of the serum creatinine assays is disappointing, which was mainly due to the unacceptable analytical bias according to the QGI analysis. Further effort is needed to enhance the trueness of the creatinine measurement.

Composition of tobaccos from countries with high and low incidences of lung cancer. I. Selenium, polonium-210, Alternaria, tar, and nicotine.

PubMed

Bogden, J D; Kemp, F W; Buse, M; Thind, I S; Louria, D B; Forgacs, J; Llanos, G; Moncoya Terrones, I

1981-01-01

Tobaccos from countries with high and low incidences of lung cancer were analyzed. Tobacco concentrations of polonium-210 were similar in cigarettes from high- and low-incidence countries, as were levels of cigarette smoke tar and nicotine. Tobaccos from low-incidence countries had significantly lower Alternaria spore counts. Mean selenium concentrations of tobaccos from the high-incidence countries (0.16 +/- 0.05 micrograms/g) were significantly lower than those of tobaccos from the low-incidence countries (0.49 +/- 0.22 micrograms/g).

14 CFR 33.25 - Accessory attachments.

Code of Federal Regulations, 2010 CFR

2010-01-01

... mounting attachment must include provisions for sealing to prevent contamination of, or unacceptable... loss of oil and to prevent contamination from sources outside the chamber enclosing the drive...

32 CFR 236.1 - Purpose.

Code of Federal Regulations, 2013 CFR

2013-07-01

... DEFENSE (DOD)-DEFENSE INDUSTRIAL BASE (DIB) VOLUNTARY CYBER SECURITY AND INFORMATION ASSURANCE (CS/IA) ACTIVITIES § 236.1 Purpose. Cyber threats to DIB unclassified information systems represent an unacceptable...

32 CFR 236.1 - Purpose.

Code of Federal Regulations, 2012 CFR

2012-07-01

... DEFENSE (DOD)-DEFENSE INDUSTRIAL BASE (DIB) VOLUNTARY CYBER SECURITY AND INFORMATION ASSURANCE (CS/IA) ACTIVITIES § 236.1 Purpose. Cyber threats to DIB unclassified information systems represent an unacceptable...

Optical analysis of high power free electron laser resonators

NASA Astrophysics Data System (ADS)

Knapp, C. E.; Viswanathan, V. K.; Appert, Q. D.; Bender, S. C.; McVey, B. D.

1987-06-01

The first part of this paper briefly describes the optics code used at Los Alamos National Laboratory to do optical analyses of various components of a free electron laser. The body of the paper then discusses the recent results in modeling low frequency gratings and ripple on the surfaces of liquid-cooled mirrors. The ripple is caused by structural/thermal effects in the mirror surface due to heating by optical absorption in high power resonators. Of interest is how much ripple can be permitted before diffractive losses or optical mode distortions become unacceptable. Preliminary work is presented involving classical diffraction problems to support the ripple study. The limitations of the techniques are discussed and the results are compared to experimental results where available.

Influence of a surface film on the particles on the electrorheological response

NASA Astrophysics Data System (ADS)

Wu, C. W.; Conrad, H.

1997-01-01

A conduction model is developed for the dc electrorheological (ER) response of highly conducting particles (e.g., metal particles) suspended in a weakly conducting oil. The numerical analyses show that a surface film with some conductivity is desired, but not a completely insulating film as previously proposed. Increasing the film conductivity leads to an increase in the ER yield stress. However, too high a conductivity will give an unacceptable level of current density. The film should also have an intermediate thickness. A small thickness increases the possibility of electrical breakdown in the film; too large a thickness decreases the ER effect. Good agreement exists between the yield stress and the current density predicted by our model and those measured.

Total elbow arthroplasty in primary osteoarthritis of the elbow.

PubMed

Kozak, T K; Adams, R A; Morrey, B F

1998-10-01

Primary osteoarthritis of the elbow is an infrequent condition typically managed by some form of debridement. There is no comment in the literature regarding prosthetic replacement for this condition. We report 5 patients (mean age, 68), with a minimum assessment of 3 years (range, 37-125 years) after total elbow arthroplasty. Complications in 4 patients included subluxation, fracture of a humeral component with particulate synovitis, heterotopic ossification, recurrent osteophyte formation, and transient ulnar neuropathy. Although revision was required in 2 of the 5, currently all experience had satisfactory outcomes. While replacement has proven ultimately to be a successful option for this high-demand patient group because of the high complication rate, we do not recommend replacement unless alternate operative options are deemed unacceptable.

Helicobacter pylori-related diseases.

PubMed

Gisbert, Javier P

2016-09-01

This article describes the main conclusions drawn from the presentations on Helicobacter pylori infection in Digestive Diseases Week, 2016. Despite the undeniable widespread reduction in the prevalence of this infection, infection rates continue to be high in developing countries. The prevalence of clarithromycin, metronidazole and quinolone resistance is markedly high in most countries and continues to rise. The management of H. pylori infection in patients with peptic ulcers still leaves much to be desired. Although H. pylori eradication reduces the incidence of gastric adenocarcinoma, it does not completely avoid its appearance. The new rapid stool antigen tests show promising results. The efficacy of standard triple therapy is clearly inadequate and continues to decline, and cannot therefore be recommended. Vonoprazan, when associated with 2 antibiotics, is more effective than traditional proton pump inhibitors, especially in clarithromycin-resistant patients. Non-bismuth quadruple (concomitant) therapy achieves eradication rates of around 90% and has a good safety profile. Concomitant therapy is more effective and simpler than sequential therapy. Although some probiotics can increase the efficacy and tolerability of triple therapy, the utility of its association with quadruple concomitant therapy has not been established. If a first treatment with clarithromycin fails, both bismuth-containing quadruple therapy and levofloxacin-containing triple therapy achieve good-but still suboptimal-results. The combination of bismuth and levofloxacin in the same regimen increases the efficacy of rescue therapy. The management of H. pylori infection by European gastroenterologists is widely heterogeneous and the eradication rates achieved by them are generally unacceptable. In Spain, the highest first-line eradication rate is obtained with quadruple concomitant therapy in 14-day regimens and with double doses of proton pump inhibitors; in second-line therapy, the use of levofloxacin- and bismuth-containing quadruple therapy improves the rates traditionally obtained with quinolones. On the other hand, there is a clear disconnect between the recommendations made in consensus documents and clinical practice in primary care. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

The Impact of Symptom Dimensions on Outcome for Exposure and Ritual Prevention Therapy in Obsessive-Compulsive Disorder

PubMed Central

Williams, Monnica T.; Farris, Samantha G.; Turkheimer, Eric N.; Franklin, Martin E.; Simpson, H. Blair; Liebowitz, Michael; Foa, Edna B.

2014-01-01

Objective Obsessive-compulsive disorder (OCD) is a severe condition with varied symptom presentations. The behavioral treatment with the most empirical support is exposure and ritual prevention (EX/RP). This study examined the impact of symptom dimensions on EX/RP outcomes in OCD patients. Method The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was used to determine primary symptoms for each participant. An exploratory factor analysis (EFA) of 238 patients identified five dimensions: contamination/cleaning, doubts about harm/checking, hoarding, symmetry/ordering, and unacceptable/taboo thoughts (including religious/moral and somatic obsessions among others). A linear regression was conducted on those who had received EX/RP (n = 87) to examine whether scores on the five symptom dimensions predicted post-treatment Y-BOCS scores, accounting for pre-treatment Y-BOCS scores. Results The average reduction in Y-BOCS score was 43.0%, however the regression indicated that unacceptable/taboo thoughts (β = .27, p = .02) and hoarding dimensions (β = .23, p = .04) were associated with significantly poorer EX/RP treatment outcomes. Specifically, patients endorsing religious/moral obsessions, somatic concerns, and hoarding obsessions showed significantly smaller reductions in Y-BOCS severity scores. Conclusions EX/RP was effective for all symptom dimensions, however it was less effective for unacceptable/taboo thoughts and hoarding than for other dimensions. Clinical implications and directions for research are discussed. PMID:24983796

Assessment of the microbiological safety of salad vegetables and sauces from kebab take-away restaurants in the United Kingdom.

PubMed

Meldrum, R J; Little, C L; Sagoo, S; Mithani, V; McLauchlin, J; de Pinna, E

2009-09-01

The purpose of this study was to establish the microbiological safety of salad vegetables and sauces served in kebab take-away restaurants. Comparison with published microbiological guidelines revealed that 4.7% of 1213 salad vegetable samples were of unsatisfactory microbiological quality due to Escherichia coli and/or Staphylococcus aureus levels at > or =10(2) cfu g(-1). Another 0.3% of salad samples were of unacceptable quality due to S. aureus at > or =10(4) cfu g(-1) (2 samples) or the presence of Salmonella Kentucky (1 sample). Cucumber was the most contaminated salad vegetable with regards to unsatisfactory levels of E. coli (6.0%) or S. aureus (4.5%). Five percent of 1208 sauce samples were of unsatisfactory microbiological quality due to E. coli, S. aureus at > or =10(2) cfu g(-1) and/or Bacillus cereus and other Bacillus spp. at > or =10(4) cfu g(-1). A further 0.6% of sauce samples were of unacceptable quality due to Bacillus spp. (Bacillus subtilis, Bacillus pumilus, Bacillus licheniformis) at > or =10(5) cfu g(-1) or the presence of Salmonella Agbeni (1 sample). More samples of chili sauce (8.7%) were of unsatisfactory or unacceptable microbiological quality than any other sauce types. The results emphasize the need for good hygiene practices in kebab take-away restaurants handling these types of ready-to-eat products.

The impact of symptom dimensions on outcome for exposure and ritual prevention therapy in obsessive-compulsive disorder.

PubMed

Williams, Monnica T; Farris, Samantha G; Turkheimer, Eric N; Franklin, Martin E; Simpson, H Blair; Liebowitz, Michael; Foa, Edna B

2014-08-01

Obsessive-compulsive disorder (OCD) is a severe condition with varied symptom presentations. The behavioral treatment with the most empirical support is exposure and ritual prevention (EX/RP). This study examined the impact of symptom dimensions on EX/RP outcomes in OCD patients. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was used to determine primary symptoms for each participant. An exploratory factor analysis (EFA) of 238 patients identified five dimensions: contamination/cleaning, doubts about harm/checking, hoarding, symmetry/ordering, and unacceptable/taboo thoughts (including religious/moral and somatic obsessions among others). A linear regression was conducted on those who had received EX/RP (n=87) to examine whether scores on the five symptom dimensions predicted post-treatment Y-BOCS scores, accounting for pre-treatment Y-BOCS scores. The average reduction in Y-BOCS score was 43.0%, however the regression indicated that unacceptable/taboo thoughts (β=.27, p=.02) and hoarding dimensions (β=.23, p=.04) were associated with significantly poorer EX/RP treatment outcomes. Specifically, patients endorsing religious/moral obsessions, somatic concerns, and hoarding obsessions showed significantly smaller reductions in Y-BOCS severity scores. EX/RP was effective for all symptom dimensions, however it was less effective for unacceptable/taboo thoughts and hoarding than for other dimensions. Clinical implications and directions for research are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

77 FR 20823 - Jyotin Parikh: Debarment Order

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-06

... failing to properly investigate, log and archive questionable, aberrant, and unacceptable laboratory... market new product lines. In furtherance of the conspiracy, in or around March 2003, Mr. Parikh...

32 CFR 236.1 - Purpose.

Code of Federal Regulations, 2014 CFR

2014-07-01

... DEFENSE (DoD)-DEFENSE INDUSTRIAL BASE (DIB) VOLUNTARY CYBER SECURITY AND INFORMATION ASSURANCE (CS/IA) ACTIVITIES § 236.1 Purpose. Cyber threats to DIB unclassified information systems represent an unacceptable...

HIV Testing Practices and Interest in Self-Testing Options among Young, Black Men Who Have Sex with Men in North Carolina

PubMed Central

HURT, Christopher B.; SONI, Karina; MILLER, William C.; HIGHTOW-WEIDMAN, Lisa B.

2016-01-01

Background Young, Black men who have sex with men (YBMSM) experience disproportionately high HIV incidence in the United States. Relative to other at-risk populations, less is known about their HIV testing behaviors and preferences regarding self-testing. Methods We used an online survey to investigate testing practices and interest in self-testing among HIV-uninfected, 18–30 year-old YBMSM in North Carolina. Results From July 2014 – March 2015, 212 completed the survey; median age was 24 years. Among 175 (83%) who had ever been tested, 160 (91%) reported testing in the prior year, 124 (71%) tested at least every 6 months, and 71 (40%) tested at least quarterly. About three-quarters (77%; n=164) were aware of HIV self-testing; 35 (17%) had ever purchased rapid (n=27) or dried blood spot-based (n=14) kits. Participants aware of kits had greater intention to test in the next 6 months; were more likely to have income for basic necessities and to ask sex partners about HIV status; and were less likely to have a main sex partner or to have had transactional sex. Among 142 participants at least somewhat likely to self-test in the future, convenience (35%), privacy (23%), and rapid result delivery (18%) were the principal motivators. Conclusions Eight of every ten YBMSM have ever been tested for HIV, but inter-test intervals remain unacceptably long for many. Awareness of and interest in self-testing is substantial, but few have used this method. Expanded use of self-tests could help increase the frequency of HIV testing in this epidemiologically important population. PMID:27513387

Are we at risk of groupthink in our approach to teamwork interventions in health care?

PubMed

Kaba, Alyshah; Wishart, Ian; Fraser, Kristin; Coderre, Sylvain; McLaughlin, Kevin

2016-04-01

The incidence of medical error, adverse clinical events and poor quality health care is unacceptably high and there are data to suggest that poor coordination of care, or teamwork, contributes to adverse outcomes. So, can we assume that increased collaboration in multidisciplinary teams improves performance and health care outcomes for patients? In this essay, the authors discuss some reasons why we should not presume that collective decision making leads to better decisions and collaborative care results in better health care outcomes. Despite an exponential increase in interventions designed to improve teamwork and interprofessional education (IPE), we are still lacking good quality data on whether these interventions improve important outcomes. There are reasons why some of the components of 'effective teamwork', such as shared mental models, team orientation and mutual trust, could impair delivery of health care. For example, prior studies have found that brainstorming results in fewer ideas rather than more, and hinders rather than helps productivity. There are several possible explanations for this effect, including 'social loafing' and cognitive overload. Similarly, attributes that improve cohesion within groups, such as team orientation and mutual trust, may increase the risk of 'groupthink' and group conformity bias, which may lead to poorer decisions. In reality, teamwork and IPE are not inherently good, bad or neutral; instead, as with any intervention, their effect is modified by the persons involved, the situation and the interaction between persons and situation. Thus, rather than assume better outcomes with teamwork and IPE interventions, as clinicians and educators we must demonstrate that our interventions improve the delivery of health care. © 2016 John Wiley & Sons Ltd.

Urinary tract injuries in laparoscopic hysterectomy: a systematic review.

PubMed

Adelman, Marisa R; Bardsley, Tyler R; Sharp, Howard T

2014-01-01

The aim of this review was to estimate the incidence of urinary tract injuries associated with laparoscopic hysterectomy and describe the long-term sequelae of these injuries and the impact of early recognition. Studies were identified by searching the PubMed database, spanning the last 10 years. The key words "ureter" or "ureteral" or "urethra" or "urethral" or "bladder" or "urinary tract" and "injury" and "laparoscopy" or "robotic" and "gynecology" were used. Additionally, a separate search was done for "routine cystoscopy" and "gynecology." The inclusion criteria were published articles of original research referring to urologic injuries occurring during either laparoscopic or robotic surgery for gynecologic indications. Only English language articles from the past 10 years were included. Studies with less than 100 patients and no injuries reported were excluded. No robotic series met these criteria. A primary search of the database yielded 104 articles, and secondary cross-reference yielded 6 articles. After reviewing the abstracts, 40 articles met inclusion criteria and were reviewed in their entirety. Of those 40 articles, 3 were excluded because of an inability to extract urinary tract injuries from total injuries. Statistical analysis was performed using a generalized linear mixed effects model. The overall urinary tract injury rate for laparoscopic hysterectomy was 0.73%. The bladder injury rate ranged from 0.05% to 0.66% across procedure types, and the ureteral injury rate ranged from 0.02% to 0.4% across procedure type. In contrast to earlier publications, which cited unacceptably high urinary tract injury rates, laparoscopic hysterectomy appears to be safe regarding the bladder and ureter. Copyright © 2014 AAGL. Published by Elsevier Inc. All rights reserved.

Fetal tissue banking for transplantation: characteristics of the donor population and considerations for donor and tissue screening.

PubMed

Newman-Gage, H; Bravo, D; Holmberg, L; Mason, J; Eisenhower, M; Nekhani, N; Fantel, A

2000-01-01

We initiated this study to evaluate the suitability for therapeutic use in transplantation of tissues obtained from human abortuses. We have developed protocols for the collection, handling and preservation of hepatic stem cells from electively aborted embryos and have developed methods for assessment of the cells so derived and processed. In this paper we present our findings regarding screening of potential donors, acquisition of fetal tissues, and assessment of the tissues for potentially infectious contaminants. We assess the suitability of the tissue donors according to current standards used for donors of commonly transplanted tissues (e.g., bone grafts, skin grafts and heart valves) and present data regarding the real availability of tissues from elective abortion procedures that would meet those standard tissue banking criteria.We specifically evaluated the donor's willingness to provide a blood sample for testing, conducted a detailed interview similar to those used for typical organ and tissue donors, and assessed the type and incidence of contamination in collected tissues. We find that although many women are willing to consent to use of the tissues for transplantation, attrition from the study for various reasons results in few fetal organs ultimately realistically available for transplantation. Typical reasons for attrition include: unwillingness to have a blood sample drawn or tested, positive serology results, social/medical high risk factors for acquisition of transmissible disease, no identifiable organs available, and unacceptable microbial contamination. Thus, although it might seem that due to the numbers of abortions performed annually, that there would be substantial numbers of suitable tissues available, only a small proportion are truly suitable for transplantation.

Profile and outcome of patients with post-neonatal tetanus in a tertiary centre in south west Nigeria: any remarkable reduction in the scourge?

PubMed Central

Animasahun, Barakat Adeola; Gbelee, Olusegun Henry; Ogunlana, Aminat Titilayo; Njokanma, Olisamedua Fidelis; Odusanya, Olumuyiwa

2015-01-01

Introduction The incidence of tetanus has remained unacceptably high in developing countries. We aimed to describe the profile and outcome of children with tetanus admitted at the Lagos State University Teaching Hospital (LASUTH), Ikeja. Methods A prospective and cross-sectional study of children aged 1 month to 12 years of age admitted with clinical diagnosis of tetanus, between January 2011 and December 2013, at the Paediatric department of LASUTH. The age, sex, presenting complaint, immunization status, portal of entry, socio-economic class, complications, duration of admission and outcome of the subjects were analyzed using Microsoft Excel supplemented with Statistical Package for Social Sciences (SPSS) version 17.0. Level of significance set at p< 0.05. Results A total of 49 subject participated in the study. Male: Female ratio was 1.7: 1.0. mean age ± SD of 6.5± 3.2 years. Only 24.5% of the subjects were fully immunized, lower limb injury was the most common portal of entry (34.7%). Majority (79.6) were of the middle and lower social classes. Most of the subjects (67.3%) presented with generalised spasm. Only 1 patient (2.0%) did not have trismus. Case fatality rate was 4.1%. Conclusion Tetanus is still prevalent among children in our environment. It is commoner among those with no immunization or incomplete immunization, commoner in those in the middle and lower social class. Lower limb injury was the most common portal of entry. Trismus was a common presenting feature. There is a need to develop programmes with will help improve compliance to immunization. PMID:26526006

Effects of porcine zona pellucida immunocontraceptives in zoo felids.

PubMed

Harrenstien, Lisa A; Munson, Linda; Chassy, Lisa M; Liu, Irwin K M; Kirkpatrick, Jay F

2004-09-01

Methods of contraception are necessary for management of zoo felids; however, the most commonly used contraceptive (melengestrol acetate implant) is associated with serious adverse reactions with long-term use. Porcine zona pellucida (pZP) vaccines are promising as contraceptives, but their safety in zoo felids has not been tested. pZP vaccine was administered to 27 female felids representing 10 species, including African lion (Panthera leo), Asian leopard (P. pardus), jaguar (P. onca), tiger (P. tigris), snow leopard (P. uncia), cougar (Felis concolor), Siberian lynx (F. lynx), Canada lynx (F. canadensis), serval (F. serval), and bobcat (F. rufus), in 15 facilities. Over 6 wk, each animal received three i.m. injections of 65 microg pZP with Freund's complete adjuvant (FCA), Freund's incomplete adjuvant, or carbopol as the adjuvant. Behavioral signs of estrus were seen in 14 of the vaccinated felids. An unacceptably high incidence of adverse reactions was seen including injection site swelling, lameness, limb swelling, or abscessation (or all) in five felids after injection with FCA as the initial adjuvant. Adverse behavioral signs, including increased irritability and aggression, were seen in four felids. Six of the felids were assayed for antibodies against pZP during the 12 mo after vaccination; all showed antibody production. Antibody levels appeared to peak 1-4 mo after vaccination began, although elevated antibody levels persisted in two animals for > 12 mo after the first injection. All vaccinated felids were ovariohysterectomized 3-13 mo after vaccination. Folliculogenesis was present in all treated animals, and there was no histopathologic evidence of inflammatory damage to ovaries. Contraceptive efficacy was not specifically evaluated in this study; however, two of the three felids housed with an intact male became pregnant during the study, one of which gave birth to healthy cubs.

Operational issues and barriers to implementation of prevention of mother-to-child transmission of HIV (PMTCT) interventions in Sub-Saharan Africa.

PubMed

Aizire, Jim; Fowler, Mary G; Coovadia, Hoosen M

2013-03-01

Over the past 10 years substantial progress has been made in the implementation of prevention of mother-to-child transmission of HIV (PMTCT) interventions in Sub-Saharan Africa (SSA). In spite of this, new pediatric infections remain unacceptably high, contributing the majority (>90%) of the estimated 390,000 infections globally in 2010; and yet prolonged breastfeeding remains the norm and crucial to overall infant survival. However, there is reason for optimism given the 2010 World Health Organization PMTCT recommendations: to start HIV infected pregnant women with CD4 cell counts less than 350 cells/mm(3) on lifelong antiretroviral therapy (ART); and for mothers not eligible for ART to provide efficacious maternal and/or infant PMTCT antiretroviral (ARV) regimens to be taken during pregnancy, labor/delivery and through breastfeeding. Current attention is on whether to extend maternal ARVs for life once triple ARV PMTCT regimens are started. To dramatically reduce new pediatric infections, individual countries need to politically commit to rapid scale-up of a multi-pronged PMTCT effort: including primary prevention to reduce HIV incidence among women of reproductive age; increased access to family planning services; HIV screening of all pregnant and breastfeeding women followed by ART or ARVs for PMTCT; and comprehensive care for HIV affected families. Efforts to achieve population-level success in SSA need to critically address operational issues and challenges to implementation (health system) and utilization (social, economic and cultural barriers), at the country, health centre and client level that have led to the relatively slow progress in the scale-up of PMTCT strategies.

Pediatric Hydrocephalus in Ethiopia: Treatment Failures and Infections: A Hospital-Based, Retrospective Study.

PubMed

Laeke, Tsegazeab; Tirsit, Abenezer; Biluts, Hagos; Murali, Deeptha; Wester, Knut

2017-04-01

Treatment of pediatric hydrocephalus in sub-Saharan countries is associated with significant complication rates. The objective of this study is to analyze the management of hydrocephalus and complication rates of surgical intervention in the Ethiopian setting to improve future quality. A retrospective cohort study was conducted in a neurosurgical teaching hospital. Two cohorts separated by 2.5 years were analyzed. A total of 128 (58.6% male and 41.4% female) children with isolated hydrocephalus, meningomyelocele (MMC)-related hydrocephalus, or MMC without hydrocephalus were included. Their age ranged from 1 day to 5 years, for a mean age of 7.2 months (median age 2 months). One hundred thirteen patients had hydrocephalus, of whom 57 (44.5.3%) had isolated hydrocephalus and 56 (43.8%) had hydrocephalus associated with MMC. Seventy-seven (74.7%) patients underwent ventriculoperitoneal (VP) shunting, whereas 24 (23.3%) underwent endoscopic third ventriculostomy (ETV). The incidence of shunt infection was 23.4%. Reoperation was needed in 54 (52.4%) patients, with the most common indication being shunt failure. ETV failed in 14 (58.3%) of the 24 patients undergoing ETV. VP shunt insertions had unacceptably high infection rate despite the presence of a protocol for the procedure. Intraoperative guidelines should be developed further and followed strictly to reduce infections. Such measures should include restricting the number of surgeons performing the procedure. In our opinion, one should avoid insertion of a VP shunt as the primary treatment. ETV has proved to be a good alternative in other studies and the decreasing pattern of ETV failure in our study also suggest ETV as a better alternative to VP shunt. Copyright © 2016 The Author(s). Published by Elsevier Inc. All rights reserved.

47 CFR 22.971 - Obligation to abate unacceptable interference.

Code of Federal Regulations, 2010 CFR

2010-10-01

... interference, with full cooperation and utmost diligence, in the shortest time practicable. Interfering... severally responsible for abating interference, with full cooperation and utmost diligence, in the shortest...

Student Classroom Misbehavior: An Exploratory Study Based on Teachers' Perceptions

PubMed Central

Sun, Rachel C. F.; Shek, Daniel T. L.

2012-01-01

This study aimed to examine the conceptions of junior secondary school student misbehaviors in classroom, and to identify the most common, disruptive, and unacceptable student problem behaviors from teachers' perspective. Twelve individual interviews with teachers were conducted. A list of 17 student problem behaviors was generated. Results showed that the most common and disruptive problem behavior was talking out of turn, followed by nonattentiveness, daydreaming, and idleness. The most unacceptable problem behavior was disrespecting teachers in terms of disobedience and rudeness, followed by talking out of turn and verbal aggression. The findings revealed that teachers perceived student problem behaviors as those behaviors involving rule-breaking, violating the implicit norms or expectations, being inappropriate in the classroom settings and upsetting teaching and learning, which mainly required intervention from teachers. PMID:22919297

When Wife-Beating Is Not Necessarily Abuse: A Feminist and Cross-Cultural Analysis of the Concept of Abuse as Expressed by Tibetan Survivors of Domestic Violence.

PubMed

Rajan, Hamsa

2016-11-20

This article describes the views of Tibetan women who have experienced physical violence from male intimate partners. How they conceptualise abuse, their views on acceptable versus unacceptable hitting, and the acts besides hitting which they felt to be unacceptable or abusive, are explored. Views of survivors' relatives/friends and men who have hit their wives are also included. Western-based domestic violence theory is shown to be incommensurate with abuse in particular socio-cultural settings. As feminist scholars emphasize listening deeply to voices of women in the global South, this article demonstrates how such listening might be undertaken when the views expressed by women diverge from feminism. © The Author(s) 2016.

Unacceptably High Error Rates in Vitek 2 Testing of Cefepime Susceptibility in Extended-Spectrum-β-Lactamase-Producing Escherichia coli

PubMed Central

Rhodes, Nathaniel J.; Richardson, Chad L.; Heraty, Ryan; Liu, Jiajun; Malczynski, Michael; Qi, Chao

2014-01-01

While a lack of concordance is known between gold standard MIC determinations and Vitek 2, the magnitude of the discrepancy and its impact on treatment decisions for extended-spectrum-β-lactamase (ESBL)-producing Escherichia coli are not. Clinical isolates of ESBL-producing E. coli were collected from blood, tissue, and body fluid samples from January 2003 to July 2009. Resistance genotypes were identified by PCR. Primary analyses evaluated the discordance between Vitek 2 and gold standard methods using cefepime susceptibility breakpoint cutoff values of 8, 4, and 2 μg/ml. The discrepancies in MICs between the methods were classified per convention as very major, major, and minor errors. Sensitivity, specificity, and positive and negative predictive values for susceptibility classifications were calculated. A total of 304 isolates were identified; 59% (179) of the isolates carried blaCTX-M, 47% (143) carried blaTEM, and 4% (12) carried blaSHV. At a breakpoint MIC of 8 μg/ml, Vitek 2 produced a categorical agreement of 66.8% and exhibited very major, major, and minor error rates of 23% (20/87 isolates), 5.1% (8/157 isolates), and 24% (73/304), respectively. The sensitivity, specificity, and positive and negative predictive values for a susceptibility breakpoint of 8 μg/ml were 94.9%, 61.2%, 72.3%, and 91.8%, respectively. The sensitivity, specificity, and positive and negative predictive values for a susceptibility breakpoint of 2 μg/ml were 83.8%, 65.3%, 41%, and 93.3%, respectively. Vitek 2 results in unacceptably high error rates for cefepime compared to those of agar dilution for ESBL-producing E. coli. Clinicians should be wary of making treatment decisions on the basis of Vitek 2 susceptibility results for ESBL-producing E. coli. PMID:24752253

Evaluation of the Eological Management and Enhancement Alernative for Remediation of the K1007-P1 Pond

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

Peterson, M.J.

2005-10-31

An evaluation of the human and ecological risks associated with the P1 Pond and surrounding environs was conducted as part of the ETTP Site-Wide Remedial Investigation. The RI provides the basis for the focus on PCBs as the most important unacceptable risk to human and ecological health in the pond. Other P1 contaminants, media, or pathways of risk to receptors are identified in the RI, but are not addressed as a major risk reduction goal for the ETTP Site-Wide Feasibility Study. Therefore, the goal of the Ecological Management alternative is to reduce unacceptable risks associated with PCBs in fish. Manymore » of the actions proposed for this alternative, however, are likely to reduce risks associated with other contaminants and their pathways. The high PCB concentrations in fish from the P1 Pond are most certainly due in part to the current ecological condition of the pond that maximizes PCB biomagnification. This basic assumption and the factors contributing to it were evaluated by conducting an intensive field study of the P1 Pond in the summer of 2004 (for a thorough presentation of current P1 Pond biological conditions, see Peterson et al. 2005). Major hypotheses regarding the P1 Pond's current fish community, PCB fate and transport processes, pond vegetation, and limnological conditions that contribute to the high PCB levels in fish were validated by the study (Appendix A), The results of the 2004 ecological assessment, in concert with long-term datasets obtained as part of the ETTP Biological Monitoring and Abatement Program (BMAP) and recent abiotic sampling for the RI, provide the basis for the assessment of current conditions.« less

Evaluation of a modified cleaning procedure in the prevention of carbapenem-resistant Acinetobacter baumannii clonal spread in a burn intensive care unit using a high-sensitivity luminometer.

PubMed

Casini, B; Selvi, C; Cristina, M L; Totaro, M; Costa, A L; Valentini, P; Barnini, S; Baggiani, A; Tagliaferri, E; Privitera, G

2017-01-01

Enhanced environmental cleaning practices are among the most accepted measures for controlling the spread of carbapenem-resistant Acinetobacter baumannii (CR-Ab). To evaluate the impact of heightened cleaning on an ongoing CR-Ab outbreak in a burn intensive care unit (BICU) of an Italian teaching hospital, where chlorhexidine-60% isopropyl alcohol was applied as a complementary disinfectant on high-touch surfaces. Compliance with the microbial limit proposed for the BICU by AFNOR-NF-S90-351 (20 colony-forming units/100cm 2 ) was assessed by plate count, and compared with the results obtained with intracellular adenosine triphosphate (ATP) detection. Genotyping was performed using pulsed-field gel electrophoresis. During the standard cleaning regimen, three out of 23 samples (13%) gave results over the AFNOR limit and five (21.7%) showed unacceptable ATP levels with 100 relative light units/100cm 2 as the benchmark limit (sensibility 86.4%, specificity 92.2%). Following improvement of the cleaning procedure, only two samples out of 50 (4%) did not satisfy the microbiological criteria and seven (14%) exceeded the ATP limit. In a successive phase, eight of 30 samples collected showed unacceptable results (27%). Adding chlorhexidine-60% isopropyl alcohol as complementary disinfectant proved to be effective for reducing environmental microbial contamination, ATP levels and CR-Ab infection/colonization in patients admitted to the BICU. Real-time monitoring by ATP assay was useful for managing the cleaning schedule and reducing hospital infections, although the calculated values must be interpreted as cleanliness indicators rather than risk indicators. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Combination of biodegradable stent placement and single-dose brachytherapy is associated with an unacceptably high complication rate in the treatment of dysphagia from esophageal cancer.

PubMed

Hirdes, Meike M C; van Hooft, Jeanin E; Wijrdeman, Harm K; Hulshof, Maarten C C M; Fockens, Paul; Reerink, Onne; van Oijen, Martijn G H; van der Tweel, Ingeborg; Vleggaar, Frank P; Siersema, Peter D

2012-08-01

For the palliative treatment of dysphagia, esophageal stent placement provides immediate improvement, whereas brachytherapy offers better long-term relief. To evaluate safety and efficacy of concurrent brachytherapy and biodegradable stent placement. Prospective, single-arm study. Two tertiary-care referral centers. Nineteen consecutive patients with significant dysphagia resulting from unresectable esophageal cancer, with a life expectancy of more than 3 months. Single-dose brachytherapy (12 Gy) on day 1 followed by biodegradable stent placement on day 2. Intervention-related major complications (determined by an expert panel) and dysphagia. Nineteen patients (13 men, median age 66 years [interquartile range (IQR) 59-71] years) were included; 7 patients (37%) also received palliative chemotherapy. After inclusion of 19 patients, the study was ended prematurely because the safety threshold was exceeded. In total, 28 major complications occurred in 17 patients (89%). In 9 patients (47%), major complications were determined intervention-related (severe retrosternal pain with or without vomiting [n = 6], hematemesis [n = 1], recurrent dysphagia [n = 2]. Dysphagia scores decreased significantly from a median of 3 (IQR 3-4) to a median of 1 (IQR 0-3) after 1 month (P < .001). Despite adequate luminal patency in 17 patients (89%), normal diet could not be tolerated in 7 patients (37%) because of retrosternal pain and vomiting. Lack of routine endoscopy or contrast esophagram to evaluate recurrent dysphagia during follow-up. Despite restoration of luminal patency, a combined treatment of brachytherapy and biodegradable stent placement cannot be recommended for the palliative treatment of esophageal cancer because of an unacceptably high intervention-related major complication rate. Copyright © 2012 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

Microwave characterization of slotline on high resistivity silicon for antenna feed network

NASA Technical Reports Server (NTRS)

Simons, Rainee N.; Taub, Susan R.; Lee, Richard Q.; Young, Paul G.

1993-01-01

Conventional silicon wafers have low resistivity and consequently unacceptably high value of dielectric attenuation constant. Microwave circuits for phased array antenna systems fabricated on these wafers therefore have low efficiency. By choosing a silicon substrate with sufficiently high resistivity it is possible to make the dielectric attenuation constant of the interconnecting microwave transmission lines approach those of GaAs or InP. In order for this to be possible, the transmission lines must be characterized. In this presentation, the effective dielectric constant (epsilon sub eff) and attenuation constant (alpha) of a slotline on high resistivity (5000 to 10 000 ohm-cm) silicon wafer will be discussed. The epsilon sub eff and alpha are determined from the measured resonant frequencies and the corresponding insertion loss of a slotline ring resonator. The results for slotline will be compared with microstrip line and coplanar waveguide.

Prediction of the Chloride Resistance of Concrete Modified with High Calcium Fly Ash Using Machine Learning

PubMed Central

Marks, Michał; Glinicki, Michał A.; Gibas, Karolina

2015-01-01

The aim of the study was to generate rules for the prediction of the chloride resistance of concrete modified with high calcium fly ash using machine learning methods. The rapid chloride permeability test, according to the Nordtest Method Build 492, was used for determining the chloride ions’ penetration in concrete containing high calcium fly ash (HCFA) for partial replacement of Portland cement. The results of the performed tests were used as the training set to generate rules describing the relation between material composition and the chloride resistance. Multiple methods for rule generation were applied and compared. The rules generated by algorithm J48 from the Weka workbench provided the means for adequate classification of plain concretes and concretes modified with high calcium fly ash as materials of good, acceptable or unacceptable resistance to chloride penetration. PMID:28793740

High Sensitivity and Specificity of Clinical Microscopy in Rural Health Facilities in Western Kenya Under an External Quality Assurance Program

PubMed Central

Wafula, Rebeccah; Sang, Edna; Cheruiyot, Olympia; Aboto, Angeline; Menya, Diana; O'Meara, Wendy Prudhomme

2014-01-01

Microscopic diagnosis of malaria is a well-established and inexpensive technique that has the potential to provide accurate diagnosis of malaria infection. However, it requires both training and experience. Although it is considered the gold standard in research settings, the sensitivity and specificity of routine microscopy for clinical care in the primary care setting has been reported to be unacceptably low. We established a monthly external quality assurance program to monitor the performance of clinical microscopy in 17 rural health centers in western Kenya. The average sensitivity over the 12-month period was 96% and the average specificity was 88%. We identified specific contextual factors that contributed to inadequate performance. Maintaining high-quality malaria diagnosis in high-volume, resource-constrained health facilities is possible. PMID:24935953

77 FR 20639 - Shashikant Shah: Debarment Order

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-05

... investigate, log, and archive questionable, aberrant, and unacceptable laboratory results so that Able could... maintaining false, fraudulent, and inaccurate data and records to obtain FDA approval to market new product...

77 FR 20641 - Jose Concepcion: Debarment Order

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-05

... investigate, log, and archive questionable, aberrant, and unacceptable laboratory results so that Able could... maintaining false, fraudulent, and inaccurate data and records to obtain FDA approval to market new product...

32 CFR 154.13 - Sensitive positions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... misconduct, malfeasance, or nonfeasance of an incumbent in any such position could result in an unacceptably... the extent feasible, the Top Secret billet structure into the component Manpower Unit Manning Document...

32 CFR 154.13 - Sensitive positions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... misconduct, malfeasance, or nonfeasance of an incumbent in any such position could result in an unacceptably... the extent feasible, the Top Secret billet structure into the component Manpower Unit Manning Document...

32 CFR 154.13 - Sensitive positions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... misconduct, malfeasance, or nonfeasance of an incumbent in any such position could result in an unacceptably... the extent feasible, the Top Secret billet structure into the component Manpower Unit Manning Document...

32 CFR 154.13 - Sensitive positions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... misconduct, malfeasance, or nonfeasance of an incumbent in any such position could result in an unacceptably... the extent feasible, the Top Secret billet structure into the component Manpower Unit Manning Document...

32 CFR 154.13 - Sensitive positions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... misconduct, malfeasance, or nonfeasance of an incumbent in any such position could result in an unacceptably... the extent feasible, the Top Secret billet structure into the component Manpower Unit Manning Document...

40 CFR 240.201-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) SOLID WASTES GUIDELINES FOR THE THERMAL PROCESSING OF SOLID WASTES Requirements and Recommended... precautions to be taken if unacceptable wastes are delivered to the facility or are improperly left there...

40 CFR 240.201-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) SOLID WASTES GUIDELINES FOR THE THERMAL PROCESSING OF SOLID WASTES Requirements and Recommended... precautions to be taken if unacceptable wastes are delivered to the facility or are improperly left there...

Methodology and measures for preventing unacceptable flow-accelerated corrosion thinning of pipelines and equipment of NPP power generating units

NASA Astrophysics Data System (ADS)

Tomarov, G. V.; Shipkov, A. A.; Lovchev, V. N.; Gutsev, D. F.

2016-10-01

Problems of metal flow-accelerated corrosion (FAC) in the pipelines and equipment of the condensate- feeding and wet-steam paths of NPP power-generating units (PGU) are examined. Goals, objectives, and main principles of the methodology for the implementation of an integrated program of AO Concern Rosenergoatom for the prevention of unacceptable FAC thinning and for increasing operational flow-accelerated corrosion resistance of NPP EaP are worded (further the Program). A role is determined and potentialities are shown for the use of Russian software packages in the evaluation and prediction of FAC rate upon solving practical problems for the timely detection of unacceptable FAC thinning in the elements of pipelines and equipment (EaP) of the secondary circuit of NPP PGU. Information is given concerning the structure, properties, and functions of the software systems for plant personnel support in the monitoring and planning of the inservice inspection of FAC thinning elements of pipelines and equipment of the secondary circuit of NPP PGUs, which are created and implemented at some Russian NPPs equipped with VVER-1000, VVER-440, and BN-600 reactors. It is noted that one of the most important practical results of software packages for supporting NPP personnel concerning the issue of flow-accelerated corrosion consists in revealing elements under a hazard of intense local FAC thinning. Examples are given for successful practice at some Russian NPP concerning the use of software systems for supporting the personnel in early detection of secondary-circuit pipeline elements with FAC thinning close to an unacceptable level. Intermediate results of working on the Program are presented and new tasks set in 2012 as a part of the updated program are denoted. The prospects of the developed methods and tools in the scope of the Program measures at the stages of design and construction of NPP PGU are discussed. The main directions of the work on solving the problems of flow-accelerated corrosion of pipelines and equipment in Russian NPP PGU are defined.

Enhanced tendon-to-bone repair through adhesive films.

PubMed

Linderman, Stephen W; Golman, Mikhail; Gardner, Thomas R; Birman, Victor; Levine, William N; Genin, Guy M; Thomopoulos, Stavros

2018-04-01

Tendon-to-bone surgical repairs have unacceptably high failure rates, possibly due to their inability to recreate the load transfer mechanisms of the native enthesis. Instead of distributing load across a wide attachment footprint area, surgical repairs concentrate shear stress on a small number of suture anchor points. This motivates development of technologies that distribute shear stresses away from suture anchors and across the enthesis footprint. Here, we present predictions and proof-of-concept experiments showing that mechanically-optimized adhesive films can mimic the natural load transfer mechanisms of the healthy attachment and increase the load tolerance of a repair. Mechanical optimization, based upon a shear lag model corroborated by a finite element analysis, revealed that adhesives with relatively high strength and low stiffness can, theoretically, strengthen tendon-to-bone repairs by over 10-fold. Lap shear testing using tendon and bone planks validated the mechanical models for a range of adhesive stiffnesses and strengths. Ex vivo human supraspinatus repairs of cadaveric tissues using multipartite adhesives showed substantial increase in strength. Results suggest that adhesive-enhanced repair can improve repair strength, and motivate a search for optimal adhesives. Current surgical techniques for tendon-to-bone repair have unacceptably high failure rates, indicating that the initial repair strength is insufficient to prevent gapping or rupture. In the rotator cuff, repair techniques apply compression over the repair interface to achieve contact healing between tendon and bone, but transfer almost all force in shear across only a few points where sutures puncture the tendon. Therefore, we evaluated the ability of an adhesive film, implanted between tendon and bone, to enhance repair strength and minimize the likelihood of rupture. Mechanical models demonstrated that optimally designed adhesives would improve repair strength by over 10-fold. Experiments using idealized and clinically-relevant repairs validated these models. This work demonstrates an opportunity to dramatically improve tendon-to-bone repair strength using adhesive films with appropriate material properties. Copyright © 2018 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

False-Positive Error Rates for Reliable Digit Span and Auditory Verbal Learning Test Performance Validity Measures in Amnestic Mild Cognitive Impairment and Early Alzheimer Disease.

PubMed

Loring, David W; Goldstein, Felicia C; Chen, Chuqing; Drane, Daniel L; Lah, James J; Zhao, Liping; Larrabee, Glenn J

2016-06-01

The objective is to examine failure on three embedded performance validity tests [Reliable Digit Span (RDS), Auditory Verbal Learning Test (AVLT) logistic regression, and AVLT recognition memory] in early Alzheimer disease (AD; n = 178), amnestic mild cognitive impairment (MCI; n = 365), and cognitively intact age-matched controls (n = 206). Neuropsychological tests scores were obtained from subjects participating in the Alzheimer's Disease Neuroimaging Initiative (ADNI). RDS failure using a ≤7 RDS threshold was 60/178 (34%) for early AD, 52/365 (14%) for MCI, and 17/206 (8%) for controls. A ≤6 RDS criterion reduced this rate to 24/178 (13%) for early AD, 15/365 (4%) for MCI, and 7/206 (3%) for controls. AVLT logistic regression probability of ≥.76 yielded unacceptably high false-positive rates in both clinical groups [early AD = 149/178 (79%); MCI = 159/365 (44%)] but not cognitively intact controls (13/206, 6%). AVLT recognition criterion of ≤9/15 classified 125/178 (70%) of early AD, 155/365 (42%) of MCI, and 18/206 (9%) of control scores as invalid, which decreased to 66/178 (37%) for early AD, 46/365 (13%) for MCI, and 10/206 (5%) for controls when applying a ≤5/15 criterion. Despite high false-positive rates across individual measures and thresholds, combining RDS ≤ 6 and AVLT recognition ≤9/15 classified only 9/178 (5%) of early AD and 4/365 (1%) of MCI patients as invalid performers. Embedded validity cutoffs derived from mixed clinical groups produce unacceptably high false-positive rates in MCI and early AD. Combining embedded PVT indicators lowers the false-positive rate. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Teaching Kids Not to Bully

MedlinePlus

... and ability to form and sustain friendships. Understanding Bullying Behavior Kids bully for many reasons. Some bully ... children they perceive as weak. Helping Kids Stop Bullying Let your child know that bullying is unacceptable ...

Final Rule (signed September 26, 2016)

EPA Pesticide Factsheets

New Listings of Substitutes; Changes of Listing Status; and Reinterpretation of Unacceptability for Closed Cell Foam Products under the SNAP Program; and Revision of Clean Air Act Section 608 Venting Prohibition for Propane.

Skid correction program : user's manual.

DOT National Transportation Integrated Search

2012-06-01

This document outlines methods for use by UDOT personnel to address pavements with unacceptable skid numbers. The program involves coordination between Safety, Pavement Management, Region, and Maintenance managers. A process has been recommended usin...

Superfund: Contaminated Sediments

EPA Pesticide Factsheets

Contaminated sediments are a significant environmental problem and contribute to the over 3,200 fish consumption advisories nationwide. The Superfund program cleans up sediment sites that present an unacceptable risk to human health or the environment.

High freezing point fuels used for aviation turbine engines

NASA Technical Reports Server (NTRS)

Friedman, R.

1979-01-01

Broadened-specification aviation fuels could be produced from a greater fraction of crude source material with improvements in fuel supply and price. These fuels, particularly those with increased final boiling temperatures, would have higher freezing temperatures than current aviation turbine fuels. For the small but significant fraction of commercial flights where low fuel temperatures make higher freezing-point fuel use unacceptable, adaptations to the fuel or fuel system may be made to accommodate this fuel. Several techniques are discussed. Fuel heating is the most promising concept. One simple design uses existing heat rejection from the fuel-lubricating oil cooler, another uses an engine-driven generator for electrical heating.

Management of respiratory distress syndrome: an update.

PubMed

Rodriguez, Ricardo J

2003-03-01

Respiratory distress syndrome is the most common respiratory disorder in preterm infants. Over the last decade, because of improvements in neonatal care and increased use of antenatal steroids and surfactant replacement therapy, mortality from respiratory distress syndrome has dropped substantially. However, respiratory morbidity, primarily bronchopulmonary dysplasia, remains unacceptably high. The management of respiratory distress syndrome in preterm infants is based on various modalities of respiratory support and the application of fundamental principles of neonatal care. To obtain best results, a multidisciplinary approach is crucial. This review discusses surfactant replacement therapy and some of the current strategies in ventilatory management of preterm infants with respiratory distress syndrome. Copyright 2003 Daedalus Enterprises

Combustion characteristics of an SI engine fueled with biogas fuel

NASA Astrophysics Data System (ADS)

Chen, Lei; Long, Wuqiang; Song, Peng

2017-04-01

An experimental research of the effect of H2 substitution and CO2 dilution on CH4 combustion has been carried out on a spark ignition engine. The results show that H2 addition could improve BMEP, thermal efficiency, CO and THC emissions. NOX emissions increased for higher low heating value (LHV) of H2 than CH4. CO2 dilution could effective reduce NOX emission of H2-CH4 combustion. Although engine performance, thermal efficiency and exhaust get unacceptable under high fuel dilution ratio (F.D.R.) conditions, it could be solved by decreasing F.D.R. and/or increasing hydrogen substitution ratio (H.S.R.).

[Fast food promotes weight gain].

PubMed

Stender, Steen; Dyerberg, Jørn; Astrup, Arne V

2007-05-07

The total amounts of fat in a fast food menu consisting of French fries and fried Chicken Nuggets from McDonald's and KFC, respectively, bought in 35 different countries vary from 41 to 71 gram. In most countries the menu contained unacceptably high amounts of industrially-produced trans fat which contributes to an increased risk of ischaemic heart disease, weight gain, abdominal fat accumulation and type 2 diabetes. The quality of the ingredients in fast food ought to be better and the size of the portions smaller and less energy-dense so that frequent fast food meals do not increase the risk of obesity and diseases among customers.

A study of the effect of flight density and background noise on V/STOL acceptability. [effective perceived noise level as measure of annoyance

NASA Technical Reports Server (NTRS)

Sternfeld, H., Jr.; Hinterkeuser, E. G.; Hackman, R. B.; Davis, J.

1974-01-01

A study was conducted in which test subjects evaluated the sounds of a helicopter, a turbofan STOL and a turbojet airplane while engaged in work and leisure activities. Exposure to a high repetitive density of the aircraft sounds did not make the individual sounds more annoying but did create an unacceptable environment. The application of a time duration term to db(A) resulted in a measure which compared favorably with EPNL as a predictor of annoyance. Temporal variations in background noise level had no significant effect on the rated annoyance.

Testing the OPERA superluminal neutrino anomaly at the LHC

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

Davoudiasl H.; Rizzo, T.

2011-11-28

The OPERA Collaboration has reported the observation of superluminal muon neutrinos, whose speed v{sub v} exceeds that of light c, with (v{sub v}-c)/c {approx_equal} 2.5 x 10{sup -5}. In a recent work, Cohen and Glashow have refuted this claim by noting that such neutrinos will lose energy, by pair emission of particles, at unacceptable rates. Following the Cohen and Glashow arguments, we point out that pair emissions consistent with the OPERA anomaly can lead to detectable signals for neutrinos originating from decays of highly boosted top quarks at the LHC, allowing an independent test of the superluminal neutrino hypothesis.

Testing the OPERA Superluminal Neutrino Anomaly at the LHC

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

Davoudiasl, Hooman; /Brookhaven; Rizzo, Thomas G.

2012-03-15

The OPERA collaboration has reported the observation of superluminal muon neutrinos, whose speed v{sub {nu}} exceeds that of light c, with (v{sub {nu}}-c)/c {approx_equal} 2.5 x 10{sup -5}. In a recent work, Cohen and Glashow (CG) have refuted this claim by noting that such neutrinos will lose energy, by pair-emission of particles, at unacceptable rates. Following the CG arguments, we point out that pair-emissions consistent with the OPERA anomaly can lead to detectable signals for neutrinos originating from decays of highly boosted top quarks at the LHC, allowing an independent test of the superluminal neutrino hypothesis.

Testing the OPERA superluminal neutrino anomaly at the LHC

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

Davoudiasl, Hooman; Rizzo, Thomas G.

2011-11-01

The OPERA Collaboration has reported the observation of superluminal muon neutrinos, whose speed v{sub {nu}} exceeds that of light c, with (v{sub {nu}}-c)/c{approx_equal}2.5x10{sup -5}. In a recent work, Cohen and Glashow have refuted this claim by noting that such neutrinos will lose energy, by pair emission of particles, at unacceptable rates. Following the Cohen and Glashow arguments, we point out that pair emissions consistent with the OPERA anomaly can lead to detectable signals for neutrinos originating from decays of highly boosted top quarks at the LHC, allowing an independent test of the superluminal neutrino hypothesis.

Prospective Study of Surgery for Primary Hyperparathyroidism (HPT) in Multiple Endocrine Neoplasia-type 1 (MEN1), and Zollinger-Ellison syndrome (ZES): Long-term Outcome of a More Virulent form of HPT

PubMed Central

Norton, JA; Venzon, DJ; Berna, MJ; Alexander, HR; Frake, DL; Libutti, SK; Marx, SJ; Gibril, F; Jensen, RT

2009-01-01

Background HPT in MEN1 patients with ZES is caused by parathyroid hyperplasia. Surgery for parathyroid hyperplasia is tricky and difficult. Long-term outcome in ZES/MEN1 /HPT is not well known. Methods 84 consecutive patients (49 F/35 M) with ZES/MEN1 /HPT underwent intial parathyroidectomy (PTX) and were followed at 1−3 yr intervals. Results Age at PTX was 36±2 yrs. Mean follow-up was 17±1 yrs. Prior to PTX, mean Ca=2.8 mmol/L (nl<2.5), PTHi=243 pg/ml (nl <65), and gastrin=6950 pg/ml (nl <100). 61% had nephrolithiasis. Each patient had parathyroid hyperplasia. 58% of patients had four parathyroid glands identified. 9/84 (11%) had 4 glands removed with immediate autograft, 40/84 (47%) 3−3.5 glands, while 35/84 (42%) <3 glands.removed. Persistent/recurrent HPT occurred in 42%/48% of patients with <3 glands, 12%/44% with 3−3.5 glands, and 0%/55% with 4 glands removed. Hypoparathyroidism occurred in 3%, 10% and 22%, respectively. The disease-free interval following surgery was significantly longer if >3 glands were removed. After surgery to correct the HPT, each biochemical parameter of ZES was improved and 20% of patients no longer had laboratory evidence of ZES. Conclusions HPT /MEN1/ZES is a severe form of parathyroid hyperplasia with a high rate of nephrolithiasis, persistent and recurrent HPT. Surgery to correct the hypercalcemia significantly ameliorates the ZES. Removal of less than 3 and ½ glands has an unacceptably high incidence of persistent HPT (42%), while 4 gland resection and transplant has an high rate of permanent hypoparathyroidism (22%). >3gland resection has a longer disease-free interval. 3 and ½ gland parathyroidectomy is the surgical procedure of choice for patients with HPT/MEN1/ ZES. Careful long-term follow-up is mandatory as a significant proportion will develop recurrent HPT. PMID:18376196

Proposed Rule (April 18, 2016)

EPA Pesticide Factsheets

Proposed Rule - Protection of Stratospheric Ozone: New Listings of Substitutes; Changes of Listing Status; Reinterpretation of Unacceptability for Closed Cell Foam Products under the Significant New Alternatives Policy Program; and Revision of Clean Air Ac

Attitudes toward jaguars and pumas and the acceptability of killing big cats in the Brazilian Atlantic Forest: An application of the Potential for Conflict Index2.

PubMed

Engel, Monica T; Vaske, Jerry J; Bath, Alistair J; Marchini, Silvio

2017-09-01

We explored the overall acceptability of killing jaguars and pumas in different scenarios of people-big cat interactions, the influence of attitudes toward big cats on acceptability, and the level of consensus on the responses. Data were obtained from 326 self-administered questionnaires in areas adjacent to Intervales State Park and Alto Ribeira State Park. Overall, people held slightly positive attitudes toward jaguars and pumas and viewed the killing of big cats as unacceptable. However, individuals that held negative attitudes were more accepting of killing. As the severity of people-big cat interactions increased, the level of consensus decreased. Knowing whether killing a big cat is acceptable or unacceptable in specific situations allows managers to anticipate conflict and avoid illegal killing of big cats.

Energy balance measurement: when something is not better than nothing.

PubMed

Dhurandhar, N V; Schoeller, D; Brown, A W; Heymsfield, S B; Thomas, D; Sørensen, T I A; Speakman, J R; Jeansonne, M; Allison, D B

2015-07-01

Energy intake (EI) and physical activity energy expenditure (PAEE) are key modifiable determinants of energy balance, traditionally assessed by self-report despite its repeated demonstration of considerable inaccuracies. We argue here that it is time to move from the common view that self-reports of EI and PAEE are imperfect, but nevertheless deserving of use, to a view commensurate with the evidence that self-reports of EI and PAEE are so poor that they are wholly unacceptable for scientific research on EI and PAEE. While new strategies for objectively determining energy balance are in their infancy, it is unacceptable to use decidedly inaccurate instruments, which may misguide health-care policies, future research and clinical judgment. The scientific and medical communities should discontinue reliance on self-reported EI and PAEE. Researchers and sponsors should develop objective measures of energy balance.

DEVELOPMENT OF AN ANTIBIOTIC OPTIONS INDEX FOR ANTIBIOTIC RESISTANCE MONITORING.

PubMed

Manomayitthikan, Taweesuk; Borlace, Glenn N; Kessomboon, Nusaraporn

2016-11-01

Using antibiogram data to indicate the overall antibiotic resistance of a pathogen is complicated by the multiple antibiotic susceptibilities reported in the antibiogram. The objectives of this study were to develop and determine the benefits of an Antibiotic Options Index (AOI); an index that summarizes antibiotic susceptibility data for a pathogen by presenting it as the availability of antibiotic treatment options. The AOI was calculated using antibiogram data for the seven most commonly isolated pathogens from the National Antimicrobial Resistance Surveillance Center of Thailand between 1998 and 2014 and was classified as acceptable (AOI ≥ 0.8) or unacceptable (AOI < 0.8) based on the availability of treatment options. The AOI identified two problematic pathogens: Acinetobacter baumannii and methicillin-resistant Staphylococcus aureus (MRSA). For A. baumannii, the probability of having at least two viable antibiotic treatment options (AOIm2) decreased from an acceptable level (0.93) in 1998 to an unacceptable level (0.53) in 2014 and for MRSA the AOIm2 decreased from an acceptable level (0.82) in 1998 to an unacceptable level (0.47) in 2014. By including the idea that the problem with increasing antibiotic resistance is a problem with treating infections, the AOI effectively compiles susceptibility data to present it as the probability of having effective antibiotic treatment. This index is calculated from widely available antibiogram data, making it more suitable to be used to monitor antibiotic resistance at the hospital, provincial and national levels.

Psychiatry's future: facing reality.

PubMed

Staton, D

1991-01-01

U.S. public and private health care costs, including mental health treatment costs, continue to rise at unacceptably high annual rates of increase. "Basic" health insurance plans presently being developed by both public and private payers, in response to this crisis, will include: (1) severely limited coverage for psychiatric care; and (2) coverage for specific categories of serious mental illness. Psychiatrists must develop cost-effective goals and treatment standards that achieve satisfactory outcomes for these high-priority conditions. Treatment standards must be compatible with economic reality. Psychiatry as a profession (i.e., all psychiatrists) must accept cost-effective treatment responsibility for society's most seriously mentally ill individuals. We need to train psychiatrists who are biologically-, crisis-, and rehabilitation-oriented and who can practice effectively and comfortably within society's treatment expectations and funding constraints.

Getting serious about protecting New Zealand children against unhealthy food marketing.

PubMed

Vandevijvere, Stefanie; Swinburn, Boyd

2015-07-03

Reducing childhood obesity is now a high priority for Government and New Zealand society, and foremost in these efforts should be getting serious about protecting children from being targeted by sophisticated marketing for the very foods and beverages that are making them fat. The marketing of unhealthy food products to children is powerful, pervasive and predatory. Previous studies in New Zealand found that food marketing targeted at children through various media is predominantly for unhealthy food products. Statutory comprehensive regulations providing full protections for children against unhealthy food marketing are recommended, but strengthening voluntary codes into a more quasi-regulatory system would allow food companies to clearly demonstrate their commitments to becoming part of the solution for New Zealand's unacceptably high rate of childhood obesity.

Evaluation of amino-oxyacetic acid as a palliative in tinnitus.

PubMed

Guth, P S; Risey, J; Briner, W; Blair, P; Reed, H T; Bryant, G; Norris, C; Housley, G; Miller, R

1990-01-01

Amino-oxyacetic acid (AOAA) was evaluated as a palliative in tinnitus. Sixty-six patients with tinnitus presumed to be of cochlear origin were given either a placebo or 75 mg of AOAA four times a day for 1 week. Response was evaluated by both audiometric measurement of tinnitus loudness and subjective rating by patients of change or no change in tinnitus severity. Because loudness measurements and self-rating have not been shown to be independent, and since the aim of clinical treatment of tinnitus is the alleviation of subjective distress, greater weight was given to the patient's self-rating. A total of 21% of all patients reported a subjective decrease in tinnitus severity, usually within 3 to 4 days after the start of AOAA use. Patients with tinnitus caused by presbycusis or Meniere's disease were the most likely to respond to AOAA treatment with a reduction in tinnitus severity, whereas those with drug-induced tinnitus were the least likely to respond. Nausea and dysequilibrium were the most common side effects of AOAA use. Of the 21% of patients who responded to AOAA, 71% developed some type of side effect. Amino-oxyacetic acid produces a reduction in the severity of tinnitus in about 20% of patients; however, the incidence of side effects makes the drug unacceptable for clinical use.

Intracavitary applicator in relation to complications of pelvic radiation: the Ernst system

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

Rotman, M.; John, M.J.; Roussis, K.

Case studies were reviewed for 100 consecutive patients with carcinoma of the cervix, Stages I to III, who were treated prior to 1968 at a large municipal hospital in New York City. Treatments consisted of orthovoltage therapy prior to or following intracavitary radium. A 250 kV x-ray unit delivered a 3000 rad tumor dose in 3 weeks through four oblique fields. Intracavitary radium delivered 6000 to 7200 mg hr using the Ernst applicator. The 9% incidence of fistulae was 4-fold higher than that found in subsequent years using /sup 60/Co teletherapy and the afterloading Fletcher-Suit applicator. A review of themore » dosimetry relating to the use of the Ernst applicator demonstrates inherent structural characteristics which lend themselves to such complications. Where less than an ideal application is possible, this rigid applicator compacts itself in accordion-like fashion, producing a so-called short-system. Coupled with a reduced source to applicator-surface distance, such applications result in unacceptable dose anisotropy and excessive radiation of critical structures where a predetermined dose is to be delivered to anatomic Point A. Information gleaned from this study can be extrapolated to other rigid unprotected short-surface distance intra-vaginal applicators that have proliferated in recent years.« less

Compound Words: A Problem in Post-Coordinate Retrieval Systems

ERIC Educational Resources Information Center

Jones, Kevin P.

1971-01-01

Compound words cause some difficulty in post-coordinate indexing systems: if too many are fractured, or the wrong categories are selected for fracturing noise will be produced at unacceptable levels on retrieval. (Author/MM)

DESIGN CONSIDERATION INVOLVING ACTIVE SEDIMENT CAPS

EPA Science Inventory

When contaminated sediments pose unacceptable risks to human health and the environment, management activities such as removal, treatment, or isolation of contaminated sediments may be required. Various capping designs are being considered for isolating contaminated sediment are...

Protocol to identify incompatible combinations of concrete materials : tech brief.

DOT National Transportation Integrated Search

2006-07-01

For this project, incompatibility of concrete materials is : defined as interactions between acceptable materials that result in unexpected or unacceptable performance. The most common problems are associated with premature stiffening (rapid sl...

Reception of distorted speech.

DOT National Transportation Integrated Search

1973-12-01

Noise, either in the form of masking or in the form of distortion products, interferes with speech intelligibility. When the signal-to-noise ratio is bad enough, articulation can drop to unacceptably--even dangerously--low levels. However, listeners ...

High sensitivity and specificity of clinical microscopy in rural health facilities in western Kenya under an external quality assurance program.

PubMed

Wafula, Rebeccah; Sang, Edna; Cheruiyot, Olympia; Aboto, Angeline; Menya, Diana; O'Meara, Wendy Prudhomme

2014-09-01

Microscopic diagnosis of malaria is a well-established and inexpensive technique that has the potential to provide accurate diagnosis of malaria infection. However, it requires both training and experience. Although it is considered the gold standard in research settings, the sensitivity and specificity of routine microscopy for clinical care in the primary care setting has been reported to be unacceptably low. We established a monthly external quality assurance program to monitor the performance of clinical microscopy in 17 rural health centers in western Kenya. The average sensitivity over the 12-month period was 96% and the average specificity was 88%. We identified specific contextual factors that contributed to inadequate performance. Maintaining high-quality malaria diagnosis in high-volume, resource-constrained health facilities is possible. © The American Society of Tropical Medicine and Hygiene.

Space augmentation of military high-level waste disposal

NASA Technical Reports Server (NTRS)

English, T.; Lees, L.; Divita, E.

1979-01-01

Space disposal of selected components of military high-level waste (HLW) is considered. This disposal option offers the promise of eliminating the long-lived radionuclides in military HLW from the earth. A space mission which meets the dual requirements of long-term orbital stability and a maximum of one space shuttle launch per week over a period of 20-40 years, is a heliocentric orbit about halfway between the orbits of earth and Venus. Space disposal of high-level radioactive waste is characterized by long-term predictability and short-term uncertainties which must be reduced to acceptably low levels. For example, failure of either the Orbit Transfer Vehicle after leaving low earth orbit, or the storable propellant stage failure at perihelion would leave the nuclear waste package in an unplanned and potentially unstable orbit. Since potential earth reencounter and subsequent burn-up in the earth's atmosphere is unacceptable, a deep space rendezvous, docking, and retrieval capability must be developed.

Transapical Implantation of a 2nd-Generation JenaValve Device in Patient with Extremely High Surgical Risk

PubMed Central

Mieres, Juan; Menéndez, Marcelo; Fernández-Pereira, Carlos; Rubio, Miguel; Rodríguez, Alfredo E.

2015-01-01

Transcatheter Aortic Valve Replacement (TAVR) is performed in patients who are poor surgical candidates. Many patients have inadequate femoral access, and alternative access sites have been used such as the transapical approach discussed in this paper. We present an elderly and fragile patient not suitable for surgery for unacceptable high risk, including poor ventricular function, previous myocardial infarction with percutaneous coronary intervention, pericardial effusion, and previous cardiac surgery with replacement of mechanical mitral valve. Transapical aortic valve replacement with a second-generation self-expanding JenaValve is performed. The JenaValve is a second-generation transapical TAVR valve consisting of a porcine root valve mounted on a low-profile nitinol stent. The valve is fully retrievable and repositionable. We discuss transapical access, implantation technique, and feasibility of valve implantation in this extremely high surgical risk patient. PMID:26346128

Transapical Implantation of a 2nd-Generation JenaValve Device in Patient with Extremely High Surgical Risk.

PubMed

Mieres, Juan; Menéndez, Marcelo; Fernández-Pereira, Carlos; Rubio, Miguel; Rodríguez, Alfredo E

2015-01-01

Transcatheter Aortic Valve Replacement (TAVR) is performed in patients who are poor surgical candidates. Many patients have inadequate femoral access, and alternative access sites have been used such as the transapical approach discussed in this paper. We present an elderly and fragile patient not suitable for surgery for unacceptable high risk, including poor ventricular function, previous myocardial infarction with percutaneous coronary intervention, pericardial effusion, and previous cardiac surgery with replacement of mechanical mitral valve. Transapical aortic valve replacement with a second-generation self-expanding JenaValve is performed. The JenaValve is a second-generation transapical TAVR valve consisting of a porcine root valve mounted on a low-profile nitinol stent. The valve is fully retrievable and repositionable. We discuss transapical access, implantation technique, and feasibility of valve implantation in this extremely high surgical risk patient.

Specific decrease in solution viscosity of antibodies by arginine for therapeutic formulations.

PubMed

Inoue, Naoto; Takai, Eisuke; Arakawa, Tsutomu; Shiraki, Kentaro

2014-06-02

Unacceptably high viscosity is observed in high protein concentration formulations due to extremely large therapeutic dose of antibodies and volume restriction of subcutaneous route of administration. Here, we show that a protein aggregation suppressor, arginine hydrochloride (ArgHCl), specifically decreases viscosity of antibody formulations. The viscosities of bovine gamma globulin (BGG) solution at 250 mg/mL and human gamma globulin (HGG) solution at 292 mg/mL at a physiological pH were too high for subcutaneous injections, but decreased to an acceptable level (below 50 cP) in the presence of 1,000 mM ArgHCl. ArgHCl also decreased the viscosity of BGG solution at acidic and alkaline pHs. Interestingly, ArgHCl decreased the viscosity of antibody solutions (BGG, HGG, and human immunoglobulin G) but not globular protein solutions (α-amylase and α-chymotrypsin). These results indicate not only high potency of ArgHCl as an excipient to decrease the solution viscosity of high concentration antibodies formulations but also specific interactions between ArgHCl and antibodies.

Potential approaches to the spectroscopic characterization of high performance polymers exposed to energetic protons and heavy ions

NASA Technical Reports Server (NTRS)

Suleman, Naushadalli K.

1991-01-01

A potential limitation to human activity on the lunar surface or in deep space is the exposure of the crew to unacceptably high levels of penetrating space radiations. The radiations of most concerns for such missions are high-energy protons emitted during solar flares, and galactic cosmic rays which are high-energy ions ranging from protons to iron. The development of materials for effective shielding from energetic space radiations will clearly require a greater understanding of the underlying mechanisms of radiation-induced damage in bulk materials. This can be accomplished in part by the detailed spectroscopic characterization of bulk materials that were exposed to simulated space radiations. An experimental data base thus created can then be used in conjunction with existing radiation transport codes in the design and fabrication of effective radiation shielding materials. Electron Paramagnetic Resonance Spectroscopy was proven very useful in elucidating radiation effects in polymers (high performance polymers are often an important components of structural composites).

Overview of SNAP

EPA Pesticide Factsheets

Section 612(c) of the Clean Air Act (CAA) requires the Agency to publish a list of acceptable and unacceptable substitutes for ozone-depleting substances (ODS). The SNAP program does not require that substitutes be risk- free to be found acceptable.

DESIGN CONSIDERATION INVOLVING ACTIVE SEDIMENT CAPS (PRESENTATION)

EPA Science Inventory

When contaminated sediments pose unacceptable risks to human health and the environment, management activities such as removal, treatment, or isolation of contaminated sediments may be required. Various capping designs are being considered for isolating contaminated sediment are...

19 CFR 134.45 - Approved markings of country name.

Code of Federal Regulations, 2011 CFR

2011-04-01

... “Brasil” for “Brazil” and “Italie” for “Italy,” are acceptable. (c) Adjectival form. The adjectival form... “Brazil nuts” are unacceptable. (d) Colonies, possessions, or protectorates. The name of a colony...

19 CFR 134.45 - Approved markings of country name.

Code of Federal Regulations, 2014 CFR

2014-04-01

... “Brasil” for “Brazil” and “Italie” for “Italy,” are acceptable. (c) Adjectival form. The adjectival form... “Brazil nuts” are unacceptable. (d) Colonies, possessions, or protectorates. The name of a colony...

19 CFR 134.45 - Approved markings of country name.

Code of Federal Regulations, 2013 CFR

2013-04-01

... “Brasil” for “Brazil” and “Italie” for “Italy,” are acceptable. (c) Adjectival form. The adjectival form... “Brazil nuts” are unacceptable. (d) Colonies, possessions, or protectorates. The name of a colony...

19 CFR 134.45 - Approved markings of country name.

Code of Federal Regulations, 2012 CFR

2012-04-01

... “Brasil” for “Brazil” and “Italie” for “Italy,” are acceptable. (c) Adjectival form. The adjectival form... “Brazil nuts” are unacceptable. (d) Colonies, possessions, or protectorates. The name of a colony...

43 CFR 3101.1-4 - Modification or waiver of lease terms and stipulations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... determines that the factors leading to its inclusion in the lease have changed sufficiently to make the... unacceptable impacts. If the authorized officer has determined, prior to lease issuance, that a stipulation...

43 CFR 3101.1-4 - Modification or waiver of lease terms and stipulations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... determines that the factors leading to its inclusion in the lease have changed sufficiently to make the... unacceptable impacts. If the authorized officer has determined, prior to lease issuance, that a stipulation...

10 CFR 862.5 - Procedures for removal of downed aircraft.

Code of Federal Regulations, 2014 CFR

2014-01-01

... this section, may be assumed to be indicative of hostile intent by security forces at such sites. (b)(1... excessive resource loss of property damage or an unacceptable disruption of federal activities; (iii) The...

10 CFR 862.5 - Procedures for removal of downed aircraft.

Code of Federal Regulations, 2011 CFR

2011-01-01

... this section, may be assumed to be indicative of hostile intent by security forces at such sites. (b)(1... excessive resource loss of property damage or an unacceptable disruption of federal activities; (iii) The...

10 CFR 862.5 - Procedures for removal of downed aircraft.

Code of Federal Regulations, 2010 CFR

2010-01-01

... this section, may be assumed to be indicative of hostile intent by security forces at such sites. (b)(1... excessive resource loss of property damage or an unacceptable disruption of federal activities; (iii) The...

10 CFR 862.5 - Procedures for removal of downed aircraft.

Code of Federal Regulations, 2012 CFR

2012-01-01

... this section, may be assumed to be indicative of hostile intent by security forces at such sites. (b)(1... excessive resource loss of property damage or an unacceptable disruption of federal activities; (iii) The...

10 CFR 862.5 - Procedures for removal of downed aircraft.

Code of Federal Regulations, 2013 CFR

2013-01-01

... this section, may be assumed to be indicative of hostile intent by security forces at such sites. (b)(1... excessive resource loss of property damage or an unacceptable disruption of federal activities; (iii) The...

The use of micro-surfacing for pavement preservation : final report.

DOT National Transportation Integrated Search

2009-04-01

The Maine Department of Transportation (MaineDOT) is responsible for maintaining approximately 8300 : miles of public highways. Maintenance of these highways consists of rehabilitation or reconstruction : when the road has deteriorated to an unaccept...

Performance evaluation of subgrade stabilization with recycled materials.

DOT National Transportation Integrated Search

2016-02-29

Due to rising costs of good quality acceptable materials for remove/replace options and traditional : subgrade stabilization materials, MDOT is in need to identify potential recycled materials to treat : unacceptable subgrade soils. Use of recycled m...

Classroom Misbehavior in the Eyes of Students: A Qualitative Study

PubMed Central

Sun, Rachel C. F.; Shek, Daniel T. L.

2012-01-01

Using individual interviews, this study investigated perceptions of classroom misbehaviors among secondary school students in Hong Kong (N = 18). Nineteen categories of classroom misbehaviors were identified, with talking out of turn, disrespecting teacher, and doing something in private being most frequently mentioned. Findings revealed that students tended to perceive misbehaviors as those actions inappropriate in the classroom settings and even disrupting teachers' teaching and other students' learning. Among various misbehaviors, talking out of turn and disrespecting teacher were seen as the most disruptive and unacceptable. These misbehaviors were unacceptable because they disturbed teaching and learning, and violated the values of respect, conformity, and obedience in the teacher-student relationship within the classroom. The frequency and intensity of misbehaviors would escalate if students found it fun, no punishment for such misbehaviors, or teachers were not authoritative enough in controlling the situations. Implications for further research and classroom management are discussed. PMID:22919316

For the greater goods? Ownership rights and utilitarian moral judgment.

PubMed

Millar, J Charles; Turri, John; Friedman, Ori

2014-10-01

People often judge it unacceptable to directly harm a person, even when this is necessary to produce an overall positive outcome, such as saving five other lives. We demonstrate that similar judgments arise when people consider damage to owned objects. In two experiments, participants considered dilemmas where saving five inanimate objects required destroying one. Participants judged this unacceptable when it required violating another's ownership rights, but not otherwise. They also judged that sacrificing another's object was less acceptable as a means than as a side-effect; judgments did not depend on whether property damage involved personal force. These findings inform theories of moral decision-making. They show that utilitarian judgment can be decreased without physical harm to persons, and without personal force. The findings also show that the distinction between means and side-effects influences the acceptability of damaging objects, and that ownership impacts utilitarian moral judgment. Copyright © 2014 Elsevier B.V. All rights reserved.

An audit of the quality of operation notes in an otolaryngology unit.

PubMed

Bateman, N D; Carney, A S; Gibbin, K P

1999-04-01

Hand-written operation notes are often produced as evidence in medico-legal cases. Incomplete and illegible notes, along with the use of confusing abbreviations, are a common source of weakness in a surgeon's defence. An audit of 100 sets of operation notes was carried out in a single otolaryngology department. Notes were scrutinised for the accuracy of data, ward, department and name of surgeon, as well as for the inclusion of unacceptable abbreviations. Using an aide-memoire attached to the front of the operation sheet, the audit was repeated with identical criteria. The aide-memoire improved the standard of operation note with respect to all measured criteria. Clear identification of operating surgeon improved from 74% to 93%, and the avoidance of unacceptable abbreviations rose from 53% to 84%. We conclude that a simple aide-memoire attached to operation note sheets can significantly improve the quality of note-keeping and potentially avoid medico-legal problems.

Image registration assessment in radiotherapy image guidance based on control chart monitoring.

PubMed

Xia, Wenyao; Breen, Stephen L

2018-04-01

Image guidance with cone beam computed tomography in radiotherapy can guarantee the precision and accuracy of patient positioning prior to treatment delivery. During the image guidance process, operators need to take great effort to evaluate the image guidance quality before correcting a patient's position. This work proposes an image registration assessment method based on control chart monitoring to reduce the effort taken by the operator. According to the control chart plotted by daily registration scores of each patient, the proposed method can quickly detect both alignment errors and image quality inconsistency. Therefore, the proposed method can provide a clear guideline for the operators to identify unacceptable image quality and unacceptable image registration with minimal effort. Experimental results demonstrate that by using control charts from a clinical database of 10 patients undergoing prostate radiotherapy, the proposed method can quickly identify out-of-control signals and find special cause of out-of-control registration events.

New algorithms for optimal reduction of technical risks

NASA Astrophysics Data System (ADS)

Todinov, M. T.

2013-06-01

The article features exact algorithms for reduction of technical risk by (1) optimal allocation of resources in the case where the total potential loss from several sources of risk is a sum of the potential losses from the individual sources; (2) optimal allocation of resources to achieve a maximum reduction of system failure; and (3) making an optimal choice among competing risky prospects. The article demonstrates that the number of activities in a risky prospect is a key consideration in selecting the risky prospect. As a result, the maximum expected profit criterion, widely used for making risk decisions, is fundamentally flawed, because it does not consider the impact of the number of risk-reward activities in the risky prospects. A popular view, that if a single risk-reward bet with positive expected profit is unacceptable then a sequence of such identical risk-reward bets is also unacceptable, has been analysed and proved incorrect.

Risk factors for displaced abomasum or ketosis in Swedish dairy herds.

PubMed

Stengärde, L; Hultgren, J; Tråvén, M; Holtenius, K; Emanuelson, U

2012-03-01

Risk factors associated with high or low long-term incidence of displaced abomasum (DA) or clinical ketosis were studied in 60 Swedish dairy herds, using multivariable logistic regression modelling. Forty high-incidence herds were included as cases and 20 low-incidence herds as controls. Incidence rates were calculated based on veterinary records of clinical diagnoses. During the 3-year period preceding the herd classification, herds with a high incidence had a disease incidence of DA or clinical ketosis above the 3rd quartile in a national database for disease recordings. Control herds had no cows with DA or clinical ketosis. All herds were visited during the housing period and herdsmen were interviewed about management routines, housing, feeding, milk yield, and herd health. Target groups were heifers in late gestation, dry cows, and cows in early lactation. Univariable logistic regression was used to screen for factors associated with being a high-incidence herd. A multivariable logistic regression model was built using stepwise regression. A higher maximum daily milk yield in multiparous cows and a large herd size (p=0.054 and p=0.066, respectively) tended to be associated with being a high-incidence herd. Not cleaning the heifer feeding platform daily increased the odds of having a high-incidence herd twelvefold (p<0.01). Keeping cows in only one group in the dry period increased the odds of having a high incidence herd eightfold (p=0.03). Herd size was confounded with housing system. Housing system was therefore added to the final logistic regression model. In conclusion, a large herd size, a high maximum daily milk yield, keeping dry cows in one group, and not cleaning the feeding platform daily appear to be important risk factors for a high incidence of DA or clinical ketosis in Swedish dairy herds. These results confirm the importance of housing, management and feeding in the prevention of metabolic disorders in dairy cows around parturition and in early lactation. Copyright © 2011 Elsevier B.V. All rights reserved.

Association of nitrogen compounds in drinking water with incidence of esophageal squamous cell carcinoma in Shexian, China.

PubMed

Zhang, Nan; Yu, Cao; Wen, Denggui; Chen, Jun; Ling, Yiwei; Terajima, Kenshi; Akazawa, Kohei; Shan, Baoen; Wang, Shijie

2012-01-01

The incidence of esophageal squamous cell carcinoma (ESCC), which is the eighth most common malignancy worldwide, is highest in China. The purpose of this study was to investigate the association between nitrogen compounds in drinking water with the incidence of ESCC by geographical spatial analysis. The incidence of ESCC is high in Shexian county, China, and environmental factors, particularly nitrogen-contaminated drinking water, are the main suspected risk factors. This study focuses on three nitrogen compounds in drinking water, namely, nitrates, nitrites, and ammonia, all of which are derived mainly from domestic garbage and agricultural fertilizer. The study surveyed 48 villages in the Shexian area with a total population of 54,716 (661 adults with ESCC and 54,055 non-cancer subjects). Hot-spot analysis was used to identify spatial clusters with a high incidence of ESCC and a high concentration of nitrogen compounds. Logistic regression analysis was used to detect risk factors for ESCC incidence. Most areas with high concentrations of nitrate nitrogen in drinking water had a high incidence of ESCC. Correlation analysis revealed a significant positive relationship between nitrate concentration and ESCC (P = 0.01). Logistic regression analysis also confirmed that nitrate nitrogen has a significantly higher odds ratio. The results indicate that nitrate nitrogen is associated with ESCC incidence in Shexian county. In conclusion, high concentrations of nitrate nitrogen in drinking water may be a significant risk factor for the incidence of ESCC.

Association of Fitness With Incident Dyslipidemias Over 25 Years in the Coronary Artery Risk Development in Young Adults Study.

PubMed

Sarzynski, Mark A; Schuna, John M; Carnethon, Mercedes R; Jacobs, David R; Lewis, Cora E; Quesenberry, Charles P; Sidney, Stephen; Schreiner, Pamela J; Sternfeld, Barbara

2015-11-01

Few studies have examined the longitudinal associations of fitness or changes in fitness on the risk of developing dyslipidemias. This study examined the associations of (1) baseline fitness with 25-year dyslipidemia incidence and (2) 20-year fitness change on dyslipidemia development in middle age in the Coronary Artery Risk Development in Young Adults Study (CARDIA). Multivariable Cox proportional hazards regression models were used to test the association of baseline fitness (1985-1986) with dyslipidemia incidence over 25 years (2010-2011) in CARDIA (N=4,898). Modified Poisson regression models were used to examine the association of 20-year change in fitness with dyslipidemia incidence between Years 20 and 25 (n=2,487). Data were analyzed in June 2014 and February 2015. In adjusted models, the risk of incident low high-density lipoprotein cholesterol (HDL-C); high triglycerides; and high low-density lipoprotein cholesterol (LDL-C) was significantly lower, by 9%, 16%, and 14%, respectively, for each 2.0-minute increase in baseline treadmill endurance. After additional adjustment for baseline trait level, the associations remained significant for incident high triglycerides and high LDL-C in the total population and for incident high triglycerides in both men and women. In race-stratified models, these associations appeared to be limited to whites. In adjusted models, change in fitness did not predict 5-year incidence of dyslipidemias, whereas baseline fitness significantly predicted 5-year incidence of high triglycerides. Our findings demonstrate the importance of cardiorespiratory fitness in young adulthood as a risk factor for developing dyslipidemias, particularly high triglycerides, during the transition to middle age. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Association of Fitness With Incident Dyslipidemias Over 25 Years in the Coronary Artery Risk Development in Young Adults Study

PubMed Central

Sarzynski, Mark A.; Schuna, John M.; Carnethon, Mercedes R.; Jacobs, David R.; Lewis, Cora E.; Quesenberry, Charles P.; Sidney, Stephen; Schreiner, Pamela J.; Sternfeld, Barbara

2015-01-01

Introduction Few studies have examined the longitudinal associations of fitness or changes in fitness on the risk of developing dyslipidemias. This study examined the associations of: (1) baseline fitness with 25-year dyslipidemia incidence; and (2) 20-year fitness change on dyslipidemia development in middle age in the Coronary Artery Risk Development in young Adults (CARDIA) study. Methods Multivariable Cox proportional hazards regression models were used to test the association of baseline fitness (1985–1986) with dyslipidemia incidence over 25 years (2010–2011) in CARDIA (N=4,898). Modified Poisson regression models were used to examine the association of 20-year change in fitness with dyslipidemia incidence between Years 20 and 25 (n=2,487). Data were analyzed in June 2014 and February 2015. Results In adjusted models, the risk of incident low high-density lipoprotein cholesterol (HDL-C), high triglycerides, and high low-density lipoprotein cholesterol (LDL-C) was significantly lower, by 9%, 16%, and 14%, respectively, for each 2.0-minute increase in baseline treadmill endurance. After additional adjustment for baseline trait level, the associations remained significant for incident high triglycerides and high LDL-C in the total population and for incident high triglycerides in both men and women. In race-stratified models, these associations appeared to be limited to whites. In adjusted models, change in fitness did not predict 5-year incidence of dyslipidemias, whereas baseline fitness significantly predicted 5-year incidence of high triglycerides. Conclusions Our findings demonstrate the importance of cardiorespiratory fitness in young adulthood as a risk factor for developing dyslipidemias, particularly high triglycerides, during the transition to middle age. PMID:26165197

A Framework to Evaluate Wildlife Feeding in Research, Wildlife Management, Tourism and Recreation

PubMed Central

Dubois, Sara; Fraser, David

2013-01-01

Simple Summary Human feeding of wildlife is a world-wide phenomenon with very diverse effects on conservation, animal welfare and public safety. From a review of the motivations, types and consequences of wildlife feeding, an evaluative framework is presented to assist policy-makers, educators and managers to make ethical- and biologically-based decisions about the appropriateness of feeding wildlife in the context of research, wildlife management, tourism and recreation. Abstract Feeding of wildlife occurs in the context of research, wildlife management, tourism and in opportunistic ways. A review of examples shows that although feeding is often motivated by good intentions, it can lead to problems of public safety and conservation and be detrimental to the welfare of the animals. Examples from British Columbia illustrate the problems (nuisance animal activity, public safety risk) and consequences (culling, translocation) that often arise from uncontrolled feeding. Three features of wildlife feeding can be distinguished: the feasibility of control, the effects on conservation and the effects on animal welfare. An evaluative framework incorporating these three features was applied to examples of feeding from the literature. The cases of feeding for research and management purposes were generally found to be acceptable, while cases of feeding for tourism or opportunistic feeding were generally unacceptable. The framework should allow managers and policy-makers to distinguish acceptable from unacceptable forms of wildlife feeding as a basis for policy, public education and enforcement. Many harmful forms of wildlife feeding seem unlikely to change until they come to be seen as socially unacceptable. PMID:26479747

Frequency and Acceptability of Adverse Events After Anterior Cervical Discectomy and Fusion: A Survey Study From the Cervical Spine Research Society.

PubMed

Wilson, Jefferson R; Radcliff, Kris; Schroeder, Gregory; Booth, Madison; Lucasti, Christopher; Fehlings, Michael; Ahmad, Nassr; Vaccaro, Alexander; Arnold, Paul; Sciubba, Daniel; Ching, Alex; Smith, Justin; Shaffrey, Christopher; Singh, Kern; Darden, Bruce; Daffner, Scott; Cheng, Ivan; Ghogawala, Zoher; Ludwig, Steven; Buchowski, Jacob; Brodke, Darrel; Wang, Jeffrey; Lehman, Ronald A; Hilibrand, Alan; Yoon, Tim; Grauer, Jonathan; Dailey, Andrew; Steinmetz, Michael; Harrop, James S

2018-06-01

Anterior cervical discectomy and fusion has a low but well-established profile of adverse events. The goal of this study was to gauge surgeon opinion regarding the frequency and acceptability of these events. A 2-page survey was distributed to attendees at the 2015 Cervical Spine Research Society (CSRS) meeting. Respondents were asked to categorize 18 anterior cervical discectomy and fusion-related adverse events as either: "common and acceptable," "uncommon and acceptable," "uncommon and sometimes acceptable," or "uncommon and unacceptable." Results were compiled to generate the relative frequency of these responses for each complication. Responses for each complication event were also compared between respondents based on practice location (US vs. non-US), primary specialty (orthopedics vs. neurosurgery) and years in practice. Of 150 surveys distributed, 115 responses were received (76.7% response rate), with the majority of respondents found to be US-based (71.3%) orthopedic surgeons (82.6%). Wrong level surgery, esophageal injury, retained drain, and spinal cord injury were considered by most to be unacceptable and uncommon complications. Dysphagia and adjacent segment disease occurred most often, but were deemed acceptable complications. Although surgeon experience and primary specialty had little impact on responses, practice location was found to significantly influence responses for 12 of 18 complications, with non-US surgeons found to categorize events more toward the uncommon and unacceptable end of the spectrum as compared with US surgeons. These results serve to aid communication and transparency within the field of spine surgery, and will help to inform future quality improvement and best practice initiatives.

Community attitudes toward breastfeeding in public places among Western Australia Adults, 1995-2009.

PubMed

Meng, Xingqiong; Daly, Alison; Pollard, Christina Mary; Binns, Colin William

2013-05-01

Community attitudes toward breastfeeding in public influence how comfortable women feel about continuing breastfeeding. Knowledge of the social context helps target breastfeeding-promoting interventions. To examine trends in Western Australian adult attitudes toward breastfeeding in public places. As part of 5 cross-sectional surveys from the Western Australian Nutrition Monitor Survey Series conducted between 1995 and 2009, 5496 adults aged 18 to 64 years were asked whether it was acceptable for mothers to breastfeed their babies in public places, including shopping centers, workplaces, and restaurants, and on public transport. Descriptive statistics and multinomial regressions were used to describe factors associated with attitudes toward publicly breastfeeding. There was no change in the acceptance of breastfeeding in shopping centers, restaurants, and workplaces and on public transport over time, but in 2009, significantly fewer people said that it was unacceptable to breastfeed in public compared with 1995. Women, people older than 44 years, those born outside Australia, and the less educated were those most likely to say that breastfeeding in public was unacceptable. In the years that the question was asked, more than 97% of respondents said that breastfeeding was acceptable if a separate room was provided. Making breastfeeding acceptable and pleasant for mothers in public spaces is a key policy recommendation. Women, people older than 44 years, and those born outside Australia were most likely to respond that breastfeeding in public was unacceptable unless a room was provided. Given that, on average, 70% of the population said that breastfeeding in public was acceptable, investigation into why some women do not think so is warranted.

Embedding High-Fidelity Simulation Into a Foundations of Nursing Course.

PubMed

Talbot, Megan Sary

2015-01-01

Delay in recognizing the need for and initiating lifesaving measures is unacceptable in health care. It is never too early to teach novice nursing students to recognize and respond to early warning signs of patient deterioration. The rapid response system was developed to expedite recognition of and response to changes in a patient's condition. Use of high-fidelity simulation by beginning nursing students to practice recognizing and responding to patient deterioration is vital to both the welfare of patients and the edification of students. Recognizing and responding quickly to patients' early warning signs of deterioration can determine a patient's outcome. This article discusses the importance of instructing beginning nursing students in identifying and reacting appropriately to early signs of patient deterioration and in following the chain of command to activate the rapid response team.

Understanding adolescent development: implications for driving safety.

PubMed

Keating, Daniel P

2007-01-01

The implementation of Graduated Driver Licensing (GDL) programs has significantly improved the crash and fatality rates of novice teen drivers, but these rates remain unacceptably high. A review of adolescent development research was undertaken to identify potential areas of improvement. Research support for GDL was found to be strong, particularly regarding early acquisition of expertise in driving safety (beyond driving skill), and to limitations that reduce opportunities for distraction. GDL regimes are highly variable, and no US jurisdictions have implemented optimal regimes. Expanding and improving GDL to enhance acquisition of expertise and self-regulation are indicated for implementation and for applied research. Driver training that effectively incorporates safety goals along with driving skill is another target. The insurance industry will benefit from further GDL enhancements. Benefits may accrue to improved driver training, improved simulation devices during training, and automated safety feedback instrumentation.

Resolving the mesospheric nighttime 4.3 µm emission puzzle: Laboratory demonstration of new mechanism for OH(υ) relaxation

NASA Astrophysics Data System (ADS)

Kalogerakis, Konstantinos S.; Matsiev, Daniel; Sharma, Ramesh D.; Wintersteiner, Peter P.

2016-09-01

We report laboratory results that support a recently proposed mechanism for relaxation of highly vibrationally excited hydroxyl radical by ground-state oxygen atoms (Sharma et al., GRL 42, 4639-4647 (2015)). According to this mechanism, which eventually leads to an enhancement of nocturnal 4.3 µm CO2 emissions in the mesosphere, the deactivation of OH(high υ) by O(3P) involves a fast, spin-allowed, multiquantum vibration-to-electronic (V-E) energy transfer process generating O(1D). We present laser-based experiments that demonstrate these energy transfer processes in action and discuss some implications of the new mechanism for mesospheric OH. These developments represent a breakthrough addressing the long-standing problem of unacceptably large discrepancies between models and observations of the nocturnal mesospheric 4.3 µm emission.

Gamma-ray Transition Matrix Elements in ^21Na: First TIGRESS Radioactive Beam Experiment

NASA Astrophysics Data System (ADS)

Hackman, Greg

2007-04-01

Modern shell model calculations should be expected to reliably reproduce the properties of the deformed five-particle nucleus ^21Na. However the lowest-lying B(E2) value deduced from lifetime and mixing ratio measurements disagrees with models by an unacceptably large factor of two. To measure the B(E2) values directly, a beam of ^21Na at 1.7 MeV/u from the TRIUMF ISAC facility was directed upon a 0.5 mg/cm^2 ^natTi target. Gamma-ray yield in coincidence with inelastically scattered heavy ions was measured with two TIGRESS high energy- and position-resolution germanium detector units and the BAMBINO highly segmented silicon detector system. The result resolves the discrepancy between the shell model and prior measurements. This represents the first radioactive in-beam experiment with TIGRESS.

Composites in energy generation and storage systems - An overview

NASA Astrophysics Data System (ADS)

Fulmer, R. W.

Applications of glass-fiber reinforced composites (GER) in renewable and high-efficiency energy systems which are being developed to replace interim, long-term unacceptable energy sources such as foreign oil are reviewed. GFR are noted to have design flexibility, high strength, and low cost, as well as featuring a choice of fiber orientation and type of reinforcement. Blades, hub covers, nacelles, and towers for large and small WECS are being fabricated and tested and are displaying satisfactory strength, resistance to corrosion and catastrophic failure, impact tolerance, and light weight. Promising results have also been shown in the use of GFR as flywheel material for kinetic energy storage in conjunction with solar and wind electric systems, in electric cars, and as load levellers. Other applications are for heliostats, geothermal power plant pipes, dam-atoll tidal wave energy systems, and intake pipes for OTECs.

Brain cancer associated with environmental lead exposure: evidence from implementation of a National Petrol-Lead Phase-Out Program (PLPOP) in Taiwan between 1979 and 2007.

PubMed

Wu, Wei-Te; Lin, Yu-Jen; Liou, Saou-Hsing; Yang, Chun-Yuh; Cheng, Kuang-Fu; Tsai, Perng-Jy; Wu, Trong-Neng

2012-04-01

In 1981, a Petrol-Lead Phase-Out Program (PLPOP) was launched in Taiwan for the abatement of environmental lead emissions. The present study was intended to examine whether the high Petrol-Lead Emission Areas (PLEA) would result in an increase in the incidence rate of brain cancer based on a national data bank. The national brain cancer incidence data was obtained from the Taiwan National Cancer Registry. Age standardized incidence rates were calculated based on the 2000 WHO world standard population, and gasoline consumption data was obtained from the Bureau of Energy. The differences in the trend tests for age-standardized incidence rates of brain cancer between high, median, low, and small PLEA were analyzed. A significant increase was found from small to high PLEA in age-standardized incidence rates of brain cancer. By taking six possible confounders into account, the age-standardized incidence rates for brain cancer were highly correlated with the median and high PLEA by reference to the small PLEA. After being adjusted for a number of relevant confounders, it could be concluded that high PLEA might result in an increase in the incidence rate of brain cancer resulting from high lead exposures. Copyright © 2011 Elsevier Ltd. All rights reserved.

24 CFR 51.102 - Responsibilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... areas and advise local officials, developers, and planning groups of the unacceptability of sites... the suitability of the acoustical environment of proposed projects; (2) Notify applicants of any... acceptability standards in commenting on the prospective impacts of transportation facilities and other noise...

24 CFR 51.102 - Responsibilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... areas and advise local officials, developers, and planning groups of the unacceptability of sites... the suitability of the acoustical environment of proposed projects; (2) Notify applicants of any... acceptability standards in commenting on the prospective impacts of transportation facilities and other noise...

Time out

MedlinePlus

... but no more than 5 minutes. Once your child shows bad behavior, explain clearly what the unacceptable behavior is, and ... a grudge -- let the issue go. Since your child has done the time out, there is no need to continue to discuss the bad behavior.

Analysis of en route operational errors : probability of resolution and time-on-position.

DOT National Transportation Integrated Search

2012-02-01

The Federation Administrations Air Traffic Control Organization Safety Management System (SMS) is : designed to prevent the introduction of unacceptable safety risk into the National Airspace System. One of the : most important safety metrics used...

JPRS Report, West Europe.

DTIC Science & Technology

1987-08-12

Isleifur Gunnarsson, Thorsteinn Palsson, Fridrik Sophusson, Fridjon Thordarson , Ellert Schräm and Thorvaldur Gardar Kristjansson. They received from three...Fridjon Thordarson and Eggert Haukdal, agreed with that view that the share of the regions was unacceptable. Matthias Bjarnason only said that he

Structural and Social Contexts of HIV Risk Among African Americans

PubMed Central

Cooper, Hannah L. F.; Osborne, Andrew H.

2009-01-01

HIV continues to be transmitted at unacceptably high rates among African Americans, and most HIV-prevention interventions have focused on behavioral change. To theorize additional approaches to HIV prevention among African Americans, we discuss how sexual networks and drug-injection networks are as important as behavior for HIV transmission. We also describe how higher-order social structures and processes, such as residential racial segregation and racialized policing, may help shape risk networks and behaviors. We then discuss 3 themes in African American culture—survival, propriety, and struggle—that also help shape networks and behaviors. Finally, we conclude with a discussion of how these perspectives might help reduce HIV transmission among African Americans. PMID:19372519

NASA redox storage system development project, calendar year 1982

NASA Technical Reports Server (NTRS)

1983-01-01

Development was continued for iron-chromium battery operation at 65 C. Membranes that were adequate at 25 C were shown to be unacceptable at 65 C with regard to selectivity. This led to the elevated-temperature, mixed-reactant mode of operation, in which each reactant solution, when discharged, contains both ferrous and chromic chlorides. This operating mode allows the use of very low-resistivity membranes, resulting in high energy efficiencies at current densities. It also allows the use of very simple techniques to correct for solvent or reactant transfer through cell membranes. Screening of candidate catalysts for the chromium electrode led to the development of a bismuth-lead candidate having several attractive characteristics.

Low-energy impact resistance of graphite-epoxy plates and ALS honeycomb sandwich panels

NASA Technical Reports Server (NTRS)

Hui, David

1989-01-01

Low energy impact may be potentially dangerous for many highly optimized stiff structures. Impact by foreign objects such as birds, ice, and runways stones or dropping of tools occur frequently and the resulting damage and stress concentrations may be unacceptable from a designer's standpoint. The barely visible, yet potentially dangerous dents due to impact of foreign objects on the Advanced Launch System (ALS) structure are studied. Of particular interest is the computation of the maximum peak impact force for a given impactor mass and initial velocity. The theoretical impact forces will be compared with the experimental dropweight results for the ALS face sheets alone as well as the ALS honeycomb sandwich panels.

Space processing of chalcogenide glasses

NASA Technical Reports Server (NTRS)

Larsen, D. C.; Ali, M. A.

1975-01-01

Chalcogenide glasses are discussed as good infrared transmitters, possessing the strength, corrosion resistance, and scale-up potential necessary for large 10.6-micron windows. The disadvantage of earth-produced chalcogenide glasses is shown to be an infrared absorption coefficient which is unacceptably high relative to alkali halides. This coefficient is traced to optical nonhomogeneities resulting from environmental and container contamination. Space processing is considered as a means of improving the infrared transmission quality of chalcogenides and of eliminating the following problems: optical inhomogeneities caused by thermal currents and density fluctuation in the l-g earth environment; contamination from the earth-melting crucible by oxygen and other elements deleterious to infrared transmission; and, heterogeneous nucleation at the earth-melting crucible-glass interface.

Pelvic radiation therapy for gynecologic malignancy in geriatric patients

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

Grant, P.T.; Jeffrey, J.F.; Fraser, R.C.

Thirty-one patients, aged 75 years or older, who received pelvic radiation therapy as part of primary treatment for a gynecologic malignancy, were reviewed. Ten patients (32%) failed to complete their treatment and 4 patients (13%) died of treatment-related complications. The treatment-related complications were independent of increasing age, but did correlate closely with the patients' pretreatment ECOG performance status. Ten patients with performance levels of 2 or higher had a mortality rate of 30%, while 70% failed to complete treatment. Treatment fractions of greater than 220 cGy per day also resulted in unacceptably high complication rates. Alternative treatment formats should bemore » considered in geriatric patients with poor initial performance levels.« less

Cross-infection risks associated with current procedures for using high-speed dental handpieces.

PubMed Central

Lewis, D L; Boe, R K

1992-01-01

When a dye solution used to simulate patient material was either injected into high-speed dental handpiece (drill) waterlines or applied to the equipment externally, internal air turbine chambers became contaminated. These chambers served as a reservoir of the material, which was slowly dislodged by air expelled during subsequent handpiece operation and which was diluted by water spray used for cooling the drilling surface. Considering the fact that patient materials could reside in internal parts of the equipment that are not usually disinfected and that the material may be subsequently sprayed into cuts and abrasions in the oral cavity, the common approach to reprocessing handpieces (external wiping in combination with flushing) may pose unacceptably high risks to those individuals treated soon after infected patients. Therefore, unless reliable data on cross-infection frequencies are obtained and prove it unnecessary, heat-treating high-speed handpieces between each patient should be considered an essential component of standard procedures whenever universal precautions are practiced in dentistry. PMID:1537909

Crippling Violence: Conflict and Incident Polio in Afghanistan.

PubMed

Norris, Alison; Hachey, Kevin; Curtis, Andrew; Bourdeaux, Margaret

2016-01-01

Designing effective public health campaigns in areas of armed conflict requires a nuanced understanding of how violence impacts the epidemiology of the disease in question. We examine the geographical relationship between violence (represented by the location of detonated Improvised Explosive Devices) and polio incidence by generating maps of IEDs and polio incidence during 2010, and by comparing the mean number of IED detonations in polio high-risk districts with non polio high-risk districts during 2004-2009. We demonstrate a geographic relationship between IED violence and incident polio. Districts that have high-risk for polio have highly statistically significantly greater mean numbers of IEDs than non polio high-risk districts (p-values 0.0010-0.0404). The geographic relationship between armed conflict and polio incidence provides valuable insights as to how to plan a vaccination campaign in violent contexts, and allows us to anticipate incident polio in the regions of armed conflict. Such information permits vaccination planners to engage interested armed combatants to co-develop strategies to mitigate the effects of violence on polio.

Understanding the Relationship between Transition Services and Postschool Outcomes for Students with High Incidence Disabilities

ERIC Educational Resources Information Center

Joshi, Gauri Salil

2012-01-01

Given the consistently poor postschool outcomes of individuals with high incidence disabilities, there is a need to examine the transition services provided to them while in school. This secondary data analysis explored the transition services received by individuals with high incidence disabilities through the National Longitudinal Transition…

Brief Report: A Growth Mixture Model of Occupational Aspirations of Individuals with High-Incidence Disabilities

ERIC Educational Resources Information Center

Lee, In Heok; Rojewski, Jay W.

2013-01-01

A previous longitudinal study of the occupational aspirations of individuals with high-incidence disabilities revealed multiple longitudinal patterns for individuals with learning disabilities or emotional-behavioral disorders. Growth mixture modeling was used to determine whether individuals in these two high-incidence disabilities groups (N =…

Design of New-Generation Open-Graded Friction Courses (Revised)

DOT National Transportation Integrated Search

1999-12-01

Open-graded friction course (OGFC) has been used by several state departments of transportation (DOT) since 1950. While many DOTs report good performance, many other states stopped using OGFC due to unacceptable performance and/or lack of adequate du...

Improving Public Health through Innovations in Exposure Science

EPA Science Inventory

In the traditional risk assessment paradigm, exposure science is relegated to a supporting role, providing an exposure estimate for comparison with hazard-based guidance values to determine whether there may be an unacceptable risk to public health. More recently, exposure scien...

Framing bioremediation decision making as negotiation: Rationale & guidelineFraming bioremediation decision making as negotiation: Rationale & guidelines

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

Bjornstad, David J.; Wolfe, Amy K.

Framing remediation decision making as negotiation: (1) social choice, not technology choice; (2) prompts decision makers to identify interested and affected parties, anticipate objections, effectively address and ameliorate objections, and avoid unacceptable decisions.

77 FR 38211 - Rescission of Quarterly Financial Reporting Requirements

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-27

... No. FMCSA-2012-0020] RIN-2126-AB48 Rescission of Quarterly Financial Reporting Requirements AGENCY..., the Federal Motor Carrier Safety Administration (FMCSA) eliminates the quarterly financial reporting... would be ineffective or unacceptable without a change. III. Background Annual Financial Reporting...

Performing the lockout/tagout risk assessment.

PubMed

Wallace, W Jon

2007-03-01

Lockout/tagout provides the greatest level routine, repetitive, and integral to the production process, a risk assessment should be performed. If the task performed poses an unacceptable risk, acceptable risk reduction methods should be implemented to reduce the risk to acceptable levels.

Clean Water Act Section 404(c) Factsheet

EPA Pesticide Factsheets

404(c) authorizes EPA to restrict, prohibit, deny, or withdraw the use of an area as a disposal site for dredged or fill material if the discharge will have unacceptable adverse effects on municipal water supplies, shellfish beds, fishery areas, etc.

Gender differences in a refractive surgery population of civilian aviators : final report.

DOT National Transportation Integrated Search

2000-07-01

INTRODUCTION. Refractive surgical procedures performed in the United States have increased in recent years and : continued growth is projected. Postoperative side effects can affect the quality of vision and may be unacceptable in a : cockpit environ...

Gender differences in a refractive surgery population of civilian aviators : final report.

DOT National Transportation Integrated Search

2000-07-01

INTRODUCTION. Refractive surgical procedures performed in the United States have increased in recent years and continued growth is projected. Postoperative side effects can affect the quality of vision and may be unacceptable in a cockpit environment...

EVALUATION OF ANTIMICROBIAL EFFICACY FOR CONTROL OF STACHYBOTRYS CHARTARUM

EPA Science Inventory

Biological contaminants in buildings are known to act as sources of indoor air pollution, discomfort, asthma and pulmonary disease to building occupants, Sick buildings are evidence of extremely problematic indoor air quality (lAO) often resulting from unacceptable concentration...

GEOCHEMICAL AND INTERFACIAL APPLICATIONS FOR ASSESSING ECOLOGICAL TOXICANT EXPOSURES

EPA Science Inventory

Numerous publications in the past several years have demonstrated that a significant fraction of our nation's waterbodies and associated underlying sediments contain sufficient quantities of contaminants such that they pose unacceptable risks to both wildlife and human health. I...

40 CFR 141.21 - Coliform sampling.

Code of Federal Regulations, 2014 CFR

2014-07-01

... water) with the intent that if the method they choose has an unacceptable false-positive or negative...), supplemented with 100 µg/mL of MUG. If the 18th edition is used, incubate the agar plate at 35 °C for 4 hours...

40 CFR 141.21 - Coliform sampling.

Code of Federal Regulations, 2012 CFR

2012-07-01

... water) with the intent that if the method they choose has an unacceptable false-positive or negative...), supplemented with 100 µg/mL of MUG. If the 18th edition is used, incubate the agar plate at 35 °C for 4 hours...

40 CFR 141.21 - Coliform sampling.

Code of Federal Regulations, 2013 CFR

2013-07-01

... water) with the intent that if the method they choose has an unacceptable false-positive or negative...), supplemented with 100 µg/mL of MUG. If the 18th edition is used, incubate the agar plate at 35 °C for 4 hours...

Cluster-sample surveys and lot quality assurance sampling to evaluate yellow fever immunisation coverage following a national campaign, Bolivia, 2007.

PubMed

Pezzoli, Lorenzo; Pineda, Silvia; Halkyer, Percy; Crespo, Gladys; Andrews, Nick; Ronveaux, Olivier

2009-03-01

To estimate the yellow fever (YF) vaccine coverage for the endemic and non-endemic areas of Bolivia and to determine whether selected districts had acceptable levels of coverage (>70%). We conducted two surveys of 600 individuals (25 x 12 clusters) to estimate coverage in the endemic and non-endemic areas. We assessed 11 districts using lot quality assurance sampling (LQAS). The lot (district) sample was 35 individuals with six as decision value (alpha error 6% if true coverage 70%; beta error 6% if true coverage 90%). To increase feasibility, we divided the lots into five clusters of seven individuals; to investigate the effect of clustering, we calculated alpha and beta by conducting simulations where each cluster's true coverage was sampled from a normal distribution with a mean of 70% or 90% and standard deviations of 5% or 10%. Estimated coverage was 84.3% (95% CI: 78.9-89.7) in endemic areas, 86.8% (82.5-91.0) in non-endemic and 86.0% (82.8-89.1) nationally. LQAS showed that four lots had unacceptable coverage levels. In six lots, results were inconsistent with the estimated administrative coverage. The simulations suggested that the effect of clustering the lots is unlikely to have significantly increased the risk of making incorrect accept/reject decisions. Estimated YF coverage was high. Discrepancies between administrative coverage and LQAS results may be due to incorrect population data. Even allowing for clustering in LQAS, the statistical errors would remain low. Catch-up campaigns are recommended in districts with unacceptable coverage.

[Health risks from pest control products].

PubMed

Pieper, C; Holthenrich, D; Schneider, H

2014-05-01

According to European biocide legislation, pest control products require assessment and authorization by the responsible national or European authorities. Biocidal products can only be authorized if they have no unacceptable effects on human health. The health risk assessment performed for authorization comprises (a) the derivation of reference values for the active substances and substances of concern contained in the biocidal product and (b) an exposure assessment. These parameters are required for risk characterization. No unacceptable health risks are expected if the determined exposure is less than the relevant reference value. In addition, the toxicological information is used for classification of the biocidal product. The assessment may, where necessary, result in specific conditions for use or other restrictions aimed at minimizing risk. The risk to human health from pest control products is mainly based on the toxicological properties of their active substances. Commonly, the coformulants used in pest control products are of less concern than the active substances (e.g., food ingredients and animal feed products). For example, most rodenticides belong to the group of anticoagulants, which are also effective in humans. Regarding intoxications through insecticides, the group of pyrethroids is of particular importance. Fumigants containing metal phosphides, hydrogen cyanide, or sulfuryl difluoride are particularly toxic. This toxicity is linked to the high acute inhalation toxicity of the gaseous active substances themselves or, in the case of phosphides, of the released gas phosphane. The aim of health risk assessment for the authorization of biocidal products is to ensure their safe application for users and all other persons involved, assuming an adequate and label-compliant use.

Blood parameters in Swedish dairy herds with high or low incidence of displaced abomasum or ketosis.

PubMed

Stengärde, Lena; Holtenius, Kjell; Emanuelson, Ulf; Hultgren, Jan; Niskanen, Rauni; Tråvén, Madeleine

2011-10-01

Sixty dairy herds were studied to investigate the association between long-term incidence of displaced abomasum and clinical ketosis and body condition score and blood profiles, including parameters estimating energy metabolism and hepatic lipidosis in the periparturient period and early lactation. Blood samples were taken around parturition and in early lactation from cows without apparent clinical symptoms of metabolic disorders. A difference in metabolism between high and low incidence herds was shown post-partum by a lower metabolic index (the revised Quantitative Insulin Sensitivity Check Index, RQUICKI), and tendencies for higher concentrations of glucose, insulin and non-esterified fatty acids in the high incidence herds. High incidence herds had more cows and produced on average 1400kg energy-corrected milk per cow per year more than the low incidence herds. No differences were found in parameters reflecting liver cell damage. In the first 3weeks post-partum the RQUICKI was a more sensitive marker of herds with a high incidence of displaced abomasum and clinical ketosis than any of the individual parameters, but further research is needed before practical applications of the RQUICKI can be foreseen. Copyright © 2010 Elsevier Ltd. All rights reserved.

Local level epidemiological analysis of TB in people from a high incidence country of birth.

PubMed

Massey, Peter D; Durrheim, David N; Stephens, Nicola; Christensen, Amanda

2013-01-22

The setting for this analysis is the low tuberculosis (TB) incidence state of New South Wales (NSW), Australia. Local level analysis of TB epidemiology in people from high incidence countries-of-birth (HIC) in a low incidence setting has not been conducted in Australia and has not been widely reported. Local level analysis could inform measures such as active case finding and targeted earlier diagnosis. The aim of this study was to use a novel approach to identify local areas in an Australian state that have higher TB rates given the local areas' country of birth profiles. TB notification data for the three year period 2006-2008 were analysed by grouping the population into those from a high-incidence country-of-birth and the remainder. During the study period there were 1401 notified TB cases in the state of NSW. Of these TB cases 76.5% were born in a high-incidence country. The annualised TB notification rate for the high-incidence country-of-birth group was 61.2/100,000 population and for the remainder of the population was 1.8/100,000. Of the 152 Local Government Areas (LGA) in NSW, nine had higher and four had lower TB notification rates in their high-incidence country-of-birth populations when compared with the high-incidence country-of-birth population for the rest of NSW. The nine areas had a higher proportion of the population with a country of birth where TB notification rates are >100/100,000. Those notified with TB in the nine areas also had a shorter length of stay in Australia than the rest of the state. The areas with higher TB notification rates were all in the capital city, Sydney. Among LGAs with higher TB notification rates, four had higher rates in both people with a high-incidence country of birth and people not born in a high-incidence country. The age distribution of the HIC population was similar across all areas, and the highest differential in TB rates across areas was in the 5-19 years age group. Analysing local area TB rates and possible explanatory variables can provide useful insights into the epidemiology of TB. TB notification rates that take country of birth in local areas into account could enable health services to strategically target TB control measures.

Assessing spatio-temporal trend of vector breeding and dengue fever incidence in association with meteorological conditions.

PubMed

Malik, Afifa; Yasar, Abdullah; Tabinda, Amtul Bari; Zaheer, Ihsan Elahi; Malik, Khalida; Batool, Adeeba; Mahfooz, Yusra

2017-04-01

Th aim of this study is to investigate spatio-temporal trends of dengue vector breeding and epidemic (disease incidence) influenced by climatic factors. The spatio-temporal (low-, medium-, and high-intensity periods) evaluation of entomological and epidemiological investigations along with climatic factors like rainfall (RF), temperature (T max ), relative humidity (RH), and larval indexing was conducted to develop correlations in the area of Lahore, Pakistan. The vector abundance and disease transmission trend was geo-tagged for spatial insight. The sufficient rainfall events and optimum temperature and relative humidity supported dengue vector breeding with high larval indices for water-related containers (27-37%). Among temporal analysis, the high-intensity period exponentially projected disease incidence followed by post-rainfall impacts. The high larval incidence that was observed in early high-intensity periods effected the dengue incidence. The disease incidence had a strong association with RF (r = 0.940, α = 0.01). The vector larva occurrence (r = 0.017, α = 0.05) influenced the disease incidence. Similarly, RH (r = 0.674, α = 0.05) and average T max (r = 0.307, α = 0.05) also induced impact on the disease incidence. In this study, the vulnerability to dengue fever highly correlates with meteorological factors during high-intensity period. It provides area-specific understanding of vector behavior, key containers, and seasonal patterns of dengue vector breeding and disease transmission which is essential for preparing an effective prevention plan against the vector.

Use of Data Comm by Flight Crew to Conduct Interval Management Operations to Parallel Dependent Runways

NASA Technical Reports Server (NTRS)

Baxley, Brian T.; Hubbs, Clay; Shay, Rick; Karanian, James

2011-01-01

The Interval Management (IM) concept is being developed as a method to maintain or increase high traffic density airport arrival throughput while allowing aircraft to conduct near idle thrust descents. The Interval Management with Spacing to Parallel Dependent Runways (IMSPiDR1) experiment at NASA Langley Research Center used 24 commercial pilots to examine IM procedures to conduct parallel dependent runway arrival operations while maintaining safe but efficient intervals behind the preceding aircraft. The use of IM procedures during these operations requires a lengthy and complex clearance from Air Traffic Control (ATC) to the participating aircraft, thereby making the use of Controller Pilot Data Link Communications (CPDLC) highly desirable as the communication method. The use of CPDLC reduces the need for voice transmissions between controllers and flight crew, and enables automated transfer of IM clearance elements into flight management systems or other aircraft avionics. The result is reduced crew workload and an increase in the efficiency of crew procedures. This paper focuses on the subset of data collected related to the use of CPDLC for IM operations into a busy airport. Overall, the experiment and results were very successful, with the mean time under 43 seconds for the flight crew to load the clearance into the IM spacing tool, review the calculated speed, and respond to ATC. An overall mean rating of Moderately Agree was given when the crews were asked if the use of CPDLC was operationally acceptable as simulated in this experiment. Approximately half of the flight crew reported the use of CPDLC below 10,000 for IM operations was unacceptable, with 83% reporting below 5000 was unacceptable. Also described are proposed modifications to the IM operations that may reduce CPDLC Respond time to less than 30 seconds and should significantly reduce the complexity of crew procedures, as well as follow-on research issues for operational use of CPDLC during IM operations.

Ethnic differences in the incidence of cancer in Norway.

PubMed

Hjerkind, Kirsti V; Qureshi, Samera A; Møller, Bjørn; Weiderpass, Elisabete; Deapen, Dennis; Kumar, Bernadette; Ursin, Giske

2017-04-15

Traditionally there have been differences in cancer incidence across geographic regions. When immigrants have moved from low-income to high-income countries, their incidence have changed as they have adapted to the lifestyle in the new host country. Given worldwide changes in lifestyle factors over time, we decided to examine cancer incidence in immigrant groups in Norway, a country with a recent immigration history, complete cancer registration and universal public health care. We linked immigration history for the complete population to information on cancer diagnosis from the Cancer Registry of Norway for the period 1990-2012. Age-standardized (world) overall and site-specific cancer incidence were estimated for different immigrant groups and compared to incidence among individuals born in Norway. Among 850,008 immigrants, 9,158 men and 10,334 women developed cancer, and among 5,508,429 Norwegian-born, 263,316 men and 235,020 women developed cancer. While incidence of breast and colorectal cancer were highest among individuals born in Norway and other high-income countries, other cancer types were higher in immigrants from low-income countries. Lung cancer incidence was highest in Eastern European men, and men and women from Eastern Europe had high incidence of stomach cancer. Incidence of liver cancer was substantially higher in immigrants from low-income countries than in individuals born in Norway and other high-income countries. Our results mirror known cancer challenges across the world. Although cancer incidence overall is lower in immigrants from low-income countries, certain cancers, such as lung, liver and stomach cancer, represent major challenges in specific immigrant groups. © 2017 UICC.

Design, Construction, and Performance of New-generation Open-graded Friction Courses

DOT National Transportation Integrated Search

2000-04-01

Open-graded friction course (OGFC) has been used by several state departments of transportation (DOT) since 1950. While many DOTs report good performance, many other states stopped using OGFC due to unacceptable performance and/or lack of adequate du...

Psychology's Contributions to Classroom Management

ERIC Educational Resources Information Center

Little, Steven G.; Akin-Little, Angeleque

2008-01-01

Classroom management (CRM) has been associated with discipline, control, or other terms that connote reducing unacceptable student behavior. However, CRM involves not merely responding effectively when problems occur, but also preventing problems from occurring by creating environments that encourage learning and appropriate behavior. Teachers'…

Templates Aid Removal Of Defects From Castings

NASA Technical Reports Server (NTRS)

Hendrickson, Robert G.

1992-01-01

Templates used to correlate defects in castings with local wall thicknesses. Placed on part to be inspected after coated with penetrant dye. Positions of colored spots (indicative of defects) noted. Ultrasonic inspector measures thickness of wall at unacceptable defects only - overall inspection not necessary.

How to Curb the Dropout Rate.

ERIC Educational Resources Information Center

Vallejo, M. Edmund

1987-01-01

Although the Pueblo (Colorado) School District's student dropout rate compares favorably with national and state data, the community found the disproportionate number of Hispanic dropouts unacceptable. This article describes the district's efforts to reorganize staff, strengthen existing programs, and institute teen mother, inhouse suspension,…