Triphasic behavioral response of motor units to submaximal fatiguing exercise.

PubMed

Dorfman, L J; Howard, J E; McGill, K C

1990-07-01

We have measured the firing rate and amplitude of 4551 motor unit action potentials (MUAPs) recorded with concentric needle electrodes from the brachial biceps muscles of 10 healthy young adults before, during, and after 45 minutes of intermittent isometric exercise at 20% of maximum voluntary contraction (MVC), using an automatic method for decomposition of electromyographic activity (ADEMG). During and after exercise, MUAPs derived from contractions of 30% MVC showed progressive increase in mean firing rate (P less than or equal to .01) and amplitude (P less than or equal to .05). The firing rate increase preceded the rise in mean amplitude, and was evident prior to the development of fatigue, defined as reduction of MVC. Analysis of individual potentials revealed that the increase in firing rate and in amplitude reflected different MUAP subpopulations. A short-term (less than 1 minute) reduction in MUAP firing rates (P less than or equal to .05) was also observed at the onset of each test contraction. These findings suggest that motor units exhibit a triphasic behavioral response to prolonged submaximal exercise: (1) short-term decline and stabilization of onset firing rates, followed by (2) gradual and progressive increase in firing rates and firing variability, and then by (3) recruitment of additional (larger) motor units. The (2) and (3) components presumably compensate for loss of force-generating capacity in the exercising muscle, and give rise jointly to the well-known increase in total surface EMG which accompanies muscle fatigue.

Hierarchical control of motor units in voluntary contractions.

PubMed

De Luca, Carlo J; Contessa, Paola

2012-01-01

For the past five decades there has been wide acceptance of a relationship between the firing rate of motor units and the afterhyperpolarization of motoneurons. It has been promulgated that the higher-threshold, larger-soma, motoneurons fire faster than the lower-threshold, smaller-soma, motor units. This relationship was based on studies on anesthetized cats with electrically stimulated motoneurons. We questioned its applicability to motor unit control during voluntary contractions in humans. We found that during linearly force-increasing contractions, firing rates increased as exponential functions. At any time and force level, including at recruitment, the firing rate values were inversely related to the recruitment threshold of the motor unit. The time constants of the exponential functions were directly related to the recruitment threshold. From the Henneman size principle it follows that the characteristics of the firing rates are also related to the size of the soma. The "firing rate spectrum" presents a beautifully simple control scheme in which, at any given time or force, the firing rate value of earlier-recruited motor units is greater than that of later-recruited motor units. This hierarchical control scheme describes a mechanism that provides an effective economy of force generation for the earlier-recruited lower force-twitch motor units, and reduces the fatigue of later-recruited higher force-twitch motor units-both characteristics being well suited for generating and sustaining force during the fight-or-flight response.

Goldmann tonometer calibration: a national survey.

PubMed

Kumar, N; Hillier, R J

2009-02-01

Recent studies suggest that Goldmann tonometers can rapidly develop calibration errors (CEs) in clinical use and routine checks are necessary to ensure accuracy. To determine current practice regarding CE checks in the United Kingdom and assess the views of senior nursing staff in charge of running ophthalmology outpatient clinics as to whom they feel to be responsible for CE checks. Every ophthalmology unit with training recognition in England, Northern Ireland, Scotland, and Wales was contacted. Senior nurses responded to a structured telephone questionnaire regarding local tonometer calibration practice and their views regarding who is responsible for CE checks. A total of 155 eye units were identified and contacted. The response rate was 100%. CEs were checked for daily in 8 units (5.2%), weekly in 20 units (12.9%), fortnightly in 1 unit (0.6%), monthly in 12 units (7.7%), trimonthly in 5 units (3.2%), biannually in 27 units (17.4%), and annually in 21 units (13.5%). CEs were either never checked or checked in a very random manner (no identifiable pattern) in 61 units (39.4%). Sixty-three (40.6%) of the respondents felt CE checks were a departmental responsibility, 48 (31.0%) felt it to be the doctor's responsibility, and 44 (28.4%) felt CE checks should be performed by the nursing staff. Our national survey suggests that very few units check their tonometers for CEs at intervals which ensure their accuracy. Our previous survey of doctors suggests that they believe nurses should check for CE, whereas the nursing staff believe CE checks are not their responsibility. This lack of communication between health-care professionals may lead to inaccurate tonometers being used in clinical practice. We suggest that every eye unit should have a protocol, which clearly identifies individuals responsible for checking for CEs at least on a monthly basis.

Hierarchical control of motor units in voluntary contractions

PubMed Central

Contessa, Paola

2012-01-01

For the past five decades there has been wide acceptance of a relationship between the firing rate of motor units and the afterhyperpolarization of motoneurons. It has been promulgated that the higher-threshold, larger-soma, motoneurons fire faster than the lower-threshold, smaller-soma, motor units. This relationship was based on studies on anesthetized cats with electrically stimulated motoneurons. We questioned its applicability to motor unit control during voluntary contractions in humans. We found that during linearly force-increasing contractions, firing rates increased as exponential functions. At any time and force level, including at recruitment, the firing rate values were inversely related to the recruitment threshold of the motor unit. The time constants of the exponential functions were directly related to the recruitment threshold. From the Henneman size principle it follows that the characteristics of the firing rates are also related to the size of the soma. The “firing rate spectrum” presents a beautifully simple control scheme in which, at any given time or force, the firing rate value of earlier-recruited motor units is greater than that of later-recruited motor units. This hierarchical control scheme describes a mechanism that provides an effective economy of force generation for the earlier-recruited lower force-twitch motor units, and reduces the fatigue of later-recruited higher force-twitch motor units—both characteristics being well suited for generating and sustaining force during the fight-or-flight response. PMID:21975447

40 CFR 270.4 - Effect of a permit.

Code of Federal Regulations, 2010 CFR

2010-07-01

... regarding leak detection systems for new and replacement surface impoundment, waste pile, and landfill units, and lateral expansions of surface impoundment, waste pile, and landfill units. The leak detection system requirements include double liners, CQA programs, monitoring, action leakage rates, and response...

Response properties of single units in the dorsal nucleus of the lateral lemniscus of decerebrate cats.

PubMed

Davis, Kevin A; Lomakin, Oleg; Pesavento, Michael J

2007-09-01

The dorsal nucleus of the lateral lemniscus (DNLL) receives afferent inputs from many brain stem nuclei and, in turn, is a major source of inhibitory inputs to the inferior colliculus (IC). The goal of this study was to characterize the monaural and binaural response properties of neurons in the DNLL of unanesthetized decerebrate cat. Monaural responses were classified according to the patterns of excitation and inhibition observed in contralateral and ipsilateral frequency response maps. Binaural classification was based on unit sensitivity to interaural level differences. The results show that units in the DNLL can be grouped into three distinct types. Type v units produce contralateral response maps that show a wide V-shaped excitatory area and no inhibition. These units receive ipsilateral excitation and exhibit binaural facilitation. The contralateral maps of type i units show a more restricted I-shaped region of excitation that is flanked by inhibition. Type o maps display an O-shaped island of excitation at low stimulus levels that is bounded by inhibition at higher levels. Both type i and type o units receive ipsilateral inhibition and exhibit binaural inhibition. Units that produce type v maps have a low best frequency (BF), whereas type i and type o units have high BFs. Type v and type i units give monotonic rate-level responses for both BF tones and broadband noise. Type o units are inhibited by tones at high levels, but are excited by high-level noise. These results show that the DNLL can exert strong, differential effects in the IC.

Exploring the relationship between patient call-light use rate and nurse call-light response time in acute care settings.

PubMed

Tzeng, Huey-Ming; Larson, Janet L

2011-03-01

Patient call-light usage and nurse responsiveness to call lights are two intertwined concepts that could affect patients' safety during hospital stays. Little is known about the relationship between call-light usage and call-light response time. Consequently, this exploratory study examined the relationship between the patient-initiated call-light use rate and the nursing staff's average call-light response time in a Michigan community hospital. It used hospital archived data retrieved from the call-light tracking system for the period from February 2007 through June 2008. Curve estimation regression and multiple regression analyses were conducted. The results showed that the call-light response time was not affected by the total nursing hours or RN hours. The nurse call-light response time was longer when the patient call-light use rate was higher and the average length of stay was shorter. It is likely that a shorter length of stay contributes to the nursing care activity level on the unit because it is associated with a higher frequency of patient admissions/discharges and treatment per patient-day. This suggests that the nursing care activity level on the unit and number of call-light alarms could affect nurse call-light response time, independently of the number of nurses available to respond.

Yield response to variable rate irrigation in corn

USDA-ARS?s Scientific Manuscript database

To investigate the impact of variable rate irrigation on corn yield, twenty plots of corn were laid out under a center pivot variable rate irrigation (VRI) system in an experimental field near Stoneville, MS. The VRI system is equipped with five VRI zone control units, a global positioning system (G...

Motor unit recruitment in human genioglossus muscle in response to hypercapnia.

PubMed

Nicholas, Christian L; Bei, Bei; Worsnop, Christopher; Malhotra, Atul; Jordan, Amy S; Saboisky, Julian P; Chan, Julia K M; Duckworth, Ella; White, David P; Trinder, John

2010-11-01

single motor unit recordings of the genioglossus (GG) muscle indicate that GG motor units have a variety of discharge patterns, including units that have higher discharge rates during inspiration (inspiratory phasic and inspiratory tonic), or expiration (expiratory phasic and expiratory tonic), or do not modify their rate with respiration (tonic). Previous studies have shown that an increase in GG muscle activity is a consequence of increased activity in inspiratory units. However, there are differences between studies as to whether this increase is primarily due to recruitment of new motor units (motor unit recruitment) or to increased discharge rate of already active units (rate coding). Sleep-wake state studies in humans have suggested the former, while hypercapnia experiments in rats have suggested the latter. In this study, we investigated the effect of hypercapnia on GG motor unit activity in humans during wakefulness. sleep research laboratory. sixteen healthy men. each participant was administered at least 6 trials with P(et)CO(2) being elevated 8.4 (SD = 1.96) mm Hg over 2 min following a 30-s baseline. Subjects were instrumented for GG EMG and respiratory measurements with 4 fine wire electrodes inserted subcutaneously into the muscle. One hundred forty-one motor units were identified during the baseline: 47% were inspiratory modulated, 29% expiratory modulated, and 24% showed no respiratory related modulation. Sixty-two new units were recruited during hypercapnia. The distribution of recruited units was significantly different from the baseline distribution, with 84% being inspiratory modulated (P < 0.001). Neither units active during baseline, nor new units recruited during hypercapnia, increased their discharge rate as P(et)CO(2) increased (P > 0.05 for all comparisons). increased GG muscle activity in humans occurs because of recruitment of previously inactive inspiratory modulated units.

Significant variations in nutritional supplementation amongst neonates in the United Kingdom.

PubMed

Gordon, Morris; Isaji, Sahira; Tyacke, Fiona

2016-08-08

To ascertain United Kingdom adherence to European society of Paediatric Gastroenterology, Hepatology and Nutrition guidance (ESPGHAN). A national cross sectional questionnaire study of neonatal units across England was completed between January and March 2014. All 174 units in the country were attempted to be contacted to complete a telephone survey. This included all level 1, 2 and 3 units. They were initially contacted by phone and asking any senior member of the team about their current practice and procedures. The first ten telephone interviews were completed with two researchers present to ensure consistency of approach. If no response was received or no details were available, one further attempt was made to contact the unit. The results were recorded in a proforma and then collated and entered into a spreadsheet for analysis. Comparison to United Kingdom adherence to ESPGHAN guidance was completed. Response rate was 53%. There was variation in use of all supplements. The survey collected data from 91 neonatal units (53% response rate). It was found that 10% of neonatal units had no fixed policy on supplements. The protocols regarding supplementation involved predominantly folic acid, vitamin A, vitamin D and iron, with much variation in doses and regimens. The criteria for prescribing supplements was largely based on age (47%) with only 7% using a weight targets to initiate supplements. Summary data regarding the appropriateness of each nutritional supplement for a variety of different weights are presented, as well as comparison to ESPGHAN guidance which suggests issues with both underdoing of Breast Fed infants and overdosing of infants on several artificial formulas which already contain significant amounts of these nutritional elements. There is significant heterogeneity in neonatal policies when prescribing supplements to neonates. National policies which take international guidance into account are recommended.

Female pheromones modulate flight muscle activation patterns during preflight warm-up.

PubMed

Crespo, José G; Vickers, Neil J; Goller, Franz

2013-08-01

At low ambient temperature Helicoverpa zea male moths engage in warm-up behavior prior to taking flight in response to an attractive female pheromone blend. Male H. zea warm up at a faster rate when sensing the attractive pheromone blend compared with unattractive blends or blank controls (Crespo et al. 2012), but the mechanisms involved in this olfactory modulation of the heating rate during preflight warm-up are unknown. Here, we test three possible mechanisms for increasing heat production: 1) increased rate of muscle contraction; 2) reduction in mechanical movement by increased overlap in activation of the antagonistic flight muscles; and 3) increased activation of motor units. To test which mechanisms play a role, we simultaneously recorded electrical activation patterns of the main flight muscles (dorsolongitudinal and dorsoventral muscles), wing movement, and thoracic temperature in moths exposed to both the attractive pheromone blend and a blank control. Results indicate that the main mechanism responsible for the observed increase in thoracic heating rate with pheromone stimulation is the differential activation of motor units during each muscle contraction cycle in both antagonistic flight muscles. This additional activation lengthens the contracted state within each cycle and thus accounts for the greater heat production. Interestingly, the rate of activation (frequency of contraction cycles) of motor units, which is temperature dependent, did not vary between treatments. This result suggests that the activation rate is determined by a temperature-dependent oscillator, which is not affected by the olfactory stimulus, but activation of motor units is modulated during each cycle.

Female pheromones modulate flight muscle activation patterns during preflight warm-up

PubMed Central

Vickers, Neil J.; Goller, Franz

2013-01-01

At low ambient temperature Helicoverpa zea male moths engage in warm-up behavior prior to taking flight in response to an attractive female pheromone blend. Male H. zea warm up at a faster rate when sensing the attractive pheromone blend compared with unattractive blends or blank controls (Crespo et al. 2012), but the mechanisms involved in this olfactory modulation of the heating rate during preflight warm-up are unknown. Here, we test three possible mechanisms for increasing heat production: 1) increased rate of muscle contraction; 2) reduction in mechanical movement by increased overlap in activation of the antagonistic flight muscles; and 3) increased activation of motor units. To test which mechanisms play a role, we simultaneously recorded electrical activation patterns of the main flight muscles (dorsolongitudinal and dorsoventral muscles), wing movement, and thoracic temperature in moths exposed to both the attractive pheromone blend and a blank control. Results indicate that the main mechanism responsible for the observed increase in thoracic heating rate with pheromone stimulation is the differential activation of motor units during each muscle contraction cycle in both antagonistic flight muscles. This additional activation lengthens the contracted state within each cycle and thus accounts for the greater heat production. Interestingly, the rate of activation (frequency of contraction cycles) of motor units, which is temperature dependent, did not vary between treatments. This result suggests that the activation rate is determined by a temperature-dependent oscillator, which is not affected by the olfactory stimulus, but activation of motor units is modulated during each cycle. PMID:23699056

Evaluating telephone follow-up of a mail survey of community pharmacies.

PubMed

Westrick, Salisa C; Mount, Jeanine K

2007-06-01

Mail and telephone are commonly used modes of survey with pharmacists. Research conducted using general population surveys consistently describes mail surveys as being less expensive but yielding lower response rates than telephone surveys. However, findings obtained from the general population may not be generalizable to pharmacist surveys. This study evaluates the effectiveness of telephone follow-up of mail survey nonrespondents by comparing the 2 survey modes on response rates, cooperation rates, cost per sample unit, and cost per usable response and evaluating potential nonresponse bias in the context of immunization activities. A census mail survey of 1,143 Washington State community pharmacies and a follow-up telephone survey of 262 randomly selected mail survey nonrespondents were compared. Both surveys included the same 15 yes/no-type questions to ask respondents about their pharmacy's involvement in immunization activities. The mail survey yielded a response rate 1 of 26.7% and a cooperation rate 1 of 26.7%, compared with 83.6% and 87.8%, respectively, for the follow-up telephone survey. With respect to cost per sample unit, the mail survey was the least expensive option ($1.20). However, when comparing cost per usable response, the mail survey was the most expensive ($4.37), and the follow-up telephone survey without an advance notification was the least expensive ($1.99). Furthermore, results suggest the presence of nonresponse bias: compared with pharmacies participating in the follow-up telephone survey, pharmacies participating in the mail survey were more likely to be involved in in-house immunization services but less likely to be involved in outsourced services. The telephone survey achieved higher outcome rates with reduced cost per usable response. A telephone survey is a viable mode that holds promise in pharmacy practice research. Maximizing response rates and assessing potential nonresponse bias should be a standard practice among pharmacy practice researchers. More methodology research specific to pharmacist surveys is needed.

75 FR 51504 - Changes in Postal Rates

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-20

... INFORMATION CONTACT: Stephen L. Sharfman, General Counsel, [email protected] or 202-789-6820... rates took effect on January 1, 2009. In Order No. 281, the Commission accepted the change in rates not... Expedited Services 2, August 19, 2009 (Order No. 281). \\4\\ See Docket No. CP2009-57, Response of the United...

Nucleus accumbens neuronal activity in freely behaving rats is modulated following acute and chronic methylphenidate administration

PubMed Central

Chong, Samuel L; Claussen, Catherine M; Dafny, Nachum

2012-01-01

Methylphenidate (MPD) is a psychostimulant that enhances dopaminergic neurotransmission in the central nervous system by using mechanisms similar to cocaine and amphetamine. The mode of action of brain circuitry responsible for an animal’s neuronal response to MPD is not fully understood. The nucleus accumbens (NAc) has been implicated in regulating the rewarding effects of psychostimulants. The present study used permanently implanted microelectrodes to investigate the acute and chronic effects of MPD on the firing rates of NAc neuronal units in freely behaving rats. On experimental day 1 (ED1), following a saline injection (control), a 30 minute baseline neuronal recording was obtained immediately followed by a 2.5 mg/kg i.p. MPD injection and subsequent 60 min neuronal recording. Daily 2.5 mg/kg MPD injections were given on ED2 through ED6 followed by 3 washout days (ED7 to 9). On ED10, neuronal recordings were resumed from the same animal after a saline and MPD (rechallenge) injection exactly as obtained on ED1. Sixty-seven NAc neuronal units exhibited similar wave shape, form and amplitude on ED1 and ED10 and their firing rates were used for analysis. MPD administration on ED1 elicited firing rate increases and decreases in 54% of NAc units when compared to their baselines. Six consecutive MPD administrations altered the neuronal baseline firing rates of 85% of NAc units. MPD rechallenge on ED10 elicited significant changes in 63% of NAc units. These alterations in firing rates are hypothesized to be through mechanisms that include D1 and D2-like DA receptor induced cellular adaptation and homeostatic adaptations/deregulation caused by acute and chronic MPD administration. PMID:22248440

Biomass-C specific temperature responses of microbial C transformations reveal consistency regardless of microbial community structure across diverse timescales of inquiry

NASA Astrophysics Data System (ADS)

Min, K.; Buckeridge, K. M.; Ziegler, S. E.; Edwards, K. A.; Bagchi, S.; Billings, S. A.

2016-12-01

The responses of heterotrophic microbial process rates to temperature in soils are often investigated in the short-term (hours to months), making it difficult to predict longer-term temperature responses. Here, we integrate the temperature sensitivity obtained from the Arrhenius model with the concepts of microbial resistance, resilience, and susceptibility to assess temporal dynamics of microbial temperature responses. We collected soils along a boreal forest climate gradient (long-term effect), and quantified exo-enzyme activities and CO2 respiration at 5, 15, and 25°C for 84 days (relatively short-term effect). Microbial process rates were examined at two levels (per g microbial biomass-C; and per g dry soil) along with community structure, to characterize driving mechanisms for temporal patterns (e.g., size of biomass, physiological plasticity, community composition). Although temperature sensitivity of exo-enzyme activities on a per g dry soil basis showed both resistance and resilience depending on the types of exo-enzyme, biomass -C-specific responses always exhibited resistance regardless of distinct community composition. Temperature sensitivity of CO2 respiration was constant across time and different communities at both units. This study advances our knowledge in two ways. First, resistant temperature sensitivity of exo-enzymes and respiration at biomass-C specific level across distinct communities and diverse timescales indicates a common relationship between microbial physiology and temperature at a fundamental level, a useful feature allowing microbial process models to be reasonably simplified. Second, different temporal responses of exo-enzymes depending on the unit selected provide a cautionary tale for those projecting future microbial behaviors, because interpretation of ecosystem process rates may vary with the unit of observation.

Response of cat cerebellar vermis induced by sound. II. The role of the mossy and climbing fibers in acoustic transmission to the cerebellar cortex and influence of stimuli parameters.

PubMed

Jastreboff, P J; Tarnecki, R

1975-01-01

Experiments were performed on cats under Chloralose or Nembutal anesthesia. The parameters of the acoustic click stimuli were found to have a strong influence on the responses registered from both the surface of the cerebellar vermis lobuli V up VII as well as from single units. It was shown that a stimulus frequency rate not greater than 1/2 s should be used, since higher frequencies caused strong attenuation of the response. The type of anesthesia did not change the latencies of reactions of both evoked potentials and single units. However, decreasing the strength of the click resulted in increased response latencies, in the case of single unit reactions. A very strong influence of weak visual stimuli on units was also observed. It is suggested that mossy fibers are the most important fibers in the transmission of acoustic information to the cerebellar cortex.

The Move to a System of Flexible Delivery Mode (Online v Paper) Unit of Study Student Evaluations at Flinders University. Management Issues and the Study of Initial Changes in Survey Volume, Response Rate and Response Level

ERIC Educational Resources Information Center

Bennett, Talitha; De Bellis, David

2010-01-01

Like the vast majority of Australian universities, Flinders University (Flinders) collects feedback from students on the quality of teaching and learning through unit of study (topic) or classroom evaluations. Prior to 2009, survey instruments at Flinders were delivered via paper mode and in person to students in the classroom. In a drive for an…

Surviving the nursing shortage: developing a nursing orientation program to prepare and retain intensive care unit nurses.

PubMed

Cavanaugh, Debra A; Huse, Anita L

2004-01-01

The shortage of nurses has reached crisis proportions around the world. In response to a critical shortage of qualified neonatal intensive care nurses, one institution developed an educational program so comprehensive that they were able to increase their nursing staff by 20% and staff the neonatal intensive care unit with well-prepared and proficient nurses. This strategy has also resulted in high retention rates, a decrease in overtime, and a relatively low error rate by new nurses.

F-22 Pilot Heart Rate Response to +Gz and Relationship to Pilot Fitness Using U.S. Air Force Fitness Test Scores

DTIC Science & Technology

2015-08-19

finger-mounted units that produced a significant amount of artifact. The collection method matured to a helmet-mounted pulse oximeter (HMPO) unit...2015-5343. Helmet-mounted pulse oximeter data exist for 5847 sorties. Each sortie contains multiple +Gz exposures and each +Gz exposure is of...AGSM anti-G straining maneuver BMI body mass index CO cardiac output HMPO helmet-mounted pulse oximeter HR heart rate ID identification

Intracortical microstimulation induced changes in spectral and temporal response properties in cat auditory cortex.

PubMed

Valentine, Pamela A; Eggermont, Jos J

2003-09-01

Intracortical microstimulation (ICMS), consisting of a 40 ms burst (rate 300 Hz) of 10 microA pulses, repetitively administered once per second, for a total duration of 1 h, induced cortical reorganization in the primary auditory cortical field of the anesthetized cat. Multiple single-unit activity was simultaneously recorded from three to nine microelectrodes. Spiking activity was recorded from the same units prior to and following the application of ICMS in conjunction with tone pips at the characteristic frequency (CF) of the stimulus electrode. ICMS produced a significant increase in the mean firing rate, and in the occurrence of burst activity. There was an increase in the cross-correlation coefficient (R) for unit pairs recorded from sites distant from the ICMS site, and a decrease in R for unit pairs that were recorded at the stimulation site. ICMS induced a shift in the CF, dependent on the difference between the baseline CF and the ICMS-paired tone pip frequency. ICMS also resulted in broader tuning curves, increased driven peak firing rate and reduced response latency. This suggests a lasting reduction in inhibition in a small region surrounding the ICMS site that allows expansion of the frequency range normally represented in the vicinity of the stimulation electrode.

Correlated physiological and perceptual effects of noise in a tactile stimulus.

PubMed

Lak, Armin; Arabzadeh, Ehsan; Harris, Justin A; Diamond, Mathew E

2010-04-27

We investigated connections between the physiology of rat barrel cortex neurons and the sensation of vibration in humans. One set of experiments measured neuronal responses in anesthetized rats to trains of whisker deflections, each train characterized either by constant amplitude across all deflections or by variable amplitude ("amplitude noise"). Firing rate and firing synchrony were, on average, boosted by the presence of noise. However, neurons were not uniform in their responses to noise. Barrel cortex neurons have been categorized as regular-spiking units (putative excitatory neurons) and fast-spiking units (putative inhibitory neurons). Among regular-spiking units, amplitude noise caused a higher firing rate and increased cross-neuron synchrony. Among fast-spiking units, noise had the opposite effect: It led to a lower firing rate and decreased cross-neuron synchrony. This finding suggests that amplitude noise affects the interaction between inhibitory and excitatory neurons. From these physiological effects, we expected that noise would lead to an increase in the perceived intensity of a vibration. We tested this notion using psychophysical measurements in humans. As predicted, subjects overestimated the intensity of noisy vibrations. Thus the physiological mechanisms present in barrel cortex also appear to be at work in the human tactile system, where they affect vibration perception.

Getting a piece of the pie? The economic boom of the 1990s and declining teen birth rates in the United States.

PubMed

Colen, Cynthia G; Geronimus, Arline T; Phipps, Maureen G

2006-09-01

In the United States, the 1990s was a decade of dramatic economic growth as well as a period characterized by substantial declines in teenage childbearing. This study examines whether falling teen fertility rates during the 1990s were responsive to expanding employment opportunities and whether the implementation of the Personal Responsibility and Work Opportunities Act (PRWORA), increasing rates of incarceration, or restrictive abortion policies may have affected this association. Fixed-effects Poisson regression models were estimated to assess the relationship between age-specific birth rates and state-specific unemployment rates from 1990 to 1999 for Black and White females aged 10-29. Falling unemployment rates in the 1990s were associated with decreased childbearing among African-American women aged 15-24, but were largely unrelated to declines in fertility for Whites. For 18-19 year-old African-Americans, the group for whom teen childbearing is most normative, our model accounted for 85% of the decrease in rates of first births. Young Black women, especially older teens, may have adjusted their reproductive behavior to take advantage of expanded labor market opportunities.

Men and Health Promotion in the United Kingdom: 20 Years Further Forward?

ERIC Educational Resources Information Center

Robertson, Steve; Baker, Peter

2017-01-01

Despite overall improvements in life expectancy, rates of premature male mortality, particularly for men in areas of socioeconomic deprivation, remain an important issue of concern in the United Kingdom. Interventions to engage men and promote their health and wellbeing have developed, albeit sporadically, over recent decades in response to this…

Advantages of concurrent biochemotherapy modified by decrescendo interleukin-2, granulocyte colony-stimulating factor, and tamoxifen for patients with metastatic melanoma.

PubMed

O'Day, S J; Gammon, G; Boasberg, P D; Martin, M A; Kristedja, T S; Guo, M; Stern, S; Edwards, S; Fournier, P; Weisberg, M; Cannon, M; Fawzy, N W; Johnson, T D; Essner, R; Foshag, L J; Morton, D L

1999-09-01

Concurrent biochemotherapy results in high response rates but also significant toxicity in patients with metastatic melanoma. We attempted to improve its efficacy and decrease its toxicity by using decrescendo dosing of interleukin-2 (IL-2), posttreatment granulocyte colony-stimulating factor (G-CSF), and low-dose tamoxifen. Forty-five patients with poor prognosis metastatic melanoma were treated at a community hospital inpatient oncology unit affiliated with the John Wayne Cancer Institute (Santa Monica, CA) between July 1995 and September 1997. A 5-day modified concurrent biochemotherapy regimen of dacarbazine, vinblastine, cisplatin, decrescendo IL-2, interferon alfa-2b, and tamoxifen was repeated at 21-day intervals. G-CSF was administered beginning on day 6 for 7 to 10 days. The overall response rate was 57% (95% confidence interval, 42% to 72%), the complete response rate was 23%, and the partial response rate was 34%. Complete remissions were achieved in an additional 11% of patients by surgical resection of residual disease after biochemotherapy. The median time to progression was 6.3 months and the median duration of survival was 11.4 months. At a maximum follow-up of 36 months (range, 10 to 36 months), 32% of patients are alive and 14% remain free of disease. Decrescendo IL-2 dosing and administration of G-CSF seemed to reduce toxicity, length of hospital stay, and readmission rates. No patient required intensive care unit monitoring, and there were no treatment-related deaths. The data from this study indicate that the modified concurrent biochemotherapy regimen reduces the toxicity of concurrent biochemotherapy with no apparent decrease in response rate in patients with poor prognosis metastatic melanoma.

Relating Resources to Personnel Readiness. Use of Army Strength Management Models,

DTIC Science & Technology

1997-01-01

far from the resources. In fact, they do not consider them. What they do consider is the historical performance of response variables, using a...hierarchy is the readiness of the force or the ability of the overall force to perform a given mission successfully. A force is composed of units...at the unit level. SORTS pro- duces unit "C-levels" that characterize the proportion of the wartime mission the unit can perform .5 Separate ratings

32 CFR 110.4 - Responsibilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... STANDARDIZED RATES OF SUBSISTENCE ALLOWANCE AND COMMUTATION INSTEAD OF UNIFORMS FOR MEMBERS OF THE SENIOR... the standard rates of commutation instead of uniforms to the Military Departments not later than... Departments during December of each year the current unit price list of uniform items to be used the following...

32 CFR 110.4 - Responsibilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... STANDARDIZED RATES OF SUBSISTENCE ALLOWANCE AND COMMUTATION INSTEAD OF UNIFORMS FOR MEMBERS OF THE SENIOR... the standard rates of commutation instead of uniforms to the Military Departments not later than... Departments during December of each year the current unit price list of uniform items to be used the following...

32 CFR 110.4 - Responsibilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... STANDARDIZED RATES OF SUBSISTENCE ALLOWANCE AND COMMUTATION INSTEAD OF UNIFORMS FOR MEMBERS OF THE SENIOR... the standard rates of commutation instead of uniforms to the Military Departments not later than... Departments during December of each year the current unit price list of uniform items to be used the following...

32 CFR 110.4 - Responsibilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... STANDARDIZED RATES OF SUBSISTENCE ALLOWANCE AND COMMUTATION INSTEAD OF UNIFORMS FOR MEMBERS OF THE SENIOR... the standard rates of commutation instead of uniforms to the Military Departments not later than... Departments during December of each year the current unit price list of uniform items to be used the following...

32 CFR 110.4 - Responsibilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... STANDARDIZED RATES OF SUBSISTENCE ALLOWANCE AND COMMUTATION INSTEAD OF UNIFORMS FOR MEMBERS OF THE SENIOR... the standard rates of commutation instead of uniforms to the Military Departments not later than... Departments during December of each year the current unit price list of uniform items to be used the following...

Vestibular afferent responses to linear accelerations in the alert squirrel monkey

NASA Technical Reports Server (NTRS)

Somps, Christopher J.; Schor, Robert H.; Tomko, David L.

1994-01-01

The spontaneous activity of 40 otolith afferents and 44 canal afferents was recorded in 4 alert, intact squirrel monkeys. Polarization vectors and response properties of otolith afferents were determined during static re-orientations relative to gravity and during Earth-horizontal, sinusoidal, linear oscillations. Canal afferents were tested for sensitivity to linear accelerations. For regular otolith afferents, a significant correlation between upright discharge rate and sensitivity to dynamic acceleration in the horizontal plane was observed. This correlation was not present in irregular units. The sensitivity of otolith afferents to both static tilts and dynamic linear acceleration was much greater in irregularly discharging units than in regularly discharging units. The spontaneous activity and static and dynamic response properties of regularly discharging otolith afferents were similar to those reported in barbiturate-anesthetized squirrel monkeys. Irregular afferents also had similar dynamic response properties when compared to anesthetized monkeys. However, this sample of irregular afferents in alert animals had higher resting discharge rates and greater sensitivity to static tilts. The majority of otolith polarization vectors were oriented near the horizontal in the plane of the utricular maculae; however, directions of maximum sensitivity were different during dynamic and static testing. Canal afferents were not sensitive to static tilts or linear oscillations of the head.

Survey of United States neurosurgical residency program directors.

PubMed

Lunsford, L Dade; Kassam, Amin; Chang, Yue-Fang

2004-02-01

The field of neurosurgery in the United States faces many challenges. Neurosurgical program directors in the United States represent a logical source for inquiries about manpower issues, the training process, and Residency Review Committee (RRC) oversight. Ninety-one active residency program directors were sent an anonymous 31-question survey. The respondents were given the option of adding additional comments. The questions were designed to address issues related to manpower, the training process, and RRC governance. Sixty-one responses were returned before an email reminder and 11 after the reminder (a total response rate of 79%). The data were entered into a database, and a descriptive analysis, with frequency distribution, was performed. The purpose of this review was to gain a preliminary understanding of the perceptions of program directors regarding the neurosurgical training process, the RRC, the oversight process, and projected manpower needs. A 79% response rate is high for a mail survey and likely reflects heightened concern and interest in such issues. The survey responses indicate general satisfaction with the role and governance of the RRC, significantly divergent perceptions of resident output and available positions, and serious concerns regarding the current training process. This survey suggests that a broader discussion of resident training issues would be valuable, perhaps using validated survey instruments.

Diverging temperature responses of CO2 assimilation and plant development explain the overall effect of temperature on biomass accumulation in wheat leaves and grains

PubMed Central

Lohraseb, Iman; Collins, Nicholas C.

2017-01-01

Abstract There is a growing consensus in the literature that rising temperatures influence the rates of biomass accumulation by shortening the development of plant organs and the whole plant and by altering the rates of respiration and photosynthesis. A model describing the net effects of these processes on biomass would be useful, but would need to reconcile reported differences in the effects of night and day temperature on plant productivity. In this study, the working hypothesis was that the temperature responses of CO2 assimilation and plant development rates were divergent, and that their net effects could explain observed differences in biomass accumulation. In wheat (Triticum aestivum) plants, we followed the temperature responses of photosynthesis, respiration and leaf elongation, and confirmed that their responses diverged. We measured the amount of carbon assimilated per ‘unit of plant development’ in each scenario and compared it to the biomass that accumulated in growing leaves and grains. Our results suggested that, up to a temperature optimum, the rate of any developmental process increased with temperature more rapidly than that of CO2 assimilation and that this discrepancy, summarised by the CO2 assimilation rate per unit of plant development, could explain the observed reductions in biomass accumulation in plant organs under high temperatures. The model described the effects of night and day temperature equally well, and offers a simple framework for describing the effects of temperature on plant growth. PMID:28069595

Contribution of intrinsic properties and synaptic inputs to motoneuron discharge patterns: a simulation study

PubMed Central

ElBasiouny, Sherif M.; Rymer, W. Zev; Heckman, C. J.

2012-01-01

Motoneuron discharge patterns reflect the interaction of synaptic inputs with intrinsic conductances. Recent work has focused on the contribution of conductances mediating persistent inward currents (PICs), which amplify and prolong the effects of synaptic inputs on motoneuron discharge. Certain features of human motor unit discharge are thought to reflect a relatively stereotyped activation of PICs by excitatory synaptic inputs; these features include rate saturation and de-recruitment at a lower level of net excitation than that required for recruitment. However, PIC activation is also influenced by the pattern and spatial distribution of inhibitory inputs that are activated concurrently with excitatory inputs. To estimate the potential contributions of PIC activation and synaptic input patterns to motor unit discharge patterns, we examined the responses of a set of cable motoneuron models to different patterns of excitatory and inhibitory inputs. The models were first tuned to approximate the current- and voltage-clamp responses of low- and medium-threshold spinal motoneurons studied in decerebrate cats and then driven with different patterns of excitatory and inhibitory inputs. The responses of the models to excitatory inputs reproduced a number of features of human motor unit discharge. However, the pattern of rate modulation was strongly influenced by the temporal and spatial pattern of concurrent inhibitory inputs. Thus, even though PIC activation is likely to exert a strong influence on firing rate modulation, PIC activation in combination with different patterns of excitatory and inhibitory synaptic inputs can produce a wide variety of motor unit discharge patterns. PMID:22031773

The Decision To Recruit Online: A Descriptive Study.

ERIC Educational Resources Information Center

Galanaki, Eleanna

2002-01-01

Responses from 34 of 99 United Kingdom information technology companies explored effects of cost effectiveness, response rate and quality, company image, targeting, time and effort, and overload. The effectiveness of online recruiting depends largely on its implementation and the quality of the recruitment process as a whole. (Contains 38…

Keeping in time: Issues affecting the sustainability of obstetric emergency simulation training in outer metropolitan, rural and remote centres in Western Australia.

PubMed

Whitelaw, Claire; Calvert, Katrina; Epee, Mathias

2018-02-01

Obstetric emergency simulation training is an evidence-based intervention for the reduction of perinatal and maternal morbidity. In Western Australia, obstetric emergency training has been run using the In Time course since 2006. The study aimed to determine if the provision of In Time train the trainer courses to outer metro, rural and remote units in Western Australia had led to sustained ongoing training in those units. Ten years following the introduction of the course, we performed a survey to examine which units are continuing to run In Time, what are the perceived benefits in units still utilising In Time, and what were the barriers to training in units that had discontinued. A link to an online survey was sent to the units where In Time training had occurred. Telephone enquiries were additionally used to ensure a good response rate. The survey response rate was 100%. Six of the 11 units where training had been provided continue to run In Time. Units where training had discontinued had done so in order to take up alternatives, or as a result of trainers leaving. Of the units who had discontinued training, one wished to recommence In Time. Local in situ training in obstetric emergencies as exemplified by the In Time course remains a popular and valued training intervention across Western Australia. This training may be of particular benefit to small and remote units, but these are the areas in which training is hardest to sustain. © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Rates of Student-Reported Antisocial Behavior, School Suspensions, and Arrests in Victoria, Australia and Washington State, United States

ERIC Educational Resources Information Center

Hemphill, Sheryl A.; McMorris, Barbara J.; Toumbourou, John W.; Herrenkohl, Todd I.; Catalano, Richard F.; Mathers, Megan

2007-01-01

Background: Few methodologically rigorous international comparisons of student-reported antisocial behavior have been conducted. This paper examines whether there are differences in the frequency of both antisocial behavior and societal responses to antisocial behavior in Victoria, Australia and Washington State, United States. These 2 states were…

Science, Engineering, and Humanities Doctorates in the United States: 1981 Profile.

ERIC Educational Resources Information Center

Maxfield, Betty; And Others

This report provides information on the demographic characteristics and employment status of recipients of doctoral degrees granted from June 1980 to January 1983 (who were residing in the United States in February 1981). Information was collected on 39,547 of the 63,022 individuals in the survey sample, yielding a response rate of 63 percent.…

Near-optimal response of instantaneous transpiration efficiency to vapour pressure deficit, temperature and [CO2] in cotton (Gossypium hirsutum L.).

USDA-ARS?s Scientific Manuscript database

The instantaneous transpiration efficiency (ITE, the ratio of photosynthesis rate to transpiration) is an important variable for crops, because it ultimately affects dry mass production per unit of plant water lost to the atmosphere. The theory that stomata optimize carbon uptake per unit water used...

A determination of the absolute radiant energy of a Robertson-Berger meter sunburn unit

NASA Astrophysics Data System (ADS)

DeLuisi, John J.; Harris, Joyce M.

Data from a Robertson-Berger (RB) sunburn meter were compared with concurrent measurements obtained with an ultraviolet double monochromator (DM), and the absolute energy of one sunburn unit measured by the RB-meter was determined. It was found that at a solar zenith angle of 30° one sunburn unit (SU) is equivalent to 35 ± 4 mJ cm -2, and at a solar zenith angle of 69°, one SU is equivalent to 20 ± 2 mJ cm -2 (relative to a wavelength of 297 nm), where the rate of change is non-linear. The deviation is due to the different response functions of the RB-meter and the DM system used to simulate the response of human skin to the incident u.v. solar spectrum. The average growth rate of the deviation with increasing solar zenith angle was found to be 1.2% per degree between solar zenith angles 30 and 50° and 2.3% per degree between solar zenith angles 50 and 70°. The deviations of response with solar zenith angle were found to be consistent with reported RB-meter characteristics.

Morphine tolerance as a function of ratio schedule: response requirement or unit price?

PubMed

Hughes, Christine E; Sigmon, Stacey C; Pitts, Raymond C; Dykstra, Linda A

2005-05-01

Key pecking by 3 pigeons was maintained by a multiple fixed-ratio 10, fixed-ratio 30, fixed-ratio 90 schedule of food presentation. Components differed with respect to amount of reinforcement, such that the unit price was 10 responses per 1-s access to food. Acute administration of morphine, l-methadone, and cocaine dose-dependently decreased overall response rates in each of the components. When a rate decreasing dose of morphine was administered daily, tolerance, as measured by an increase in the dose that reduced response rates to 50% of control (i.e., the ED50 value), developed in each of the components; however, the degree of tolerance was smallest in the fixed-ratio 90 component (i.e., the ED50 value increased the least). When the l-methadone dose-effect curve was redetermined during the chronic morphine phase, the degree of cross-tolerance conferred to l-methadone was similar across components, suggesting that behavioral variables may not influence the degree of cross-tolerance between opioids. During the chronic phase, the cocaine dose-effect curve shifted to the right for 2 pigeons and to the left for 1 pigeon, which is consistent with predictions based on the lack of pharmacological similarity between morphine and cocaine. When the morphine, l-methadone, and cocaine dose-effect curves were redetermined after chronic morphine administration ended, the morphine and l-methadone ED50s replicated those obtained prior to chronic morphine administration. The morphine data suggest that the fixed-ratio value (i.e., the absolute output) determines the degree of tolerance and not the unit price.

Motor unit activation patterns during concentric wrist flexion in humans with different muscle fibre composition.

PubMed

Søgaard, K; Christensen, H; Fallentin, N; Mizuno, M; Quistorff, B; Sjøgaard, G

1998-10-01

Muscle activity was recorded from the flexor carpi radialis muscle during static and dynamic-concentric wrist flexion in six subjects, who had exhibited large differences in histochemically identified muscle fibre composition. Motor unit recruitment patterns were identified by sampling 310 motor units and counting firing rates in pulses per second (pps). During concentric wrist flexion at 30% of maximal exercise intensity the mean firing rate was 27 (SD 13) pps. This was around twice the value of 12 (SD 5) pps recorded during sustained static contraction at 30% of maximal voluntary contraction, despite a larger absolute force level during the static contraction. A similar pattern of higher firing rates during dynamic exercise was seen when concentric wrist flexion at 60% of maximal exercise intensity [30 (SD 14) pps] was compared with sustained static contraction at 60% of maximal voluntary contraction [19 (SD 8) pps]. The increase in dynamic exercise intensity was accomplished by recruitment of additional motor units rather than by increasing the firing rate as during static contractions. No difference in mean firing rates was found among subjects with different muscle fibre composition, who had previously exhibited marked differences in metabolic response during corresponding dynamic contractions. It was concluded that during submaximal dynamic contractions motor unit firing rate cannot be deduced from observations during static contractions and that muscle fibre composition may play a minor role.

Association of Safety Culture with Surgical Site Infection Outcomes.

PubMed

Fan, Caleb J; Pawlik, Timothy M; Daniels, Tania; Vernon, Nora; Banks, Katie; Westby, Peggy; Wick, Elizabeth C; Sexton, J Bryan; Makary, Martin A

2016-02-01

Hospital workplace culture may have an impact on surgical outcomes; however, this association has not been established. We designed a study to evaluate the association between safety culture and surgical site infection (SSI). Using the Hospital Survey on Patient Safety Culture and National Healthcare Safety Network definitions, we measured 12 dimensions of safety culture and colon SSI rates, respectively, in the surgical units of Minnesota community hospitals. A Pearson's r correlation was calculated for each of 12 dimensions of surgical unit safety culture and SSI rate and then adjusted for surgical volume and American Society of Anesthesiologists (ASA) classification. Seven hospitals participated in the study, with a mean survey response rate of 43%. The SSI rates ranged from 0% to 30%, and surgical unit safety culture scores ranged from 16 to 92 on a scale of 0 to 100. Ten dimensions of surgical unit safety culture were associated with colon SSI rates: teamwork across units (r = -0.96; 95% CI [-0.76, -0.99]), organizational learning (r = -0.95; 95% CI [-0.71, -0.99]), feedback and communication about error (r = -0.92; 95% CI [-0.56, -0.99]), overall perceptions of safety (r = -0.90; 95% CI [-0.45, -0.99]), management support for patient safety (r = -0.90; 95% CI [-0.44, -0.98]), teamwork within units (r = -0.88; 95% CI [-0.38, -0.98]), communication openness (r = -0.85; 95% CI [-0.26, -0.98]), supervisor/manager expectations and actions promoting safety (r = -0.85; 95% CI [-0.25, -0.98]), non-punitive response to error (r = -0.78; 95% CI [-0.07, -0.97]), and frequency of events reported (r = -0.76; 95% CI [-0.01, -0.96]). After adjusting for surgical volume and ASA classification, 9 of 12 dimensions of surgical unit safety culture were significantly associated with lower colon SSI rates. These data suggest an important role for positive safety and teamwork culture and engaged hospital management in producing high-quality surgical outcomes. Copyright © 2016. Published by Elsevier Inc.

Motor unit recruitment and derecruitment induced by brief increase in contraction amplitude of the human trapezius muscle

PubMed Central

Westad, C; Westgaard, R H; De Luca, C J

2003-01-01

The activity pattern of low-threshold human trapezius motor units was examined in response to brief, voluntary increases in contraction amplitude (‘EMG pulse’) superimposed on a constant contraction at 4–7% of the surface electromyographic (EMG) response at maximal voluntary contraction (4–7% EMGmax). EMG pulses at 15–20% EMGmax were superimposed every minute on contractions of 5, 10, or 30 min duration. A quadrifilar fine-wire electrode recorded single motor unit activity and a surface electrode recorded simultaneously the surface EMG signal. Low-threshold motor units recruited at the start of the contraction were observed to stop firing while motor units of higher recruitment threshold stayed active. Derecruitment of a motor unit coincided with the end of an EMG pulse. The lowest-threshold motor units showed only brief silent periods. Some motor units with recruitment threshold up to 5% EMGmax higher than the constant contraction level were recruited during an EMG pulse and kept firing throughout the contraction. Following an EMG pulse, there was a marked reduction in motor unit firing rates upon return of the surface EMG signal to the constant contraction level, outlasting the EMG pulse by 4 s on average. The reduction in firing rates may serve as a trigger to induce derecruitment. We speculate that the silent periods following derecruitment may be due to deactivation of non-inactivating inward current (‘plateau potentials’). The firing behaviour of trapezius motor units in these experiments may thus illustrate a mechanism and a control strategy to reduce fatigue of motor units with sustained activity patterns. PMID:14561844

Preceding muscle activity influences motor unit discharge and rate of torque development during ballistic contractions in humans

PubMed Central

Van Cutsem, Michaël; Duchateau, Jacques

2005-01-01

To investigate the effect of initial conditions on the modulation of motor unit discharge during fast voluntary contractions, we compared ballistic isometric contractions of the ankle dorsiflexor muscles that were produced from either a resting state or superimposed on a sustained contraction. The torque of the dorsiflexors and the surface and intramuscular EMGs from the tibialis anterior were recorded. The results showed that the performance of a ballistic contraction from a sustained contraction (∼25% maximal voluntary contraction (MVC)) had a negative effect on the maximal rate of torque development. Although the electromechanical delay was shortened, the EMG activity during the ballistic contraction was less synchronized. These observations were associated with a significant decline in the average discharge rate of single motor units (89.8 ± 3.8 versus 115 ± 5.8 Hz) and in the percentage of units (6.2 versus 15.5% of the whole sample) that exhibited double discharges at brief intervals (= 5 ms). High-threshold units that were not recruited during the sustained contraction displayed the same activation pattern, which indicates that the mechanisms responsible for the decline in discharge rate were not restricted to previously activated units, but appear to influence the entire motor unit pool. When a premotor silent period (SP) was observed at the transition from the sustained muscular activity to the ballistic contraction (19% of the trials), these adjustments in motor unit activity were not present, and the ballistic contractions were similar to those performed from a resting state. Together, these results indicate that initial conditions can influence the capacity for motor unit discharge rate and hence the performance of a fast voluntary contraction. PMID:15539402

Prevalence of HIV Infection Among Young Adults in the United States: Results From the Add Health Study

PubMed Central

Morris, Martina; Handcock, Mark S.; Miller, William C.; Ford, Carol A.; Schmitz, John L.; Hobbs, Marcia M.; Cohen, Myron S.; Harris, Kathleen M.; Udry, J. Richard

2006-01-01

Objectives. We estimated HIV prevalence rates among young adults in the United States. Methods. We used survey data from the third wave of the National Longitudinal Study of Adolescent Health, a random sample of nearly 19000 young adults initiated in 1994–1995. Consenting respondents were screened for the presence of antibodies to HIV-1 in oral mucosal transudate specimens. We calculated prevalence rates, accounting for survey design, response rates, and test performance. Results. Among the 13184 participants, the HIV prevalence rate was 1.0 per 1000 (95% confidence interval [CI] = 0.4, 1.7). Gender-specific prevalence rates were similar, but rates differed markedly between non-Hispanic Blacks (4.9 per 1000; 95% CI=1.8, 8.7) and members of other racial/ethnic groups (0.22 per 1000; 95% CI=0.00, 0.64). Conclusions. Racial disparities in HIV in the United States are established early in the life span, and our data suggest that 15% to 30% of all cases of HIV occur among individuals younger than 25 years. PMID:16670236

Update on Electronic Dental Record and Clinical Computing Adoption Among Dental Practices in the United States

PubMed Central

Schroeder, Dixie; Schwei, Kelsey; Chyou, Po-Huang

2017-01-01

This study sought to re-characterize trends and factors affecting electronic dental record (EDR) and technologies adoption by dental practices and the impact of the Health Information Technology for Economic and Clinical Health (HITECH) act on adoption rates through 2012. A 39-question survey was disseminated nationally over 3 months using a novel, statistically-modeled approach informed by early response rates to achieve a predetermined sample. EDR adoption rate for clinical support was 52%. Adoption rates were higher among: (1) younger dentists; (2) dentists ≤ 15 years in practice; (3) females; and (4) group practices. Top barriers to adoption were EDR cost/expense, cost-benefit ratio, electronic format conversion, and poor EDR usability. Awareness of the Federal HITECH incentive program was low. The rate of chairside computer implementation was 72%. Adoption of EDR in dental offices in the United States was higher in 2012 than electronic health record adoption rates in medical offices and was not driven by the HITECH program. Patient portal adoption among dental practices in the United States remained low. PMID:29229631

76 FR 47615 - Postal Rate Changes

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-05

... CONTACT: Stephen L. Sharfman, General Counsel, at 202-789-6820 (case-related information) or DocketAdmins... Expedited Services.\\2\\ The rates took effect on January 1, 2009. In Order No. 281, the Commission accepted... Expedited Services 2, August 19, 2009 (Order No. 281). \\4\\ See Docket No. CP2009-57, Response of the United...

An audit of chronic hepatitis B contact tracing in metropolitan Western Australia.

PubMed

Mascarenhas, Lester; Mak, Donna B

2014-03-01

People with chronic hepatitis B (CHB) are a source of transmission and those in contact with them are a national priority population for hepatitis B testing and vaccination. This audit examined contact tracing success rate and barriers. Success was defined as contacts tested and vaccinated if required. An online survey of 26 general practitioners (GPs), and computer-assisted telephone interviews of 40 patients with CHB notified between 1 September 2011 and 1 September 2012. Half of the patients with CHB (16/31) were asked to take responsibility for informing contacts; contacts of five patients were traced by doctors and those of three patients were traced by nurses. The overall success rate was 75%. Contact tracing by nurses was 100% successful; after excluding nurse contact tracing from the analysis, the success rate was 57%. GPs reported 'insufficient resources' as the most frequent doctor-related barrier to contact tracing and 58% of doctors reported that public health units should be responsible for contact tracing. Increasing contact tracing by nurses could improve success rates. Public health unit assistance for contact tracing of complex cases should continue.

The Effects of Observation of Learn Units during Reinforcement and Correction Conditions on the Rate of Learning Math Algorithms by Fifth Grade Students

ERIC Educational Resources Information Center

Neu, Jessica Adele

2013-01-01

I conducted two studies on the comparative effects of the observation of learn units during (a) reinforcement or (b) correction conditions on the acquisition of math objectives. The dependent variables were the within-session cumulative numbers of correct responses emitted during observational sessions. The independent variables were the…

Diverging temperature responses of CO2 assimilation and plant development explain the overall effect of temperature on biomass accumulation in wheat leaves and grains.

PubMed

Collins, Nicholas C; Parent, Boris

2017-01-09

There is a growing consensus in the literature that rising temperatures influence the rate of biomass accumulation by shortening the development of plant organs and the whole plant and by altering rates of respiration and photosynthesis. A model describing the net effects of these processes on biomass would be useful, but would need to reconcile reported differences in the effects of night and day temperature on plant productivity. In this study, the working hypothesis was that the temperature responses of CO 2 assimilation and plant development rates were divergent, and that their net effects could explain observed differences in biomass accumulation. In wheat (Triticum aestivum) plants, we followed the temperature responses of photosynthesis, respiration and leaf elongation, and confirmed that their responses diverged. We measured the amount of carbon assimilated per "unit of plant development" in each scenario and compared it to the biomass that accumulated in growing leaves and grains. Our results suggested that, up to a temperature optimum, the rate of any developmental process increased with temperature more rapidly than that of CO 2 assimilation and that this discrepancy, summarised by the CO 2 assimilation rate per unit of plant development, could explain the observed reductions in biomass accumulation in plant organs under high temperatures. The model described the effects of night and day temperature equally well, and offers a simple framework for describing the effects of temperature on plant growth. Published by Oxford University Press on behalf of the Annals of Botany Company.

Comparison of temporal properties of auditory single units in response to cochlear infrared laser stimulation recorded with multi-channel and single tungsten electrodes

NASA Astrophysics Data System (ADS)

Tan, Xiaodong; Xia, Nan; Young, Hunter; Richter, Claus-Peter

2015-02-01

Auditory prostheses may benefit from Infrared Neural Stimulation (INS) because optical stimulation allows for spatially selective activation of neuron populations. Selective activation of neurons in the cochlear spiral ganglion can be determined in the central nucleus of the inferior colliculus (ICC) because the tonotopic organization of frequencies in the cochlea is maintained throughout the auditory pathway. The activation profile of INS is well represented in the ICC by multichannel electrodes (MCEs). To characterize single unit properties in response to INS, however, single tungsten electrodes (STEs) should be used because of its better signal-to-noise ratio. In this study, we compared the temporal properties of ICC single units recorded with MCEs and STEs in order to characterize the response properties of single auditory neurons in response to INS in guinea pigs. The length along the cochlea stimulated with infrared radiation corresponded to a frequency range of about 0.6 octaves, similar to that recorded with STEs. The temporal properties of single units recorded with MCEs showed higher maximum rates, shorter latencies, and higher firing efficiencies compared to those recorded with STEs. When the preset amplitude threshold for triggering MCE recordings was raised to twice over the noise level, the temporal properties of the single units became similar to those obtained with STEs. Undistinguishable neural activities from multiple sources in MCE recordings could be responsible for the response property difference between MCEs and STEs. Thus, caution should be taken in single unit recordings with MCEs.

Force-frequency and fatigue properties of motor units in muscles that control digits of the human hand.

PubMed

Fuglevand, A J; Macefield, V G; Bigland-Ritchie, B

1999-04-01

Modulation of motor unit activation rate is a fundamental process by which the mammalian nervous system encodes muscle force. To identify how rate coding of force may change as a consequence of fatigue, intraneural microstimulation of motor axons was used to elicit twitch and force-frequency responses before and after 2 min of intermittent stimulation (40-Hz train for 330 ms, 1 train/s) in single motor units of human long finger flexor muscles and intrinsic hand muscles. Before fatigue, two groups of units could be distinguished based on the stimulus frequency needed to elicit half-maximal force; group 1 (n = 8) required 9.1 +/- 0.5 Hz (means +/- SD), and group 2 (n = 5) required 15.5 +/- 1.1 Hz. Twitch contraction times were significantly different between these two groups (group 1 = 66. 5 ms; group 2 = 45.9 ms). Overall 18% of the units were fatigue resistant [fatigue index (FI) > 0.75], 64% had intermediate fatigue sensitivity (0.25

Review of laparoscopic training in pediatric surgery in the United Kingdom.

PubMed

Stormer, Emma J; Sabharwal, Atul J

2009-04-01

To review the exposure pediatric surgery trainees have to laparoscopic surgery in the United Kingdom (UK). A confidential postal questionnaire was sent to all trainees working at registrar level in centers responsible for pediatric surgical training in the UK. Questions assessed the number of consultants with an interest in laparoscopic surgery, types of cases performed laparoscopically, and trainees' role in laparoscopic appendicectomy (LA). Questionnaires were sent to 112 trainees with a 55% response rate (62 replies). At least one response was received from each unit. Based on responses, 49 to 67 consultants in 21 training centers have an interest in laparoscopic surgery (0%-100% of consultants per unit). LA was offered in 20 out of 21 training centers. There was no significant difference in the proportion of appendicectomies performed laparoscopically by junior (years 1-3) and senior (years 4-6) trainees. A significantly higher proportion of junior trainees had not performed any LAs (P = 0.02). Seventy-three percent of trainees were the principal operator. For trainees who were principal operators, the cameraperson was a consultant in 52% and a junior trainee in 17%. The time of day affected the likelihood of a procedure being carried out laparoscopically in 43 (81%) responses. The majority of trainees' exposure to laparoscopic surgery could be viewed as suboptimal; however, the exposure gained varies significantly between different units throughout the UK. In an age moving in favor of minimal access surgery, all units must be in a position to offer pediatric laparoscopic surgical training.

10 CFR 455.112 - Davis-Bacon wage rate requirement.

Code of Federal Regulations, 2010 CFR

2010-01-01

... OWNED BY UNITS OF LOCAL GOVERNMENT AND PUBLIC CARE INSTITUTIONS Applicant Responsibilities-Grants to... measure or group of measures in a building, funded under this part, has a total estimated cost for...

Attrition due to orthopedic reasons during combat training: rates, types of injuries, and comparison between infantry and noninfantry units.

PubMed

Schwartz, Oren; Levinson, Tal; Astman, Nadav; Haim, Lavon

2014-08-01

The purpose of this study is to identify the prevalence and types of orthopedic injuries in infantry and noninfantry units responsible for attrition from combat training. 18,651 soldiers consecutively recruited to combat units (5 infantry and 4 noninfantry units) were included in this study. All recruited soldiers underwent and successfully passed a meticulous medical selection process. In all units, the soldiers participated in a suited fitness program that included marching, running, and strength training. Data were collected directly from attrite soldiers' files and detailed lists provided by the units' medical clinics. Out of 18,651 recruits, 641 (3.44%) attrite because of medical reasons. The leading cause of attrition was orthopedic diagnoses, and their overall rate was 43% (274 out of 641). Overuse injuries accounted for 90% of all orthopedic injuries. Low-back and lower extremity injuries accounted for 71.5% of all orthopedic injuries. There was high similarity in orthopedic injuries types and rates between infantry and noninfantry units. On the basis of our results, we recommend a multidisciplinary intense effort including physicians, physical training officers, physiotherapists, and commanders to significantly reduce overuse injuries, especially in the low-back and lower extremity regions. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Rare disease surveillance: An international perspective

PubMed Central

Elliott, Elizabeth J; Nicoll, Angus; Lynn, Richard; Marchessault, Victor; Hirasing, Remy; Ridley, Greta

2001-01-01

BACKGROUND: The International Network of Paediatric Surveillance Units (INoPSU) was established in 1998 and met formally for the first time in Ottawa, Ontario in June 2000. OBJECTIVES: To document the methodology and activities of existing national paediatric surveillance units; the formation of INoPSU; the diseases studied by INoPSU members; and the impact of such studies on education, public health and paediatric practice. METHODS: Directors of paediatric surveillance units in Australia, Britain, Canada, Germany, the Netherlands, Latvia, Malaysia, Papua New Guinea, New Zealand and Switzerland were asked to provide information on each unit’s affiliations, funding and staffing; the method of case ascertainment, the mailing list and response rates; and diseases studied. Original articles that reported data derived from units were identified by a search of an electronic database (MEDLINE), and additional information was obtained from units’ annual reports. RESULTS: Worldwide, 10 units (established from 1986 to 1997), use active national surveillance of more than 8500 clinicians each month to identify cases of rare or uncommon diseases in a childhood population (younger than 15 years of age) of over 47 million (monthly response rate 73% to 98%). By January 1999, units had initiated 147 studies on 103 different conditions, and 63 studies were completed. CONCLUSION: INoPSU enhances collaboration among units from four continents, providing a unique opportunity for simultaneous cross-sectional studies of rare diseases in populations with diverse geographical and ethnic characteristics. It facilitates the sharing of ideas regarding current methodology, ethics, the most appropriate means of evaluating units and their potential application. PMID:20084246

Do former preterm infants remember and respond to neonatal intensive care unit noise?

PubMed

Barreto, Edwin D; Morris, Brenda H; Philbin, M Kathleen; Gray, Lincoln C; Lasky, Robert E

2006-11-01

Previous studies have shown that 4-month-old infants have a decrease in heart rate, a component of the orienting reflex, in response to interesting auditory stimuli and an increase in heart rate to aversive auditory stimuli. To compare the heart rate responses of former preterm and term infants at 4-5 months corrected age to a recording of NICU noises. 13 former preterm infants and 17 full-term infants were presented NICU noise and another noise of similar level and frequency content in random order. Heart rate 10s prior to the stimulus and for 20s during the stimulus was analyzed. Group differences in second by second heart rate changes in response to the two noise stimuli were compared by analysis of covariance. Both the preterm and term newborns responded similarly to the NICU noise and the control noise. The preterm infants did not alter their heart rate in response to either stimulus. In contrast, the term infants displayed an orienting response to the second stimulus presented regardless of whether it was the NICU or control noise. Former preterm infants at 4-5 months corrected age have reduced responsiveness to auditory stimulation in comparison to 4- to 5-month-old term infants. Furthermore, they did not respond to the NICU noise as an aversive stimulus.

Implementation of Fiber Substructuring Into Strain Rate Dependent Micromechanics Analysis of Polymer Matrix Composites

NASA Technical Reports Server (NTRS)

Goldberg, Robert K.

2001-01-01

A research program is in progress to develop strain rate dependent deformation and failure models for the analysis of polymer matrix composites subject to impact loads. Previously, strain rate dependent inelastic constitutive equations developed to model the polymer matrix were incorporated into a mechanics of materials based micromechanics method. In the current work, the micromechanics method is revised such that the composite unit cell is divided into a number of slices. Micromechanics equations are then developed for each slice, with laminate theory applied to determine the elastic properties, effective stresses and effective inelastic strains for the unit cell. Verification studies are conducted using two representative polymer matrix composites with a nonlinear, strain rate dependent deformation response. The computed results compare well to experimentally obtained values.

Examining the Socialization of Physical Education Teachers: A Case Study

ERIC Educational Resources Information Center

Geisler, Thomas M.

2017-01-01

In the last thirty years childhood obesity and inactivity rates in the United States have increased at alarming rates (Ogden, Carroll, Kit, & Flegal, 2014). In response to this, physical education curriculum is shifting to focus more on health promotion rather than competitive team sports and game play. This focus is reflected in the recently…

A Nationwide Overview of Sight-Singing Requirements of Large-Group Choral Festivals

ERIC Educational Resources Information Center

Norris, Charles E.

2004-01-01

The purpose of this study was to examine sight-singing requirements at junior and senior high school large-group ratings-based choral festivals throughout the United States. Responses to the following questions were sought from each state: (1) Are there ratings-based large-group choral festivals? (2) Is sight-singing a requirement? (3) Are there…

Effects and empirical critical loads of nitrogen for ecoregions of the United States

Treesearch

Linda H. Pardo; Molly J. Robin-Abbot; Mark E. Fenn; Christine L. Goodale; Linda H. Geiser; Charles T. Driscoll; Edith B. Allen; Jill S. Baron; Roland Bobbink; William D. Bowman; Christopher M. Clark; Bridget Emmett; Frank S. Gilliam; Tara L. Greaver; Sharon J. Hall; Erik A. Lilleskov; Lingli Liu; Jason A. Lynch; Knute J. Nadelhoffer; Steven J. Perakis; John L. Stoddard; Kathleen C. Weathers; Robin L. Dennis

2015-01-01

Human activity in the last century has led to a significant increase in nitrogen (N) emissions and deposition (Galloway et al. 2004). Total N emissions in the United States have increased significantly since the 1950s (Galloway 1998, Galloway et al. 2003). As S deposition has declined in response to regulation, the rate of N deposition relative to S deposition has...

The critical role of extreme heat for maize production in the United States

NASA Astrophysics Data System (ADS)

Lobell, David B.; Hammer, Graeme L.; McLean, Greg; Messina, Carlos; Roberts, Michael J.; Schlenker, Wolfram

2013-05-01

Statistical studies of rainfed maize yields in the United States and elsewhere have indicated two clear features: a strong negative yield response to accumulation of temperatures above 30°C (or extreme degree days (EDD)), and a relatively weak response to seasonal rainfall. Here we show that the process-based Agricultural Production Systems Simulator (APSIM) is able to reproduce both of these relationships in the Midwestern United States and provide insight into underlying mechanisms. The predominant effects of EDD in APSIM are associated with increased vapour pressure deficit, which contributes to water stress in two ways: by increasing demand for soil water to sustain a given rate of carbon assimilation, and by reducing future supply of soil water by raising transpiration rates. APSIM computes daily water stress as the ratio of water supply to demand, and during the critical month of July this ratio is three times more responsive to 2°C warming than to a 20% precipitation reduction. The results suggest a relatively minor role for direct heat stress on reproductive organs at present temperatures in this region. Effects of elevated CO2 on transpiration efficiency should reduce yield sensitivity to EDD in the coming decades, but at most by 25%.

Listing Practices for Morbidly Obese Patients at Liver Transplantation Centers in the United States.

PubMed

Halegoua-De Marzio, Dina L; Wong, She-Yan; Fenkel, Jonathan M; Doria, Cataldo; Sass, David A

2016-12-01

The effect of morbid obesity on liver transplant outcomes has yielded mixed results. The aim of this study was to determine listing practices for morbidly obese patients at liver transplant centers in the United States. A 19-item survey was created to assess liver transplant evaluation and listing practices for morbidly obese patients. All adult liver transplant medical and surgical directors in the United States were contacted by e-mail, which provided an Internet link to an online survey. We sent a total of 187 surveys by e-mail, with responses received from 46 physicians (24.7% response rate). A policy on evaluation and listing of obese patients was present at 70.5% of institutions, with most (54.5%) reporting that their body mass index cutoff for transplant was 40 kg/m2, but a range of 35 kg/m2 to unlimited was noted. Most respondents agreed that patients with high body mass index were less likely to be evaluated for transplant. Respondents reported increased complication rates among obese patients, with the most common being poor wound healing and increased infection rates. Most medical and surgical liver transplant directors have a strong appreciation of the possible morbidity risks associated with performing liver transplants in morbidly obese patients and have policies in effect to minimize these risks.

Australian Paediatric Surveillance Unit : progress report.

PubMed

Morris, A; Ridley, G F; Elliott, E J

2002-02-01

The Australian Paediatric Surveillance Unit (APSU), through active surveillance, collects information on the epidemiology of rare or uncommon childhood conditions. This research resource allows paediatricians to collaborate at State, national and international levels. The APSU sends a monthly report card to all (currently 971) paediatricians in Australia, who in turn indicate whether or not they have seen a patient in the last month with any of the conditions listed (98% response rate in 1999). Study investigators, notified by the APSU of positive case reports, obtain demographic and clinical data on the patient from the reporting doctor by postal questionnaire (90% response rate in 1999). Since 1993, the APSU has monitored 27 conditions, including conditions that are vaccine-preventable, otherwise infectious, genetic, congenital and non-communicable. Information collected is disseminated to paediatricians and other health professionals via an annual report, newsletters and publications and is made available to the International Network of Paediatric Surveillance Units. Information provided by the APSU has raised awareness among paediatricians of rare and uncommon childhood conditions, and has been used by health authorities for planning of prevention and intervention strategies and allocation of health resources.

Gamma loop contributing to maximal voluntary contractions in man.

PubMed Central

Hagbarth, K E; Kunesch, E J; Nordin, M; Schmidt, R; Wallin, E U

1986-01-01

A local anaesthetic drug was injected around the peroneal nerve in healthy subjects in order to investigate whether the resulting loss in foot dorsiflexion power in part depended on a gamma-fibre block preventing 'internal' activation of spindle end-organs and thereby depriving the alpha-motoneurones of an excitatory spindle inflow during contraction. The motor outcome of maximal dorsiflexion efforts was assessed by measuring firing rates of individual motor units in the anterior tibial (t.a.) muscle, mean voltage e.m.g. from the pretibial muscles, dorsiflexion force and range of voluntary foot dorsiflexion movements. The tests were performed with and without peripheral conditioning stimuli, such as agonist or antagonist muscle vibration or imposed stretch of the contracting muscles. As compared to control values of t.a. motor unit firing rates in maximal isometric voluntary contractions, the firing rates were lower and more irregular during maximal dorsiflexion efforts performed during subtotal peroneal nerve blocks. During the development of paresis a gradual reduction of motor unit firing rates was observed before the units ceased responding to the voluntary commands. This change in motor unit behaviour was accompanied by a reduction of the mean voltage e.m.g. activity in the pretibial muscles. At a given stage of anaesthesia the e.m.g. responses to maximal voluntary efforts were more affected than the responses evoked by electric nerve stimuli delivered proximal to the block, indicating that impaired impulse transmission in alpha motor fibres was not the sole cause of the paresis. The inability to generate high and regular motor unit firing rates during peroneal nerve blocks was accentuated by vibration applied over the antagonistic calf muscles. By contrast, in eight out of ten experiments agonist stretch or vibration caused an enhancement of motor unit firing during the maximal force tasks. The reverse effects of agonist and antagonist vibration on the ability to activate the paretic muscles were evidenced also by alterations induced in mean voltage e.m.g. activity, dorsiflexion force and range of dorsiflexion movements. The autogenetic excitatory and the reciprocal inhibitory effects of muscle vibration rose in strength as the vibration frequency was raised from 90 to 165 Hz. Reflex effects on maximal voluntary contraction strength similar to those observed during partial nerve blocks were not seen under normal conditions when the nerve supply was intact.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:3612576

Impact and determinants of nurse turnover: a pan-Canadian study.

PubMed

O'Brien-Pallas, Linda; Murphy, Gail Tomblin; Shamian, Judith; Li, Xiaoqiang; Hayes, Laureen J

2010-11-01

As part of a large study of nursing turnover in Canadian hospitals, the present study focuses on the impact and key determinants of nurse turnover and implications for management strategies in nursing units. Nursing turnover is an issue of ever-increasing priority as work-related stress and job dissatisfaction are influencing nurses' intention to leave their positions. Data sources included the nurse survey, unit managers, medical records and human resources databases. A broad sample of hospitals was represented with nine different types of nursing units included. Nurses turnover is a major problem in Canadian hospitals with a mean turnover rate of 19.9%. Higher levels of role ambiguity and role conflict were associated with higher turnover rates. Increased role conflict and higher turnover rates were associated with deteriorated mental health. Higher turnover rates were associated with lower job satisfaction. Higher turnover rate and higher level of role ambiguity were associated with an increased likelihood of medical error. Managing turnover within nursing units is critical to high-quality patient care. A supportive practice setting in which role responsibilities are understood by all members of the caregiver team would promote nurse retention. Stable nurse staffing and adequate managerial support are essential to promote job satisfaction and high-quality patient care. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

Medical Rapid Response in Psychiatry: Reasons for Activation and Immediate Outcome.

PubMed

Manu, Peter; Loewenstein, Kristy; Girshman, Yankel J; Bhatia, Padam; Barnes, Maira; Whelan, Joseph; Solderitch, Victoria A; Rogozea, Liliana; McManus, Marybeth

2015-12-01

Rapid response teams are used to improve the recognition of acute deteriorations in medical and surgical settings. They are activated by abnormal physiological parameters, symptoms or clinical concern, and are believed to decrease hospital mortality rates. We evaluated the reasons for activation and the outcome of rapid response interventions in a 222-bed psychiatric hospital in New York City using data obtained at the time of all activations from January through November, 2012. The primary outcome was the admission rate to a medical or surgical unit for each of the main reasons for activation. The 169 activations were initiated by nursing staff (78.7 %) and psychiatrists (13 %) for acute changes in condition (64.5 %), abnormal physiological parameters (27.2 %) and non-specified concern (8.3 %). The most common reasons for activation were chest pain (14.2 %), fluctuating level of consciousness (9.5 %), hypertension (9.5 %), syncope or fall (8.9 %), hypotension (8.3 %), dyspnea (7.7 %) and seizures (5.9 %). The rapid response team transferred 127 (75.2 %) patients to the Emergency Department and 46 (27.2 %) were admitted to a medical or surgical unit. The admission rates were statistically similar for acute changes in condition, abnormal physiological parameters, and clinicians' concern. In conclusion, a majority of rapid response activations in a self-standing psychiatric hospital were initiated by nursing staff for changes in condition, rather than for policy-specified abnormal physiological parameters. The findings suggest that a rapid response system may empower psychiatric nurses to use their clinical skills to identify patients requiring urgent transfer to a general hospital.

Microprocessor realizations of range rate filters

NASA Technical Reports Server (NTRS)

1979-01-01

The performance of five digital range rate filters is evaluated. A range rate filter receives an input of range data from a radar unit and produces an output of smoothed range data and its estimated derivative range rate. The filters are compared through simulation on an IBM 370. Two of the filter designs are implemented on a 6800 microprocessor-based system. Comparisons are made on the bases of noise variance reduction ratios and convergence times of the filters in response to simulated range signals.

Species-Independent Down-Regulation of Leaf Photosynthesis and Respiration in Response to Shading: Evidence from Six Temperate Tree Species

PubMed Central

Chen, Anping; Lichstein, Jeremy W.; Osnas, Jeanne L. D.; Pacala, Stephen W.

2014-01-01

The ability to down-regulate leaf maximum net photosynthetic capacity (Amax) and dark respiration rate (Rdark) in response to shading is thought to be an important adaptation of trees to the wide range of light environments that they are exposed to across space and time. A simple, general rule that accurately described this down-regulation would improve carbon cycle models and enhance our understanding of how forest successional diversity is maintained. In this paper, we investigated the light response of Amax and Rdark for saplings of six temperate forest tree species in New Jersey, USA, and formulated a simple model of down-regulation that could be incorporated into carbon cycle models. We found that full-sun values of Amax and Rdark differed significantly among species, but the rate of down-regulation (proportional decrease in Amax or Rdark relative to the full-sun value) in response to shade was not significantly species- or taxon-specific. Shade leaves of sun-grown plants appear to follow the same pattern of down-regulation in response to shade as leaves of shade-grown plants. Given the light level above a leaf and one species-specific number (either the full-sun Amax or full-sun Rdark), we provide a formula that can accurately predict the leaf's Amax and Rdark. We further show that most of the down regulation of per unit area Rdark and Amax is caused by reductions in leaf mass per unit area (LMA): as light decreases, leaves get thinner, while per unit mass Amax and Rdark remain approximately constant. PMID:24727745

Participating on Equal Terms? The Gender Dimensions of Direct Participation in Organisational Change: Findings from the EPOC Survey.

ERIC Educational Resources Information Center

Schnabel, Annette; Webster, Juliet

The gender dimensions of direct participation in organizational change were examined in a survey of general managers at 32,582 workplaces in the following European countries: Denmark, France, Germany, Ireland, Italy, the Netherlands, Portugal, Spain, Sweden, and the United Kingdom. Responses were received from 5,786 managers (response rate,…

Groundwater dynamics mediate low-flow response to global warming in snow-dominated alpine regions

Treesearch

Christina Tague; Gordon E. Grant

2009-01-01

In mountain environments, spatial and temporal patterns of snow accumulation and melt are dominant controls on hydrologic responses to climate change. In this paper, we develop a simple conceptual model that links the timing of peak snowmelt with geologically mediated differences in rate of streamflow recession. This model demonstrates that within the western United...

Phase shift method to estimate solids circulation rate in circulating fluidized beds

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

Ludlow, James Christopher; Panday, Rupen; Shadle, Lawrence J.

2013-01-01

While solids circulation rate is a critical design and control parameter in circulating fluidized bed (CFB) reactor systems, there are no available techniques to measure it directly at conditions of industrial interest. Cold flow tests have been conducted at NETL in an industrial scale CFB unit where the solids flow has been the topic of research in order to develop an independent method which could be applied to CFBs operating under the erosive and corrosive high temperatures and pressures of a coal fired boiler or gasifier. The dynamic responses of the CFB loop to modest modulated aeration flows in themore » return leg or standpipe were imposed to establish a periodic response in the unit without causing upset in the process performance. The resulting periodic behavior could then be analyzed with a dynamic model and the average solids circulation rate could be established. This method was applied to the CFB unit operated under a wide range of operating conditions including fast fluidization, core annular flow, dilute and dense transport, and dense suspension upflow. In addition, the system was operated in both low and high total solids inventories to explore the influence of inventory limiting cases on the estimated results. The technique was able to estimate the solids circulation rate for all transport circulating fluidized beds when operating above upper transport velocity, U{sub tr2}. For CFB operating in the fast fluidized bed regime (i.e., U{sub g}< U{sub tr2}), the phase shift technique was not successful. The riser pressure drop becomes independent of the solids circulation rate and the mass flow rate out of the riser does not show modulated behavior even when the riser pressure drop does.« less

Effects of root-zone acidity on utilization of nitrate and ammonium in tobacco plants

NASA Technical Reports Server (NTRS)

Henry, L. T.; Raper, C. D. Jr; Raper CD, J. r. (Principal Investigator)

1989-01-01

Tobacco (Nicotiana tabacum L., cv. 'Coker 319') plants were grown for 28 days in flowing nutrient culture containing either 1.0 mM NO3- or 1.0 mM NH4+ as the nitrogen source in a complete nutrient solution. Acidities of the solutions were controlled at pH 6.0 or 4.0 for each nitrogen source. Plants were sampled at intervals of 6 to 8 days for determination of dry matter and nitrogen accumulation. Specific rates of NO3- or NH4+ uptake (rate of uptake per unit root mass) were calculated from these data. Net photosynthetic rates per unit leaf area were measured on attached leaves by infrared gas analysis. When NO3- [correction of NO-] was the sole nitrogen source, root growth and nitrogen uptake rate were unaffected by pH of the solution, and photosynthetic activity of leaves and accumulation of dry matter and nitrogen in the whole plant were similar. When NH4+ was the nitrogen source, photosynthetic rate of leaves and accumulation of dry matter and nitrogen in the whole plant were not statistically different from NO3(-) -fed plants when acidity of the solution was controlled at pH 6.0. When acidity for NH4(+) -fed plants was increased to pH 4.0, however, specific rate of NH4+ uptake decreased by about 50% within the first 6 days of treatment. The effect of acidity on root function was associated with a decreased rate of accumulation of nitrogen in shoots that was accompanied by a rapid cessation of leaf development between days 6 and 13. The decline in leaf growth rate of NH4(+) -fed plants at pH 4.0 was followed by reductions in photosynthetic rate per unit leaf area. These responses of NH4(+) -fed plants to increased root-zone acidity are characteristic of the sequence of responses that occur during onset of nitrogen stress.

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

O'Shaughnessy, Eric; Ardani, Kristen; Cutler, Dylan

Solar 'plus' refers to an emerging approach to distributed solar photovoltaic (PV) deployment that uses energy storage and controllable devices to optimize customer economics. The solar plus approach increases customer system value through technologies such as electric batteries, smart domestic water heaters, smart air-conditioner (AC) units, and electric vehicles We use an NREL optimization model to explore the customer-side economics of solar plus under various utility rate structures and net metering rates. We explore optimal solar plus applications in five case studies with different net metering rates and rate structures. The model deploys different configurations of PV, batteries, smart domesticmore » water heaters, and smart AC units in response to different rate structures and customer load profiles. The results indicate that solar plus improves the customer economics of PV and may mitigate some of the negative impacts of evolving rate structures on PV economics. Solar plus may become an increasingly viable model for optimizing PV customer economics in an evolving rate environment.« less

Solar Plus: A Holistic Approach to Distributed Solar PV

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

OShaughnessy, Eric J.; Ardani, Kristen B.; Cutler, Dylan S.

Solar 'plus' refers to an emerging approach to distributed solar photovoltaic (PV) deployment that uses energy storage and controllable devices to optimize customer economics. The solar plus approach increases customer system value through technologies such as electric batteries, smart domestic water heaters, smart air-conditioner (AC) units, and electric vehicles We use an NREL optimization model to explore the customer-side economics of solar plus under various utility rate structures and net metering rates. We explore optimal solar plus applications in five case studies with different net metering rates and rate structures. The model deploys different configurations of PV, batteries, smart domesticmore » water heaters, and smart AC units in response to different rate structures and customer load profiles. The results indicate that solar plus improves the customer economics of PV and may mitigate some of the negative impacts of evolving rate structures on PV economics. Solar plus may become an increasingly viable model for optimizing PV customer economics in an evolving rate environment.« less

The Role of Inhibition in a Computational Model of an Auditory Cortical Neuron during the Encoding of Temporal Information

PubMed Central

Bendor, Daniel

2015-01-01

In auditory cortex, temporal information within a sound is represented by two complementary neural codes: a temporal representation based on stimulus-locked firing and a rate representation, where discharge rate co-varies with the timing between acoustic events but lacks a stimulus-synchronized response. Using a computational neuronal model, we find that stimulus-locked responses are generated when sound-evoked excitation is combined with strong, delayed inhibition. In contrast to this, a non-synchronized rate representation is generated when the net excitation evoked by the sound is weak, which occurs when excitation is coincident and balanced with inhibition. Using single-unit recordings from awake marmosets (Callithrix jacchus), we validate several model predictions, including differences in the temporal fidelity, discharge rates and temporal dynamics of stimulus-evoked responses between neurons with rate and temporal representations. Together these data suggest that feedforward inhibition provides a parsimonious explanation of the neural coding dichotomy observed in auditory cortex. PMID:25879843

The Federal Forest Stewardship Program and its implications for sustainable forestry on private forest ownerships in the United States

Treesearch

Robert J. Moulton; J. Dixon Esseks

2002-01-01

A 72 percent response rate was achieved in 1998 and 1999 national survey of 1,238 participants in the USDA Forest Service's Forest Stewardship Program, under which 130,000 individual multiple resource plans encompassing 16.5 million acres (6.5 million ha) of privately owned forest lands in the United States had been completed. Objectives were to determine if the...

Bigheaded carps : a biological synopsis and environmental risk assessment

USGS Publications Warehouse

Kolar, Cindy S.; Chapman, Duane C.; Courtenay, Walter R.; Housel, Christine M.; Williams, James D.; Jennings, Dawn P.

2007-01-01

Includes information on taxonomy and distinguishing characteristics, hybrids, native and introduced ranges, temperature and salinity tolerances, fecundity, sexual maturity and mating behavior, spawning, early development, feeding habits, growth rate and longevity, response to physical stimuli, associated diseases and parasites, human uses, environmental effects, potential range, population control measures. Summarizes United States federal and state regulations, and assesses the risk posed by these species in the United States.

Risk of fetal mortality after exposure to Listeria monocytogenes based on dose-response data from pregnant guinea pigs and primates.

PubMed

Williams, Denita; Castleman, Jennifer; Lee, Chi-Ching; Mote, Beth; Smith, Mary Alice

2009-11-01

One-third of the annual cases of listeriosis in the United States occur during pregnancy and can lead to miscarriage or stillbirth, premature delivery, or infection of the newborn. Previous risk assessments completed by the Food and Drug Administration/the Food Safety Inspection Service of the U.S. Department of Agriculture/the Centers for Disease Control and Prevention (FDA/USDA/CDC) and Food and Agricultural Organization/the World Health Organization (FAO/WHO) were based on dose-response data from mice. Recent animal studies using nonhuman primates and guinea pigs have both estimated LD(50)s of approximately 10(7) Listeria monocytogenes colony forming units (cfu). The FAO/WHO estimated a human LD(50) of 1.9 x 10(6) cfu based on data from a pregnant woman consuming contaminated soft cheese. We reevaluated risk based on dose-response curves from pregnant rhesus monkeys and guinea pigs. Using standard risk assessment methodology including hazard identification, exposure assessment, hazard characterization, and risk characterization, risk was calculated based on the new dose-response information. To compare models, we looked at mortality rate per serving at predicted doses ranging from 10(-4) to 10(12) L. monocytogenes cfu. Based on a serving of 10(6) L. monocytogenes cfu, the primate model predicts a death rate of 5.9 x 10(-1) compared to the FDA/USDA/CDC (fig. IV-12) predicted rate of 1.3 x 10(-7). Based on the guinea pig and primate models, the mortality rate calculated by the FDA/USDA/CDC is underestimated for this susceptible population.

Neural responses from the wind-sensitive interneuron population in four cockroach species

PubMed Central

McGorry, Clare A.; Newman, Caroline N.; Triblehorn, Jeffrey D.

2014-01-01

The wind-sensitive insect cercal sensory system is involved in important behaviors including predator detection and initiating terrestrial escape responses as well as flight maintenance. However, not all insects possessing a cercal system exhibit these behaviors. In cockroaches, wind evokes strong terrestrial escape responses in Periplaneta americana and Blattella germanica, but only weak escape responses in Blaberus craniifer and no escape responses in Gromphadorhina portentosa. Both P. americana and Blab. craniifer possesses pink flight muscles correlated with flight ability while Blat. germanica possesses white flight muscles that cannot support flight and G. portentosa lacks wings. These different behavioral combinations could correlate with differences in sensory processing of wind information by the cercal system. In this study, we focused on the wind-sensitive interneurons (WSIs) since they provide input to the premotor/motor neurons that influence terrestrial escape and flight behavior. Using extracellular recordings, we characterized the responses from the WSI population by generating stimulus-response (S-R) curves and examining spike firing rates. Using cluster analysis, we also examined the activity of individual units (four per species, though not necessarily homologous) comprising the population response in each species. Our main results were: 1) all four species possessed ascending WSIs in the abdominal connectives; 2) wind elicited the weakest WSI responses (lowest spike counts and spike rates) in G. portentosa; 3) wind elicited WSI responses in Blab. craniifer that were greater than P. americana or Blat. germanica; 4) the activity of four individual units comprising the WSI population response in each species was similar across species. PMID:24879967

Understanding the biological activity of high rate algae ponds through the calculation of oxygen balances.

PubMed

Arbib, Zouhayr; de Godos Crespo, Ignacio; Corona, Enrique Lara; Rogalla, Frank

2017-06-01

Microalgae culture in high rate algae ponds (HRAP) is an environmentally friendly technology for wastewater treatment. However, for the implementation of these systems, a better understanding of the oxygenation potential and the influence of climate conditions is required. In this work, the rates of oxygen production, consumption, and exchange with the atmosphere were calculated under varying conditions of solar irradiance and dilution rate during six months of operation in a real scale unit. This analysis allowed determining the biological response of these dynamic systems. The rates of oxygen consumption measured were considerably higher than the values calculated based on the organic loading rate. The response to light intensity in terms of oxygen production in the bioreactor was described with one of the models proposed for microalgae culture in dense concentrations. This model is based on the availability of light inside the culture and the specific response of microalgae to this parameter. The specific response to solar radiation intensity showed a reasonable stability in spite of the fluctuations due to meteorological conditions. The methodology developed is a useful tool for optimization and prediction of the performance of these systems.

78 FR 53671 - Regulated Navigation Areas, Security Zones: Dignitary Arrival/Departure and United Nations...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-30

... security zones. We are reorganizing Sec. 165.164 and adding descriptive designations to name each of the... evaluates these actions annually and rates each agency's responsiveness to small business. If you wish to...

A new role for the ACNP: the rapid response team leader.

PubMed

Morse, Kate J; Warshawsky, Deborah; Moore, Jacqueline M; Pecora, Denise C

2006-01-01

The implementation of a rapid response team or medical emergency team is 1 of the 6 initiatives of the Institute for Healthcare Improvement's 100,000 Lives Campaign with the goal to reduce the number of cardiopulmonary arrests outside the intensive care unit and inpatient mortality rates. The concept of RRT was pioneered in Australia and is now being implemented in many hospitals across the United States. This article reviews the current literature and describes the implementation of an RRT in a community hospital. The first-quarter data after implementation are described. The unique role of the acute care nurse practitioner in this hospital's model is described.

Nurse-Patient Communication Interactions in the Intensive Care Unit

PubMed Central

Happ, Mary Beth; Garrett, Kathryn; Thomas, Dana DiVirgilio; Tate, Judith; George, Elisabeth; Houze, Martin; Radtke, Jill; Sereika, Susan

2011-01-01

Background The inability to speak during critical illness is a source of distress for patients, yet nurse-patient communication in the intensive care unit has not been systematically studied or measured. Objectives To describe communication interactions, methods, and assistive techniques between nurses and nonspeaking critically ill patients in the intensive care unit. Methods Descriptive observational study of the nonintervention/usual care cohort from a larger clinical trial of nurse-patient communication in a medical and a cardiothoracic surgical intensive care unit. Videorecorded interactions between 10 randomly selected nurses (5 per unit) and a convenience sample of 30 critically ill adults (15 per unit) who were awake, responsive, and unable to speak because of respiratory tract intubation were rated for frequency, success, quality, communication methods, and assistive communication techniques. Patients self-rated ease of communication. Results Nurses initiated most (86.2%) of the communication exchanges. Mean rate of completed communication exchange was 2.62 exchanges per minute. The most common positive nurse act was making eye contact with the patient. Although communication exchanges were generally (>70%) successful, more than one-third (37.7%) of communications about pain were unsuccessful. Patients rated 40% of the communication sessions with nurses as somewhat difficult to extremely difficult. Assistive communication strategies were uncommon, with little to no use of assistive communication materials (eg, writing supplies, alphabet or word boards). Conclusions Study results highlight specific areas for improvement in communication between nurses and nonspeaking patients in the intensive care unit, particularly in communication about pain and in the use of assistive communication strategies and communication materials. PMID:21362711

Neural responses in the primary auditory cortex of freely behaving cats while discriminating fast and slow click-trains.

PubMed

Dong, Chao; Qin, Ling; Liu, Yongchun; Zhang, Xinan; Sato, Yu

2011-01-01

Repeated acoustic events are ubiquitous temporal features of natural sounds. To reveal the neural representation of the sound repetition rate, a number of electrophysiological studies have been conducted on various mammals and it has been proposed that both the spike-time and firing rate of primary auditory cortex (A1) neurons encode the repetition rate. However, previous studies rarely examined how the experimental animals perceive the difference in the sound repetition rate, and a caveat to these experiments is that they compared physiological data obtained from animals with psychophysical data obtained from humans. In this study, for the first time, we directly investigated acoustic perception and the underlying neural mechanisms in the same experimental animal by examining spike activities in the A1 of free-moving cats while performing a Go/No-go task to discriminate the click-trains at different repetition rates (12.5-200 Hz). As reported by previous studies on passively listening animals, A1 neurons showed both synchronized and non-synchronized responses to the click-trains. We further found that the neural performance estimated from the precise temporal information of synchronized units was good enough to distinguish all 16.7-200 Hz from the 12.5 Hz repetition rate; however, the cats showed declining behavioral performance with the decrease of the target repetition rate, indicating an increase of difficulty in discriminating two slower click-trains. Such behavioral performance was well explained by the firing rate of some synchronized and non-synchronized units. Trial-by-trial analysis indicated that A1 activity was not affected by the cat's judgment of behavioral response. Our results suggest that the main function of A1 is to effectively represent temporal signals using both spike timing and firing rate, while the cats may read out the rate-coding information to perform the task in this experiment.

Reliability of the identification of the systemic inflammatory response syndrome in critically ill infants and children.

PubMed

Juskewitch, Justin E; Prasad, Swati; Salas, Carlos F Santillan; Huskins, W Charles

2012-01-01

To assess interobserver reliability of the identification of episodes of the systemic inflammatory response syndrome in critically ill hospitalized infants and children. Retrospective, cross-sectional study of the application of the 2005 consensus definition of systemic inflammatory response syndrome in infants and children by two independent, trained reviewers using information in the electronic medical record. Eighteen-bed pediatric multidisciplinary medical/surgical pediatric intensive care unit. A randomly selected sample of children admitted consecutively to the pediatric intensive care unit between May 1 and September 30, 2009. None. Sixty infants and children were selected from a total of 343 admitted patients. Their median age was 3.9 yrs (interquartile range, 1.5-12.7), 57% were female, and 68% were Caucasian. Nineteen (32%) children were identified by both reviewers as having an episode of systemic inflammatory response syndrome (88% agreement, 95% confidence interval 78-94; κ = 0.75, 95% confidence interval 0.59-0.92). Among these 19 children, agreement between the reviewers for individual systemic inflammatory response syndrome criteria was: temperature (84%, 95% confidence interval 60-97); white blood cell count (89%, 95% confidence interval 67-99); respiratory rate (84%, 95% confidence interval 60-97); and heart rate (68%, 95% confidence interval 33-87). Episodes of systemic inflammatory response syndrome in critically ill infants and children can be identified reproducibly using the consensus definition.

Enabling Efficient, Responsive, and Resilient Buildings: Collaboration Between the United States and India

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

Basu, Chandrayee; Ghatikar, Girish

The United States and India have among the largest economies in the world, and they continue to work together to address current and future challenges in reliable electricity supply. The acceleration to efficient, grid-responsive, resilient buildings represents a key energy security objective for federal and state agencies in both countries. The weaknesses in the Indian grid system were manifest in 2012, in the country’s worst blackout, which jeopardized the lives of half of India’s 1.2 billion people. While both countries are investing significantly in power sector reform, India, by virtue of its colossal growth rate in commercial energy intensity andmore » commercial floor space, is better placed than the United States to integrate and test state-of-art Smart Grid technologies in its future grid-responsive commercial buildings. This paper presents a roadmap of technical collaboration between the research organizations, and public-private stakeholders in both countries to accelerate the building-to-grid integration through pilot studies in India.« less

Responses of 1-year-old cottonwood to increasing soil moisture tension

Treesearch

F.T. Bonner

1967-01-01

Cottonwood cuttings planted in sandy loam and clay soils showed a sensitive control of water loss as soil moisture tension increased. Transpiration rates began decreasing at leaf water deficits of 2.5 percent in sandy loam and 4.5 percent in clay. There were no significant differences in rates per unit of leaf area or shoot dry weight between plants grown in the two...

Combining Distance and Face-To Teaching and Learning in Spatial Computations

NASA Astrophysics Data System (ADS)

Gulland, E.-K.; Schut, A. G. T.; Veenendaal, B.

2011-09-01

Retention and passing rates as well as student engagement in computer programming and problem solving units are a major concern in tertiary spatial science courses. A number of initiatives were implemented to improve this. A pilot study reviews the changes made to the teaching and learning environment, including the addition of new resources and modifications to assessments, and investigates their effectiveness. In particular, the study focuses on the differences between students studying in traditional, oncampus mode and distance, e-learning mode. Student results and retention rates from 2009-2011, data from in-lecture clicker response units and two anonymous surveys collected in 2011 were analysed. Early results indicate that grades improved for engaged students but pass rates or grades of the struggling cohort of students did not improve significantly.

Who sends the email? Using electronic surveys in violence research.

PubMed

Sutherland, Melissa A; Amar, Angela F; Laughon, Kathryn

2013-08-01

Students aged 16-24 years are at greatest risk for interpersonal violence and the resulting short and long-term health consequences. Electronic survey methodology is well suited for research related to interpersonal violence. Yet methodological questions remain about best practices in using electronic surveys. While researchers often indicate that potential participants receive multiple emails as reminders to complete the survey, little mention is made of the sender of the recruitment email. The purpose of this analysis is to describe the response rates from three violence-focused research studies when the recruitment emails are sent from a campus office, researcher or survey sampling firm. Three violence-focused studies were conducted about interpersonal violence among college students in the United States. Seven universities and a survey sampling firm were used to recruit potential participants to complete an electronic survey. The sender of the recruitment emails varied within and across the each of the studies depending on institutional review boards and university protocols. An overall response rate of 30% was noted for the 3 studies. Universities in which researcher-initiated recruitment emails were used had higher response rates compared to universities where campus officials sent the recruitment emails. Researchers found lower response rates to electronic surveys at Historically Black Colleges or Universities and that other methods were needed to improve response rates. The sender of recruitment emails for electronic surveys may be an important factor in response rates for violence-focused research. For researchers identification of best practices for survey methodology is needed to promote accurate disclosure and increase response rates.

Auditory thresholds in the American cockroach (Orthoptera: Blattidae): estimates using single-unit and compound-action potential recordings.

PubMed

Decker, T N; Jones, T A; Gold, R E

1989-06-01

Recent commercial suggestions that insect populations can be controlled through the use of ultrasound raises the question of whether or not certain insects have receptors that are sensitive to high-frequency sound. Single neural unit discharges and compound-action potentials were recorded from the ventral nerve cord in the American cockroach, Periplaneta americana L., to constant rise time tone pulses from 100 to 40,000 hertz (Hz). Unit responses and compound-action potentials show that the cockroach is insensitive to sound above approximately 3,000 Hz. Data relating latency of the response to intensity of the stimulus suggest that the cockroach cercal system operates on the principle of energy envelope detection. Decreases in latency likely occur primarily as a result of increases in the rate of membrane depolarization in cercal dendrites.

Behavioral Emergency Response Team: Implementation Improves Patient Safety, Staff Safety, and Staff Collaboration.

PubMed

Zicko, Cdr Jennifer M; Schroeder, Lcdr Rebecca A; Byers, Cdr William S; Taylor, Lt Adam M; Spence, Cdr Dennis L

2017-10-01

Staff members working on our nonmental health (non-MH) units (i.e., medical-surgical [MS] units) were not educated in recognizing or deescalating behavioral emergencies. Published evidence suggests a behavioral emergency response team (BERT) composed of MH experts who assist with deescalating behavioral emergencies may be beneficial in these situations. Therefore, we sought to implement a BERT on the inpatient non-MH units at our military treatment facility. The objectives of this evidence-based practice process improvement project were to determine how implementation of a BERT affects staff and patient safety and to examine nursing staffs' level of knowledge, confidence, and support in caring for psychiatric patients and patients exhibiting behavioral emergencies. A BERT was piloted on one MS unit for 5 months and expanded to two additional units for 3 months. Pre- and postimplementation staff surveys were conducted, and the number of staff assaults and injuries, restraint usage, and security intervention were compared. The BERT responded to 17 behavioral emergencies. The number of assaults decreased from 10 (pre) to 1 (post); security intervention decreased from 14 to 1; and restraint use decreased from 8 to 1. MS staffs' level of BERT knowledge and rating of support between MH staff and their staff significantly increased. Both MS and MH nurses rated the BERT as supportive and effective. A BERT can assist with deescalating behavioral emergencies, and improve staff collaboration and patient and staff safety. © 2017 Sigma Theta Tau International.

Survey of brachytherapy practice in the United States: a report of the Clinical Research Committee of the American Endocurietherapy Society.

PubMed

Nag, S; Owen, J B; Farnan, N; Pajak, T F; Martinez, A; Porter, A; Blasko, J; Harrison, L B

1995-01-01

To obtain reliable data on the extent of the brachytherapy practice in the United States by conducting a comprehensive survey of all facilities. The Clinical Research Committee of the AES surveyed all 1321 radiation oncology facilities identified in the Patterns of Care Study (PCS) of the American College of Radiology (ACR). Multiple mailings and follow-up were made to obtain a high response rate. Survey responders and nonresponders were compared using chi-square tests. Summary statistics were reported. Of the 1321 facilities, 1054 responded (80%). Hospital-based and larger facilities had a statistically significant higher rate of response. Brachytherapy was being performed at 819 facilities (the median number of procedures = 21-50). Two hundred and two facilities did no brachytherapy. The common isotopes used were 137Cs (705 facilities), 192Ir (585 facilities), 125I (236 facilities), and 131I (194 facilities). The common brachytherapy techniques used were intracavitary (751 facilities), interstitial (536 facilities), intraluminal (310 facilities), and plaques (148 facilities). Remote afterloaded brachytherapy was used at 205 centers as follows: high dose rate (HDR) (164), medium dose rate (MDR) (5), and low dose rate (LDR) (36). Computerized dosimetry was most commonly used (790 facilities), followed by Patterson-Parker (104 facilities) and Quimby (72 facilities). The common sites treated were cervix (701 facilities), endometrium (565 facilities), head and neck (354 facilities), and lung (344 facilities). Data regarding brachytherapy practice has been obtained from a large percentage (80%) of all facilities in the United States. The majority (78-81%) of radiation oncology facilities perform brachytherapy; however, its use is restricted to gynecological implants in many of these centers. The results from this survey will be used to develop a pattern of care study and data registry in brachytherapy.

Analytical and experimental evaluation of an aluminum bridge deck panel. Part 1, Service load performance.

DOT National Transportation Integrated Search

1999-01-01

Deck deterioration is responsible for the majority of deficient bridge ratings in the United States (Sotiropoulos & GangaRao, 1993). Subject to dynamic loading, cyclic loading, and occasional overloading, bridge decks are the most severely stressed e...

Deciphering the contribution of intrinsic and synaptic currents to the effects of transient synaptic inputs on human motor unit discharge

PubMed Central

Powers, Randall K.; Türker, Kemal S.

2010-01-01

The amplitude and time course of synaptic potentials in human motoneurons can be estimated in tonically discharging motor units by measuring stimulus-evoked changes in the rate and probability of motor unit action potentials. However, in spite of the fact that some of these techniques have been used for over thirty years, there is still no consensus on the best way to estimate the characteristics of synaptic potentials or on the accuracy of these estimates. In this review, we compare different techniques for estimating synaptic potentials from human motor unit discharge and also discuss relevant animal models in which estimated synaptic potentials can be compared to those directly measured from intracellular recordings. We also review the experimental evidence on how synaptic noise and intrinsic motoneuron properties influence their responses to synaptic inputs. Finally, we consider to what extent recordings of single motor unit discharge in humans can be used to distinguish the contribution of changes in synaptic inputs versus changes in intrinsic motoneuron properties to altered motoneuron responses following CNS injury. PMID:20427230

Testing inferior colliculus neurons for selectivity to the rate or duration of frequency modulated sweeps

NASA Astrophysics Data System (ADS)

Faure, Paul A.; Morrison, James A.; Valdizón-Rodríguez, Roberto

2018-05-01

Here we propose a method for testing how the responses of so-called "FM duration-tuned neurons (DTNs)" encode temporal properties of frequency modulated (FM) sweeps to determine if the responses of so-called "FM duration-tuned neurons (DTNs)" are tuned to FM rate or FM duration. Based on previous studies it was unclear if the responses of "FM DTNs" were tuned to signal duration, like pure-tone DTNs, or FM sweep rate. We tested this using single-unit extracellular recording in the inferior colliculus (IC) of the big brown bat (Eptesicus fuscus). We presented IC cells with linear FM sweeps that were varied in FM center frequency (CEF) and spectral bandwidth (BW) to measure the FM rate tuning responses of a cell. We also varied FM signal duration to measure the best duration (BD) and temporal BW of duration tuning of a cell. We then doubled (and halved) the best FM BW, while keeping the CEF constant, and remeasured the BD and temporal BW of duration tuning with FM bandwidth manipulated signals. We reasoned that the range of excitatory signal durations should not change in a true FM DTN whose responses are tuned to signal duration; however, when stimulated with bandwidth manipulated FM sounds the range of excitatory signal durations should predictably vary in a FM rate-tuned cell. Preliminary data indicate that our stimulus paradigm can disambiguate whether the evoked responses of an IC neuron are FM sweep rate tuned or FM duration tuned.

Scalable and responsive event processing in the cloud

PubMed Central

Suresh, Visalakshmi; Ezhilchelvan, Paul; Watson, Paul

2013-01-01

Event processing involves continuous evaluation of queries over streams of events. Response-time optimization is traditionally done over a fixed set of nodes and/or by using metrics measured at query-operator levels. Cloud computing makes it easy to acquire and release computing nodes as required. Leveraging this flexibility, we propose a novel, queueing-theory-based approach for meeting specified response-time targets against fluctuating event arrival rates by drawing only the necessary amount of computing resources from a cloud platform. In the proposed approach, the entire processing engine of a distinct query is modelled as an atomic unit for predicting response times. Several such units hosted on a single node are modelled as a multiple class M/G/1 system. These aspects eliminate intrusive, low-level performance measurements at run-time, and also offer portability and scalability. Using model-based predictions, cloud resources are efficiently used to meet response-time targets. The efficacy of the approach is demonstrated through cloud-based experiments. PMID:23230164

Development of a Model of Soldier Effectiveness: Retranslation Materials and Results

DTIC Science & Technology

1987-05-01

covering financial responsibility, particularly the family checking account . Consequent- ly, the bad check rate for the unit drop- ped from 70 a month...Alcohol, and Aggressive Acts " Showing prudence in financial management and responsibility in personal/family matters; avoiding alcohol and other drugs or...threatening others, etc. versus " Acting irresponsibly in financial or personal/family affairs such that command time is required to counsel or otherwise

Changes in Respiratory Mitochondrial Machinery and Cytochrome and Alternative Pathway Activities in Response to Energy Demand Underlie the Acclimation of Respiration to Elevated CO2 in the Invasive Opuntia ficus-indica1[OA

PubMed Central

Gomez-Casanovas, Nuria; Blanc-Betes, Elena; Gonzalez-Meler, Miquel A.; Azcon-Bieto, Joaquim

2007-01-01

Studies on long-term effects of plants grown at elevated CO2 are scarce and mechanisms of such responses are largely unknown. To gain mechanistic understanding on respiratory acclimation to elevated CO2, the Crassulacean acid metabolism Mediterranean invasive Opuntia ficus-indica Miller was grown at various CO2 concentrations. Respiration rates, maximum activity of cytochrome c oxidase, and active mitochondrial number consistently decreased in plants grown at elevated CO2 during the 9 months of the study when compared to ambient plants. Plant growth at elevated CO2 also reduced cytochrome pathway activity, but increased the activity of the alternative pathway. Despite all these effects seen in plants grown at high CO2, the specific oxygen uptake rate per unit of active mitochondria was the same for plants grown at ambient and elevated CO2. Although decreases in photorespiration activity have been pointed out as a factor contributing to the long-term acclimation of plant respiration to growth at elevated CO2, the homeostatic maintenance of specific respiratory rate per unit of mitochondria in response to high CO2 suggests that photorespiratory activity may play a small role on the long-term acclimation of respiration to elevated CO2. However, despite growth enhancement and as a result of the inhibition in cytochrome pathway activity by elevated CO2, total mitochondrial ATP production was decreased by plant growth at elevated CO2 when compared to ambient-grown plants. Because plant growth at elevated CO2 increased biomass but reduced respiratory machinery, activity, and ATP yields while maintaining O2 consumption rates per unit of mitochondria, we suggest that acclimation to elevated CO2 results from physiological adjustment of respiration to tissue ATP demand, which may not be entirely driven by nitrogen metabolism as previously suggested. PMID:17660349

Global dynamics of a stochastic neuronal oscillator

NASA Astrophysics Data System (ADS)

Yamanobe, Takanobu

2013-11-01

Nonlinear oscillators have been used to model neurons that fire periodically in the absence of input. These oscillators, which are called neuronal oscillators, share some common response structures with other biological oscillations such as cardiac cells. In this study, we analyze the dependence of the global dynamics of an impulse-driven stochastic neuronal oscillator on the relaxation rate to the limit cycle, the strength of the intrinsic noise, and the impulsive input parameters. To do this, we use a Markov operator that both reflects the density evolution of the oscillator and is an extension of the phase transition curve, which describes the phase shift due to a single isolated impulse. Previously, we derived the Markov operator for the finite relaxation rate that describes the dynamics of the entire phase plane. Here, we construct a Markov operator for the infinite relaxation rate that describes the stochastic dynamics restricted to the limit cycle. In both cases, the response of the stochastic neuronal oscillator to time-varying impulses is described by a product of Markov operators. Furthermore, we calculate the number of spikes between two consecutive impulses to relate the dynamics of the oscillator to the number of spikes per unit time and the interspike interval density. Specifically, we analyze the dynamics of the number of spikes per unit time based on the properties of the Markov operators. Each Markov operator can be decomposed into stationary and transient components based on the properties of the eigenvalues and eigenfunctions. This allows us to evaluate the difference in the number of spikes per unit time between the stationary and transient responses of the oscillator, which we show to be based on the dependence of the oscillator on past activity. Our analysis shows how the duration of the past neuronal activity depends on the relaxation rate, the noise strength, and the impulsive input parameters.

Global dynamics of a stochastic neuronal oscillator.

PubMed

Yamanobe, Takanobu

2013-11-01

Nonlinear oscillators have been used to model neurons that fire periodically in the absence of input. These oscillators, which are called neuronal oscillators, share some common response structures with other biological oscillations such as cardiac cells. In this study, we analyze the dependence of the global dynamics of an impulse-driven stochastic neuronal oscillator on the relaxation rate to the limit cycle, the strength of the intrinsic noise, and the impulsive input parameters. To do this, we use a Markov operator that both reflects the density evolution of the oscillator and is an extension of the phase transition curve, which describes the phase shift due to a single isolated impulse. Previously, we derived the Markov operator for the finite relaxation rate that describes the dynamics of the entire phase plane. Here, we construct a Markov operator for the infinite relaxation rate that describes the stochastic dynamics restricted to the limit cycle. In both cases, the response of the stochastic neuronal oscillator to time-varying impulses is described by a product of Markov operators. Furthermore, we calculate the number of spikes between two consecutive impulses to relate the dynamics of the oscillator to the number of spikes per unit time and the interspike interval density. Specifically, we analyze the dynamics of the number of spikes per unit time based on the properties of the Markov operators. Each Markov operator can be decomposed into stationary and transient components based on the properties of the eigenvalues and eigenfunctions. This allows us to evaluate the difference in the number of spikes per unit time between the stationary and transient responses of the oscillator, which we show to be based on the dependence of the oscillator on past activity. Our analysis shows how the duration of the past neuronal activity depends on the relaxation rate, the noise strength, and the impulsive input parameters.

Muscle fibre recruitment can respond to the mechanics of the muscle contraction.

PubMed

Wakeling, James M; Uehli, Katrin; Rozitis, Antra I

2006-08-22

This study investigates the motor unit recruitment patterns between and within muscles of the triceps surae during cycling on a stationary ergometer at a range of pedal speeds and resistances. Muscle activity was measured from the soleus (SOL), medial gastrocnemius (MG) and lateral gastrocnemius (LG) using surface electromyography (EMG) and quantified using wavelet and principal component analysis. Muscle fascicle strain rates were quantified using ultrasonography, and the muscle-tendon unit lengths were calculated from the segmental kinematics. The EMG intensities showed that the body uses the SOL relatively more for the higher-force, lower-velocity contractions than the MG and LG. The EMG spectra showed a shift to higher frequencies at faster muscle fascicle strain rates for MG: these shifts were independent of the level of muscle activity, the locomotor load and the muscle fascicle strain. These results indicated that a selective recruitment of the faster motor units occurred within the MG muscle in response to the increasing muscle fascicle strain rates. This preferential recruitment of the faster fibres for the faster tasks indicates that in some circumstances motor unit recruitment during locomotion can match the contractile properties of the muscle fibres to the mechanical demands of the contraction.

SEROLOGICAL RESPONSES TO CRYPTOSPORIDIUM ANTIGENS AMONG USERS OF SURFACE VERSUS UNDERGROUND DRINKING WATER SOURCES

EPA Science Inventory

Cryptosporidium oocysts have been detected in source and treated drinking waters in the United States and elsewhere. Enhanced enteric disease surveillance, initiated following detection of oocysts, has not often detected elevated rates of infection or of symptoms compatible with...

78 FR 21116 - Superior Supplier Incentive Program

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-09

... (Quality of Product). Schedule. Cost Control. Management Responsiveness. Management of Key Personnel... unit can only be rated in either the goods or services category. In the event a contractor is within... will provide contractors with the greatest motivation to achieve SSS? 3. What contract terms and...

Worldwide orthopaedic research activity 2010-2014: Publication rates in the top 15 orthopaedic journals related to population size and gross domestic product.

PubMed

Hohmann, Erik; Glatt, Vaida; Tetsworth, Kevin

2017-06-18

To perform a bibliometric analysis of publications rates in orthopedics in the top 15 orthopaedic journals. Based on their 2015 impact factor, the fifteen highest ranked orthopaedic journals between January 2010 and December 2014 were used to establish the total number of publications; cumulative impact factor points (IF) per country were determined, and normalized to population size, GDP, and GDP/capita, comparison to the median country output and the global leader. Twenty-three thousand and twenty-one orthopaedic articles were published, with 66 countries publishing. The United States had 8149 publications, followed by the United Kingdom (1644) and Japan (1467). The highest IF was achieved by the United States (24744), United Kingdom (4776), and Japan (4053). Normalized by population size Switzerland lead. Normalized by GDP, Croatia was the top achiever. Adjusting GDP/capita, for publications and IF, China, India, and the United States were the leaders. Adjusting for population size and GDP, 28 countries achieved numbers of publications to be considered at least equivalent with the median academic output. Adjusting GDP/capita only China and India reached the number of publications to be considered equivalent to the current global leader, the United States. Five countries were responsible for 60% of the orthopaedic research output over this 5-year period. After correcting for GDP/capita, only 28 of 66 countries achieved a publication rate equivalent to the median country. The United States, United Kingdom, South Korea, Japan, and Germany were the top five countries for both publication totals and cumulative impact factor points.

The economics of the law of effect.

PubMed Central

Collier, G H; Johnson, D F; Hill, W L; Kaufman, L W

1986-01-01

A corollary of the law of effect predicts that the larger the reinforcement, the greater the rate of responding. However, an animal must eat more small portions than large portions to obtain the same daily intake, and one would predict, therefore, that when eating smaller portions an efficient animal would eat less (conserving time and energy) and/or respond faster (conserving time). The latter of these predictions was supported by the present experiments with free-feeding rats for which portion size (pellet size or duration of feeder presentation) and portion price within meals were varied. Response rate was a function of the unit price (responses/g) of food: Rats responded faster when portions were smaller or when prices were higher. Meal size and frequency were relatively unaffected by unit price, but were influenced by the price of meal initiation. The results are discussed in relation to the economic differences between traditional operant and free-feeding paradigms and to both traditional and more recent formulations of the law of effect. PMID:3760748

Behavior of medial gastrocnemius motor units during postural reactions to external perturbations after stroke.

PubMed

Pollock, C L; Ivanova, T D; Hunt, M A; Garland, S J

2015-10-01

This study investigated the behavior of medial gastrocnemius (GM) motor units (MU) during external perturbations in standing in people with chronic stroke. GM MUs were recorded in standing while anteriorly-directed perturbations were introduced by applying loads of 1% body mass (BM) at the pelvis every 25-40s until 5% BM was maintained. Joint kinematics, surface electromyography (EMG), and force platform measurements were assessed. Although external loads caused a forward progression of the anterior-posterior centre of pressure (APCOP), people with stroke decreased APCOP velocity and centre of mass (COM) velocity immediately following the highest perturbations, thereby limiting movement velocity in response to perturbations. MU firing rate did not increase with loading but the GM EMG magnitude increased, reflecting MU recruitment. MU inter spike interval (ISI) during the dynamic response was negatively correlated with COM velocity and hip angular velocity. The GM utilized primarily MU recruitment to maintain standing during external perturbations. The lack of MU firing rate modulation occurred with a change in postural central set. However, the relationship of MU firing rate with kinematic variables suggests underlying long-loop responses may be somewhat intact after stroke. People with stroke demonstrate alterations in postural control strategies which may explain MU behavior with external perturbations. Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Utilization of ammonium as a nitrogen source: effects of ambient acidity on growth and nitrogen accumulation by soybean

NASA Technical Reports Server (NTRS)

Tolley-Henry, L.; Raper, C. D. Jr; Raper CD, J. r. (Principal Investigator)

1986-01-01

Dry matter accumulation of plants utilizing NH4+ as the sole nitrogen source generally is less than that of plants receiving NO3- unless acidity of the root-zone is controlled at a pH of about 6.0. To test the hypothesis that the reduction in growth is a consequence of nitrogen stress within the plant in response to effects of increased acidity during uptake of NH4+ by roots, nonnodulated soybean plants (Glycine max [L.] Merr. cv Ransom) were grown for 24 days in flowing nutrient culture containing 1.0 millimolar NH4+ as the nitrogen source. Acidities of the culture solutions were controlled at pH 6.1, 5.1, and 4.1 +/- 0.1 by automatic additions of 0.01 N H2SO4 or Ca(OH)2. Plants were sampled at intervals of 3 to 4 days for determination of dry matter and nitrogen accumulation. Rates of NH4+ uptake per gram root dry weight were calculated from these data. Net CO2 exchange rates per unit leaf area were measured on attached leaves by infrared gas analysis. When acidity of the culture solution was increased from pH 6.1 to 5.1, dry matter and nitrogen accumulation were reduced by about 40% within 14 days. Net CO2 exchange rates per unit leaf area, however, were not affected, and the decreased growth was associated with a reduction in rates of appearance and expansion of new leaves. The uptake rates of NH4+ per gram root were about 25% lower throughout the 24 days at pH 5.1 than at 6.1. A further increase in solution acidity from pH 5.1 to 4.1 resulted in cessation of net dry matter production and appearance of new leaves within 10 days. Net CO2 exchange rates per unit leaf area declined rapidly until all viable leaves had abscised by 18 days. Uptake rates of NH4+, which were initially about 50% lower at pH 4.1 than at 6.1 continued to decline with time of exposure until net uptake ceased at 10 days. Since these responses also are characteristic of the sequence of responses that occur during onset and progression of a nitrogen stress, they corroborate our hypothesis.

Generational attitudes of rural mental health nurses.

PubMed

Crowther, Andrew; Kemp, Michael

2009-04-01

To determine how attitudes of rural mental health nurses differ across generations. Survey. Mental health services in rural New South Wales. Practising mental health nurses. Survey responses. Survey response rate 44%. A total of 89 mental health nurses, clustered in inpatient units and community health centres, responded. Of these nurses, 4 were veterans, 52 baby boomers, 17 Generation X and 5 Generation Y. There are significant differences in how mental health nurses from different generations view their work, and in what is expected from managers. Managers need to modify traditional working styles, allowing greater flexibility of employment. They must also accept lower staff retention rates, and facilitate the development of younger staff.

Response Strength in Extreme Multiple Schedules

PubMed Central

McLean, Anthony P; Grace, Randolph C; Nevin, John A

2012-01-01

Four pigeons were trained in a series of two-component multiple schedules. Reinforcers were scheduled with random-interval schedules. The ratio of arranged reinforcer rates in the two components was varied over 4 log units, a much wider range than previously studied. When performance appeared stable, prefeeding tests were conducted to assess resistance to change. Contrary to the generalized matching law, logarithms of response ratios in the two components were not a linear function of log reinforcer ratios, implying a failure of parameter invariance. Over a 2 log unit range, the function appeared linear and indicated undermatching, but in conditions with more extreme reinforcer ratios, approximate matching was observed. A model suggested by McLean (1991), originally for local contrast, predicts these changes in sensitivity to reinforcer ratios somewhat better than models by Herrnstein (1970) and by Williams and Wixted (1986). Prefeeding tests of resistance to change were conducted at each reinforcer ratio, and relative resistance to change was also a nonlinear function of log reinforcer ratios, again contrary to conclusions from previous work. Instead, the function suggests that resistance to change in a component may be determined partly by the rate of reinforcement and partly by the ratio of reinforcers to responses. PMID:22287804

Prevention of Transfusion-Associated Graft-versus-Host Disease by Irradiation: Technical Aspect of a New Ferrous Sulphate Dosimetric System

PubMed Central

Del Lama, Lucas Sacchini; de Góes, Evamberto Garcia; Petchevist, Paulo César Dias; Moretto, Edson Lara; Borges, José Carlos; Covas, Dimas Tadeu; de Almeida, Adelaide

2013-01-01

Irradiation of whole blood and blood components before transfusion is currently the only accepted method to prevent Transfusion-Associated Graft-Versus-Host-Disease (TA-GVHD). However, choosing the appropriate technique to determine the dosimetric parameters associated with blood irradiation remains an issue. We propose a dosimetric system based on the standard Fricke Xylenol Gel (FXG) dosimeter and an appropriate phantom. The modified dosimeter was previously calibrated using a 60Co teletherapy unit and its validation was accomplished with a 137Cs blood irradiator. An ionization chamber, standard FXG, radiochromic film and thermoluminescent dosimeters (TLDs) were used as reference dosimeters to determine the dose response and dose rate of the 60Co unit. The dose distributions in a blood irradiator were determined with the modified FXG, the radiochromic film, and measurements by TLD dosimeters. A linear response for absorbed doses up to 54 Gy was obtained with our system. Additionally, the dose rate uncertainties carried out with gel dosimetry were lower than 5% and differences lower than 4% were noted when the absorbed dose responses were compared with ionization chamber, film and TLDs. PMID:23762345

Audits of oncology units - an effective and pragmatic approach.

PubMed

Abratt, Raymond Pierre; Eedes, David; Bailey, Belinda; Salmon, Chris; Govender, Yogi; Oelofse, Ivan; Burger, Henriette

2017-05-24

Audits of oncology units are part of all quality-assurance programmes. However, they do not always come across as pragmatic and helpful to staff. To report on the results of an online survey on the usefulness and impact of an audit process for oncology units. Staff in oncology units who were part of the audit process completed the audit self-assessment form for the unit. This was followed by a visit to each unit by an assessor, and then subsequent personal contact, usually via telephone. The audit self-assessment document listed quality-assurance measures or items in the physical and functional areas of the oncology unit. There were a total of 153 items included in the audit. The online survey took place in October 2016. The invitation to participate was sent to 59 oncology units at which staff members had completed the audit process. The online survey was completed by 54 (41%) of the 132 potential respondents. The online survey found that the audit was very or extremely useful in maintaining personal professional standards in 89% of responses. The audit process and feedback was rated as very or extremely satisfactory in 80% and 81%, respectively. The self-assessment audit document was scored by survey respondents as very or extremely practical in 63% of responses. The feedback on the audit was that it was very or extremely helpful in formulating improvement plans in oncology units in 82% of responses. Major and minor changes that occurred as a result of the audit process were reported as 8% and 88%, respectively. The survey findings show that the audit process and its self- assessment document meet the aims of being helpful and pragmatic.

X-ray induced dominant lethal mutations in mature and immature oocytes of guinea-pigs and golden hamsters.

PubMed

Cox, B D; Lyon, M F

1975-06-01

The induction of dominant lethal mutations by doses of 100-400 rad X-rays in oocytes of the guinea-pig and golden hamster was studied using criteria of embryonic mortality. For both species higher yields were obtained from mature than from immature oocytes, in contrast to results for the mouse. Data on fertility indicated that in the golden hamster, as in the mouse, immature oocytes were more sensitive to killing by X-rays than mature oocytes but that the converse was true in the guinea-pig. The dose-response relationship for mutation to dominant lethals in pre-ovulatory oocytes of guinea-pig and golden hamsters was linear, both when based on pre- and post-implantation loss and when on post-implantation loss only. The rate per unit dose was higher for the golden hamster, and the old golden hamsters were possibly slightly more sensitive than young ones. The mutation rate data for mature oocytes of the mouse, using post-implantation loss alone, also fitted a linear dose-response relationship, except that the rate per unit dose was lower than for the other two species.

Increase in incidence of congenital syphilis - United States, 2012-2014.

PubMed

Bowen, Virginia; Su, John; Torrone, Elizabeth; Kidd, Sarah; Weinstock, Hillard

2015-11-13

Congenital syphilis (CS) occurs when a mother infected with syphilis transmits the infection to her child during pregnancy. CS can cause severe illness, miscarriage, stillbirth, and early infant death. However, among pregnant women with syphilis who deliver after 20 weeks gestation, maternal treatment with penicillin is 98% effective at preventing CS (1). In the United States, the rate of CS decreased during 1991–2005 but increased slightly during 2005–2008 (2). To assess recent trends in CS, CDC analyzed national surveillance data reported during 2008–2014, calculated rates, and described selected characteristics of infants with CS and their mothers. The overall rate of reported CS decreased from 10.5 to 8.4 cases per 100,000 live births during 2008–2012, and then increased to 11.6 cases per 100,000 live births in 2014, the highest CS rate reported since 2001. From 2012 to 2014, reported cases and rates of CS increased across all regions of the United States. To reduce CS, the timely identification of and response to increases in syphilis among women of reproductive age and men who have sex with women are essential. All women should have access to quality prenatal care, including syphilis screening and adequate treatment, during pregnancy (3).

Listening to Staff.

ERIC Educational Resources Information Center

Davies, Peter; Owen, Jane

Levels of staff satisfaction across the United Kingdom's post-16 sector were examined by distributing a questionnaire at more than 80 further education colleges. The questionnaire elicited 9,515 responses. Study participants rated 38 statements on a 4-point scale. The questions focused on the following areas: (1) faculty members' perceptions of…

Recruiting International Students to Your Campus

ERIC Educational Resources Information Center

McFadden, Cheryl; Maahs-Fladung, Cathy; Mallett, William

2012-01-01

The purpose of this paper was to determine what institutional, program, and recruitment characteristics influenced international students to attend institutions in the United States. Two hundred sixteen international students at a Southern public research university responded to the survey (53% response rate) from 56 countries representing 8…

19 CFR 10.553 - Textile and apparel site visits.

Code of Federal Regulations, 2010 CFR

2010-04-01

... THE TREASURY ARTICLES CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. United States-Singapore Free...) Visits to enterprises of Singapore. U.S. officials may undertake to conduct site visits to enterprises in the territory of Singapore. U.S. officials will conduct such visits together with responsible...

Relationship between Corporate Governance and Information Security Governance Effectiveness in United States Corporations

ERIC Educational Resources Information Center

Davis, Robert E.

2017-01-01

Cyber attackers targeting large corporations achieved a high perimeter penetration success rate during 2013, resulting in many corporations incurring financial losses. Corporate information technology leaders have a fiduciary responsibility to implement information security domain processes that effectually address the challenges for preventing…

No improvement in serological response among serofast latent patients retreated with benzathine penicillin.

PubMed

Ren, Rong-Xin; Wang, Lin-Na; Zheng, He-Yi; Li, Jun

2016-01-01

Persistent non-treponemal titres after treatment are common among patients with latent syphilis. Although retreatment is often done in clinical practice, optimal management remains uncertain due to the paucity of data regarding serological response to retreatment and long-term outcomes. We compared the serological responses of serofast latent syphilis patients retreated with 7.2 million units of benzathine penicillin with the responses of patients who did not receive retreatment (control group). We retrospectively analysed the serological response to therapy following retreatment of 35 serofast latent syphilis patients at 12 months with benzathine penicillin 2.4 million units weekly for 3 weeks. In all, 74.3% (26/35) of the cases with latent syphilis who failed to achieve serological cure at 12 months after initial therapy achieved serological cure after retreatment and after an additional 12 months of follow-up. However, statistically similar serological cure rate was observed in 80.0% (28/35) of the control group (p > .05). Our findings illustrate no improvement in serological response among serofast latent patients retreated with three doses of benzathine penicillin. © The Author(s) 2015.

Campus Computing, 2000: The 11th National Survey of Computing and Information Technology in American Higher Education.

ERIC Educational Resources Information Center

Green, Kenneth C.

The 2000 Campus Computing Survey, the 11th such survey, was sent to the chief academic officer at 1,176 two-year and four-year colleges and universities across the United States. By October 2000, 506 responses had been received, a response rate of 43%. New data reveal that the growing demand for technology talent across all sectors of the U.S.…

United We Stand, Divided We Fall: Increasing Response Capability in Kentucky through Regionalization and Leadership

DTIC Science & Technology

2011-03-01

trust (Yang & Mossholder, 2010). In “Disaster and Emergency Management: Canadian Nurses ’ Perceptions of Preparedness on Hospital Front Lines,” the...authors examined nurses ’ perceptions in terms of their confidence rating of their level of preparedness, awareness of hospital plans, perceptions of...significant role in the ice storm response. Public health nurses worked in shelters; environmentalists were called upon to ensure that restaurants with

Neurometric amplitude-modulation detection threshold in the guinea-pig ventral cochlear nucleus

PubMed Central

Sayles, Mark; Füllgrabe, Christian; Winter, Ian M

2013-01-01

Amplitude modulation (AM) is a pervasive feature of natural sounds. Neural detection and processing of modulation cues is behaviourally important across species. Although most ecologically relevant sounds are not fully modulated, physiological studies have usually concentrated on fully modulated (100% modulation depth) signals. Psychoacoustic experiments mainly operate at low modulation depths, around detection threshold (∼5% AM). We presented sinusoidal amplitude-modulated tones, systematically varying modulation depth between zero and 100%, at a range of modulation frequencies, to anaesthetised guinea-pigs while recording spikes from neurons in the ventral cochlear nucleus (VCN). The cochlear nucleus is the site of the first synapse in the central auditory system. At this locus significant signal processing occurs with respect to representation of AM signals. Spike trains were analysed in terms of the vector strength of spike synchrony to the amplitude envelope. Neurons showed either low-pass or band-pass temporal modulation transfer functions, with the proportion of band-pass responses increasing with increasing sound level. The proportion of units showing a band-pass response varies with unit type: sustained chopper (CS) > transient chopper (CT) > primary-like (PL). Spike synchrony increased with increasing modulation depth. At the lowest modulation depth (6%), significant spike synchrony was only observed near to the unit's best modulation frequency for all unit types tested. Modulation tuning therefore became sharper with decreasing modulation depth. AM detection threshold was calculated for each individual unit as a function of modulation frequency. Chopper units have significantly better AM detection thresholds than do primary-like units. AM detection threshold is significantly worse at 40 dB vs. 10 dB above pure-tone spike rate threshold. Mean modulation detection thresholds for sounds 10 dB above pure-tone spike rate threshold at best modulation frequency are (95% CI) 11.6% (10.0–13.1) for PL units, 9.8% (8.2–11.5) for CT units, and 10.8% (8.4–13.2) for CS units. The most sensitive guinea-pig VCN single unit AM detection thresholds are similar to human psychophysical performance (∼3% AM), while the mean neurometric thresholds approach whole animal behavioural performance (∼10% AM). PMID:23629508

Estimating Preferential Flow in Karstic Aquifers Using Statistical Mixed Models

PubMed Central

Anaya, Angel A.; Padilla, Ingrid; Macchiavelli, Raul; Vesper, Dorothy J.; Meeker, John D.; Alshawabkeh, Akram N.

2013-01-01

Karst aquifers are highly productive groundwater systems often associated with conduit flow. These systems can be highly vulnerable to contamination, resulting in a high potential for contaminant exposure to humans and ecosystems. This work develops statistical models to spatially characterize flow and transport patterns in karstified limestone and determines the effect of aquifer flow rates on these patterns. A laboratory-scale Geo-HydroBed model is used to simulate flow and transport processes in a karstic limestone unit. The model consists of stainless-steel tanks containing a karstified limestone block collected from a karst aquifer formation in northern Puerto Rico. Experimental work involves making a series of flow and tracer injections, while monitoring hydraulic and tracer response spatially and temporally. Statistical mixed models are applied to hydraulic data to determine likely pathways of preferential flow in the limestone units. The models indicate a highly heterogeneous system with dominant, flow-dependent preferential flow regions. Results indicate that regions of preferential flow tend to expand at higher groundwater flow rates, suggesting a greater volume of the system being flushed by flowing water at higher rates. Spatial and temporal distribution of tracer concentrations indicates the presence of conduit-like and diffuse flow transport in the system, supporting the notion of both combined transport mechanisms in the limestone unit. The temporal response of tracer concentrations at different locations in the model coincide with, and confirms the preferential flow distribution generated with the statistical mixed models used in the study. PMID:23802921

Estimating preferential flow in karstic aquifers using statistical mixed models.

PubMed

Anaya, Angel A; Padilla, Ingrid; Macchiavelli, Raul; Vesper, Dorothy J; Meeker, John D; Alshawabkeh, Akram N

2014-01-01

Karst aquifers are highly productive groundwater systems often associated with conduit flow. These systems can be highly vulnerable to contamination, resulting in a high potential for contaminant exposure to humans and ecosystems. This work develops statistical models to spatially characterize flow and transport patterns in karstified limestone and determines the effect of aquifer flow rates on these patterns. A laboratory-scale Geo-HydroBed model is used to simulate flow and transport processes in a karstic limestone unit. The model consists of stainless steel tanks containing a karstified limestone block collected from a karst aquifer formation in northern Puerto Rico. Experimental work involves making a series of flow and tracer injections, while monitoring hydraulic and tracer response spatially and temporally. Statistical mixed models (SMMs) are applied to hydraulic data to determine likely pathways of preferential flow in the limestone units. The models indicate a highly heterogeneous system with dominant, flow-dependent preferential flow regions. Results indicate that regions of preferential flow tend to expand at higher groundwater flow rates, suggesting a greater volume of the system being flushed by flowing water at higher rates. Spatial and temporal distribution of tracer concentrations indicates the presence of conduit-like and diffuse flow transport in the system, supporting the notion of both combined transport mechanisms in the limestone unit. The temporal response of tracer concentrations at different locations in the model coincide with, and confirms the preferential flow distribution generated with the SMMs used in the study. © 2013, National Ground Water Association.

Inhibition linearizes firing rate responses in human motor units: implications for the role of persistent inward currents.

PubMed

Revill, Ann L; Fuglevand, Andrew J

2017-01-01

Motor neurons are the output neurons of the central nervous system and are responsible for controlling muscle contraction. When initially activated during voluntary contraction, firing rates of motor neurons increase steeply but then level out at modest rates. Activation of an intrinsic source of excitatory current at recruitment onset may underlie the initial steep increase in firing rate in motor neurons. We attempted to disable this intrinsic excitatory current by artificially activating an inhibitory reflex. When motor neuron activity was recorded while the inhibitory reflex was engaged, firing rates no longer increased steeply, suggesting that the intrinsic excitatory current was probably responsible for the initial sharp rise in motor neuron firing rate. During graded isometric contractions, motor unit (MU) firing rates increase steeply upon recruitment but then level off at modest rates even though muscle force continues to increase. The mechanisms underlying such firing behaviour are not known although activation of persistent inward currents (PICs) might be involved. PICs are intrinsic, voltage-dependent currents that activate strongly when motor neurons (MNs) are first recruited. Such activation might cause a sharp escalation in depolarizing current and underlie the steep initial rise in MU firing rate. Because PICs can be disabled with synaptic inhibition, we hypothesized that artificial activation of an inhibitory pathway might curb this initial steep rise in firing rate. To test this, human subjects performed slow triangular ramp contractions of the ankle dorsiflexors in the absence and presence of tonic synaptic inhibition delivered to tibialis anterior (TA) MNs by sural nerve stimulation. Firing rate profiles (expressed as a function of contraction force) of TA MUs recorded during these tasks were compared for control and stimulation conditions. Under control conditions, during the ascending phase of the triangular contractions, 93% of the firing rate profiles were best fitted by rising exponential functions. With stimulation, however, firing rate profiles were best fitted with linear functions or with less steeply rising exponentials. Firing rate profiles for the descending phases of the contractions were best fitted with linear functions for both control and stimulation conditions. These results seem consistent with the idea that PICs contribute to non-linear firing rate profiles during ascending but not descending phases of contractions. © 2016 The Authors. The Journal of Physiology © 2016 The Physiological Society.

Evaluation of the functional performance and technical quality of an Electronic Documentation System of the Nursing Process.

PubMed

de Oliveira, Neurilene Batista; Peres, Heloisa Helena Ciqueto

2015-01-01

To evaluate the functional performance and the technical quality of the Electronic Documentation System of the Nursing Process of the Teaching Hospital of the University of São Paulo. exploratory-descriptive study. The Quality Model of regulatory standard 25010 and the Evaluation Process defined under regulatory standard 25040, both of the International Organization for Standardization/International Electrotechnical Commission. The quality characteristics evaluated were: functional suitability, reliability, usability, performance efficiency, compatibility, security, maintainability and portability. The sample was made up of 37 evaluators. in the evaluation of the specialists in information technology, only the characteristic of usability obtained a rate of positive responses of less than 70%. For the nurse lecturers, all the quality characteristics obtained a rate of positive responses of over 70%. The staff nurses of the medical and surgical clinics with experience in using the system) and staff nurses from other units of the hospital and from other health institutions (without experience in using the system) obtained rates of positive responses of more than 70% referent to the functional suitability, usability, and security. However, performance efficiency, reliability and compatibility all obtained rates below the parameter established. the software achieved rates of positive responses of over 70% for the majority of the quality characteristics evaluated.

Response and Recovery of Streams From an Extreme Flood

NASA Astrophysics Data System (ADS)

Kantack, K. M.; Renshaw, C. E.; Magilligan, F. J.; Dethier, E.

2015-12-01

In temperate regions, channels are expected to recover from intense floods in a matter of months to years, but quantitative empirical support for this idea remains limited. Moreover, existing literature fails to address the spatial variability of the recovery process. Using an emerging technology, we investigate the immediate response to and progressive recovery of channels in the Northeastern United States from an extreme flood. We seek to determine what factors, including the nature and extent of the immediate response of the channel to the flood and post-flood availability of sediment, contribute to the spatial variability of the rate of recovery. Taking advantage of the 2011 flooding from Tropical Storm Irene, for which pre- and post-flood aerial lidar exist, along with a third set of terrestrial lidar collected in 2015, we assess channel response and recovery with multi-temporal lidar comparison. This method, with kilometers of continuous data, allows for analysis beyond traditional cross-section and reach-scale studies. Results indicate that landscape-scale factors, such as valley morphology and gradients in unit stream power, are controls on channel response to the flood, producing spatially variable impacts. Along a 16.4-km section (drainage area = 82 km2) of the Deerfield River in Vermont, over 148,000 m3 or erosion occurred during the flood. The spatial variation of impacts was correlated (R2= 0.476) with the ratio of channel width to valley width. We expect the recovery process will similarly exhibit spatial variation in rate and magnitude, possibly being governed by gradients in unit stream power and sediment availability. We test the idea that channel widening during the flood reduces post-flood unit stream power, creating a pathway for deposition and recovery to pre-flood width. Flood-widened reaches downstream of point-sources of sediment, such as landslides, will recover more quickly than those without consistent sediment supply. Results of this study will improve our ability to predict the nature and location of flood impacts and determine what factors contribute to the spatial variability of channel recovery.

Response Strength in Extreme Multiple Schedules

ERIC Educational Resources Information Center

McLean, Anthony P.; Grace, Randolph C.; Nevin, John A.

2012-01-01

Four pigeons were trained in a series of two-component multiple schedules. Reinforcers were scheduled with random-interval schedules. The ratio of arranged reinforcer rates in the two components was varied over 4 log units, a much wider range than previously studied. When performance appeared stable, prefeeding tests were conducted to assess…

Toward an Apartheid Economy?

ERIC Educational Resources Information Center

Freeman, Richard B.; And Others

1996-01-01

Suggests that in the last 20 years, the normal rate of inequality in the United States, except in the category of gender, has jumped. Cites specific examples of economic inequality and offers solutions to the problem. Responses are given by union representatives, economic researchers, the Secretary of Labor, a financial forecaster, and a bank…

Hispanics in the Work Force, Part II: Hispanic Women.

ERIC Educational Resources Information Center

Escutia, Marta M.; Prieto, Margarita

This paper evaluates the status of Hispanic women in the United States work force. First, demographic information on age patterns, fertility rates, and educational attainment is reviewed. Then, labor market status is assessed in relation to Hispanic women's labor force participation, employment patterns, and poverty. Next, the Federal response to…

Semiochemical-mediated flight responses of sap beetle vectors of oak wilt, Ceratocystis fagacearum

Treesearch

John F. Kyhl; Robert J. Bartelt; Allard Cosse; Jennifer Juzwik; Steven J. Seybold

2002-01-01

The sap beetle, Colopterus truncatus (Coleoptera: Nitidulidae), is one of the primary vectors of the oak wilt pathogen, Ceratocystis fagacearum, in the north-central United States. Field behavioral assays utilizing various release rates and blends of three methyl-branched hydrocarbon aggregation pheromone components showed that...

Job-sharing a clinical teacher's position: an evaluation.

PubMed

Williams, S; Murphy, L

1994-01-01

The aim of this study was to evaluate the effects on staff of having two teachers share one clinical teaching position in their intensive care unit (ICU). Three, six and 12 months after the job-sharing arrangement was initiated, an 11 item questionnaire was distributed to 26 students in post-registration critical care courses, 41 clinical staff in ICU and 9 RN-managers with responsibilities for the unit. The overall response rate to the three questionnaires was 58%. All groups agreed that job-sharing was a viable alternative to full-time work. Three months after the shared position was initiated, there was uncertainty about the consistency of the teachers' performance and the adequacy of communication between them. Nine months later, there was a high level of positive responses to all areas of the teachers' performance. Most respondents felt they could approach either teacher and that more diverse ideas were generated by having two people in the teaching position.

Worldwide orthopaedic research activity 2010-2014: Publication rates in the top 15 orthopaedic journals related to population size and gross domestic product

PubMed Central

Hohmann, Erik; Glatt, Vaida; Tetsworth, Kevin

2017-01-01

AIM To perform a bibliometric analysis of publications rates in orthopedics in the top 15 orthopaedic journals. METHODS Based on their 2015 impact factor, the fifteen highest ranked orthopaedic journals between January 2010 and December 2014 were used to establish the total number of publications; cumulative impact factor points (IF) per country were determined, and normalized to population size, GDP, and GDP/capita, comparison to the median country output and the global leader. RESULTS Twenty-three thousand and twenty-one orthopaedic articles were published, with 66 countries publishing. The United States had 8149 publications, followed by the United Kingdom (1644) and Japan (1467). The highest IF was achieved by the United States (24744), United Kingdom (4776), and Japan (4053). Normalized by population size Switzerland lead. Normalized by GDP, Croatia was the top achiever. Adjusting GDP/capita, for publications and IF, China, India, and the United States were the leaders. Adjusting for population size and GDP, 28 countries achieved numbers of publications to be considered at least equivalent with the median academic output. Adjusting GDP/capita only China and India reached the number of publications to be considered equivalent to the current global leader, the United States. CONCLUSION Five countries were responsible for 60% of the orthopaedic research output over this 5-year period. After correcting for GDP/capita, only 28 of 66 countries achieved a publication rate equivalent to the median country. The United States, United Kingdom, South Korea, Japan, and Germany were the top five countries for both publication totals and cumulative impact factor points. PMID:28660144

The use of dextran post free tissue transfer.

PubMed

Ridha, H; Jallali, N; Butler, P E

2006-01-01

Dextran has been used in microsurgery to reduce the risk of free tissue transfer loss. A number of regimens which vary considerably in dosage and timing have been published in the literature. Using a postal questionnaire, a survey was conducted to delineate the current practise of UK plastic surgeons. Data were received from 161 plastic surgeons in 51 units (response rate of 61%). Forty-five percent of microsurgeons routinely use dextran post-operatively whilst 29% use alternative thromboprophylaxis. The indications, post-operative regimes and duration of administration of dextran vary significantly amongst surgeons and units. The reported success rates of free tissue transfer and digital replants were 97 and 85.1%, respectively, and was not significantly affected by the use of dextran. We conclude that there is considerable variation amongst UK plastic surgeons regarding thromboprophylaxis post microsurgery. Our data suggest that the use of dextrans does not affect free tissue transfer success rates.

Project RED Impacts Patient Experience.

PubMed

Cancino, Ramon S; Manasseh, Chris; Kwong, Lana; Mitchell, Suzanne E; Martin, Jessica; Jack, Brian W

2017-12-01

Hospitalized patients are frequently unprepared to care for themselves after discharge often leading to unplanned hospital readmission. One strategy to reduce readmission rates is improving the quality of patient education and preparation before hospital discharge. The ReEngineered Discharge (RED) is a standardized hospital-based program designed to provide patients and caregivers the information they need to continue care at home. We sought to study the impact of the RED intervention on posthospitalization adult patient experience scores in an urban academic safety-net hospital. We conducted a descriptive study of a pilot program that compared posthospitalization survey responses to the Press Ganey survey item "Instructions were given about how to care for yourself at home." We compared the survey results for 3 groups of adult patients: those receiving the RED program, those receiving a standard discharge on the same hospital unit, and those receiving a standard discharge on other hospital units. A greater percentage of adult patients who received the RED discharge program rated the quality of their discharge as "very good" as compared to those receiving a standard discharge on the same hospital unit and those receiving a standard discharge on other hospital units (61%, 35%, and 41%, respectively, P = .0001). Delivery of a standardized hospital discharge program resulted in a larger proportion of top-box "very good" responses on a Press Ganey posthospitalization survey. Future research should examine whether hospital-based transition programs can sustain improvement in patient experience measures and whether these improvements can be observed in other patient populations.

Mental health of Cambodian refugees 2 decades after resettlement in the United States.

PubMed

Marshall, Grant N; Schell, Terry L; Elliott, Marc N; Berthold, S Megan; Chun, Chi-Ah

2005-08-03

Little is known about the long-term mental health of trauma-exposed refugees years after permanent resettlement in host countries. To assess the prevalence, comorbidity, and correlates of psychiatric disorders in the US Cambodian refugee community. A cross-sectional, face-to-face interview conducted in Khmer language on a random sample of households from the Cambodian community in Long Beach, Calif, the largest such community in the United States, between October 2003 and February 2005. A total of 586 adults aged 35 to 75 years who lived in Cambodia during the Khmer Rouge reign and immigrated to the United States prior to 1993 were selected. One eligible individual was randomly sampled from each household, with an overall response rate (eligibility screening and interview) of 87% (n = 490). Exposure to trauma and violence before and after immigration (using the Harvard Trauma Questionnaire and Survey of Exposure to Community Violence); weighted past-year prevalence rates of posttraumatic stress disorder (PTSD) and major depression (using the Composite International Diagnostic Interview version 2.1); and alcohol use disorder (by the Alcohol Use Disorders Identification Test). All participants had been exposed to trauma before immigration. Ninety-nine percent (n = 483) experienced near-death due to starvation and 90% (n = 437) had a family member or friend murdered. Seventy percent (n = 338) reported exposure to violence after settlement in the United States. High rates of PTSD (62%, weighted), major depression (51%, weighted), and low rates of alcohol use disorder were found (4%, weighted). PTSD and major depression were highly comorbid in this population (n = 209; 42%, weighted) and each showed a strong dose-response relationship with measures of traumatic exposure. In bivariate analyses, older age, having poor English-speaking proficiency, unemployment, being retired or disabled, and living in poverty were also associated with higher rates of PTSD and major depression. Following multivariate analyses, premigration trauma remained associated with PTSD (odds ratio [OR], 2.08; 95% CI, 1.37-3.16) and major depression (OR, 1.56; 95% CI, 1.24-1.97); postmigration trauma with PTSD (OR, 1.65; 95% CI, 1.21-2.26) and major depression (OR, 1.45; 95% CI, 1.12-1.86); and older age with PTSD (OR, 1.76; 95% CI, 1.46-2.13) and major depression (OR, 1.47; 95% CI, 1.15-1.89). More than 2 decades have passed since the end of the Cambodian civil war and the subsequent resettlement of refugees in the United States; however, this population continues to have high rates of psychiatric disorders associated with trauma.

The Effect of Music Therapy Entrainment on Physiologic Measures of Infants in the Cardiac Intensive Care Unit: Single Case Withdrawal Pilot Study.

PubMed

Yurkovich, Jennifer; Burns, Debra S; Harrison, Tondi

2018-03-09

Although evidence suggests music therapy lowers the heart rate of ill adults undergoing painful procedures and premature infants in the NICU, the effect of music therapy interventions on physiologic response in infants with congenital heart disease (CHD) being cared for in the cardiac intensive care unit (CICU) has not been explored. The purpose of this study was to explore the effect of the music therapy entrainment on physiologic responses of infants with CHD in the CICU. Five infants in the CICU received music therapy entrainment 3-5 times per week for up to 3 weeks. Sessions took place both prior to and after the infant's surgical cardiac repair. Heart rate, respiratory rate, blood pressure, and oxygen saturations were recorded every 15 seconds for 20 minutes prior to the intervention (baseline), during the 20-minute music therapy entrainment (intervention), and for 20 minutes after the intervention (return to baseline). Comparisons of baseline to intervention measures were based on means, standard deviations, and derivatives of the signal. Four of 5 infants experienced a decrease in average heart and respiratory rates as well as improvement in the derivative of the heart rate signal. Greater improvements were found when infants were located in the open bay and were receiving sedatives or narcotics. Our findings provide initial evidence that music therapy entrainment may be a valuable intervention to support improved physiologic stability in infants with CHD.

Adequacy of Fixed-Dose Heparin Infusions for Venous Thromboembolism Prevention after Microsurgical Procedures.

PubMed

Bertolaccini, Corinne M; Prazak, Ann Marie B; Agarwal, Jayant; Goodwin, Isak A; Rockwell, W Bradford; Pannucci, Christopher J

2018-05-22

 In microvascular surgery, patients often receive unfractionated heparin infusions to minimize risk for microvascular thrombosis. Patients who receive intravenous (IV) heparin are believed to have adequate prophylaxis against venous thromboembolism (VTE). Whether a fixed dose of IV heparin provides detectable levels of anticoagulation, or whether the "one size fits all" approach provides adequate prophylaxis against VTE remains unknown. This study examined the pharmacodynamics of fixed-dose heparin infusions and the effects of real-time, anti-factor Xa (aFXa) level driven heparin dose adjustments.  This prospective clinical trial recruited adult microvascular surgery patients placed on a fixed-dose (500 units/h) unfractionated heparin infusion during their initial microsurgical procedure. Steady-state aFXa levels, a marker of unfractionated heparin efficacy and safety, were monitored. Patients with out-of-range aFXa levels received protocol-driven real-time dose adjustments. Outcomes of interest included aFXa levels in response to heparin 500 units/h, number of dose adjustments required to achieve goal aFXa levels, time to reach goal aFXa level, and 90-day clinically relevant bleeding and VTE.  Twenty patients were recruited prospectively. None of 20 patients had any detectable level of anticoagulation in response to heparin infusions at 500 units/h. The median number of dose adjustments required to reach goal level was five, and median weight-based dose to reach goal level was 11.8 units/kg/h. Real-time dose adjustments significantly increased the proportion of patients with in-range levels (60 vs. 0%, p  = 0.0001). The 90-day VTE rate was 5% and 90-day clinically relevant bleeding rate was 5%.  Fixed-dose heparin infusions at a rate of 500 units/h do not provide a detectable level of anticoagulation after microsurgical procedures and are insufficient for the majority of patients who require VTE prophylaxis. Weight-based heparin infusions at 10 to 12 units/kg/h deserve future study in patients undergoing microsurgical procedures to increase the proportion of patients receiving adequate VTE prophylaxis. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

An Analysis of Counterinsurgency Campaigns Using Lanchestrian Based Marketing Differential Equations

DTIC Science & Technology

2010-09-01

Coca - Cola would be assessed to be high relative to Shasta Brand cola , as Coca - Cola advertises more than Shasta. The analogous comparison in our model...marketing models. . . have a strong resemblance to Lanchester’s models of warfare.” (Little, 1979) Mathematical modeling of marketing and advertising ... advertising expenditure or effort, ρ is the response constant measuring the rate of effectiveness per unit of effort, and δ is the rate at which the

Radiofrequency ablation of renal cell carcinoma: a follow up of outcomes.

PubMed

Curry, David; Yassin, Musaab; Thwaini, Ali; Pahuja, Ajay; Alanbuki, Ammar H; Rajan, Thiagarajan Nambi; Loan, Willie

2014-02-01

To present the oncological outcomes in a series of patients with cT1a renal cell carcinoma (RCC) treated with radiofrequency ablation (RFA) and its effect on the glomerular filtration rate (GFR). Forty-five patients (48 renal units) treated at the Belfast City Hospital, over 4 years. Average age is 61.5 years (range 41-80). Eighteen patients (22 renal units) were included with American Society of Anesthesiologists (ASA) II and III. The rest were ASA I. Average tumor size was 2.63 cm (range 1.2 cm-6 cm). Renal function before and after RFA was recorded by means of the estimated glomerular filtration rate (eGFR) and the changes are presented. Oncological outcomes were established from follow up imaging. A satisfactory response was defined by disappearance or a persistence of non-enhancing lesion of smaller size at follow up. A partial response was defined by a persistent but non-enhancing similar size lesion. A failed response was defined by enlarging or persistently enhancing lesions. Mean follow up was 30.6 months (4-60 months). A good response was found in 33 (74%) patients. A partial response was found in 3 (8%) patients and failed response was identified in 8 (18%) patients. The average reduction in eGFR was 11 mL/min. Two patients had a 50% reduction in their eGFR. No patient required dialysis following treatment. RFA presents safe treatment choice for patients with RCC, particularly those that are high risk surgical candidates and those who refuse surgery. Short term results suggest good oncological outcomes and preservation of renal function.

TU-D-201-07: Severity Indication in High Dose Rate Brachytherapy Emergency Response Procedure

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

Li, K; Rustad, F

Purpose: Understanding the corresponding dose to different staff during the High Dose Rate (HDR) Brachytherapy emergency response procedure could help to develop a strategy in efficiency and effective action. In this study, the variation and risk analysis methodology was developed to simulation the HDR emergency response procedure based on severity indicator. Methods: A GammaMedplus iX HDR unit from Varian Medical System was used for this simulation. The emergency response procedure was decomposed based on risk management methods. Severity indexes were used to identify the impact of a risk occurrence on the step including dose to patient and dose to operationmore » staff by varying the time, HDR source activity, distance from the source to patient and staff and the actions. These actions in 7 steps were to press the interrupt button, press emergency shutoff switch, press emergency button on the afterloader keypad, turn emergency hand-crank, remove applicator from the patient, disconnect transfer tube and move afterloader from the patient, and execute emergency surgical recovery. Results: Given the accumulated time in second at the assumed 7 steps were 15, 5, 30, 15, 180, 120, 1800, and the dose rate of HDR source is 10 Ci, the accumulated dose in cGy to patient at 1cm distance were 188, 250, 625, 813, 3063, 4563 and 27063, and the accumulated exposure in rem to operator at outside the vault, 1m and 10cm distance were 0.0, 0.0, 0.1, 0.1, 22.6, 37.6 and 262.6. The variation was determined by the operators in action at different time and distance from the HDR source. Conclusion: The time and dose were estimated for a HDR unit emergency response procedure. It provided information in making optimal decision during the emergency procedure. Further investigation would be to optimize and standardize the responses for other emergency procedure by time-spatial-dose severity function.« less

UV-crosslinkable and thermo-responsive chitosan hybrid hydrogel for NIR-triggered localized on-demand drug delivery.

PubMed

Wang, Lei; Li, Baoqiang; Xu, Feng; Xu, Zheheng; Wei, Daqing; Feng, Yujie; Wang, Yaming; Jia, Dechang; Zhou, Yu

2017-10-15

Innovative drug delivery technologies based on smart hydrogels for localized on-demand drug delivery had aroused great interest. To acquire smart UV-crosslinkable chitosan hydrogel for NIR-triggered localized on-demanded drug release, a novel UV-crosslinkable and thermo-responsive chitosan was first designed and synthesized by grafting with poly N-isopropylacrylamide, acetylation of methacryloyl groups and embedding with photothermal carbon. The UV-crosslinkable unit (methacryloyl groups) endowed chitosan with gelation via UV irradiation. The thermo-responsive unit (poly N-isopropylacrylamide) endowed chitosan hydrogel with temperature-triggered volume shrinkage and reversible swelling/de-swelling behavior. The chitosan hybrid hydrogel embedded with photothermal carbon exhibited distinct NIR-triggered volume shrinkage (∼42% shrinkage) in response to temperature elevation as induced by NIR laser irradiation. As a demonstration, doxorubicin release rate was accelerated and approximately 40 times higher than that from non-irradiated hydrogels. The UV-crosslinkable and thermal-responsive hybrid hydrogel served as in situ forming hydrogel-based drug depot is developed for NIR-triggered localized on-demand release. Copyright © 2017 Elsevier Ltd. All rights reserved.

Reported foodborne outbreaks due to fresh produce in the United States and European Union: trends and causes.

PubMed

Callejón, Raquel M; Rodríguez-Naranjo, M Isabel; Ubeda, Cristina; Hornedo-Ortega, Ruth; Garcia-Parrilla, M Carmen; Troncoso, Ana M

2015-01-01

The consumption of fruit and vegetables continues to rise in the United States and European Union due to healthy lifestyle recommendations. Meanwhile, the rate of foodborne illness caused by the consumption of these products remains high in both regions, representing a significant public health and financial issue. This study addresses the occurrence of reported foodborne outbreaks associated with fresh fruits and vegetables consumption in the United States and European Union during the period 2004-2012, where data are available. Special attention is paid to those pathogens responsible for these outbreaks, the mechanisms of contamination, and the fresh produce vehicles involved. Norovirus is shown to be responsible for most of the produce-related outbreaks, followed by Salmonella. Norovirus is mainly linked with the consumption of salad in the United States and of berries in the European Union, as demonstrated by the Multiple Correspondence Analysis (MCA). Salmonella was the leading cause of multistate produce outbreaks in the United States and was the pathogen involved in the majority of sprouts-associated outbreaks. As is reflected in the MCA, the pattern of fresh produce outbreaks differed in the United States and European Union by the type of microorganism and the food vehicle involved.

Tactile directional sensibility: peripheral neural mechanisms in man.

PubMed

Olausson, H; Wessberg, J; Kakuda, N

2000-06-02

Tactile directional sensibility, i.e. the ability to tell the direction of an object's motion across the skin, is an easily observed sensory function that is highly sensitive to disturbances of the somatosensory system. Based on previous psychophysical experiments on healthy subjects it was concluded that directional sensibility depends on two kinds of information from cutaneous mechanoreceptors; spatio-temporal information and information about friction-induced changes in skin stretch. In the present study responses to similar probe movements as in the psychophysical experiments were recorded from human single mechanoreceptors in the forearm skin. All slowly adapting type 2 (SA2) units were spontaneously active, and with increasing force of friction their discharge rates were modified by probe movements at increasing distances from the Ruffini end-organ, reflecting the high stretch-sensitivity of these units. Slowly adapting type 1 (SA1) and field units responded to the moving probe within well-defined skin areas directly overlying the individual receptor terminals, and compared to the SA2 units their response properties were less dependent on the force of friction. The results suggest that SA1 and field units have the capacity to signal spatio-temporal information, whereas a population of SA2 units have the capacity to signal direction-specific information about changes in lateral skin stretch.

Estradiol selectively enhances auditory function in avian forebrain neurons

PubMed Central

Caras, Melissa L.; O’Brien, Matthew; Brenowitz, Eliot A.; Rubel, Edwin W

2012-01-01

Sex steroids modulate vertebrate sensory processing, but the impact of circulating hormone levels on forebrain function remains unclear. We tested the hypothesis that circulating sex steroids modulate single-unit responses in the avian telencephalic auditory nucleus, field L. We mimicked breeding or non-breeding conditions by manipulating plasma 17β-estradiol levels in wild-caught female Gambel’s white-crowned sparrows (Zonotrichia leucophrys gambelii). Extracellular responses of single neurons to tones and conspecific songs presented over a range of intensities revealed that estradiol selectively enhanced auditory function in cells that exhibited monotonic rate-level functions to pure tones. In these cells, estradiol treatment increased spontaneous and maximum evoked firing rates, increased pure tone response strengths and sensitivity, and expanded the range of intensities over which conspecific song stimuli elicited significant responses. Estradiol did not significantly alter the sensitivity or dynamic ranges of cells that exhibited non-monotonic rate-level functions. Notably, there was a robust correlation between plasma estradiol concentrations in individual birds and physiological response properties in monotonic, but not non-monotonic neurons. These findings demonstrate that functionally distinct classes of anatomically overlapping forebrain neurons are differentially regulated by sex steroid hormones in a dose-dependent manner. PMID:23223283

Are we on course for reporting on the Millennium Development Goals in 2015?

PubMed

Rugg, Deborah; Marais, Hein; Carael, Michel; De Lay, Paul; Warner-Smith, Matthew

2009-12-01

At the 2001 United Nations General Assembly Special Session on HIV/AIDS (UNGASS), Member States agreed to regularly review progress made in national responses to HIV. This article provides (1) a brief overview of how the resultant global UNGASS reporting system was developed; (2) the origins, background, limitations and potential of that system; (3) an overview of the articles in this supplement; and (4) crosscutting institutional and methodological issues. United Nations Member States biennially provide The Joint United Nations Programme on HIV/AIDS (UNAIDS) with data on 25 core indicators of national responses to HIV, collected in Country Progress Reports. This article critically reviews and interprets these data in light of international political considerations and overall data needs. There has been a considerable improvement in response rates, accompanied by an increase in data quality and completeness. Both nationally and internationally, the UNGASS process is viewed as being more substantial and important than a reporting exercise to the United Nations General Assembly. The process has catalyzed the development of national monitoring systems and has created opportunities for civil society to monitor and challenge government commitments and deeds. Although the UNGASS global reporting system now comprises an unequaled wealth of data on HIV responses, collected from a broad range of countries, it cannot yet answer several critical questions about the progress and effectiveness of those responses. Evaluation studies that go beyond indicator monitoring are needed, but they will take time to design, fund, implement and interpret. In the meantime, this global monitoring system provides a good indication of the overall progress in the global response to HIV and whether Millennium Development Goal (MDG) 6 (to halt and reverse the HIV epidemic) is likely to be reached by 2015.

A Nationwide Survey of Quality of End-of-Life Cancer Care in Designated Cancer Centers, Inpatient Palliative Care Units, and Home Hospices in Japan: The J-HOPE Study.

PubMed

Miyashita, Mitsunori; Morita, Tatsuya; Sato, Kazuki; Tsuneto, Satoru; Shima, Yasuo

2015-07-01

End-of-life (EOL) cancer care in general hospitals and home care has not previously been evaluated in Japan. This study aimed to evaluate EOL cancer care from the perspective of bereaved family members in nationwide designated cancer centers, inpatient palliative care units (PCUs), and home hospices in Japan. We conducted a cross-sectional, anonymous, self-report questionnaire survey for bereaved family members of cancer patients in March 2008 for 56 designated cancer centers and in June 2007 for 100 PCUs and 14 home hospices. Outcomes were overall care satisfaction, structure and process of care (Care Evaluation Scale), and achievement of a good death (Good Death Inventory). In designated cancer centers, PCUs, and home hospices, 2794 (response rate 59%), 5312 (response rate 69%), and 292 (response rate 67%) bereaved family members participated, respectively. Mean scores for overall care satisfaction were high for all places of death, at 4.3 ± 1.2 for designated cancer centers, 5.0 ± 1.2 for PCUs, and 5.0 ± 1.0 for home hospices. Designated cancer centers showed significantly lower ratings than PCUs and home hospices for structure and process of care and achievement of a good death (P = 0.0001 each). Home hospices were rated significantly higher than PCUs for achievement of a good death (P = 0.0001). The main findings of this study were: (1) overall, bereaved family members were satisfied with end-of-life care in all three places of death; (2) designated cancer centers were inferior to PCUs and home hospices and had more room for improvement; and 3) home hospices were rated higher than PCUs for achieving a good death, although home hospices remain uncommon in Japan. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

A common fluence threshold for first positive and second positive phototropism in Arabidopsis thaliana

NASA Technical Reports Server (NTRS)

Janoudi, A.; Poff, K. L.

1990-01-01

The relationship between the amount of light and the amount of response for any photobiological process can be based on the number of incident quanta per unit time (fluence rate-response) or on the number of incident quanta during a given period of irradiation (fluence-response). Fluence-response and fluence rate-response relationships have been measured for second positive phototropism by seedlings of Arabidopsis thaliana. The fluence-response relationships exhibit a single limiting threshold at about 0.01 micromole per square meter when measured at fluence rates from 2.4 x 10(-5) to 6.5 x 10(-3) micromoles per square meter per second. The threshold values in the fluence rate-response curves decrease with increasing time of irradiation, but show a common fluence threshold at about 0.01 micromole per square meter. These thresholds are the same as the threshold of about 0.01 micromole per square meter measured for first positive phototropism. Based on these data, it is suggested that second positive curvature has a threshold in time of about 10 minutes. Moreover, if the times of irradiation exceed the time threshold, there is a single limiting fluence threshold at about 0.01 micromole per square meter. Thus, the limiting fluence threshold for second positive phototropism is the same as the fluence threshold for first positive phototropism. Based on these data, we suggest that this common fluence threshold for first positive and second positive phototropism is set by a single photoreceptor pigment system.

Which plant trait explains the variations in relative growth rate and its response to elevated carbon dioxide concentration among Arabidopsis thaliana ecotypes derived from a variety of habitats?

PubMed

Oguchi, Riichi; Ozaki, Hiroshi; Hanada, Kousuke; Hikosaka, Kouki

2016-03-01

Elevated atmospheric carbon dioxide (CO2) concentration ([CO2]) enhances plant growth, but this enhancement varies considerably. It is still uncertain which plant traits are quantitatively related to the variation in plant growth. To identify the traits responsible, we developed a growth analysis model that included primary parameters associated with morphology, nitrogen (N) use, and leaf and root activities. We analysed the vegetative growth of 44 ecotypes of Arabidopsis thaliana L. grown at ambient and elevated [CO2] (800 μmol mol(-1)). The 44 ecotypes were selected such that they were derived from various altitudes and latitudes. Relative growth rate (RGR; growth rate per unit plant mass) and its response to [CO2] varied by 1.5- and 1.7-fold among ecotypes, respectively. The variation in RGR at both [CO2]s was mainly explained by the variation in leaf N productivity (LNP; growth rate per leaf N),which was strongly related to photosynthetic N use efficiency (PNUE). The variation in the response of RGR to [CO2] was also explained by the variation in the response of LNP to [CO2]. Genomic analyses indicated that there was no phylogenetic constraint on inter-ecotype variation in the CO2 response of RGR or LNP. We conclude that the significant variation in plant growth and its response to [CO2] among ecotypes reflects the variation in N use for photosynthesis among ecotypes, and that the response of PNUE to CO2 is an important target for predicting and/or breeding plants that have high growth rates at elevated [CO2].

[Population planning unit is developed in the Congo].

PubMed

Amouali, C; Poukouta, P

1989-01-01

This article is an update on the demographic situation in the Congo and the institutionalization of a population unit in The Ministry of Plan. From 1974-84 the population increased 44.9% going from 1,319,790 to 1,912,429 at a growth rate of 3.48% and possibly doubling in 20 years (2005). However, the major transformation has been the growth of the urban areas over the rural. From 1974-84 the rural population went from 819,430 to 934,849 while the urban population went from 500,360 in 1974 to 977,580 in 1984. The growth rate of the rural areas was 1.22% while that for the urban was 6.38% Infant mortality rate stands at 73/1000; life expectancy is 46.9 for men and 50.0 for women. The average fertility rate is 6. This demographic situation with the inherent problems of the rapidly growing urbanization of the 2 principal cities, Brazzaville and Pointe-Noire, has led to problems in health services and high morbidity and mortality rates. The Government has created 3 national organizations to coordinate population activities in the country: 1) The National Council on Population, (1988) an interministerial council, presided over by the Prime Minister, that defines and formulates national population policies as integral components to the country's socioeconomic development plans; 2) The National Commission on Population (CONAPO), headed by the Minister of Plan, Finance and Economics as the administrative organ of The National Council on Population, and responsible for the technical and evaluation activities of The National Council on Population; and 3) The Population Planning Unit headed by the Director of Human Resources in the Ministry of Plan responsible for identifying, formulating and evaluating population policies in the Congo. These institutions were created as a result of the 1974 Bucharest Conference and the 1984 Arusha Conference were population and development were considered integral components, and of results of 2 censuses and population surveys highlighting the demographic situation in the Congo.

Asynchronous recruitment of low-threshold motor units during repetitive, low-current stimulation of the human tibial nerve

PubMed Central

Dean, Jesse C.; Clair-Auger, Joanna M.; Lagerquist, Olle; Collins, David F.

2014-01-01

Motoneurons receive a barrage of inputs from descending and reflex pathways. Much of our understanding about how these inputs are transformed into motor output in humans has come from recordings of single motor units during voluntary contractions. This approach, however, is limited because the input is ill-defined. Herein, we quantify the discharge of soleus motor units in response to well-defined trains of afferent input delivered at physiologically-relevant frequencies. Constant frequency stimulation of the tibial nerve (10–100 Hz for 30 s), below threshold for eliciting M-waves or H-reflexes with a single pulse, recruited motor units in 7/9 subjects. All 25 motor units recruited during stimulation were also recruited during weak (<10% MVC) voluntary contractions. Higher frequencies recruited more units (n = 3/25 at 10 Hz; n = 25/25 at 100 Hz) at shorter latencies (19.4 ± 9.4 s at 10 Hz; 4.1 ± 4.0 s at 100 Hz) than lower frequencies. When a second unit was recruited, the discharge of the already active unit did not change, suggesting that recruitment was not due to increased synaptic drive. After recruitment, mean discharge rate during stimulation at 20 Hz (7.8 Hz) was lower than during 30 Hz (8.6 Hz) and 40 Hz (8.4 Hz) stimulation. Discharge was largely asynchronous from the stimulus pulses with “time-locked” discharge occurring at an H-reflex latency with only a 24% probability. Motor units continued to discharge after cessation of the stimulation in 89% of trials, although at a lower rate (5.8 Hz) than during the stimulation (7.9 Hz). This work supports the idea that the afferent volley evoked by repetitive stimulation recruits motor units through the integration of synaptic drive and intrinsic properties of motoneurons, resulting in “physiological” recruitment which adheres to Henneman’s size principle and results in relatively low discharge rates and asynchronous firing. PMID:25566025

Asynchronous recruitment of low-threshold motor units during repetitive, low-current stimulation of the human tibial nerve.

PubMed

Dean, Jesse C; Clair-Auger, Joanna M; Lagerquist, Olle; Collins, David F

2014-01-01

Motoneurons receive a barrage of inputs from descending and reflex pathways. Much of our understanding about how these inputs are transformed into motor output in humans has come from recordings of single motor units during voluntary contractions. This approach, however, is limited because the input is ill-defined. Herein, we quantify the discharge of soleus motor units in response to well-defined trains of afferent input delivered at physiologically-relevant frequencies. Constant frequency stimulation of the tibial nerve (10-100 Hz for 30 s), below threshold for eliciting M-waves or H-reflexes with a single pulse, recruited motor units in 7/9 subjects. All 25 motor units recruited during stimulation were also recruited during weak (<10% MVC) voluntary contractions. Higher frequencies recruited more units (n = 3/25 at 10 Hz; n = 25/25 at 100 Hz) at shorter latencies (19.4 ± 9.4 s at 10 Hz; 4.1 ± 4.0 s at 100 Hz) than lower frequencies. When a second unit was recruited, the discharge of the already active unit did not change, suggesting that recruitment was not due to increased synaptic drive. After recruitment, mean discharge rate during stimulation at 20 Hz (7.8 Hz) was lower than during 30 Hz (8.6 Hz) and 40 Hz (8.4 Hz) stimulation. Discharge was largely asynchronous from the stimulus pulses with "time-locked" discharge occurring at an H-reflex latency with only a 24% probability. Motor units continued to discharge after cessation of the stimulation in 89% of trials, although at a lower rate (5.8 Hz) than during the stimulation (7.9 Hz). This work supports the idea that the afferent volley evoked by repetitive stimulation recruits motor units through the integration of synaptic drive and intrinsic properties of motoneurons, resulting in "physiological" recruitment which adheres to Henneman's size principle and results in relatively low discharge rates and asynchronous firing.

The Quality of Psychotherapy Case Formulations: A Comparison of Expert, Experienced, and Novice Cognitive-Behavioral and Psychodynamic Therapists

ERIC Educational Resources Information Center

Eells, Tracy D.; Lombart, Kenneth G.; Kendjelic, Edward M.; Turner, L. Carolyn; Lucas, Cynthia P.

2005-01-01

Sixty-five expert, experienced, and novice cognitive-behavioral and psychodynamic psychotherapists provided "think aloud" case formulations in response to 6 standardized patient vignettes varying in disorder and prototypicality. The 390 formulations were reliably transcribed, segmented into idea units, content coded, and rated on multiple…

Career and Family Balance of Texas Agricultural Science Teachers by Gender

ERIC Educational Resources Information Center

Hainline, Mark S.; Ulmer, Jonathan D.; Ritz, Rudy R.; Burris, Scott; Gibson, Courtney D.

2015-01-01

With the high rates of agricultural teacher burnout and attrition in the United States, the need for teachers to strike a balance between their work and family responsibilities is imperative. The purpose of this research study was to explore the influence of gender on Texas agricultural teachers' perceived job obligations and family…

The Effects of Looping in the Cuban Classroom: Teacher Perception and Academic Achievement

ERIC Educational Resources Information Center

Pickett, Gabriela

2016-01-01

The system of public education in the United States lacks responsiveness to differing maturation rates and learning styles of young children. U.S. public education focuses more on satisfying governmental mandates and a common curriculum measured through standardized tests than on addressing the individual learning needs of each student.…

Teacher Isolation: How Mentoring Programs Can Help

ERIC Educational Resources Information Center

Heider, Kelly L.

2005-01-01

Teacher attrition has become a very serious problem in the United States in recent years. Studies have shown that many talented, new teachers are leaving the profession early in their careers due to feelings of isolation. In response to the alarming turnover rate, school districts have adopted mentoring programs which have been successful at…

75 FR 29776 - Tobacco Product Advertising and Promotion to Youth and Racial and Ethnic Minority Populations...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-27

... designed to appeal to specific racial and ethnic minority populations in the United States. For the same... Tobacco products are responsible for more than 440,000 deaths each year. The rates of tobacco use and..., ``[t]argeting of various population groups--including * * * specific racial and ethnic populations...

A Descriptive Analysis of Undergraduate PETE Programs in the Central District

ERIC Educational Resources Information Center

Hetland, Kristen M.; Strand, Bradford

2010-01-01

The current study described physical education teacher education (PETE) programs at institutions located within the Central District of the United States (CDAAAHPERD). Of the 72 institutions invited to participate, 44 institutions completed the survey (58% response rate). The purpose of this study was to describe the general profile/practices of…

Adolescent Immunization: Challenges and Opportunities

ERIC Educational Resources Information Center

Grace, Judith A.

2006-01-01

Immunization is one of the greatest public health achievements of the past century. Vaccines are responsible for the worldwide eradication of smallpox, the elimination of polio in the western hemisphere, and most recently the elimination of rubella as a public health threat in the United States. Childhood vaccination rates are at an all-time high,…

1983 Salaries. Society Membership Survey. AIP Report.

ERIC Educational Resources Information Center

Skelton, W. Keith; And Others

Variation and changes in the salaries of members of the American Institute of Physics are examined. Graphics highlighting some of the patterns are presented, along with detailed tables and brief summary text. The data are based on a sample survey of the United Statess members conducted in spring 1983. The overall response rate was 69%, Tables…

Challenges for Governance: A National Report.

ERIC Educational Resources Information Center

Tierney, William G.; Minor, James T.

This report is designed to help policymakers, administrators, faculty, and researchers address the challenges of institutional governance by providing empirical data on the current role of faculty in institutional governance. It presents the results of a survey of more than 2,000 faculty and provosts across the United States (response rate of 53%)…

Control of Advanced Reactor-Coupled Heat Exchanger System: Incorporation of Reactor Dynamics in System Response to Load Disturbances

DOE PAGES

Skavdahl, Isaac; Utgikar, Vivek; Christensen, Richard; ...

2016-05-24

We present an alternative control schemes for an Advanced High Temperature Reactor system consisting of a reactor, an intermediate heat exchanger, and a secondary heat exchanger (SHX) in this paper. One scheme is designed to control the cold outlet temperature of the SHX (T co) and the hot outlet temperature of the intermediate heat exchanger (T ho2) by manipulating the hot-side flow rates of the heat exchangers (F h/F h2) responding to the flow rate and temperature disturbances. The flow rate disturbances typically require a larger manipulation of the flow rates than temperature disturbances. An alternate strategy examines the controlmore » of the cold outlet temperature of the SHX (T co) only, since this temperature provides the driving force for energy production in the power conversion unit or the process application. The control can be achieved by three options: (1) flow rate manipulation; (2) reactor power manipulation; or (3) a combination of the two. The first option has a quicker response but requires a large flow rate change. The second option is the slowest but does not involve any change in the flow rates of streams. The final option appears preferable as it has an intermediate response time and requires only a minimal flow rate change.« less

Infusional 5-FU for advanced colorectal cancer.

PubMed

Lokich, J

1995-01-01

5-Fluorouracil (5-FU) has been studied over the past two decades in five prospective randomized trials comparing bolus with infusional schedules. Response rates and time to progression are improved with infusional schedules and survival as determined by the proportion of patients alive at 2 years is also superior for infusional administration. Biochemical modulation of infusional 5-FU by leucovorin or interferon does not increase the therapeutic effect (in contrast to the modulation of bolus delivery) but does effect the toxicity profile adversely. Time modulation of infusional 5-FU has been reported to improve response rates, and survival over constant or flat infusion and additional studies are ongoing. A proposed experimental design for a comparative trial in advanced colon cancer is presented to address the questions of the optimal infusion duration; the role of dose intensity; and the role of chronomodulation. The application of infusional 5-FU into the adjuvant setting seems to be a reasonable step, and such trials have been initiated in both the United States and the United Kingdom. Bolus single agent 5-FU should be abandoned as a treatment option for colon cancer.

Innovative system to improve use of patient education materials.

PubMed Central

Smith, J. L.; Levitt, C.; Franco, E. D.

1997-01-01

OBJECTIVE: To evaluate a new storage system for patient education materials. DESIGN: Anonymous surveys before and after implementation of new storage system. SETTING: Family medicine residency teaching centre. PARTICIPANTS: All nurses, staff doctors, and first- and second-year residents in the unit. INTERVENTIONS: Implementation of a new storage system for patient education materials, orientation of all health professionals in the unit to the new system, and periodic distribution of patient education newsletters. MAIN OUTCOME MEASURES: Self-reported use of patient education materials. RESULTS: Response rates were 73% (30 of 41 health professionals) in 1990 and 86% (36 of 42) in 1992. Responses to the first survey on use of 20 categories of patient education materials showed materials were seldom used by most respondents. Back Care, Nutrition, Diabetes, VD/Birth Control, and Pregnancy categories were the most frequently used. In the second survey, more respondents reported using these five categories of pamphlets. Rates of use varied only slightly for the remaining 15 categories. CONCLUSIONS: Health professionals reported more frequent use of certain patient education materials following implementation of a new storage system. PMID:9626424

Changes in cortisol release and heart rate and heart rate variability during the initial training of 3-year-old sport horses.

PubMed

Schmidt, Alice; Aurich, Jörg; Möstl, Erich; Müller, Jürgen; Aurich, Christine

2010-09-01

Based on cortisol release, a variety of situations to which domestic horses are exposed have been classified as stressors but studies on the stress during equestrian training are limited. In the present study, Warmblood stallions (n=9) and mares (n=7) were followed through a 9 respective 12-week initial training program in order to determine potentially stressful training steps. Salivary cortisol concentrations, beat-to-beat (RR) interval and heart rate variability (HRV) were determined. The HRV variables standard deviation of the RR interval (SDRR), RMSSD (root mean square of successive RR differences) and the geometric means standard deviation 1 (SD1) and 2 (SD2) were calculated. Nearly each training unit was associated with an increase in salivary cortisol concentrations (p<0.01). Cortisol release varied between training units and occasionally was more pronounced in mares than in stallions (p<0.05). The RR interval decreased slightly in response to lunging before mounting of the rider. A pronounced decrease occurred when the rider was mounting, but before the horse showed physical activity (p<0.001). The HRV variables SDRR, RMSSD and SD1 decreased in response to training and lowest values were reached during mounting of a rider (p<0.001). Thereafter RR interval and HRV variables increased again. In contrast, SD2 increased with the beginning of lunging (p<0.05) and no changes in response to mounting were detectable. In conclusion, initial training is a stressor for horses. The most pronounced reaction occurred in response to mounting by a rider, a situation resembling a potentially lethal threat under natural conditions. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Job satisfaction and importance for intensive care unit research coordinators: results from binational survey.

PubMed

Rickard, Claire M; Roberts, Brigit L; Foote, Jonathon; McGrail, Matthew R

2007-09-01

To measure Intensive Care Unit Research coordinator job satisfaction and importance and to identify priorities for role development. Research coordinator numbers are growing internationally in response to increasing clinical research activity. In Australia, 1% of registered nurses work principally in research, many as Research coordinators. Internationally, the Association of Clinical Research Professionals currently has 6536 certified Research coordinators in 13 countries, with likely additional large numbers practicing without the voluntary certification. Research coordinators are almost always nurses, but little is know about this emerging specialty. Design. Cross-sectional study using anonymous self-report questionnaire. After ethics approval, the McCloskey-Mueller Satisfaction Scale and McCloskey-Mueller Importance Scale were administered via the Internet. The sample was 49 (response rate 71%) Research coordinators from the Australia and New Zealand Intensive Care Unit Research coordinators' Interest Group. Research coordinators were satisfied with structural aspects of the position working business hours; flexibility of working hours; high levels of responsibility and control over their work. Dissatisfaction was expressed regarding: remuneration and recognition; compensation for weekend work; salary package; career advancement opportunities; and childcare facilities. High priorities for role development are those rated highly important but with much lower satisfaction. These are: compensation for weekend call-out work; salary and remuneration package; recognition by management and clinicians; career advancement opportunities; departmental research processes; encouragement and feedback; and number of working hours. Increasing numbers of nurses have been attracted to this clinically based research position. These data contribute to the understanding and development of the role.

TiO2 induced structural modifications in Cs containing borosilicate glasses: Raman and infrared studies

NASA Astrophysics Data System (ADS)

Pandey, M.; Banerjee, D.; Sudarsan, V.; Kshirsagar, R. J.

2018-04-01

Effect of TiO2 addition in Cs containing Sodium-borosilicate glasses is studied using Raman and infrared spectroscopic techniques. As revealed from infrared and Raman studies, TiO2 does not form segregated phase, but instead enters into the borosilicate network. It is further observed that TiO2 addition results in modifications of the borate and silicate structural units by transforming into tetraborates and metasilicate structural units. These structural modifications are responsible for Cs immobilization, leach rate and chemical durability of these glasses.

The impact of patient demographics and comorbidities upon burns admitted to Tygerberg Hospital Burns Unit, Western Cape, South Africa.

PubMed

Cloake, T; Haigh, T; Cheshire, J; Walker, D

2017-03-01

In South Africa, burns are a major public health problem responsible for significant morbidity and long-term physical disability. This is, in part, due to a significant proportion of the urban population living in poorly constructed, combustible accommodation. The presence of co-morbid diseases such as diabetes and malignancy in patients with burns has been associated with a poorer outcome. The impact of other diseases such as HIV has yet to be defined. A retrospective data collection study analysed the 221 patients admitted to Tygerberg Hospital Burns Unit in 2011 and the first six months of 2013. Using hospital records, patient demographic data was collected alongside burn agent, ICU admission, complications, and patient outcome in terms of length of stay and mortality. The most common burn agent was hot liquid (45.7%). A significant proportion of patients were subject to intentional attacks (34.3%). Shack fires and flame accounted cumulatively for 85% of total inhalational burns, the highest rates of admission to ICU (85.5%), the highest rate of complications, as well as 92.3% of all total fatalities. HIV+ patients had a higher mortality (13.3% vs 5%, p=0.22) and a higher complication rate (46.7% vs 30%, p=0.21). There was no difference in length of stay between the HIV+ and HIV- cohort (12days vs. 15.5 days, p=0.916). Burns are a significant yet preventable cause of mortality and morbidity. The rising number of shack fires, responsible for extensive burns and resultant mortality is concerning and indicates urgent attention and action. HIV complicates the recovery from burn and is responsible for an increased rate of in hospital mortality. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Expert assessment of physical ergonomics at video-display unit workstations: repeatability, validity and responsiveness to changes.

PubMed

Ketola, Ritva; Toivonen, Risto; Luukkonen, Ritva; Takala, Esa-Pekka; Viikari-Juntura, Eira

2004-08-01

Inter-observer repeatability, validity and responsiveness to change were determined for an expert assessment method for video-display unit (VDU) workstation ergonomics. The aim was to determine to what extent the expert assessment of ergonomics is related to the technical measurements, tidiness and space, work chair ergonomics and responds to changes in these characteristics. Technical measurements and video-recordings before and 2 months after an ergonomic intervention were made for 109 VDU office workstations. Two experts in ergonomics analysed and rated the ergonomics of the workstations. A researcher analysed tidiness and available space. A physiotherapist classified the work chairs used according to their ergonomic properties. The intra-class correlation coefficient between the workstation ergonomic ratings of the two experts was 0.74 at the baseline and 0.81 at the follow-up. Workstation tidiness and space, and work chair ergonomics, had a strong effect on the assessments of both experts. For both experts a change in the locations of the mouse, the screen and the keyboard and values of tidiness and space and work chair ergonomics during the intervention showed a significant association with the ratings. The assessment method studied can be utilized by an expert in a repeatable manner both in cross-sectional and in longitudinal settings.

Curriculum development for a national cardiotocography education program: a Delphi survey to obtain consensus on learning objectives.

PubMed

Thellesen, Line; Hedegaard, Morten; Bergholt, Thomas; Colov, Nina P; Hoegh, Stinne; Sorensen, Jette L

2015-08-01

To define learning objectives for a national cardiotocography (CTG) education program based on expert consensus. A three-round Delphi survey. One midwife and one obstetrician from each maternity unit in Denmark were appointed based on CTG teaching experience and clinical obstetric experience. Following national and international guidelines, the research group determined six topics as important when using CTG: fetal physiology, equipment, indication, interpretation, clinical management, and communication/responsibility. In the first Delphi round, participants listed one to five learning objectives within the predefined topics. Responses were analyzed by a directed approach to content analysis. Phrasing was modified in accordance with Bloom's taxonomy. In the second and third Delphi rounds, participants rated each objective on a five-point relevance scale. Consensus was predefined as objectives with a mean rating value of ≥ 3. A prioritized list of CTG learning objectives. A total of 42 midwives and obstetricians from 21 maternity units were invited to participate, of whom 26 completed all three Delphi rounds, representing 18 maternity units. The final prioritized list included 40 objectives. The highest ranked objectives emphasized CTG interpretation and clinical management. The lowest ranked objectives emphasized fetal physiology. Mean ratings of relevance ranged from 3.15 to 5.00. National consensus on CTG learning objectives was achieved using the Delphi methodology. This was an initial step in developing a valid CTG education program. A prioritized list of objectives will clarify which topics to emphasize in a CTG education program. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

Multinational Comparison of Prophylactic Antibiotic Use for Eyelid Surgery.

PubMed

Fay, Aaron; Nallasamy, Nambi; Bernardini, Francesco; Wladis, Edward J; Durand, Marlene L; Devoto, Martin H; Meyer, Dale; Hartstein, Morris; Honavar, Santosh; Osaki, Midori H; Osaki, Tammy H; Santiago, Yvette M; Sales-Sanz, Marco; Vadala, Giuseppe; Verity, David

2015-07-01

Antibiotic stewardship is important in controlling resistance, adverse reactions, and cost. The literature regarding antibiotic use for eyelid surgery is lacking. To determine standard care and assess factors influencing antibiotic prescribing practices for eyelid surgery. A survey study was conducted from February 2, 2014, to March 24, 2014. The survey was distributed to 2397 oculoplastic surgeons in private and academic oculoplastic surgery practices in 43 countries. All surgeons were members of ophthalmic plastic and reconstructive surgery societies. Data were analyzed by geographic location. Linear regression was performed to quantify contributions to rates of prescribing postoperative antibiotics for routine eyelid surgical procedures. Rates of prescribing prophylactic intravenous, oral, and topical antibiotics as well as factors that influence surgeons' prescribing practices. A total of 782 responses were received from 2397 surgeons (average response rate, 36.7%; 2.5% margin of error) from 43 countries. Topical antibiotic use was common in all regions (85.2%). Perioperative intravenous antibiotic use was uncommon in all regions (13.5%). Geographic location was the greatest predictor of antibiotic prescribing practices (range, 2.9% in the United Kingdom to 86.7% in India; mean, 24%). Within Europe, Italy had the highest rate of antibiotic prescriptions for eyelid surgery (41.7%) and the United Kingdom had the lowest rate (2.9%.) In South America, Venezuela had the highest rate of antibiotic prescriptions for eyelid surgery (83.3%) and Chile had the lowest rate (0%). The practice locations that were associated with routinely prescribing postoperative oral antibiotics were India (odds ratio [OR], 15.83; 95% CI, 4.85-51.68; P < .001), Venezuela (OR, 13.47; 95% CI, 1.43-127.19; P = .02), and Southeast Asia (OR, 2.80; 95% CI, 1.15-6.84; P = .02). Conversely, practice location in the United Kingdom (OR, 0.048; 95% CI, 0.0063-0.37; P = .004), Australia and New Zealand (OR, 0.15; 95% CI, 0.033-0.67; P = .01), and the United States and Canada (OR, 0.41; 95% CI, 0.23-0.72; P = .002) were associated with decreased rates of postoperative oral antibiotic use. Surgeons' concern for allergic reactions was associated with decreased rates of prescribing antibiotics (OR, 0.34; 95% CI, 0.23-0.49; P < .001), while surgeons' concern for infection was associated with increased rates of prescribing antibiotics (OR 1.80; 95% CI, 1.45-2.23; P < .001). These results from members of ophthalmic plastic and reconstructive surgery societies confirm that antibiotic prescribing practices for routine eyelid surgical procedures vary widely throughout the world. No standard of care has been established that would require the routine use of postoperative prophylactic antibiotics following eyelid surgery.

Improving staff response to seizures on the epilepsy monitoring unit with online EEG seizure detection algorithms.

PubMed

Rommens, Nicole; Geertsema, Evelien; Jansen Holleboom, Lisanne; Cox, Fieke; Visser, Gerhard

2018-05-11

User safety and the quality of diagnostics on the epilepsy monitoring unit (EMU) depend on reaction to seizures. Online seizure detection might improve this. While good sensitivity and specificity is reported, the added value above staff response is unclear. We ascertained the added value of two electroencephalograph (EEG) seizure detection algorithms in terms of additional detected seizures or faster detection time. EEG-video seizure recordings of people admitted to an EMU over one year were included, with a maximum of two seizures per subject. All recordings were retrospectively analyzed using Encevis EpiScan and BESA Epilepsy. Detection sensitivity and latency of the algorithms were compared to staff responses. False positive rates were estimated on 30 uninterrupted recordings (roughly 24 h per subject) of consecutive subjects admitted to the EMU. EEG-video recordings used included 188 seizures. The response rate of staff was 67%, of Encevis 67%, and of BESA Epilepsy 65%. Of the 62 seizures missed by staff, 66% were recognized by Encevis and 39% by BESA Epilepsy. The median latency was 31 s (staff), 10 s (Encevis), and 14 s (BESA Epilepsy). After correcting for walking time from the observation room to the subject, both algorithms detected faster than staff in 65% of detected seizures. The full recordings included 617 h of EEG. Encevis had a median false positive rate of 4.9 per 24 h and BESA Epilepsy of 2.1 per 24 h. EEG-video seizure detection algorithms may improve reaction to seizures by improving the total number of seizures detected and the speed of detection. The false positive rate is feasible for use in a clinical situation. Implementation of these algorithms might result in faster diagnostic testing and better observation during seizures. Copyright © 2018. Published by Elsevier Inc.

Developmental Experience Alters Information Coding in Auditory Midbrain and Forebrain Neurons

PubMed Central

Woolley, Sarah M. N.; Hauber, Mark E.; Theunissen, Frederic E.

2010-01-01

In songbirds, species identity and developmental experience shape vocal behavior and behavioral responses to vocalizations. The interaction of species identity and developmental experience may also shape the coding properties of sensory neurons. We tested whether responses of auditory midbrain and forebrain neurons to songs differed between species and between groups of conspecific birds with different developmental exposure to song. We also compared responses of individual neurons to conspecific and heterospecific songs. Zebra and Bengalese finches that were raised and tutored by conspecific birds, and zebra finches that were cross-tutored by Bengalese finches were studied. Single-unit responses to zebra and Bengalese finch songs were recorded and analyzed by calculating mutual information, response reliability, mean spike rate, fluctuations in time-varying spike rate, distributions of time-varying spike rates, and neural discrimination of individual songs. Mutual information quantifies a response’s capacity to encode information about a stimulus. In midbrain and forebrain neurons, mutual information was significantly higher in normal zebra finch neurons than in Bengalese finch and cross-tutored zebra finch neurons, but not between Bengalese finch and cross-tutored zebra finch neurons. Information rate differences were largely due to spike rate differences. Mutual information did not differ between responses to conspecific and heterospecific songs. Therefore, neurons from normal zebra finches encoded more information about songs than did neurons from other birds, but conspecific and heterospecific songs were encoded equally. Neural discrimination of songs and mutual information were highly correlated. Results demonstrate that developmental exposure to vocalizations shapes the information coding properties of songbird auditory neurons. PMID:20039264

Rapid resetting of rabbit aortic baroreceptors and reflex heart rate responses by directional changes in blood pressure.

PubMed

Burke, S L; Dorward, P K; Korner, P I

1986-09-01

In both anaesthetized and conscious rabbits, perivascular balloon inflations slowly raised or lowered mean arterial pressure (M.A.P.), at 1-2 mmHg/s, from resting to various plateau pressures. Deflations then returned the M.A.P. to resting. 'Steady-state' curves relating M.A.P. to unitary aortic baroreceptor firing, integrated aortic nerve activity and heart rate were derived during the primary and return pressure changes and they formed typical hysteresis loops. In single units, return M.A.P.-frequency curves were shifted in the same direction as the primary pressure changes by an average 0.37 mmHg per mmHg change in M.A.P. Shifts were linearly related to the changes in M.A.P. between resting and plateau levels for all pressure rises and for falls less than 30 mmHg. They were established within 30 s and were quantitatively similar to the rapid resetting of baroreceptor function curves found 15 min-2 h after a change in resting M.A.P. (Dorward, Andresen, Burke, Oliver & Korner, 1982). Unit threshold pressures were shifted within 20 s to the same extent as the over-all curve shift to which they contributed. In the whole aortic nerve, return M.A.P.-integrated activity curves were shifted to same degree as unit function curves in both anaesthetized and conscious rabbits. Simultaneous shifts of return reflex M.A.P.-heart rate curves were also seen in conscious rabbits within 30 s. During M.A.P. falls, receptor and reflex hysteresis was similar, but during M.A.P. rises, reflex shifts were double baroreceptor shifts, suggesting the involvement of other pressure-sensitive receptors. We conclude that hysteresis shifts in baroreceptor function curves, which follow the reversal of slow ramp changes in blood pressure are a form of rapid resetting. They are accompanied by rapid resetting of reflex heart rate responses. We regard this as an important mechanism in blood pressure control which produces relatively high-gain reflex responses, during slow directional pressure changes, over a wider range of absolute pressure levels than would otherwise be possible.

Serological markers for hepatitis types A and B among U.S. Arym soldiers, Germany.

PubMed Central

James, J J; Smith, L

1979-01-01

Viral hepatitis rates among U.S. Army soldiers in Europe have been found to be two to three times higher than corresponding rates for soldiers stationed in the U.S. Sera from 89 per cent of a representative Army unit with 865 members and a known hepatitis problem were tested for HBsAg, anti-HBs, anti-HBc, and anti-HA. The prevalence of HB markers was 20 per cent, and hepatitis A antibody was present in 25 per cent. A six-month follow-up, conducted on 260 individuals initially negative for all four tests, revealed that 11 of these were now HB seropositive, whereas none had seroconverted to anti-HA positive. The HB virus was the principal agent responsible for hepatitis in the unit surveyed. PMID:228562

Comparing the epidemic in U.S. and Britain.

PubMed

Harmon, K S

1999-01-01

Cultural differences between the United States and Britain influence how the AIDS/HIV epidemic is being addressed and why AIDS rates are smaller in the United Kingdom. The author proposes that highly diverse and racist societies, like in the United States, may cause distrust among different groups in the effort to challenge the spread of HIV/AIDS, leaving people to fend for themselves. Because of racism and distrust between ethnic and racial groups, as well as differences in financial resources between groups, the AIDS epidemic in the United States is being fought on too many fronts without the benefit of a uniform response. Ironically, this problem has also spurred a greater ability among US AIDS service providers to work with diverse communities during the course of the epidemic.

Sympathetic and cardiovascular responses to venous distension in an occluded limb.

PubMed

Cui, Jian; Leuenberger, Urs A; Gao, Zhaohui; Sinoway, Lawrence I

2011-12-01

We recently showed that a fixed volume (i.e., 40 ml) of saline infused into the venous circulation of an arterially occluded vascular bed increases muscle sympathetic nerve activity (MSNA) and blood pressure. In the present report, we hypothesized that the volume and rate of infusion would influence the magnitude of the sympathetic response. Blood pressure, heart rate, and MSNA were assessed in 13 young healthy subjects during forearm saline infusions (arrested circulation). The effects of different volumes of saline (i.e., 2%, 3%, 4%, or 5% forearm volume at 30 ml/min) and different rates of infusion (i.e., 5% forearm volume at 10, 20, or 30 ml/min) were evaluated. MSNA and blood pressure responses were linked with the infusion volume. Infusion of 5% of forearm volume evoked greater MSNA responses than did infusion of 2% of forearm volume (Δ11.6 ± 1.9 vs. Δ3.1 ± 1.8 bursts/min and Δ332 ± 105 vs. Δ38 ± 32 units/min, all P < 0.05). Moreover, greater MSNA responses were evoked by saline infusion at 30 ml/min than 10 ml/min (P < 0.05). Sonographic measurements confirmed that the saline infusions induced forearm venous distension. The results suggest that volume and rate of saline infusion are important factors in evoking sympathetic activation. We postulate that venous distension contributes to cardiovascular autonomic adjustment in humans.

Patient safety culture assessment in oman.

PubMed

Al-Mandhari, Ahmed; Al-Zakwani, Ibrahim; Al-Kindi, Moosa; Tawilah, Jihane; Dorvlo, Atsu S S; Al-Adawi, Samir

2014-07-01

To illustrate the patient safety culture in Oman as gleaned via 12 indices of patient safety culture derived from the Hospital Survey on Patient Safety Culture (HSPSC) and to compare the average positive response rates in patient safety culture between Oman and the USA, Taiwan, and Lebanon. This was a cross-sectional research study employed to gauge the performance of HSPSC safety indices among health workers representing five secondary and tertiary care hospitals in the northern region of Oman. The participants (n=398) represented different professional designations of hospital staff. Analyses were performed using univariate statistics. The overall average positive response rate for the 12 patient safety culture dimensions of the HSPSC survey in Oman was 58%. The indices from HSPSC that were endorsed the highest included 'organizational learning and continuous improvement' while conversely, 'non-punitive response to errors' was ranked the least. There were no significant differences in average positive response rates between Oman and the United States (58% vs. 61%; p=0.666), Taiwan (58% vs. 64%; p=0.386), and Lebanon (58% vs. 61%; p=0.666). This study provides the first empirical study on patient safety culture in Oman which is similar to those rates reported elsewhere. It highlights the specific strengths and weaknesses which may stem from the specific milieu prevailing in Oman.

Modeling the Growth Rates of Tetragonal Lysozyme Crystal Faces

NASA Technical Reports Server (NTRS)

Li, Meirong; Nadarajah, Arunan; Pusey, Marc L.

1998-01-01

The measured macroscopic growth rates of the (110) and (101) faces of tetragonal lysozyme show an unexpectedly complex dependence on the supersaturation. The growth rates decay asymptotically to zero when the supersaturation is lowered to zero and increase rapidly when the supersaturation is increased. When supersaturations are increased still further the growth rates attain a maximum before starting to decrease. However, growth of these crystals is known to proceed by the classical dislocation and 2D nucleation growth mechanisms. This anomaly can be explained if growth is assumed to occur not by monomer units but by lysozyme aggregates. Analysis of the molecular packing of these crystals revealed that they were constructed of strongly bonded 4(sub 3) helices, while weaker bonds were responsible for binding the helices to each other. It follows that during crystal growth the stronger bonds are formed before the weaker ones. Thus, the growth of these crystals could be viewed as a two step process: aggregate growth units corresponding to the 4(sub 3) helix are first formed in the bulk solution by stronger intermolecular bonds and then attached to the crystal face by weaker bonds on dislocation hillocks or 2D islands. This will lead to a distribution of aggregates in the solution with monomers and lower order aggregates being predominant at low supersaturations and higher order aggregates being predominant at high supersaturations. If the crystal grows mostly by higher order aggregates, such as tetramers and octamers, it would explain the anomalous dependence of the growth rates on the supersaturation. Besides the analysis of molecular packing, a comprehensive analysis of the measured (110) and (101) growth rates was also undertaken in this study. The distribution of aggregates in lysozyme nutrient solutions at various solution conditions were determined from reversible aggregation reactions at equilibrium. The supersaturation was defined for each aggregate species with respect to its concentration at saturation in order to apply growth rate models to this process. The measured growth rates were then compared with the predicted ones from several dislocation and 2D nucleation growth models, employing tetramer and octamer growth units in polydisperse solutions and monomer units in monodisperse solutions. For the (110) face, the calculations consistently showed that the measured growth rates followed the expected model relations with octamer growth units. For the (101) face, it is not possible to obtain a clear agreement between the predicted and measured growth rates for a single growth unit as done for the (110) face. However, the calculations do indicate that the average size of the growth unit is between a tetramer and an octamer. This suggests that tetramers, octamers and other intermediate size growth units all participate in the growth process for this face. These calculations show that it is possible to model the macroscopic protein crystal growth rates if the molecular level processes can be account for, particularly protein aggregation processes in the bulk solution. Our recent investigations of tetragonal lysozyme crystals employing high resolution atomic force microscopy scans have further confirmed the growth of these crystals by aggregate growth units corresponding to 4(sub 3) helices.

The Small Area Health Statistics Unit: a national facility for investigating health around point sources of environmental pollution in the United Kingdom.

PubMed Central

Elliott, P; Westlake, A J; Hills, M; Kleinschmidt, I; Rodrigues, L; McGale, P; Marshall, K; Rose, G

1992-01-01

STUDY OBJECTIVE--The Small Area Health Statistics Unit (SAHSU) was established at the London School of Hygiene and Tropical Medicine in response to a recommendation of the enquiry into the increased incidence of childhood leukaemia near Sellafield, the nuclear reprocessing plant in West Cumbria. The aim of this paper was to describe the Unit's methods for the investigation of health around point sources of environmental pollution in the United Kingdom. DESIGN--Routine data currently including deaths and cancer registrations are held in a large national database which uses a post code based retrieval system to locate cases geographically and link them to the underlying census enumeration districts, and hence to their populations at risk. Main outcome measures were comparison of observed/expected ratios (based on national rates) within bands delineated by concentric circles around point sources of environmental pollution located anywhere in Britain. MAIN RESULTS--The system is illustrated by a study of mortality from mesothelioma and asbestosis near the Plymouth naval dockyards during 1981-87. Within a 3 km radius of the docks the mortality rate for mesothelioma was higher than the national rate by a factor of 8.4, and that for asbestosis was higher by a factor of 13.6. CONCLUSIONS--SAHSU is a new national facility which is rapidly able to provide rates of mortality and cancer incidence for arbitrary circles drawn around any point in Britain. The example around Plymouth of mesothelioma and asbestosis demonstrates the ability of the system to detect an unusual excess of disease in a small locality, although in this case the findings are likely to be related to occupational rather than environmental exposure. PMID:1431704

Effects of Effortful Swallow on Cardiac Autonomic Regulation.

PubMed

Gomes, Lívia M S; Silva, Roberta G; Melo, Monique; Silva, Nayra N; Vanderlei, Franciele M; Garner, David M; de Abreu, Luiz Carlos; Valenti, Vitor E

2016-04-01

Swallowing-induced changes in heart rate have been recently reported. However, it is not apparent the responses of heart rate variability (HRV) elicited by effortful swallow maneuver. We investigated the acute effects of effortful swallowing maneuver on HRV. This study was performed on 34 healthy women between 18 and 35 years old. We assessed heart rate variability in the time (SDNN, RMSSD, and pNN50) and frequency (HF, LF, and LF/HF ratio) domains and, visual analysis through the Poincaré plot. The subjects remained at rest for 5 min during spontaneous swallowing and then performed effortful swallowing for 5 min. HRV was analyzed during spontaneous and effortful swallowing. We found no significant differences for SDNN, pNN50, RMSSD, HF in absolute units (ms(2)). There is a trend for increase of LF in absolute (p = 0.05) and normalized (p = 0.08) units during effortful swallowing. HF in normalized units reduced (p = 0.02) during effortful swallowing and LF/HF ratio (p = 0.03) increased during effortful swallowing. In conclusion effortful swallow maneuver in healthy women increased sympathetic cardiac modulation, indicating a cardiac overload.

Early labour services: changes, triggers, monitoring and evaluation.

PubMed

Spiby, Helen; Green, Josephine M; Richardson-Foster, Helen; Hucknall, Clare

2013-04-01

to identify the changes to early labour services, their triggers and monitoring. a mixed methods approach in two stages, firstly a postal questionnaire survey of Heads of Midwifery (HoM) services in NHS Trusts in England (cover sheet to each HoM and questionnaire for each unit in their jurisdiction) and, secondly, semi-structured telephone interviews with a purposive sample of senior midwives. The interviews sought further information about reasons for change; the impact of changes and explored the unit's particular innovations. PARTICIPANTS AND RESPONSE RATE: 145 (89%) NHS Trusts provided data (cover sheet and/or questionnaire); responses were received from all areas and types of unit. Seventeen HoMs or designated senior midwives were interviewed. 83 of 170 units (49%) had made changes to early labour service provision during the past 5 years, including home assessment; the introduction of triage units and telephone assessment tools. Changes were more likely in high volume units and in consultant units with midwifery-led care areas. Further changes were planned by 93/178 (25%) units. Triggers for changes to early labour services comprised local or unit-based factors, including Category X (non-labour) admissions, response to service users and research evidence. The impact of Category X admissions on workload contributed to the triggers for change. Fifty-six (31%) could provide a confirmed figure or estimate for category X admissions. Experiences of introducing change included issues related to engagement of the workforce and the contribution of clinical leadership. Thirty-eight (48%) units did not routinely monitor use of early labour services. Overall monitoring of services was not significantly more likely in units that had made changes. Audit activity was reported more frequently in units that had made changes to their early labour services. early labour services had undergone significant changes following a range of triggers but the extent of change was not reflected in monitoring and evaluation activity. Changes to service provision should be accompanied by monitoring and evaluation. Changes to services require utilisation of appropriate change management strategies. Copyright © 2012 Elsevier Ltd. All rights reserved.

Evaluation of management practices in wetland meadows at Grays Lake National Wildlife Refuge, Idaho, 1997-2000

USGS Publications Warehouse

Austin, J.E.; Pyle, W.H.; Keough, J.R.; Johnson, D.H.

2002-01-01

We assessed the relative values of 4 management practices (idle, late season grazing, fall prescribed burning, and rotation of idle and summer grazing) to biotic resources of the grassland-wetland meadow ecosystem at Grays Lake during 1997-2000. Three replicates of each treatment were randomly assigned to 12 experimental units that bordered the deep emergent marsh. Biotic factors examined included the breeding bird community and abundance, nesting activity and nest success, small mammal abundance, plant community, and annual plant biomass production. Fall burns achieved treatment objectives, removing most residual vegetation across a range of cover types. Objectives for grazing treatments were mostly attained; however, vegetation use levels were insufficient for consistent attainment of treatment objectives. Savannah sparrow, American coot, Canada goose, sandhill crane, mallard, and yellow-headed blackbird were the most common bird species present. Densities of 2 bird species (savannah sparrow and red-winged blackbird) were related to year effect only. The effect of unit on densities of redhead, lesser scaup, ruddy duck, sora, long-billed curlew, and common snipe likely reflects habitat differences among units. Densities of 6 species (eared grebe, canvasback, American coot, American avocet, willet, and common yellowthroat) were related to both year and unit effects. Treatment affected densities of 6 of the 29 species examined (mallard, northern shoveler, cinnamon teal, blue-winged teal, American crow, and yellow-headed blackbird); we found no common trend in response to treatments among those species. Overall, idled habitat did not stand out to be a valuable treatment, whereas grazing tended to have positive responses for a number of species. Burning was more likely to result in reduced bird densities than other treatments. We also describe the distribution of species observations among 8 different habitat types. Of the 23 nesting species sampled in the experimental units, the most common were American coot, sandhill crane, Canada goose, American avocet, mallard, and cinnamon teal. Daily survival rates (DSRs) of dabbling duck nests (all species pooled) were negatively affected by fall grazing. We detected no effects of treatments on DSRs of Canada geese or sandhill crane nests. DSRs for sandhill crane nests were higher in 1998 than in 1999 or 2000 and were slightly higher than that in 1997. DSRs for coot nests were affected by both year and treatment; within-treatment differences among years were extensive, In 1998, when all units were idled, DSRs for coot nests were higher in units assigned to idle treatment than those assigned to fall-grazed or rotation treatment. DSRs for coot nests did not differ among treatment blocks in 1997 (all units idled) or 1999 (first year after treatments). We speculate that compaction of residual vegetation by snowpack reduced any differences between idle and treated units and thus lessened the value of idle habitat for most nesting birds. Nesting densities and nest success rates of Canada geese, dabbling ducks, and sandhill cranes were lower those that reported from Steel's (1952) study in 1949-1950, but differences in habitats and areas searched relative to our study make comparisons difficult. Nest success rates of sandhill cranes also were lower than those reported by Drewien (1973). Declines in nest success probably are related to changes in predator community. We captured 5 species of small mammals (meadow vole, montane vole, deer mouse, vagrant shrew, and ermine). Populations of meadow and montane voles irrupted in 1998 then crashed in spring 1999; the most marked changes were in montane vole numbers. Capture rates of ermine and observation rates for striped skunks and raptors suggested a numerical response (higher recruitment) by these predators to higher prey abundance and possibly distributional shifts (movement into areas of more abundant microtines). We did not detect differences

The impact of an invasive ambrosia beetle on the riparian habitats of the Tijuana River Valley, California

PubMed Central

2016-01-01

The Tijuana River Valley is the first natural habitat in California to be substantially invaded by the Kuroshio Shot Hole Borer (KSHB, Euwallacea sp.), an ambrosia beetle native to Southeast Asia. This paper documents the distribution of the KSHB in the riparian vegetation in the valley and assesses the damage done to the vegetation as of early 2016, approximately six months after the beetle was first observed in the valley. I divided the riparian habitats into 29 survey units so that the vegetation within each unit was relatively homogenous in terms of plant species composition, age and density. From a random point within each unit, I examined approximately 60 individuals of the dominant plant species for evidence of KSHB infestation and evidence of major damage such as limb breakage. In the 22 forested units,I examined the dominant arroyo and black willows (Salix lasiolepis Benth. and S. gooddingii C.R. Ball), and in the seven scrub units, I examined mule fat (Baccharis salicifolia (Ruiz & Pav.) Pers.). Evidence of KSHB infestation was found in 25 of the 29 units. In the forest units, infestation rates ranged from 0 to 100% and were high (>60%) in 16 of the units. In the scrub units, infestation rates ranged from 0 to 33%. Infestation rates were significantly correlated with the wetness of a unit; wetter units had higher infestation rates. Evidence of major physical damage was found in 24 units, and dense stands of willows were reduced to broken trunks in several areas. Overall, I estimated that more than 280,000 (70%) of the willows in the valley were infested, and more than 140,000 had suffered major limb damage. In addition, I recorded evidence of KSHB infestation in the other common plant species in the valley; of the 23 species examined, 14 showed evidence of beetle attack. The four species with the highest rates of infestation were native trees in the Salicaceae family. The three species considered to be the worst invasive plants in the valley, Ricinus communis L., Tamarix ramosissima Ledeb. and Arundo donax L., had low rates of infestation. Several findings from this study have significance for resource managers: (1) the KSHB attack caused extensive mortality of trees soon after being first discovered so, if managers are to control the spread of the beetle, they will need to develop an effective early detection and rapid response program; (2) infestation rates were highest in units that were wet, so resource managers trying to detect the beetle in other areas should thoroughly search trees near water, particularly nutrient-enriched water; (3) the infestation appears to be a novel form of disturbance, and the affected forests may need special management actions in order to recover; and (4) the infestation has altered the structure of the forest canopy, and this is likely to promote the growth of invasive plant species that were relatively inconspicuous in the forests prior to the beetle attack but will now need more attention. PMID:27366644

The impact of an invasive ambrosia beetle on the riparian habitats of the Tijuana River Valley, California.

PubMed

Boland, John M

2016-01-01

The Tijuana River Valley is the first natural habitat in California to be substantially invaded by the Kuroshio Shot Hole Borer (KSHB, Euwallacea sp.), an ambrosia beetle native to Southeast Asia. This paper documents the distribution of the KSHB in the riparian vegetation in the valley and assesses the damage done to the vegetation as of early 2016, approximately six months after the beetle was first observed in the valley. I divided the riparian habitats into 29 survey units so that the vegetation within each unit was relatively homogenous in terms of plant species composition, age and density. From a random point within each unit, I examined approximately 60 individuals of the dominant plant species for evidence of KSHB infestation and evidence of major damage such as limb breakage. In the 22 forested units,I examined the dominant arroyo and black willows (Salix lasiolepis Benth. and S. gooddingii C.R. Ball), and in the seven scrub units, I examined mule fat (Baccharis salicifolia (Ruiz & Pav.) Pers.). Evidence of KSHB infestation was found in 25 of the 29 units. In the forest units, infestation rates ranged from 0 to 100% and were high (>60%) in 16 of the units. In the scrub units, infestation rates ranged from 0 to 33%. Infestation rates were significantly correlated with the wetness of a unit; wetter units had higher infestation rates. Evidence of major physical damage was found in 24 units, and dense stands of willows were reduced to broken trunks in several areas. Overall, I estimated that more than 280,000 (70%) of the willows in the valley were infested, and more than 140,000 had suffered major limb damage. In addition, I recorded evidence of KSHB infestation in the other common plant species in the valley; of the 23 species examined, 14 showed evidence of beetle attack. The four species with the highest rates of infestation were native trees in the Salicaceae family. The three species considered to be the worst invasive plants in the valley, Ricinus communis L., Tamarix ramosissima Ledeb. and Arundo donax L., had low rates of infestation. Several findings from this study have significance for resource managers: (1) the KSHB attack caused extensive mortality of trees soon after being first discovered so, if managers are to control the spread of the beetle, they will need to develop an effective early detection and rapid response program; (2) infestation rates were highest in units that were wet, so resource managers trying to detect the beetle in other areas should thoroughly search trees near water, particularly nutrient-enriched water; (3) the infestation appears to be a novel form of disturbance, and the affected forests may need special management actions in order to recover; and (4) the infestation has altered the structure of the forest canopy, and this is likely to promote the growth of invasive plant species that were relatively inconspicuous in the forests prior to the beetle attack but will now need more attention.

Impact of euthanasia rates, euthanasia practices, and human resource practices on employee turnover in animal shelters.

PubMed

Rogelberg, Steven G; Reeve, Charlie L; Spitzmüller, Christiane; DiGiacomo, Natalie; Clark, Olga L; Teeter, Lisa; Walker, Alan G; Starling, Paula G; Carter, Nathan T

2007-03-01

To examine the effects of euthanasia rates, euthanasia practices, and human resource practices on the turnover rate among employees with euthanasia responsibilities at animal shelters. Cross-sectional original study. 36 shelters across the United States that employed at least 5 full-time employees and performed euthanasia on site. By mail, 1 survey was sent to each shelter. Surveys were completed by a senior member of management and were returned by mail. Questions assessed characteristics (eg, euthanasia rates) and practices of the animal shelter, along with employee turnover rates. By use of correlation coefficients and stepwise regression analyses, key predictors of turnover rates among employees with euthanasia responsibilities were investigated. Employee turnover rates were positively related to euthanasia rate. Practices that were associated with decreased turnover rates included provision of a designated euthanasia room, exclusion of other live animals from vicinity during euthanasia, and removal of euthanized animals from a room prior to entry of another animal to be euthanized. Making decisions regarding euthanasia of animals on the basis of factors other than behavior and health reasons was related to increased personnel turnover. With regard to human resources practices, shelters that used a systematic personnel selection procedure (eg, standardized testing) had comparatively lower employee turnover. Data obtained may suggest several specific avenues that can be pursued to mitigate turnover among employees with euthanasia responsibilities at animal shelters and animal control or veterinary medical organizations.

The slow component of O(2) uptake is not accompanied by changes in muscle EMG during repeated bouts of heavy exercise in humans.

PubMed

Scheuermann, B W; Hoelting, B D; Noble, M L; Barstow, T J

2001-02-15

1. We hypothesized that either the recruitment of additional muscle motor units and/or the progressive recruitment of less efficient fast-twitch muscle fibres was the predominant contributor to the additional oxygen uptake (VO2) observed during heavy exercise. Using surface electromyographic (EMG) techniques, we compared the VO2 response with the integrated EMG (iEMG) and mean power frequency (MPF) response of the vastus lateralis with the VO2 response during repeated bouts of moderate (below the lactate threshold, < LT) and heavy (above the lactate threshold, > LT) intensity cycle ergometer exercise. 2. Seven male subjects (age 29 +/- 7 years, mean +/- S.D.) performed three transitions to a work rate (WR) corresponding to 90 % LT and two transitions to a work rate that would elicit a VO2 corresponding to 50 % of the difference between peak VO2 and the LT (i.e. Delta50 %, > LT1 and > LT2). 3. The VO2 slow component was significantly reduced by prior heavy intensity exercise (> LT1, 410 +/- 196 ml min(-1); > LT2, 230 +/- 191 ml min-1). The time constant (tau), amplitude (A) and gain (DeltaVO2/DeltaWR) of the primary VO2 response (phase II) were not affected by prior heavy exercise when a three-component, exponential model was used to describe the V2 response. 4. Integrated EMG and MPF remained relatively constant and at the same level throughout both > LT1 and > LT2 exercise and therefore were not associated with the VO2 slow component. 5. These data are consistent with the view that the increased O2 cost (i.e. VO2 slow component) associated with performing heavy exercise is coupled with a progressive increase in ATP requirements of the already recruited motor units rather than to changes in the recruitment pattern of slow versus fast-twitch motor units. Further, the lack of speeding of the kinetics of the primary VO2 component with prior heavy exercise, thought to represent the initial muscle VO2 response, are inconsistent with O2 delivery being the limiting factor in V > O2 kinetics during heavy exercise.

Lethal factor antibodies contribute to lethal toxin neutralization in recipients of anthrax vaccine precipitated.

PubMed

Dumas, Eric K; Garman, Lori; Cuthbertson, Hannah; Charlton, Sue; Hallis, Bassam; Engler, Renata J M; Choudhari, Shyamal; Picking, William D; James, Judith A; Farris, A Darise

2017-06-08

A major difference between two currently licensed anthrax vaccines is presence (United Kingdom Anthrax Vaccine Precipitated, AVP) or absence (United States Anthrax Vaccine Adsorbed, AVA) of quantifiable amounts of the Lethal Toxin (LT) component Lethal Factor (LF). The primary immunogen in both vaccine formulations is Protective Antigen (PA), and LT-neutralizing antibodies directed to PA are an accepted correlate of vaccine efficacy; however, vaccination studies in animal models have demonstrated that LF antibodies can be protective. In this report we compared humoral immune responses in cohorts of AVP (n=39) and AVA recipients (n=78) matched 1:2 for number of vaccinations and time post-vaccination, and evaluated whether the LF response contributes to LT neutralization in human recipients of AVP. PA response rates (≥95%) and PA IgG concentrations were similar in both groups; however, AVP recipients exhibited higher LT neutralization ED 50 values (AVP: 1464.0±214.7, AVA: 544.9±83.2, p<0.0001) and had higher rates of LF IgG positivity (95%) compared to matched AVA vaccinees (1%). Multiple regression analysis revealed that LF IgG makes an independent and additive contribution to the LT neutralization response in the AVP group. Affinity purified LF antibodies from two independent AVP recipients neutralized LT and bound to LF Domain 1, confirming contribution of LF antibodies to LT neutralization. This study documents the benefit of including an LF component to PA-based anthrax vaccines. Copyright © 2017 Elsevier Ltd. All rights reserved.

Patient- and family-centred care in the intensive care unit: a challenge in the daily practice of healthcare professionals.

PubMed

van Mol, Margo Mc; Boeter, Trudi Gw; Verharen, Lisbeth; Kompanje, Erwin Jo; Bakker, Jan; Nijkamp, Marjan D

2017-10-01

To evaluate the impact of supportive interventions perceived by both the intensive care unit patients' relatives and the healthcare providers, such as deferred intake interviews for providing information and discussing the emotional impacts, encouragement to keep a diary, and the introduction of weekly psychosocial rounds, on the perceptions of relatives of patients in the intensive care unit. Patient- and family-centred care is gaining interest, with a shift from provider-centric norms to care arranged around patients' and relatives individual beliefs and needs. This is expected to have a positive influence on the quality of care. Communication is one of the most important factors impacting the perceived quality of care in the intensive care unit from the perspective of patients' relatives. New interventions have been introduced to help the patients' relatives to meet their communication needs. A time-trend quantitative design. Two convenience samples of relatives were included (in 2012 and 2013) in four different intensive care units from a large university medical centre in the Netherlands. Survey data from 211 relatives (75% net response rate in 2012) and 123 relatives (66% net response rate in 2013) were used for the analysis. The second measurement showed significant improvements regarding informational aspects of care, clarification of roles in participatory caretaking and shared decision-making. The results suggest that the additional support offered to patients' relatives increased perceived quality of care, particularly with respect to informational needs. However, patient- and family-centred care still requires a change in the mindset of healthcare professionals. This new point of view should overcome perceived barriers and foster a culture of partnership with patients' relatives in the intensive care unit. Training in providing psychosocial support for the needs of relatives leads to a stronger perception of patient-centredness. © 2016 John Wiley & Sons Ltd.

Opening a Conversation between Department Chairs: Possibilities for the U.S. and Australia.

ERIC Educational Resources Information Center

Wolverton, Mimi; And Others

This study identified and compared the environmental pressures and work-related stresses that impact the chairs of academic departments at universities in Australia and the United States. Surveys were mailed to every department chair at all 40 Australian universities (1680 chairs) with a 51 percent response rate. Surveys were also mailed to a…

77 FR 56877 - Biweekly Notice; Applications and Amendments to Facility Operating Licenses and Combined Licenses...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-14

... leak rate test following the replacement of the steam generators in Unit 2. The intent of post... to be publicly disclosed. The NRC posts all comment submissions at http://www.regulations.gov as well... evaluated? Response: No. There are no changes to design, no changes to operating procedures and the revised...

Mothers' Judgments of Students with Emotional Disturbance and Social Maladjustment/Conduct Disorder: Comparisons of Target Students and Siblings

ERIC Educational Resources Information Center

Easler, Ray C., Jr.; Medway, Frederic J.

2004-01-01

In response to United States special education law requirements, this study attempted to differentiate emotionally disturbed and socially maladjusted students using parent ratings on the FACES III and a newly developed interview measure of primarily internalizing and externalizing behaviors. Forty mothers of students in special education and 40…

National Study of State Universities and Land Grant Colleges: Off Campus Inservice Activities.

ERIC Educational Resources Information Center

Seldin, Clement A.

Information concerning off-campus inservice activity (OCIA) at state universities and land grant colleges in the United States was surveyed. There was a 92.5 percent response rate to questionnaires sent to 107 deans of schools, colleges, and departments of education. Inservice activities were considered to be courses, workshops, needs assessments,…

STUDIES TO ADDRESS THE ASSOCIATION BETWEEN PARTICULATE MATTER (PM) EXPOSURE AND DEVELOPMENT/EXACERBATION OF LUNG INJURY, INFLAMMATION, AND INCREASED AIRWAY RESPONSIVENESS.

EPA Science Inventory

Asthma, an inflammatory airways disease, has become an urgent health problem affecting an estimated 17 million persons in the United States alone (CDC 1998 MMWR 47). Since 1979, the death rate from asthma has increased by almost 56%. Epidemiologic studies have demonstrated posit...

Testing Telephone and Web Surveys for Studying Men's Sexual Assault Perpetration Behaviors

ERIC Educational Resources Information Center

DiNitto, Diana M.; Busch-Armendariz, Noel Bridget; Bender, Kimberly; Woo, Hyeyoung; Tackett-Gibson, Melissa; Dyer, James

2008-01-01

Three pilot studies were conducted to obtain information about sexual assault perpetration from adult men in the United States. Each used the same random digit-dial sampling and recruitment strategy. One pilot was administered by telephone and two via the Web. Response rates in all pilots were low. Although results cannot be generalized beyond the…

Elemental cycling response of an Adirondack subalpine spruce-fir forest to atmospheric and environmental change

Treesearch

Andrew J. Friedland; Eric K. Miller

1996-01-01

Patterns and trends in forest elemental cycling can become more apparent in the presence of atmospheric perturbations. High-elevation forests of the northeastern United States have received large amounts of atmospheric deposition of pollutants, which have altered natural elemental cycling and retention rates in a variety of ways. This study examined atmospheric...

The politics of obesity: a current assessment and look ahead.

PubMed

Kersh, Rogan

2009-03-01

The continuing rise in obesity rates across the United States has proved impervious to clinical treatment or public health exhortation, necessitating policy responses. Nearly a decade's worth of political debates may be hardening into an obesity issue regime, comprising established sets of cognitive frames, stakeholders, and policy options. This article is a survey of reports on recently published studies. Much of the political discussion regarding obesity is centered on two "frames," personal-responsibility and environmental, yielding very different sets of policy responses. While policy efforts at the federal level have resulted in little action to date, state and/or local solutions such as calorie menu labeling and the expansion of regulations to reduce unhealthy foods at school may have more impact. Obesity politics is evolving toward a relatively stable state of equilibrium, which could make comprehensive reforms to limit rising obesity rates less feasible. Therefore, to achieve meaningful change, rapid-response research identifying a set of promising reforms, combined with concerted lobbying action, will be necessary.

Successful treatment of chronic hepatitis C with pegylated interferon in combination with ribavirin in a methadone maintenance treatment program

PubMed Central

Litwin, Alain H.; Harris, Kenneth A.; Nahvi, Shadi; Zamor, Philippe J.; Soloway, Irene J.; Tenore, Peter L.; Kaswan, Daniel; Gourevitch, Marc. N.; Arnsten, Julia H.

2009-01-01

Injection drug users constitute 60% of the more than 4 million people in the United States with hepatitis C virus (HCV), including many methadone maintenance patients. Few data exist describing clinical outcomes for patients receiving HCV treatment on-site in a methadone maintenance settings. In this retrospective study, we describe clinical outcomes for 73 patients receiving HCV treatment on-site in a methadone maintenance treatment program. Fifty-five percent of patients achieved end-of-treatment response, and 45% achieved sustained viral response. These treatment response rates are nearly equivalent to previously published HCV treatment response rates, despite high prevalences of ongoing drug use (49%), psychiatric comorbidity (67%), and HIV coinfection (32%). These data show that on-site HCV treatment with pegylated interferon and ribavirin is effective in methadone-maintained patients, many of whom are active drug users, psychiatrically ill, or HIV coinfected, and that methadone maintenance treatment programs represent an opportunity to safely treat chronic hepatitis C. PMID:19038524

Emergency response planning in hospitals, United States: 2003-2004.

PubMed

Niska, Richard W; Burt, Catharine W

2007-08-20

This study presents baseline data to determine which hospital characteristics are associated with preparedness for terrorism and natural disaster in the areas of emergency response planning and availability of equipment and specialized care units. Information from the Bioterrorism and Mass Casualty Preparedness Supplements to the 2003 and 2004 National Hospital Ambulatory Medical Care Surveys was used to provide national estimates of variations in hospital emergency response plans and resources by residency and medical school affiliation, hospital size, ownership, metropolitan statistical area status, and Joint Commission accreditation. Of 874 sampled hospitals with emergency or outpatient departments, 739 responded for an 84.6 percent response rate. Estimates are presented with 95 percent confidence intervals. About 92 percent of hospitals had revised their emergency response plans since September 11, 2001, but only about 63 percent had addressed natural disasters and biological, chemical, radiological, and explosive terrorism in those plans. Only about 9 percent of hospitals had provided for all 10 of the response plan components studied. Hospitals had a mean of about 14 personal protective suits, 21 critical care beds, 12 mechanical ventilators, 7 negative pressure isolation rooms, and 2 decontamination showers each. Hospital bed capacity was the factor most consistently associated with emergency response planning and availability of resources.

Physical Therapist Practice in the Intensive Care Unit: Results of a National Survey

PubMed Central

Ridgeway, Kyle; Nordon-Craft, Amy; Moss, Parker; Schenkman, Margaret; Moss, Marc

2015-01-01

Background Early rehabilitation improves outcomes, and increased use of physical therapist services in the intensive care unit (ICU) has been recommended. Little is known about the implementation of early rehabilitation programs or physical therapists' preparation and perceptions of care in the United States. Objective A national survey was conducted to determine the current status of physical therapist practice in the ICU. Design This study used a cross-sectional, observational design. Methods Self-report surveys were mailed to members of the Acute Care Section of the American Physical Therapy Association. Questions addressed staffing, training, barriers, and protocols, and case scenarios were used to determine perceptions about providing rehabilitation. Results The response rate was 29% (667/2,320). Staffing, defined as the number of physical therapists per 100 ICU beds, was highest in community hospitals (academic: median=5.4 [range=3.6–9.2]; community: median=6.7 [range=4.4–10.0]) and in the western United States (median=7.5 [range=4.2–12.9]). Twelve percent of physical therapists reported no training. Barriers to providing ICU rehabilitation included insufficient staffing and training, departmental prioritization policies, and inadequate consultation criteria. Responses to case scenarios demonstrated differences in the likelihood of consultation and physical therapists' prescribed frequency and intensity of care based on medical interventions rather than characteristics of patients. Physical therapists in academic hospitals were more likely to be involved in the care of patients in each scenario and were more likely to perform higher-intensity mobilization. Limitations Members of the Acute Care Section of the American Physical Therapy Association may not represent most practicing physical therapists, and the 29% return rate may have contributed to response bias. Conclusions Although staffing was higher in community hospitals, therapists in academic and community hospitals cited insufficient staffing as the most common barrier to providing rehabilitation in the ICU. Implementing strategies to overcome barriers identified in this study may improve the delivery of ICU rehabilitation services. PMID:26045604

Macro-economic conditions and infant health: a changing relationship for black and white infants in the United States.

PubMed

Orsini, Chiara; Avendano, Mauricio

2015-01-01

We study whether the relationship between the state unemployment rate at the time of conception and infant health, infant mortality and maternal characteristics in the United States has changed over the years 1980-2004. We use microdata on births and deaths for years 1980-2004 and find that the relationship between the state unemployment rate at the time of conception and infant mortality and birthweight changes over time and is stronger for blacks than whites. For years 1980-1989 increases in the state unemployment rate are associated with a decline in infant mortality among blacks, an effect driven by mortality from gestational development and birth weight, and complications of placenta while in utero. In contrast, state economic conditions are unrelated to black infant mortality in years 1990-2004 and white infant mortality in any period, although effects vary by cause of death. We explore potential mechanisms for our findings and, including mothers younger than 18 in the analysis, uncover evidence of age-related maternal selection in response to the business cycle. In particular, in years 1980-1989 an increase in the unemployment rate at the time of conception is associated with fewer babies born to young mothers. The magnitude and direction of the relationship between business cycles and infant mortality differs by race and period. Age-related selection into motherhood in response to the business cycle is a possible explanation for this changing relationship.

Macro-Economic Conditions and Infant Health: A Changing Relationship for Black and White Infants in the United States

PubMed Central

Orsini, Chiara; Avendano, Mauricio

2015-01-01

We study whether the relationship between the state unemployment rate at the time of conception and infant health, infant mortality and maternal characteristics in the United States has changed over the years 1980-2004. We use microdata on births and deaths for years 1980-2004 and find that the relationship between the state unemployment rate at the time of conception and infant mortality and birthweight changes over time and is stronger for blacks than whites. For years 1980-1989 increases in the state unemployment rate are associated with a decline in infant mortality among blacks, an effect driven by mortality from gestational development and birth weight, and complications of placenta while in utero. In contrast, state economic conditions are unrelated to black infant mortality in years 1990-2004 and white infant mortality in any period, although effects vary by cause of death. We explore potential mechanisms for our findings and, including mothers younger than 18 in the analysis, uncover evidence of age-related maternal selection in response to the business cycle. In particular, in years 1980-1989 an increase in the unemployment rate at the time of conception is associated with fewer babies born to young mothers. The magnitude and direction of the relationship between business cycles and infant mortality differs by race and period. Age-related selection into motherhood in response to the business cycle is a possible explanation for this changing relationship. PMID:25974070

Increasing Trend of Fatal Falls in Older Adults in the United States, 1992 to 2005: Coding Practice or Reporting Quality?

PubMed

Kharrazi, Rebekah J; Nash, Denis; Mielenz, Thelma J

2015-09-01

To investigate whether changes in death certificate coding and reporting practices explain part or all of the recent increase in the rate of fatal falls in adults aged 65 and older in the United States. Trends in coding and reporting practices of fatal falls were evaluated under mortality coding schemes for International Classification of Diseases (ICD), Ninth Revision (1992-1998) and Tenth Revision (1999-2005). United States, 1992 to 2005. Individuals aged 65 and older with falls listed as the underlying cause of death (UCD) on their death certificates. The primary outcome was annual fatal falls rates per 100,000 U.S. residents aged 65 and older. Coding practice was assessed through analysis of trends in rates of specific UCD fall ICD e-codes over time. Reporting quality was assessed by examining changes in the location on the death certificate where fall e-codes were reported, in particular, the percentage of fall e-codes recorded in the proper location on the death certificate. Fatal falls rates increased over both time periods: 1992 to 1998 and 1999 to 2005. A single falls e-code was responsible for the increasing trend of fatal falls overall from 1992 to 1998 (E888, other and unspecified fall) and from 1999 to 2005 (W18, other falls on the same level), whereas trends for other falls e-codes remained stable. Reporting quality improved steadily throughout the study period. Better reporting quality, not coding practices, contributed to the increasing rate of fatal falls in older adults in the United States from 1992 to 2005. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

A motor unit-based model of muscle fatigue

PubMed Central

2017-01-01

Muscle fatigue is a temporary decline in the force and power capacity of skeletal muscle resulting from muscle activity. Because control of muscle is realized at the level of the motor unit (MU), it seems important to consider the physiological properties of motor units when attempting to understand and predict muscle fatigue. Therefore, we developed a phenomenological model of motor unit fatigue as a tractable means to predict muscle fatigue for a variety of tasks and to illustrate the individual contractile responses of MUs whose collective action determines the trajectory of changes in muscle force capacity during prolonged activity. An existing MU population model was used to simulate MU firing rates and isometric muscle forces and, to that model, we added fatigue-related changes in MU force, contraction time, and firing rate associated with sustained voluntary contractions. The model accurately estimated endurance times for sustained isometric contractions across a wide range of target levels. In addition, simulations were run for situations that have little experimental precedent to demonstrate the potential utility of the model to predict motor unit fatigue for more complicated, real-world applications. Moreover, the model provided insight into the complex orchestration of MU force contributions during fatigue, that would be unattainable with current experimental approaches. PMID:28574981

Nursing Leaders' Satisfaction with Information Systems in the Day-to-Day Operations Management in Hospital Units.

PubMed

Peltonen, Laura-Maria; Junttila, Kristiina; Salanterä, Sanna

2018-01-01

Information usage in the day-to-day operations management of hospital units is complex due to numerous information systems in use. The aim of this study was to describe and compare nurse leaders' satisfaction with information systems used in the day-to-day operations management in hospital units. The design was a cross-sectional survey with five questions rated from one (disagree) to five (fully agree). The response rate was 65 % (n = 453). Respondents reported fair satisfaction with how information systems support decision-making (median 4, IQR 3-4) and improve ease of access to information (median 4, IQR 3-4). However, respondents were less satisfied with how systems improve speed of access to information (median 3, IQR 3-4). Nor did respondents think that systems were developed for them (median 3, IQR 2-4). Respondents further reported needing numerous systems daily to support decision-making (median 4, IQR 3-5). A clear need for one system, which would gather important information for display was stated (median 5, IQR 4-5). Work experience, gender and time when overseeing the unit were associated with some aspects related to satisfaction. In conclusion, information system improvements are needed to better support the day-to-day operations management in hospital units.

Association between aggressive care and bereaved families' evaluation of end-of-life care for veterans with non-small cell lung cancer who died in Veterans Affairs facilities.

PubMed

Ersek, Mary; Miller, Susan C; Wagner, Todd H; Thorpe, Joshua M; Smith, Dawn; Levy, Cari R; Gidwani, Risha; Faricy-Anderson, Katherine; Lorenz, Karl A; Kinosian, Bruce; Mor, Vincent

2017-08-15

To the authors' knowledge, little is known regarding the relationship between patients' and families' satisfaction with aggressive end-of-life care. Herein, the authors examined the associations between episodes of aggressive care (ie, chemotherapy, mechanical ventilation, acute hospitalizations, and intensive care unit admissions) within the last 30 days of life and families' evaluations of end-of-life care among patients with non-small cell lung cancer (NSCLC). A total of 847 patients with NSCLC (34% of whom were aged <65 years) who died in a nursing home or intensive care, acute care, or hospice/palliative care (HPC) unit at 1 of 128 Veterans Affairs Medical Centers between 2010 and 2012 were examined. Data sources included Veterans Affairs administrative and clinical data, Medicare claims, and the Bereaved Family Survey. The response rate for the Bereaved Family Survey was 62%. Greater than 72% of veterans with advanced lung cancer who died in an inpatient setting had at least 1 episode of aggressive care and 31% received chemotherapy within the last 30 days of life. For all units except for HPC, when patients experienced at least 1 episode of aggressive care, bereaved families rated care lower compared with when patients did not receive any aggressive care. For patients dying in an HPC unit, the associations between overall ratings of care and ≥2 inpatient admissions or any episode of aggressive care were not found to be statistically significant. Rates of aggressive care were not associated with age, and family ratings of care were similar for younger and older patients. Aggressive care within the last month of life is common among patients with NSCLC and is associated with lower family evaluations of end-of-life care. Specialized care provided within an HPC unit may mitigate the negative effects of aggressive care on these outcomes. Cancer 2017;123:3186-94. © 2017 American Cancer Society. © 2017 American Cancer Society.

Phenobarbital for Neonatal Seizures: Response Rate and Predictors of Refractoriness.

PubMed

Spagnoli, Carlotta; Seri, Stefano; Pavlidis, Elena; Mazzotta, Silvia; Pelosi, Annalisa; Pisani, Francesco

2016-10-01

Background Phenobarbital is the first-line choice for neonatal seizures treatment, despite a response rate of approximately 45%. Failure to respond to acute anticonvulsants is associated with poor neurodevelopmental outcome, but knowledge on predictors of refractoriness is limited. Objective To quantify response rate to phenobarbital and to establish variables predictive of its lack of efficacy. Methods We retrospectively evaluated newborns with electrographically confirmed neonatal seizures admitted between January 1999 and December 2012 to the neonatal intensive care unit of Parma University Hospital (Italy), excluding neonates with status epilepticus. Response was categorized as complete (cessation of clinical and electrographic seizures after phenobarbital administration), partial (reduction but not cessation of electrographic seizures with the first bolus, response to the second bolus), or absent (no response after the second bolus). Multivariate analysis was used to identify independent predictors of refractoriness. Results Out of 91 newborns receiving phenobarbital, 57 (62.6%) responded completely, 15 (16.5%) partially, and 19 (20.9%) did not respond. Seizure type (p = 0.02), background electroencephalogram (EEG; p ≤ 0.005), and neurologic examination (p  ≤  0.005) correlated with response to phenobarbital. However, EEG (p  ≤  0.02) and seizure type (p  ≤  0.001) were the only independent predictors. Conclusion Our results suggest a prominent role of neurophysiological variables (background EEG and electrographic-only seizure type) in predicting the absence of response to phenobarbital in high-risk newborns. Georg Thieme Verlag KG Stuttgart · New York.

Preterm infants' sympathetic arousal and associated behavioral responses to sound stimuli in the neonatal intensive care unit.

PubMed

Salavitabar, Arash; Haidet, Kim Kopenhaver; Adkins, Cherie S; Susman, Elizabeth J; Palmer, Charles; Storm, Hanne

2010-06-01

To evaluate the utility of skin conductance (SC) as a measure of autonomic arousal to sound stimuli in preterm infants. A pilot cross-sectional, correlations study. Eleven preterm infants with a mean gestational age of 31.6 weeks without anomalies or conditions associated with neurodevelopmental delay composed the sample. On days 5-7 of life, the following infant responses were simultaneously recorded in response to naturally occurring sound stimuli in the NICU: real-time measurements of heart rate, respiratory rate, and oxygen saturations; sympathetic-mediated sweating via SC; and behavioral responses using the Newborn Individualized Developmental Care and Assessment Program naturalistic observation. Baseline sound levels (BSL, <55 dBA) and high sound levels (HSL, >65 dBA) were measured to index patterns of response during a nonhandling period preceding care. Mean heart rate during precare was directly associated with higher SC increases to sound stimuli (r[10] = 0.697, P = .017). The SC during HSL was significantly higher than that during BSL (P < .0001). Males demonstrated higher SC increases to sound stimuli than females (P = .030). Changes in SC induced by increases in sound intensity were associated with lower attention responses (r[10] = -0.92, P < .0001) and lower summated behavioral responses (r[10] = -0.59, P = .054). SC provides a noninvasive, sensitive measure of sympathetic arousal that may not be apparent in behavioral cues or states, or determined by standard physiological responses alone.

Cell phone recycling experiences in the United States and potential recycling options in Brazil.

PubMed

Silveira, Geraldo T R; Chang, Shoou-Yuh

2010-11-01

This paper presents an overview of cell phone recycling programs currently available in the United States. At the same time, it also provides analyses of the current recycling situation and possible recycling alternatives for Brazil. Although there are several recycling options in the United States, collection rates are still only 10% of all potential devices because customers are not aware of these possibilities. The whole system is financially based on reselling refurbished cell phones and recycled materials to developing countries which represent an effective and strong market. Several recyclers offer funds to collection partners who are either charities or who work with charities while obtaining the materials that they need in order to run their operations. A mobile phone recycling system for Brazil considering the United States experience and the Extended Producer Responsibility (EPR) principle is suggested. A deposit/refund/advance-recycling fee is proposed which might be implemented as a voluntary industrial initiative managed by PRO Brazil, a producer responsibility organization. One widespread public-private agreement will integrate all mobile phone stakeholders, and environmental education actions and promotional events will promote citizen's participation. Copyright © 2010 Elsevier Ltd. All rights reserved.

Hair cell tufts and afferent innervation of the bullfrog crista ampullaris

NASA Technical Reports Server (NTRS)

Myers, Steven F.; Lewis, Edwin R.

1990-01-01

Within the bullfrog semicircular canal crista, hair cell tuft types were defined and mapped with the aid of scanning electron microscopy. Dye-filled planar afferent axons had mean distal axonal diameters of 1.6-4.9 microns, highly branched arbors, and contacted 11-24 hair cells. Dye-filled isthmus afferent axons had mean distal axonal diameters of 1.8-7.9 microns, with either small or large field arbors contacting 4-9 or 25-31 hair cells. The estimated mean number of contacts per innervated hair cell was 2.2 for planar and 1.3 for isthmus afferent neurons. Data on evoked afferent responses were available only for isthmus units that were observed to respond to our microrotational stimuli. Of 21 such afferent neurons, eight were successfully dye-filled. Within this sample, high-gain units had large field arbors and lower-gain units had small field arbors. The sensitivity of each afferent neuron was analyzed in terms of noise equivalent input (NEI), the stimulus amplitude for which the afferent response amplitude is just equivalent to the rms deviation of the instantaneous spike rate. NEI for isthmus units varied from 0.63 to 8.2 deg/s; the mean was 3.2 deg/s.

An overview of patient safety climate in the VA.

PubMed

Hartmann, Christine W; Rosen, Amy K; Meterko, Mark; Shokeen, Priti; Zhao, Shibei; Singer, Sara; Falwell, Alyson; Gaba, David M

2008-08-01

To assess variation in safety climate across VA hospitals nationally. Data were collected from employees at 30 VA hospitals over a 6-month period using the Patient Safety Climate in Healthcare Organizations survey. We sampled 100 percent of senior managers and physicians and a random 10 percent of other employees. At 10 randomly selected hospitals, we sampled an additional 100 percent of employees working in units with intrinsically higher hazards (high-hazard units [HHUs]). Data were collected using an anonymous survey design. We received 4,547 responses (49 percent response rate). The percent problematic response--lower percent reflecting higher levels of patient safety climate--ranged from 12.0-23.7 percent across hospitals (mean=17.5 percent). Differences in safety climate emerged by management level, clinician status, and workgroup. Supervisors and front-line staff reported lower levels of safety climate than senior managers; clinician responses reflected lower levels of safety climate than those of nonclinicians; and responses of employees in HHUs reflected lower levels of safety climate than those of workers in other areas. This is the first systematic study of patient safety climate in VA hospitals. Findings indicate an overall positive safety climate across the VA, but there is room for improvement.

Eye health care in Hungary.

PubMed

Németh, J; Molnár, F; Kocur, I

2002-01-01

To describe eye health-care services provided by in patient Departments of Ophthalmology in Hungary as of 1998. A standardised questionnaire was sent to all Hungarian in-patient ophthalmic departments. The response rate was 100%, and data from six university departments and 56 hospitals with ophthalmic units are summarised. During the 12-month period, a total of 78,008 ophthalmic operations were performed, by 489 ophthalmologists. They worked in 62 in-patient ophthalmic units having a total of 1952 beds. The cataract rate was 3564 operations per million inhabitants; intraocular lens implantation was performed on 97% of the cases. There were 591 corneal transplants, 1698 operations for retinal detachment and 510 vitrectomies for diabetic eye complications. The level of ophthalmic care in Hungary, judged on the basis of key objective parameters including number of ophthalmic specialists, number of ophthalmic beds, and the rates of surgery, generally conforms to standards prevailing in Western Europe, in spite of financial difficulties and the consequent lack of investment in new equipment and instruments, both major and minor.

Breastfeeding Practices and Barriers to Implementing the Ten Steps to Successful Breastfeeding in Mississippi Hospitals.

PubMed

Alakaam, Amir; Lemacks, Jennifer; Yadrick, Kathleen; Connell, Carol; Choi, Hwanseok Winston; Newman, Ray G

2018-05-01

Mississippi has the lowest rates of breastfeeding in the United States at 6 and 12 months. There is growing evidence that the rates and duration of infant breastfeeding improve after hospitals implement the Ten Steps to Successful Breastfeeding; moreover, the Ten Steps approach is considered the standard model for evaluation of breastfeeding practices in birthplaces. Research aim: This study aimed to examine the implementation level of the Ten Steps and identify barriers to implementing the Ten Steps in Mississippi hospitals. A cross-sectional self-report survey was used to answer the research aim. Nurse managers of the birthing and maternity units of all 43 Mississippi hospitals that provided birthing and maternity care were recruited. A response rate of 72% ( N = 31) was obtained. Implementation of the Ten Steps in these hospitals was categorized as low, partial, moderate, or high. The researcher classified implementation in 29% of hospitals as moderate and in 71% as partial. The hospital level of implementation was significantly positively associated with the hospital delivery rate along with the hospital cesarean section rate per year. The main barriers for the implementation process of the Ten Steps reported were resistance to new policies, limited financial and human resources, and lack of support from national and state governments. Breastfeeding practices in Mississippi hospitals need to be improved. New policies need to be established in Mississippi to encourage hospitals to adopt the Ten Steps policies and practice in the maternity and birthing units.

Vital signs: melanoma incidence and mortality trends and projections - United States, 1982-2030.

PubMed

Guy, Gery P; Thomas, Cheryll C; Thompson, Trevor; Watson, Meg; Massetti, Greta M; Richardson, Lisa C

2015-06-05

Melanoma incidence rates have continued to increase in the United States, and risk behaviors remain high. Melanoma is responsible for the most skin cancer deaths, with about 9,000 persons dying from it each year. CDC analyzed current (2011) melanoma incidence and mortality data, and projected melanoma incidence, mortality, and the cost of treating newly diagnosed melanomas through 2030. Finally, CDC estimated the potential melanoma cases and costs averted through 2030 if a comprehensive skin cancer prevention program was implemented in the United States. In 2011, the melanoma incidence rate was 19.7 per 100,000, and the death rate was 2.7 per 100,000. Incidence rates are projected to increase for white males and females through 2019. Death rates are projected to remain stable. The annual cost of treating newly diagnosed melanomas was estimated to increase from $457 million in 2011 to $1.6 billion in 2030. Implementation of a comprehensive skin cancer prevention program was estimated to avert 230,000 melanoma cases and $2.7 billion in initial year treatment costs from 2020 through 2030. If additional prevention efforts are not undertaken, the number of melanoma cases is projected to increase over the next 15 years, with accompanying increases in health care costs. Much of this morbidity, mortality, and health care cost can be prevented. Substantial reductions in melanoma incidence, mortality, and cost can be achieved if evidence-based comprehensive interventions that reduce ultraviolet (UV) radiation exposure and increase sun protection are fully implemented and sustained.

Registered Replication Report: Strack, Martin, & Stepper (1988).

PubMed

Acosta, Alberto; Adams, Reginald B; Albohn, Daniel N; Allard, Eric S; Beek, Titia; Benning, Stephen D; Blouin- Hudon, Eve-Marie; Bulnes, Luis Carlo; Caldwell, Tracy L; Calin-Jageman, Robert J; Capaldi, Colin A; Carfagno, Nicholas S; Chasten, Kelsie T; Cleeremans, Axel; Connell, Louise; DeCicco, Jennifer M.; Dijkhoff, Laura; Dijkstra, Katinka; Fischer, Agneta H; Foroni, Francesco; Gronau, Quentin F; Hess, Ursula; Holmes, Kevin J; Jones, Jacob L H; Klein, Olivier; Koch, Christopher; Korb, Sebastian; Lewinski, Peter; Liao, Julia D; Lund, Sophie; Lupiáñez, Juan; Lynott, Dermot; Nance, Christin N; Oosterwijk, Suzanne; Özdog˘ru, Asil Ali; Pacheco-Unguetti, Antonia Pilar; Pearson, Bethany; Powis, Christina; Riding, Sarah; Roberts, Tomi-Ann; Rumiati, Raffaella I; Senden, Morgane; Shea-Shumsky, Noah B; Sobocko, Karin; Soto, Jose A; Steiner, Troy G; Talarico, Jennifer M; vanAllen, Zack M; Wagenmakers, E-J; Vandekerckhove, Marie; Wainwright, Bethany; Wayand, Joseph F; Zeelenberg, Rene; Zetzer, Emily E; Zwaan, Rolf A

2016-11-01

According to the facial feedback hypothesis, people's affective responses can be influenced by their own facial expression (e.g., smiling, pouting), even when their expression did not result from their emotional experiences. For example, Strack, Martin, and Stepper (1988) instructed participants to rate the funniness of cartoons using a pen that they held in their mouth. In line with the facial feedback hypothesis, when participants held the pen with their teeth (inducing a "smile"), they rated the cartoons as funnier than when they held the pen with their lips (inducing a "pout"). This seminal study of the facial feedback hypothesis has not been replicated directly. This Registered Replication Report describes the results of 17 independent direct replications of Study 1 from Strack et al. (1988), all of which followed the same vetted protocol. A meta-analysis of these studies examined the difference in funniness ratings between the "smile" and "pout" conditions. The original Strack et al. (1988) study reported a rating difference of 0.82 units on a 10-point Likert scale. Our meta-analysis revealed a rating difference of 0.03 units with a 95% confidence interval ranging from -0.11 to 0.16. © The Author(s) 2016.

Functional modeling of the human auditory brainstem response to broadband stimulationa)

PubMed Central

Verhulst, Sarah; Bharadwaj, Hari M.; Mehraei, Golbarg; Shera, Christopher A.; Shinn-Cunningham, Barbara G.

2015-01-01

Population responses such as the auditory brainstem response (ABR) are commonly used for hearing screening, but the relationship between single-unit physiology and scalp-recorded population responses are not well understood. Computational models that integrate physiologically realistic models of single-unit auditory-nerve (AN), cochlear nucleus (CN) and inferior colliculus (IC) cells with models of broadband peripheral excitation can be used to simulate ABRs and thereby link detailed knowledge of animal physiology to human applications. Existing functional ABR models fail to capture the empirically observed 1.2–2 ms ABR wave-V latency-vs-intensity decrease that is thought to arise from level-dependent changes in cochlear excitation and firing synchrony across different tonotopic sections. This paper proposes an approach where level-dependent cochlear excitation patterns, which reflect human cochlear filter tuning parameters, drive AN fibers to yield realistic level-dependent properties of the ABR wave-V. The number of free model parameters is minimal, producing a model in which various sources of hearing-impairment can easily be simulated on an individualized and frequency-dependent basis. The model fits latency-vs-intensity functions observed in human ABRs and otoacoustic emissions while maintaining rate-level and threshold characteristics of single-unit AN fibers. The simulations help to reveal which tonotopic regions dominate ABR waveform peaks at different stimulus intensities. PMID:26428802

Virtual Reality for Pain Management in Cardiac Surgery

PubMed Central

Mosso-Vázquez, José Luis; Gao, Kenneth; Wiederhold, Brenda K.

2014-01-01

Abstract Surgical anxiety creates psychological and physiological stress, causes complications in surgical procedures, and prolongs recovery. Relaxation of patients in postoperative intensive care units can moderate patient vital signs and reduce discomfort. This experiment explores the use of virtual reality (VR) cybertherapy to reduce postoperative distress in patients that have recently undergone cardiac surgery. Sixty-seven patients were monitored at IMSS La Raza National Medical Center within 24 hours of cardiac surgery. Patients navigated through a 30 minute VR simulation designed for pain management. Results were analyzed through comparison of pre- and postoperative vital signs and Likert scale survey data. A connection was found in several physiological factors with subjective responses from the Likert scale survey. Heavy positive correlation existed between breathing rate and Likert ratings, and a moderate correlation was found between mean arterial pressure and Likert ratings and heart rate and Likert ratings, all of which indicated lower pain and stress within patients. Further study of these factors resulted in the categorization of patients based upon their vital signs and subjective response, providing a context for the effectiveness of the therapy to specific groups of patients. PMID:24892200

Surface response of blind thrust shown from high resolution topographic data and updated geochronology at Wheeler Ridge, CA

NASA Astrophysics Data System (ADS)

Kleber, E.; Arrowsmith, R.; DeVecchio, D. E.; Johnstone, S. A.; Rittenour, T. M.

2015-12-01

Wheeler Ridge is an asymmetric east-propagating anticline (10km axis, 330m relief) above a north-vergent blind thrust deforming Quaternary alluvial fan and shallow marine rocks at the northern front of the Transverse Ranges, San Joaquin Valley, CA. This area was a research foci in the 1990's when the soils, u-series soil carbonate dating, and subsurface structure of deformed strata identified from oil wells were used to create a kinematic model of deformation, and estimates of fault slip, uplift, and lateral propagation rates. A recent collection of light detection and ranging (lidar) topographic data and optically stimulated luminescence (OSL) data allow us to complete meter scale topographic analyses of the fluvial networks and hillslopes and correlate geomorphic response to tectonics. We interpret these results using a detailed morphological map and observe drainage network and hillslope process transitions both along and across the fold axis. With lidar topography, we extract common morphometrics (e.g., channel steepness-- ksn, eroded volume, hillslope relief) to illustrate how the landscape is responding to variations in uplift rate along the fold axis and show asymmetry of surface response on the forelimb and backlimb. The forelimb is dominated by large drainages with landslides initiating in the marine units at the core of the fold. Our topographic analysis shows that the stream channel indices values on the forelimb increase along the fold axis, away from the propagation tip. The backlimb drainages are dominantly long and linear with broad ridgelines. Using lidar and fieldwork, we see that uplifted backlimb surfaces preserve the deformed fan surface. The preliminary OSL results from alluvial fan units improve age control of previously defined surfaces, refining our understanding of the deposition and uplift of alluvial fan units on preserved on backlimb.

[2001 national survey of nosocomial infection prevalence among newborns and under-eighteen children and adolescents in France].

PubMed

Branger, B

2005-07-01

To know nosocomial infections (NI) rates among newborns and hospitalised children according to age and units of hospitalisation, In 2001, the Comité technique des infections nosocomiales (CTIN) initiated a one-day prevalence survey on an arranged date. It was conducted by the 5 centres de coordination de lutte contre les infections nosocomiales (C.CLIN). Paediatric data only were analysed dividing them into 2 groups: newborns (NB) up to 28 days old, whether in maternity, neonatology or intensive care units, and children (CH) from 29 days to 18 years old with separate analysis for surgery, cancer units and intermediate care and rehabilitation centres (ICRC). The survey included 21 596 children under 18 years old: 9136 NB and 12,460 CH, i.e. 7.1% of the total hospital population on that one given day. A total of 2.6% of the patients were infected, with 1.2% of NB and 3.3% of CH. There were 1.09 infections per patient. 456 different microorganisms were responsible for 562 infections, i.e. 81.1%: 18,6% Staphylococcus aureus of which 26.7% were methicillin resistant (MRSA), 21.9% Staphylococcus epidermis, 21.9% enterobacteries, 10.3% Pseudomonas aeruginosa, 4.4% Candida albicans, and 4.2% rotavirus. NB and CH infection factors were studied separately. Selective criteria for hospitalised NB were: gender: male(P < 0.05), level of gravity (P < 0.05), surgery (P < 0.001), catheter (P < 0.01) and hospital type (P < 0.01). For EN, criteria were severity score (P < 0.01), surgery (P < 0.001), catheter (P < 0.01), and hospital type (P < 0.01). The rate for patients hospitalised in cancer units was 13.2% with no significant factors found. The rate of infected patients in intensive care units was 7.8% for NB and 16.2% for CH, with 9.6% neonatal, 30.8% heart condition, 26.3% non-specialised units and 14.2% children units. ICRC infection rate was 4.5% while surgery units had a rate of 1.9% with 2.4% orthopaedic, 0.7% children units, 2.0% non-specialised units and 8.1% neurosurgery. The 2001 NI level showed a significant fall from 3.5% in the 1996 survey (all ages) to 2.4%. However, including newborns from private maternity units into the survey may have partly lowered this level. MRSA levels have also dropped from 46% in 1996 to 27% in 2001. It is difficult to compare international data as definitions vary. Furthermore, it should be possible to separate newborns from older children as well as specifying the type of units involved. Infected patients levels are generally lower in the French surveys, no matter the age group or units studied than in other surveys. This survey has enabled the monitoring of the children population in maternity units, on a given day, in France. It showed that the rate of NI in the paediatric population seems low compared to previous data or other countries'data. Efforts need to be made in order to lower it further. Incidence surveillance method is preferable to single out which risk factors can be acted upon. Standardized national protocols are offered to maternity units and should soon be available for newborns units as well as older children units.

A randomized trial found online questionnaires supplemented by postal reminders generated a cost-effective and generalizable sample but don't forget the reminders.

PubMed

Loban, Amanda; Mandefield, Laura; Hind, Daniel; Bradburn, Mike

2017-12-01

The objective of this study was to compare the response rates, data completeness, and representativeness of survey data produced by online and postal surveys. A randomized trial nested within a cohort study in Yorkshire, United Kingdom. Participants were randomized to receive either an electronic (online) survey questionnaire with paper reminder (N = 2,982) or paper questionnaire with electronic reminder (N = 2,855). Response rates were similar for electronic contact and postal contacts (50.9% vs. 49.7%, difference = 1.2%, 95% confidence interval: -1.3% to 3.8%). The characteristics of those responding to the two groups were similar. Participants nevertheless demonstrated an overwhelming preference for postal questionnaires, with the majority responding by post in both groups. Online survey questionnaire systems need to be supplemented with a postal reminder to achieve acceptable uptake, but doing so provides a similar response rate and case mix when compared to postal questionnaires alone. For large surveys, online survey systems may be cost saving. Copyright © 2017 Elsevier Inc. All rights reserved.

Guns, germs, and stealing: exploring the link between infectious disease and crime.

PubMed

Shrira, Ilan; Wisman, Arnaud; Webster, Gregory

2013-03-27

Can variation in crime rates be traced to the threat of infectious disease? Pathogens pose an ongoing challenge to survival, leading humans to adapt defenses to manage this threat. In addition to the biological immune system, humans have psychological and behavioral responses designed to protect against disease. Under persistent disease threat, xenophobia increases and people constrict social interactions to known in-group members. Though these responses reduce disease transmission, they can generate favorable crime conditions in two ways. First, xenophobia reduces inhibitions against harming and exploiting out-group members. Second, segregation into in-group factions erodes people's concern for the welfare of their community and weakens the collective ability to prevent crime. The present study examined the effects of infection incidence on crime rates across the United States. Infection rates predicted violent and property crime more strongly than other crime covariates. Infections also predicted homicides against strangers but not family or acquaintances, supporting the hypothesis that in-group-out-group discrimination was responsible for the infections-crime link. Overall, the results add to evidence that disease threat shapes interpersonal behavior and structural characteristics of groups.

Differences on the projective hand test among chronic pain patients reporting three different pain experiences.

PubMed

Panek, Paul E; Skowronski, John J; Wagner, Edwin E

2002-10-01

This study examined personality differences among individuals experiencing 3 different types of pain. The projective Hand Test was administered to 90 individuals who were seeking treatment at a pain clinic in an urban area of the southeast United States. These people were seeking treatment for either arthritis (n = 31), fibromyalgia (n = 29), or migraine headaches (n = 30). A 2 (gender) x 3 (pain group) x Age Group multivariate analysis of variance was conducted using the quantitative Hand Test scoring variables as dependent measures. Results indicated that individuals who were seeking treatment for migraine headaches had a higher production rate of responses involving exhibitionistic displays (EXH) than individuals in the other 2 groups. Individuals who were seeking treatment for fibromyalgia had a higher production rate of responses indicating fear and phobic concerns (FEAR) than individuals in the other 2 groups. Individuals who were seeking treatment for arthritis had a higher production rate of Active (ACT) responses than individuals in the other 2 groups. Possible causes and consequences of these effects are discussed.

Comparing Lay Community and Academic Survey Center Interviewers in Conducting Household Interviews in Latino Communities.

PubMed

Chan-Golston, Alec M; Friedlander, Scott; Glik, Deborah C; Prelip, Michael L; Belin, Thomas R; Brookmeyer, Ron; Santos, Robert; Chen, Jie; Ortega, Alexander N

2016-01-01

The employment of professional interviewers from academic survey centers to conduct surveys has been standard practice. Because one goal of community-engaged research is to provide professional skills to community residents, this paper considers whether employing locally trained lay interviewers from within the community may be as effective as employing interviewers from an academic survey center with regard to unit and item nonresponse rates and cost. To study a nutrition-focused intervention, 1035 in-person household interviews were conducted in East Los Angeles and Boyle Heights, 503 of which were completed by lay community interviewers. A chi-square test was used to assess differences in unit nonresponse rates between professional and community interviewers and Welch's t tests were used to assess differences in item nonresponse rates. A cost comparison analysis between the two interviewer groups was also conducted. Interviewers from the academic survey center had lower unit nonresponse rates than the lay community interviewers (16.2% vs. 23.3%; p < 0.01). However, the item nonresponse rates were lower for the community interviewers than the professional interviewers (1.4% vs. 3.3%; p < 0.01). Community interviewers cost approximately $415.38 per survey whereas professional interviewers cost approximately $537.29 per survey. With a lower cost per completed survey and lower item nonresponse rates, lay community interviewers are a viable alternative to professional interviewers for fieldwork in community-based research. Additional research is needed to assess other important aspects of data quality interviewer such as interviewer effects and response error.

Drainage basin control of acid loadings to two Adirondack lakes

NASA Astrophysics Data System (ADS)

Booty, W. G.; Depinto, J. V.; Scheffe, R. D.

1988-07-01

Two adjacent Adirondack Park (New York) calibrated watersheds (Woods Lake and Cranberry Pond), which receive identical atmospheric inputs, generate significantly different unit area of watershed loading rates of acidity to their respective lakes. A watershed acidification model is used to evaluate the watershed parameters which are responsible for the observed differences in acid loadings to the lakes. The greater overall mean depth of overburden on Woods Lake watershed, which supplies a greater buffer capacity as well as a longer retention time of groundwater, appears to be the major factor responsible for the differences.

Properties of human motoneurones and their synaptic noise deduced from motor unit recordings with the aid of computer modelling.

PubMed

Matthews, P B

1999-01-01

This paper reviews two new facets of the behaviour of human motoneurones; these were demonstrated by modelling combined with analysis of long periods of low-frequency tonic motor unit firing (sub-primary range). 1) A novel transformation of the interval histogram has shown that the effective part of the membrane's post-spike voltage trajectory is a segment of an exponential (rather than linear), with most spikes being triggered by synaptic noise before the mean potential reaches threshold. The curvature of the motoneurone's trajectory affects virtually all measures of its behaviour and response to stimulation. The 'trajectory' is measured from threshold, and so includes any changes in threshold during the interspike interval. 2) A novel rhythmic stimulus (amplitude-modulated pulsed vibration) has been used to show that the motoneurone produces appreciable phase-advance during sinusoidal excitation. At low frequencies, the advance increases with rising stimulus frequency but then, slightly below the motoneurones mean firing rate, it suddenly becomes smaller. The gain has a maximum for stimuli at the mean firing rate (the 'carrier'). Such behaviour is functionally important since it affects the motoneurone's response to any rhythmic input, whether generated peripherally by the receptors (as in tremor) or by the CNS (as with cortical oscillations). Low mean firing rates favour tremor, since the high gain and reduced phase advance at the 'carrier' reduce the stability of the stretch reflex.

Variability of Thermosphere and Ionosphere Responses to Solar Flares

NASA Technical Reports Server (NTRS)

Qian, Liying; Burns, Alan G.; Chamberlin, Philip C.; Solomon, Stanley C.

2011-01-01

We investigated how the rise rate and decay rate of solar flares affect the thermosphere and ionosphere responses to them. Model simulations and data analysis were conducted for two flares of similar magnitude (X6.2 and X5.4) that had the same location on the solar limb, but the X6.2 flare had longer rise and decay times. Simulated total electron content (TEC) enhancements from the X6.2 and X5.4 flares were 6 total electron content units (TECU) and approximately 2 TECU, and the simulated neutral density enhancements were approximately 15% -20% and approximately 5%, respectively, in reasonable agreement with observations. Additional model simulations showed that for idealized flares with the same magnitude and location, the thermosphere and ionosphere responses changed significantly as a function of rise and decay rates. The Neupert Effect, which predicts that a faster flare rise rate leads to a larger EUV enhancement during the impulsive phase, caused a larger maximum ion production enhancement. In addition, model simulations showed that increased E x B plasma transport due to conductivity increases during the flares caused a significant equatorial anomaly feature in the electron density enhancement in the F region but a relatively weaker equatorial anomaly feature in TEC enhancement, owing to dominant contributions by photochemical production and loss processes. The latitude dependence of the thermosphere response correlated well with the solar zenith angle effect, whereas the latitude dependence of the ionosphere response was more complex, owing to plasma transport and the winter anomaly.

The reef-building coral Siderastrea siderea exhibits parabolic responses to ocean acidification and warming.

PubMed

Castillo, Karl D; Ries, Justin B; Bruno, John F; Westfield, Isaac T

2014-12-22

Anthropogenic increases in atmospheric CO2 over this century are predicted to cause global average surface ocean pH to decline by 0.1-0.3 pH units and sea surface temperature to increase by 1-4°C. We conducted controlled laboratory experiments to investigate the impacts of CO2-induced ocean acidification (pCO2 = 324, 477, 604, 2553 µatm) and warming (25, 28, 32°C) on the calcification rate of the zooxanthellate scleractinian coral Siderastrea siderea, a widespread, abundant and keystone reef-builder in the Caribbean Sea. We show that both acidification and warming cause a parabolic response in the calcification rate within this coral species. Moderate increases in pCO2 and warming, relative to near-present-day values, enhanced coral calcification, with calcification rates declining under the highest pCO2 and thermal conditions. Equivalent responses to acidification and warming were exhibited by colonies across reef zones and the parabolic nature of the corals' response to these stressors was evident across all three of the experiment's 30-day observational intervals. Furthermore, the warming projected by the Intergovernmental Panel on Climate Change for the end of the twenty-first century caused a fivefold decrease in the rate of coral calcification, while the acidification projected for the same interval had no statistically significant impact on the calcification rate-suggesting that ocean warming poses a more immediate threat than acidification for this important coral species.

Hand-hygiene compliance does not predict rates of resistant infections in critically ill surgical patients.

PubMed

Jayaraman, Sudha P; Klompas, Michael; Bascom, Molli; Liu, Xiaoxia; Piszcz, Regina; Rogers, Selwyn O; Askari, Reza

2014-10-01

Our institution had a major outbreak of multi-drug-resistant Acinetobacter (MDRA) in its general surgical and trauma intensive care units (ICUs) in 2011, requiring implementation of an aggressive infection-control response. We hypothesized that poor hand-hygiene compliance (HHC) may have contributed to the outbreak of MDRA. A response to the outbreak including aggressive environmental cleaning, cohorting, and increased hand hygiene compliance monitoring may have led to an increase in HHC after the outbreak and to a consequent decrease in the rates of infection by the nosocomial pathogens methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and Clostridium difficile. Hand-hygiene compliance, tracked in monthly audits by trained and anonymous observers, was abstracted from an infection control database. The incidences of nosocomial MRSA, VRE, and C. difficile were calculated from a separate prospectively collected data base for 6 mo before and 12 mo after the 2011 outbreak of MDRA in the institution's general surgical and trauma ICUs, and data collected prospectively from two unaffected ICUs (the thoracic surgical ICU and medical intensive care unit [MICU]). We created a composite endpoint of "any resistant pathogen," defined as MRSA, VRE, or C. difficile, and compared incidence rates over time, using the Wilcoxon signed rank test and Pearson product-moment correlation coefficient to measure the correlations among these rates. Rates of HHC before and after the outbreak of MDRA were consistently high in both the general surgical (median rates: 100% before and 97.6% after the outbreak, p=0.93) and trauma ICUs (median rates: 90% before and 96.75% after the outbreak, p=0.14). In none of the ICUs included in the study did the rates of HHC increase in response to the outbreak of MDRA. The incidence of "any resistant pathogen" decreased in the general surgical ICU after the outbreak (from 6.7/1,000 patient-days before the outbreak to 2.7/1,000 patient-days after the outbreak, p=0.04), but this decrease did not correlate with HHC (trauma ICU: Pearson correlation [ρ]=-0.34, p=0.28; general surgical ICU: ρ=0.52, p=0.08). The 2011 outbreak of MDRA at our institution occurred despite high rates of HHC. Notwithstanding stable rates of HHC, the rates of infection with MRSA, VRE and C. difficile decreased in the general surgical ICU after the outbreak. This suggests that infection control tactics other than HHC play a crucial role in preventing the transmission of nosocomial pathogens, especially when rates of HHC have been maximized.

Productive responses of breeding Cashmere goats and their kids to different stocking rates on improved upland pastures.

PubMed

Celaya, R; Moreno-Gonzalo, J; López López, C; Ferreira, L M M; García, U; Ferre, I; Osoro, K

2016-03-01

Although goat meat production could be an option for diversification in improved upland pastures in northern Spain, precise information on the optimal grazing management to enhance goat performance and maximize production per unit land area is lacking. The objective of this study was to compare the effects of 3 stocking rates, high stocking rate (HSR; 20 goats/ha), medium stocking rate (MSR; 15 goats/ha), and low stocking rate (LSR; 10 goats/ha), on gastrointestinal (GI) nematode infections and productive responses of Cashmere goats grazing such pastures. Treatments were replicated twice on 6 paddocks sown with and and with a high presence of the native grass . The experiment lasted 3 grazing seasons (from spring to autumn). Pastures were sampled for sward height and botanical and proximate composition. Body weight and BCS changes of goats were monitored and GI nematode infections were assessed by fecal egg counts (FEC). The established treatments resulted in lower mean sward height in the HSR than in the MSR and LSR (9.6, 11.5, and 14.4 cm, respectively; < 0.001). Pasture botanical composition and nutritive quality did not differ between treatments. The mean FEC of does across the 3 grazing seasons were greater ( < 0.05) in the HSR than in the LSR. spp., , and were the most prevalent nematode species identified in coprocultures. Does showed more favorable ( < 0.001) BW and BCS changes in the LSR than in the MSR and HSR (-14, -30, and -52 g/d and -0.1, -0.3, and -0.7 BCS units [scale 1 to 5], respectively). Greater ( < 0.001) kids' BW gains were observed in the LSR and MSR (average 94 g/d) compared with the HSR (70 g/d). Inversely, kid output per unit land area was greater in the HSR than in the MSR and LSR (320, 258, and 192 kg∙ha∙yr, respectively; < 0.001), whereas daily kids' BW gains per hectare were greater ( < 0.001) in the HSR and MSR (average 1.37 kg∙d∙ha) compared with the LSR (0.98 kg∙d∙ha). A medium stocking rate of 15 goats/ha could represent the best compromise between animal health, performance, and productivity per unit land area in this type of upland pastures, but stricter controls of parasite levels during the grazing season would be necessary to avoid production losses, unless alternative nutraceuticals are provided.

The range and response of Neonicotinoids on hemlock woolly adelgid, Adelges tsugae (Hemiptera: Adelgidae)

Treesearch

Shimat V. Joseph; S. Kristine Braman; Jim Quick; James L. Hanula

2011-01-01

Hemlock woolly adelgid (HWA), Adelges tsugae Annand is a serious pest of eastern and Carolina hemlock in the eastern United States. A series of experiments compared commercially available and experimental insecticides, rates, application methods and timing for HWA control in Georgia and North Carolina. Safari 20 SG (dinotefuran) provided an average of 79 to 87%...

Depression among Couples in the United States in the Context of Intimate Partner Violence

ERIC Educational Resources Information Center

Vaeth, Patrice A. C.; Ramisetty-Mikler, Suhasini; Caetano, Raul

2010-01-01

This paper examines the relationship between intimate partner violence and depression. A multicluster random household sample of U.S. couples was interviewed as part of a five-year national longitudinal study (response rate = 72%). Depression was assessed with the CES-D. The multivariate analyses for men showed that the odds of depression did not…

The Self-Perceived Leadership Styles of Chief State School Officers and Models of Educational Governance

ERIC Educational Resources Information Center

Wiggins, Lori A.

2013-01-01

This study examined the leadership styles of the chief state school officers of the United States and the District of Columbia. The entire population of 51 chief state school officers was surveyed and a response rate of 60% was obtained. The study examined the relationship between the leadership style, select demographic variables, and the…

Reduced Spiking in Entorhinal Cortex during the Delay Period of a Cued Spatial Response Task

ERIC Educational Resources Information Center

Gupta, Kishan; Keller, Lauren A.; Hasselmo, Michael E.

2012-01-01

Intrinsic persistent spiking mechanisms in medial entorhinal cortex (mEC) neurons may play a role in active maintenance of working memory. However, electrophysiological studies of rat mEC units have primarily focused on spatial modulation. We sought evidence of differential spike rates in the mEC in rats trained on a T-maze, cued spatial delayed…

Hunter Ethics: A Look at Hunter Behavior and Hunter Education in the U.S. and Canada.

ERIC Educational Resources Information Center

Elliott, Denis S.

This study examines issues of unethical hunting practices and promotion of ethical hunter behavior in the United States and Canada. Hunter education coordinators (HECs) in all states and provinces were surveyed, with a response rate of 66 percent. Results indicate: (1) there has been little change in the types of hunter ethics problems in recent…

Drought-Related Mortality in Pinyon-Juniper Woodlands: A Test Case for the FIA Annual Inventory System

Treesearch

John D. Shaw

2006-01-01

Several years of drought in the Southwest United States are associated with widespread mortality in the pinyon-juniper forest type. A complex of drought, insects, and disease is responsible for pinyon mortality rates approaching 100 percent in some areas, while other areas have experienced little or no mortality. Implementation of the Forest Inventory and Analysis...

Use of Research-Based Instructional Strategies in Introductory Physics: Where Do Faculty Leave the Innovation-Decision Process?

ERIC Educational Resources Information Center

Henderson, Charles; Dancy, Melissa; Niewiadomska-Bugaj, Magdalena

2012-01-01

During the fall of 2008 a web survey, designed to collect information about pedagogical knowledge and practices, was completed by a representative sample of 722 physics faculty across the United States (50.3% response rate). This paper presents partial results to describe how 20 potential predictor variables correlate with faculty knowledge about…

Improving response rates using a monetary incentive for patient completion of questionnaires: an observational study

PubMed Central

Brealey, Stephen D; Atwell, Christine; Bryan, Stirling; Coulton, Simon; Cox, Helen; Cross, Ben; Fylan, Fiona; Garratt, Andrew; Gilbert, Fiona J; Gillan, Maureen GC; Hendry, Maggie; Hood, Kerenza; Houston, Helen; King, David; Morton, Veronica; Orchard, Jo; Robling, Michael; Russell, Ian T; Torgerson, David; Wadsworth, Valerie; Wilkinson, Clare

2007-01-01

Background Poor response rates to postal questionnaires can introduce bias and reduce the statistical power of a study. To improve response rates in our trial in primary care we tested the effect of introducing an unconditional direct payment of £5 for the completion of postal questionnaires. Methods We recruited patients in general practice with knee problems from sites across the United Kingdom. An evidence-based strategy was used to follow-up patients at twelve months with postal questionnaires. This included an unconditional direct payment of £5 to patients for the completion and return of questionnaires. The first 105 patients did not receive the £5 incentive, but the subsequent 442 patients did. We used logistic regression to analyse the effect of introducing a monetary incentive to increase the response to postal questionnaires. Results The response rate following reminders for the historical controls was 78.1% (82 of 105) compared with 88.0% (389 of 442) for those patients who received the £5 payment (diff = 9.9%, 95% CI 2.3% to 19.1%). Direct payments significantly increased the odds of response (adjusted odds ratio = 2.2, 95% CI 1.2 to 4.0, P = 0.009) with only 12 of 442 patients declining the payment. The incentive did not save costs to the trial – the extra cost per additional respondent was almost £50. Conclusion The direct payment of £5 significantly increased the completion of postal questionnaires at negligible increase in cost for an adequately powered study. PMID:17326837

Temporal selectivity by single neurons in the torus semicircularis of Batrachyla antartandica (Amphibia: Leptodactylidae).

PubMed

Penna, M; Lin, W Y; Feng, A S

2001-12-01

We investigated the response selectivities of single auditory neurons in the torus semicircularis of Batrachyla antartandica (a leptodactylid from southern Chile) to synthetic stimuli having diverse temporal structures. The advertisement call for this species is characterized by a long sequence of brief sound pulses having a dominant frequency of about 2000 Hz. We constructed five different series of synthetic stimuli in which the following acoustic parameters were systematically modified, one at a time: pulse rate, pulse duration, pulse rise time, pulse fall time, and train duration. The carrier frequency of these stimuli was fixed at the characteristic frequency of the units under study (n=44). Response patterns of TS units to these synthetic call variants revealed different degrees of selectivity for each of the temporal variables. A substantial number of neurons showed preference for pulse rates below 2 pulses s(-1), approximating the values found in natural advertisement calls. Tonic neurons generally showed preferences for long pulse durations, long rise and fall times, and long train durations. In contrast, phasic and phasic-burst neurons preferred stimuli with short duration, short rise and fall times and short train durations.

Cardiorespiratory Kinetics Determined by Pseudo-Random Binary Sequences - Comparisons between Walking and Cycling.

PubMed

Koschate, J; Drescher, U; Thieschäfer, L; Heine, O; Baum, K; Hoffmann, U

2016-12-01

This study aims to compare cardiorespiratory kinetics as a response to a standardised work rate protocol with pseudo-random binary sequences between cycling and walking in young healthy subjects. Muscular and pulmonary oxygen uptake (V̇O 2 ) kinetics as well as heart rate kinetics were expected to be similar for walking and cycling. Cardiac data and V̇O 2 of 23 healthy young subjects were measured in response to pseudo-random binary sequences. Kinetics were assessed applying time series analysis. Higher maxima of cross-correlation functions between work rate and the respective parameter indicate faster kinetics responses. Muscular V̇O 2 kinetics were estimated from heart rate and pulmonary V̇O 2 using a circulatory model. Muscular (walking vs. cycling [mean±SD in arbitrary units]: 0.40±0.08 vs. 0.41±0.08) and pulmonary V̇O 2 kinetics (0.35±0.06 vs. 0.35±0.06) were not different, although the time courses of the cross-correlation functions of pulmonary V̇O 2 showed unexpected biphasic responses. Heart rate kinetics (0.50±0.14 vs. 0.40±0.14; P=0.017) was faster for walking. Regarding the biphasic cross-correlation functions of pulmonary V̇O 2 during walking, the assessment of muscular V̇O 2 kinetics via pseudo-random binary sequences requires a circulatory model to account for cardio-dynamic distortions. Faster heart rate kinetics for walking should be considered by comparing results from cycle and treadmill ergometry. © Georg Thieme Verlag KG Stuttgart · New York.

A novel approach to optimize workflow in grid-based teleradiology applications.

PubMed

Yılmaz, Ayhan Ozan; Baykal, Nazife

2016-01-01

This study proposes an infrastructure with a reporting workflow optimization algorithm (RWOA) in order to interconnect facilities, reporting units and radiologists on a single access interface, to increase the efficiency of the reporting process by decreasing the medical report turnaround time and to increase the quality of medical reports by determining the optimum match between the inspection and radiologist in terms of subspecialty, workload and response time. Workflow centric network architecture with an enhanced caching, querying and retrieving mechanism is implemented by seamlessly integrating Grid Agent and Grid Manager to conventional digital radiology systems. The inspection and radiologist attributes are modelled using a hierarchical ontology structure. Attribute preferences rated by radiologists and technical experts are formed into reciprocal matrixes and weights for entities are calculated utilizing Analytic Hierarchy Process (AHP). The assignment alternatives are processed by relation-based semantic matching (RBSM) and Integer Linear Programming (ILP). The results are evaluated based on both real case applications and simulated process data in terms of subspecialty, response time and workload success rates. Results obtained using simulated data are compared with the outcomes obtained by applying Round Robin, Shortest Queue and Random distribution policies. The proposed algorithm is also applied to a real case teleradiology application process data where medical reporting workflow was performed based on manual assignments by the chief radiologist for 6225 inspections. RBSM gives the highest subspecialty success rate and integrating ILP with RBSM ratings as RWOA provides a better response time and workload distribution success rate. RWOA based image delivery also prevents bandwidth, storage or hardware related stuck and latencies. When compared with a real case teleradiology application where inspection assignments were performed manually, the proposed solution was found to increase the experience success rate by 13.25%, workload success rate by 63.76% and response time success rate by 120%. The total response time in the real case application data was improved by 22.39%. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Patient Safety Culture Assessment in Oman

PubMed Central

Al-Mandhari, Ahmed; Al-Zakwani, Ibrahim; Al-Kindi, Moosa; Tawilah, Jihane; Dorvlo, Atsu S.S.; Al-Adawi, Samir

2014-01-01

Objective To illustrate the patient safety culture in Oman as gleaned via 12 indices of patient safety culture derived from the Hospital Survey on Patient Safety Culture (HSPSC) and to compare the average positive response rates in patient safety culture between Oman and the USA, Taiwan, and Lebanon. Methods This was a cross-sectional research study employed to gauge the performance of HSPSC safety indices among health workers representing five secondary and tertiary care hospitals in the northern region of Oman. The participants (n=398) represented different professional designations of hospital staff. Analyses were performed using univariate statistics. Results The overall average positive response rate for the 12 patient safety culture dimensions of the HSPSC survey in Oman was 58%. The indices from HSPSC that were endorsed the highest included ‘organizational learning and continuous improvement’ while conversely, ‘non-punitive response to errors’ was ranked the least. There were no significant differences in average positive response rates between Oman and the United States (58% vs. 61%; p=0.666), Taiwan (58% vs. 64%; p=0.386), and Lebanon (58% vs. 61%; p=0.666). Conclusion This study provides the first empirical study on patient safety culture in Oman which is similar to those rates reported elsewhere. It highlights the specific strengths and weaknesses which may stem from the specific milieu prevailing in Oman. PMID:25170407

Six-year follow-up on work force and finances of the United States anesthesiology training programs: 2000 to 2006.

PubMed

Kheterpal, Sachin; Tremper, Kevin K; Shanks, Amy; Morris, Michelle

2009-01-01

In the mid 1990s, interest in the field of anesthesiology decreased significantly among medical students, resulting in a decreasing resident class size and, subsequently, fewer anesthesiologists entering the United States workforce. This apparent practitioner shortage was associated with increased salary demands, which placed anesthesiology training departments in financial jeopardy. Starting in 1999, a survey was sent to the department chairs of the United States anesthesiology training programs to assess the status of faculty and finances of their departments. Follow-up surveys have been conducted each year thereafter. We present the results of the 2006 survey and 7 yr trend data. Surveys were distributed by e-mail in September 2006 to anesthesiology department chairs of the United States training programs. The responses were received by e-mail. Descriptive statistics were performed on responder data. In addition, a linear regression model to predict institutional support was developed. One-hundred-eighteen departments were surveyed with a response rate of 61%. There were an average of 4 open faculty positions in the 71% of the departments reporting open faculty positions. This would imply an overall 5% open position rate, down from 10% in 2000. Of the 96% of departments who employ certified registered nurse anesthetists, 70% had an average of 4 open positions, or approximately 11% shortage. The average department received $5,500,000 in total institutional support annually ($120,000/faculty). When the portion of this support provided for certified registered nurse anesthetists was removed, the average amount received was $4,600,000 or $100,000/faculty. This is a 10% increase over the previous year and an approximate 300% increase over the year 2000. Faculty academic time averaged 18% (where 20% is 1 day per week). The departments billed an average of 12,200 U/faculty/year. The average anesthesia unit value collected was $31/unit, while departments would require $46/unit to meet expenses. In a linear regression model, clinical revenue per unit billed minus expenses per unit billed predicted faculty support per full-time equivalent. This current survey reveals a continuing need for institutional support to keep anesthesiology training departments financially solvent. The amount of support is associated with the reimbursement for anesthesia work. There is also a continuing, but decreasing, number of open faculty anesthesiologist positions nationwide.

21 CFR 211.22 - Responsibilities of quality control unit.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 4 2011-04-01 2011-04-01 false Responsibilities of quality control unit. 211.22... Personnel § 211.22 Responsibilities of quality control unit. (a) There shall be a quality control unit that... have been fully investigated. The quality control unit shall be responsible for approving or rejecting...

21 CFR 211.22 - Responsibilities of quality control unit.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Responsibilities of quality control unit. 211.22... Personnel § 211.22 Responsibilities of quality control unit. (a) There shall be a quality control unit that... have been fully investigated. The quality control unit shall be responsible for approving or rejecting...

Efficacy of TACE in TIPS Patients: Comparison of Treatment Response to Chemoembolization for Hepatocellular Carcinoma in Patients With and Without a Transjugular Intrahepatic Portosystemic Shunt

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

Kuo, Yuo-Chen, E-mail: yuo-chen.kuo@ucsf.edu; Kohi, Maureen P., E-mail: maureen.kohi@ucsf.edu; Naeger, David M., E-mail: david.naeger@ucsf.edu

Purpose: To compare treatment response after transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) in patients with and without a transjugular intrahepatic portosystemic shunt (TIPS). Materials and Methods: A retrospective review of patients who underwent conventional TACE for HCC between January 2005 and December 2009 identified 10 patients with patent TIPS. From the same time period, 23 patients without TIPS were selected to control for comparable Model for End-Stage Liver Disease and Child-Pugh-Turcotte scores. The two groups showed similar distribution of Barcelona Clinic Liver Cancer and United Network of Organ Sharing stages. Target HCC lesions were evaluated according to the modifiedmore » response evaluation criteria in solid tumors (mRECIST) guidelines. Transplantation rate, time to tumor progression, and overall survival (OS) were documented. Results: After TACE, the rate of complete response was significantly greater in non-TIPS patients compared with TIPS patients (74 vs. 30 %, p = 0.03). Objective response rate (complete and partial response) trended greater in the non-TIPS group (83 vs. 50 %, p = 0.09). The liver transplantation rate was 80 and 74 % in the TIPS and non-TIPS groups, respectively (p = 1.0). Time to tumor progression was similar (p = 0.47) between the two groups. OS favored the non-TIPS group (p = 0.01) when censored for liver transplantation. Conclusion: TACE is less effective in achieving complete or partial response using mRECIST criteria in TIPS patients compared with those without a TIPS. Nevertheless, similar clinical outcomes may be achieved, particularly in TIPS patients who are liver-transplantation candidates.« less

[Feeding practices with human milk in newborns less than 1.500 g or less than 32 weeks].

PubMed

Alonso-Díaz, Clara; Utrera-Torres, Isabel; de Alba-Romero, Concepción; Flores-Antón, Beatriz; López-Maestro, María; Lora-Pablos, David; Pallás-Alonso, Carmen R

2016-07-01

There is currently no unified policy on either breastfeeding support or enteral nutrition practices, as regards human milk (HM) in pre-term newborns. The aim of this study was to describe breastfeeding support measures, as well as the use of HM in very preterm infants in Spanish public hospitals. A questionnaire on enteral feeding practices was distributed. Data were analysed from units caring for newborns less than 32 weeks or 1,500g. A univariate analysis was performed comparing level ii and iii care units. There was a 91% response rate. A total of 93 units cared for infants less than 32 weeks or 1,500g (17 level ii and 76 level iii), and 49% of the units recorded the breastfeeding rate on discharge. Around 75% (70/93) had a guideline on managing HM (level iii 81 vs. level ii 47%, P=.002), and 25% had access to donor human milk. Just under half (46%) started trophic feeding in the first 6h. Target enteral feeding volume in stable preterm infants was ≥ 180ml/kg/day in 89% of the units (level iii 93% vs. level ii 70%, P =.017). HM fortifier was used in 96% of the units. In 92%, it was added when the required enteral volume was tolerated. In 59% of the units, adjustments in the quantity of fortifier were made according to weight, and in 36%, it depended on analytical criteria. Some units (9%) used pure protein fortifier. There is a marked variability in breastfeeding support measures and in feeding practices of preterm infants in Spanish neonatal units. Copyright © 2015 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

An updated stress map of the continental United States reveals heterogeneous intraplate stress

NASA Astrophysics Data System (ADS)

Levandowski, Will; Herrmann, Robert B.; Briggs, Rich; Boyd, Oliver; Gold, Ryan

2018-06-01

Knowledge of the state of stress in Earth's crust is key to understanding the forces and processes responsible for earthquakes. Historically, low rates of natural seismicity in the central and eastern United States have complicated efforts to understand intraplate stress, but recent improvements in seismic networks and the spread of human-induced seismicity have greatly improved data coverage. Here, we compile a nationwide stress map based on formal inversions of focal mechanisms that challenges the idea that deformation in continental interiors is driven primarily by broad, uniform stress fields derived from distant plate boundaries. Despite plate-boundary compression, extension dominates roughly half of the continent, and second-order forces related to lithospheric structure appear to control extension directions. We also show that the states of stress in several active eastern United States seismic zones differ significantly from those of surrounding areas and that these anomalies cannot be explained by transient processes, suggesting that earthquakes are focused by persistent, locally derived sources of stress. Such spatially variable intraplate stress appears to justify the current, spatially variable estimates of seismic hazard. Future work to quantify sources of stress, stressing-rate magnitudes and their relationship with strain and earthquake rates could allow prospective mapping of intraplate hazard.

Impact of short- compared to long-haul international travel on the sleep and wellbeing of national wheelchair basketball athletes.

PubMed

Thornton, Heidi R; Miller, Joanna; Taylor, Lee; Sargent, Charli; Lastella, Michele; Fowler, Peter M

2018-07-01

Currently, very little is known about the impact of short- or long-haul air travel on the sleep and wellbeing of wheelchair basketball athletes. Eleven national wheelchair basketball athletes wore actigraphy monitors prior, during, and after air travel to the United Kingdom. Upon arrival, participants rated their subjective jet-lag, fatigue, and vigor. Individuals traveled to the United Kingdom from different locations in Australia, the United States, and Europe and were categorised according to travel length [LONG (up to 30.2 h) or SHORT (up to 6.5 h)]. Linear mixed models determined effects of travel length on sleep and subjective ratings of jet-lag, fatigue, and vigor. During competition, subjective fatigue and jet-lag were substantially higher (ES = 0.73; ±0.77) and (ES = 0.57; ±0.60), subjective vigor was lower (ES = 1.94; ±0.72), and get-up time was earlier (ES = 0.57; ±0.60) for LONG when compared to SHORT. Travelling greater distances by airplane had a larger effect on subjective ratings of jet-lag, fatigue and vigor, rather than sleep. Irrespective of travel group, sleep and subjective responses were compromised, reflecting the travel requirements, competition-mediated influences, and/or due to a change in environment.

Acclimation of isoprene emission and photosynthesis to growth temperature in hybrid aspen: resolving structural and physiological controls

PubMed Central

Rasulov, Bahtijor; Bichele, Irina; Hüve, Katja; Vislap, Vivian; Niinemets, Ülo

2018-01-01

Acclimation of foliage to growth temperature involves both structural and physiological modifications, but the relative importance of these two mechanisms of acclimation is poorly known, especially for isoprene emission responses. We grew hybrid aspen (Populus tremula x P. tremuloides) under control (day/night temperature of 25/20 °C) and high temperature conditions (35/27 °C) to gain insight into the structural and physiological acclimation controls. Growth at high temperature resulted in larger and thinner leaves with smaller and more densely packed chloroplasts and with lower leaf dry mass per area (MA). High growth temperature also led to lower photosynthetic and respiration rates, isoprene emission rate and leaf pigment content and isoprene substrate dimethylallyl diphosphate pool size per unit area, but to greater stomatal conductance. However, the declining characteristics were similar when expressed per unit dry mass, indicating that the area-based differences were primarily driven by MA. Acclimation to high temperature further increased heat stability of photosynthesis, and increased activation energies for isoprene emission and isoprene synthase rate constant. This study demonstrates that temperature acclimation of photosynthetic and isoprene emission characteristics per unit leaf area was primarily driven by structural modifications, and we argue that future studies investigating acclimation to growth temperature must consider structural modifications. PMID:25158785

The impact of summer rainfall on the temperature gradient along the United States-Mexico border

NASA Technical Reports Server (NTRS)

Balling, Robert C., Jr.

1989-01-01

The international border running through the Sonoran Desert in southern Arizona and northern Sonora is marked by a sharp discontinuity in albedo and grass cover. The observed differences in surface properties are a result of long-term, severe overgrazing of the Mexican lands. Recently, investigators have shown the Mexican side of the border to have higher surface and air temperatures when compared to adjacent areas in the United State. The differences in temperatures appear to be more associated with differential evapotranspiration rates than with albedo changes along the border. In this study, the impact of summer rainfall on the observed seasonal and daily gradient in maximum temperature is examined. On a seasonal time scale, the temperature gradient increases with higher moisture levels, probably due to a vegetative response on the United States' side of the border; at the daily level, the gradient in maximum temperature decreases after a rain event as evaporation rates equalize between the countries. The results suggest that temperature differences between vegetated and overgrazed landscapes in arid areas are highly dependent upon the amount of moisture available for evapotranspiration.

Fiber Optic Cable Feedthrough and Sealing

NASA Technical Reports Server (NTRS)

Fan, Robert J.

1998-01-01

A novel fiberoptic hermetic bulkhead feedthrough has been developed which will offer cryogenic sealing at leak rates of 10(exp -11) cc/sec helium. This feedthrough was developed for NASA in response to needs for a hermetically sealed feedthrough which could withstand a range of temperatures from low cryogenic (-196 C), due to liquid fuels and oxidizers, to high temperatures (+200 C) encountered in the proximity of combustion gasses. The development effort will be reported from conceptual design of single and multi-channel feedthrough units with single interconnection interfaces to units with double-ended interconnection interfaces. Various combinations of fiber/buffers are reported with recommendations based on test results. A comprehensive series of environmental and mechanical tests were performed to evaluate the feedthroughs in adverse conditions. Test results are reported including insertion loss, salt spray, sinusoidal vibration, random vibration, mechanical shock, thermal shock and humidity. A second set of feedthrough units was exposed to 3 different types of radiation. Optical transmittance changes during the tests were monitored and leak rate testing was done after each test. State-of-the-art technology in optical fiber feedthroughs constructed with polycrystalline ceramic is presented.

Cross-cultural differences in demented geropsychiatric inpatients with behavioral disturbances.

PubMed

Akpaffiong, M; Kunik, M E; Hale, D; Molinari, V; Orengo, C

1999-10-01

Cross-cultural differences in treatment and diagnosis exist in several psychiatric disorders. This study examines phenomenological and treatment differences between Caucasian and African-American patients presenting to a geropsychiatric unit for treatment of behavioral disturbances associated with dementia. One hundred and forty-one Caucasian patients were compared to 56 African-American patients consecutively admitted to a VA geropsychiatric inpatient unit. At admission, differences in behavior disturbances between the two groups were examined using the Mini-Mental State Examination (MMSE), Cohen-Mansfield Agitation Inventory (CMAI), Hamilton Rating Scale for Depression (HAM-D), Brief Psychiatric Rating Scale (BPRS) and the Positive and Negative Syndrome Scale for Schizophrenia (PANSS). Differences in treatment were assessed by comparing medication types and doses between the two groups. Results showed that Caucasian and African-American patients with dementia and behavioral disturbances presented and responded similarly to like treatment on an inpatient geropsychiatric unit. The similarity between the two groups may be explained by the multi-ethnic make-up of the interdisciplinary treatment team and by the use of standardized scales to measure symptomatology and response. Copyright 1999 John Wiley & Sons, Ltd.

The endoscopy Global Rating Scale – Canada: Development and implementation of a quality improvement tool

PubMed Central

MacIntosh, Donald; Dubé, Catherine; Hollingworth, Roger; van Zanten, Sander Veldhuyzen; Daniels, Sandra; Ghattas, George

2013-01-01

BACKGROUND: Increasing use of gastrointestinal endoscopy, particularly for colorectal cancer screening, and increasing emphasis on health care quality highlight the need for endoscopy facilities to review the quality of the service they offer. OBJECTIVE: To adapt the United Kingdom Global Rating Scale (UK-GRS) to develop a web-based and patient-centred tool to assess and improve the quality of endoscopy services provided. METHODS: Based on feedback from 22 sites across Canada that completed the UK endoscopy GRS, and integrating results of the Canadian consensus on safety and quality indicators in endoscopy and other Canadian consensus reports, a working group of endoscopists experienced with the GRS developed the GRS-Canada (GRS-C). RESULTS: The GRS-C mirrors the two dimensions (clinical quality and quality of the patient experience) and 12 patient-centred items of the UK-GRS, but was modified to apply to Canadian health care infrastructure, language and current practice. Each item is assessed by a yes/no response to eight to 12 statements that are divided into levels graded D (basic) through A (advanced). A core team consisting of a booking clerk, charge nurse and the physician responsible for the unit is recommended to complete the GRS-C twice yearly. CONCLUSION: The GRS-C is intended to improve endoscopic services in Canada by providing endoscopy units with a straightforward process to review the quality of the service they provide. PMID:23472242

Mechanisms and implications of a type IV functional response for short-term intake rate of dry matter in large mammalian herbivores.

PubMed

Mezzalira, Jean C; Bonnet, Olivier J F; Carvalho, Paulo C de F; Fonseca, Lidiane; Bremm, Carolina; Mezzalira, Carlos C; Laca, Emilio A

2017-09-01

The functional response (i.e. the relationship between consumers' intake rate and resource density) is central in plant-herbivore interactions. Its shape and the biological processes leading to it have significant implications for both foraging theory and ecology of grazing systems. A type IV functional response (i.e. dome-shaped relationship) of short-term intake rate of dry matter (intake while grazing) has rarely been reported for large herbivores and the conditions that can lead to it are poorly understood. We report a type IV functional response observed in heifers grazing monocultures of Cynodon sp. and Avena strigosa. The mechanisms and consequences of this type of functional response for grazed system dynamics are discussed. Intake rate was higher at intermediate than at short or tall sward heights in both grass species. The type IV functional response resulted from changes in bite mass instead of a longer time needed to encounter and process bites. Thus, the decrease of intake rate of dry matter in tall swards is not explained by a shift from process 3 (potential bites are concentrated and apparent) to process 2 (potential bites are apparent but dispersed, Spalinger & Hobbs 1992). Bite mass was smaller in tall than in intermediate swards due to a reduction of bite volume possibly caused by the greater proportion of stem and sheath acting as a physical barrier to bite formation. It is generally accepted that potential bites are abundant and apparent in most grassland and meadow systems, as they were in the present experiments. Therefore, a type IV response of intake rate not directly related to digestive constraints may determine the dynamics of intake and defoliation under a much larger set of conditions than previously thought. These results have implications for foraging theory and stability of grazing systems. For example, if animals prefer patches of intermediate stature that yield the highest intake rate, grazing should lead to the widely observed bimodal distribution of plant mass per unit area, even when tall patches are not of significantly lower digestive quality than the pasture average. © 2017 The Authors. Journal of Animal Ecology © 2017 British Ecological Society.

Ventral tegmental area neurons are either excited or inhibited by cocaine’s actions in the peripheral nervous system

PubMed Central

Mejías-Aponte, Carlos A.; Kiyatkin, Eugene A.

2012-01-01

Cocaine’s multiple pharmacological substrates are ubiquitously present in the peripheral and central nervous system. Thus, upon its administration, cocaine acts in the periphery before directly acting in the brain. We determined whether cocaine alters ventral tegmental area (VTA) neuronal activity via peripheral actions, and whether this precedes its central actions. In urethane-anesthetized rats, we recorded VTA neurons responses to intravenous injections of two cocaine analogs: cocaine-hydrochloride (HCl, 0.25 mg/kg) that readily cross the blood-brain barrier (BBB) and cocaine-methiodide (MI, 0.33 mg/kg) that does not cross the BBB. Both cocaine analogs produced sustained changes in discharge rates that began 5s after the initiation of a 10s drug infusion. Within the first 90s post-injection the magnitudes of neuronal responsive of both cocaine analogs were comparable, but later in time the effects of cocaine-HCl were stronger and persisted longer than those of cocaine-MI. The proportion of neurons responsive to cocaine-HCl was twice to that of cocaine-MI (74% and 35% respectively). Both analogs also differed in the response onsets. Cocaine-MI rarely evoked responses after 1 min whereas cocaine-HCl continued to evoke responses within 3 min post-injection. VTA neurons were either excited or inhibited by both cocaine analogs. Most units responsive to cocaine-MI, regardless of excitation or inhibition, had electrophysiological characteristics of putative DA neurons. Units inhibited by cocaine-HCl also had characteristic of DA neurons whereas excited neurons had widely varying action potential durations and discharge rates. Cocaine-MI and cocaine-HCl each produced changes in VTA neuron activity under full DA receptor blockade. However, the duration of inhibition was shortened, the number of excitations increased, and they occurred with an earlier onset during DA receptor blockade. These findings indicate that cocaine acts peripherally with a short latency and alters the activity of VTA neurons prior to its well-known direct actions in the brain. PMID:22300980

Type of unit and population served matters when implementing a smoke-free policy in mental health settings: Perceptions of unit managers across England.

PubMed

Zabeen, Sara; Tsourtos, George; Campion, Jonathan; Lawn, Sharon

2015-11-01

Globally, smoking remains a significant issue for mental health populations. Many mental health trusts in England are facing challenges of implementing the National Institute for Health and Care Excellence guidance according to which all mental health settings, no matter the type, should be entirely smoke-free and provide comprehensive smoking cessation support. The aim of this paper was to determine if unit type and unit manager smoking status influence mental health smoke-free policy implementation. This paper reports on the secondary analysis of data from a cross-sectional survey of 147 mental health inpatient settings in England, in 2010. The original study's main aim was to understand unit managers' perceived reasons for success or failure of smoke-free policy. Unit managers (n = 131) held a positive stance towards supporting smoke-free policy and most perceived that the policy was successful. Non-smoker unit managers were more likely to adopt complete bans than smoker unit managers, whereas smoker unit managers were more likely than non-smoker unit managers to think that stopping smoking aggravated patients' mental illness. Smoking rates for staff and patients remain high, as perceived by unit managers, regardless of unit type. Proportion of units offering nicotine replacement therapy and peer support to patients was significantly higher in locked units compared to semi-locked or residential rehabilitation. Applied strategies significantly vary by type of unit, whereas unit managers' knowledge, attitude and practices vary by their smoking status. There are nuanced differences in how smoke-free policy is enacted which vary by unit type. These variations recognise the differing contexts of care provision in different types of units serving different patient groups. Addressing staff smoking rates, promoting consistency of staff response to patients' smoking and providing staff education and support continue to be key strategies to successful smoke-free policy. Our results demonstrate the importance of taking into account the type of unit and acuity of patients when enacting smoke-free policy and addressing staff smoking. © The Author(s) 2015.

Independence of motor unit recruitment and rate modulation during precision force control.

PubMed

Kamen, G; Du, D C

1999-01-01

The vertebrate motor system chiefly employs motor unit recruitment and rate coding to modulate muscle force output. In this paper, we studied how the recruitment of new motor units altered the firing rate of already-active motor units during precision force production in the first dorsal interosseous muscle. Six healthy adults performed linearly increasing isometric voluntary contractions while motor unit activity and force output were recorded. After motor unit discharges were identified, motor unit firing rates were calculated before and after the instances of new motor unit recruitment. Three procedures were applied to compute motor unit firing rate, including the mean of a fixed number of inter-spike intervals and the constant width weighted Hanning window filter method, as well as a modified boxcar technique. In contrast to previous reports, the analysis of the firing rates of over 200 motor units revealed that reduction of the active firing rates was not a common mechanism used to accommodate the twitch force produced by the recruitment of a new motor unit. Similarly, during de-recruitment there was no tendency for motor unit firing rates to increase immediately following the cessation of activity in other motor units. Considerable consistency in recruitment behavior was observed during repeated contractions. However, firing rates during repeated contractions demonstrated considerably more fluctuation. It is concluded that the neuromuscular system does not use short-term preferential motor unit disfacilitation to effect precise regulation of muscular force output.

Voltage gating by molecular subunits of Na+ and K+ ion channels: higher-dimensional cubic kinetics, rate constants, and temperature

PubMed Central

2015-01-01

The structural similarity between the primary molecules of voltage-gated Na and K channels (alpha subunits) and activation gating in the Hodgkin-Huxley model is brought into full agreement by increasing the model's sodium kinetics to fourth order (m3 → m4). Both structures then virtually imply activation gating by four independent subprocesses acting in parallel. The kinetics coalesce in four-dimensional (4D) cubic diagrams (16 states, 32 reversible transitions) that show the structure to be highly failure resistant against significant partial loss of gating function. Rate constants, as fitted in phase plot data of retinal ganglion cell excitation, reflect the molecular nature of the gating transitions. Additional dimensions (6D cubic diagrams) accommodate kinetically coupled sodium inactivation and gating processes associated with beta subunits. The gating transitions of coupled sodium inactivation appear to be thermodynamically irreversible; response to dielectric surface charges (capacitive displacement) provides a potential energy source for those transitions and yields highly energy-efficient excitation. A comparison of temperature responses of the squid giant axon (apparently Arrhenius) and mammalian channel gating yields kinetic Q10 = 2.2 for alpha unit gating, whose transitions are rate-limiting at mammalian temperatures; beta unit kinetic Q10 = 14 reproduces the observed non-Arrhenius deviation of mammalian gating at low temperatures; the Q10 of sodium inactivation gating matches the rate-limiting component of activation gating at all temperatures. The model kinetics reproduce the physiologically large frequency range for repetitive firing in ganglion cells and the physiologically observed strong temperature dependence of recovery from inactivation. PMID:25867741

Physiological recruitment of motor units by high-frequency electrical stimulation of afferent pathways.

PubMed

Dideriksen, Jakob L; Muceli, Silvia; Dosen, Strahinja; Laine, Christopher M; Farina, Dario

2015-02-01

Neuromuscular electrical stimulation (NMES) is commonly used in rehabilitation, but electrically evoked muscle activation is in several ways different from voluntary muscle contractions. These differences lead to challenges in the use of NMES for restoring muscle function. We investigated the use of low-current, high-frequency nerve stimulation to activate the muscle via the spinal motoneuron (MN) pool to achieve more natural activation patterns. Using a novel stimulation protocol, the H-reflex responses to individual stimuli in a train of stimulation pulses at 100 Hz were reliably estimated with surface EMG during low-level contractions. Furthermore, single motor unit recruitment by afferent stimulation was analyzed with intramuscular EMG. The results showed that substantially elevated H-reflex responses were obtained during 100-Hz stimulation with respect to a lower stimulation frequency. Furthermore, motor unit recruitment using 100-Hz stimulation was not fully synchronized, as it occurs in classic NMES, and the discharge rates differed among motor units because each unit was activated only after a specific number of stimuli. The most likely mechanism behind these observations is the temporal summation of subthreshold excitatory postsynaptic potentials from Ia fibers to the MNs. These findings and their interpretation were also verified by a realistic simulation model of afferent stimulation of a MN population. These results suggest that the proposed stimulation strategy may allow generation of considerable levels of muscle activation by motor unit recruitment that resembles the physiological conditions. Copyright © 2015 the American Physiological Society.

Infection Prevention Practices in Japan, Thailand, and the United States: Results From National Surveys.

PubMed

Krein, Sarah L; Greene, M Todd; Apisarnthanarak, Anucha; Sakamoto, Fumie; Tokuda, Yasuharu; Sakihama, Tomoko; Fowler, Karen E; Ratz, David; Saint, Sanjay

2017-05-15

Numerous evidence-based practices for preventing device-associated infections are available, yet the extent to which these practices are regularly used in acute care hospitals across different countries has not been compared, to our knowledge. Data from hospital surveys conducted in Japan, the United States, and Thailand in 2012, 2013, and 2014, respectively, were evaluated to determine the use of recommended practices to prevent central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia (VAP), and catheter-associated urinary tract infection (CAUTI). The outcomes were the percentage of hospitals reporting regular use (a score of 4 or 5 on a scale from 1 [never use] to 5 [always use]) of each practice across countries and identified hospital characteristics associated with the use of selected practices in each country. Survey response rates were 71% in Japan and the United States and 87% in Thailand. A majority of hospitals in Japan (76.6%), Thailand (63.2%), and the United States (97.8%) used maximum barrier precautions for preventing CLABSI and semirecumbent positioning to prevent VAP (66.2% for Japan, 86.7% for Thailand, and 98.7% for the United States). Nearly all hospitals (>90%) in Thailand and the United States reported monitoring CLABSI, VAP, and CAUTI rates, whereas in Japan only CLABSI rates were monitored by a majority of hospitals. Regular use of CAUTI prevention practices was variable across the 3 countries, with only a few practices adopted by >50% of hospitals. A majority of hospitals in Japan, Thailand, and the United States have adopted certain practices to prevent CLABSI and VAP. Opportunities for targeting prevention activities and reducing device-associated infection risk in hospitals exist across all 3 countries. Published by Oxford University Press for the Infectious Diseases Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Systems to support health technology assessment (HTA) in member states of the European union with limited institutionalization of HTA.

PubMed

Moharra, Montse; Espallargues, Mireia; Kubesch, Nadine; Estrada, Maria-Dolors; Parada, Antoni; Vondeling, Hindrik; Lo Scalzo, Alessandra; Cristofides, Stelios; Turk, Eva; Raab, Martin

2009-12-01

The aim of this study was to support health technology assessment (HTA) capacity building in Member States of the European Union with limited experience or without institutionalized HTA. The main output is a Handbook on HTA Capacity Building. The methods used were worldwide surveys of (i) HTA organizations, (ii) information management units, and (iii) HTA educational programs. The results of two surveys (i & ii) were combined with expert opinion to produce the Handbook on HTA Capacity Building. Survey of HTA organizations (n = 41, response rate 35 percent). Most of the organizations were established by the government (61 percent), and all were not-for-profit. Working on HTA (80.5 percent) and doing research (63.4 percent) were the main lines of activity. Survey on information management units (n = 23, response rate 23 percent). Most (74.2 percent) of the responding HTA agencies reported having personnel dedicated to HTA information services. Survey on HTA educational programs (n = 48, response rate 60 percent). In total, nine Master of Science (MSc) programs were identified (three MSc in HTA and six MSc in HTA-related areas). Handbook on HTA Capacity Building. A group of twenty experts from thirteen countries developed the handbook. It consists of nine chapters focusing on HTA institutional development (structural setup, work processes, and visibility). Setting up organizational structures and establishing effective HTA programs that guide key policy decisions is a challenging task. There are no standard models or pathways. "One size fits all" is not a useful principle because of the wide systemic and cultural differences between countries. The Handbook on HTA Capacity Building includes approaches for overall institutional development, especially in formulating objectives, setting up structures, and defining work processes.

Comparison of Opioid Prescribing Patterns in the United States and Japan: Primary Care Physicians' Attitudes and Perceptions.

PubMed

Onishi, Eriko; Kobayashi, Tadashi; Dexter, Eve; Marino, Miguel; Maeno, Tetsuhiro; Deyo, Richard A

2017-01-01

Far fewer opioids are prescribed in Japan than in the United States. We conducted an online physician survey assessing attitudes and perceptions that might influence prescribing. A Japanese version was distributed to members of the Japan Primary Care Association and an English version to members of the American Academy of Family Physicians practicing in Oregon. We received 461 Japanese responses and 198 from the United States, though overall response rates were low (Japan: 10.1%, United States: 18.5%). Japanese respondents reported far less opioid prescribing than US respondents, especially for acute pain (acute pain: 49.4% vs 97.0%; chronic pain: 63.7% vs 90.9%; P < .001 for both). Almost half of respondents from both countries indicated that patient expectations and satisfaction were important factors that influence prescribing. US respondents were significantly more likely to identify medical indication and legal expectation as reasons to prescribe opioids for acute pain. Most US respondents (95.4%) thought opioids were used too often, versus 6.6% of Japanese respondents. Lower opioid use was reported in Japan, especially for acute pain, which may help minimize long-term use. Patient expectations and satisfaction seem to influence opioid prescribing in both countries. The United States could learn from Japanese regulatory and cultural perspectives. © Copyright 2017 by the American Board of Family Medicine.

A Simple Network Architecture Accounts for Diverse Reward Time Responses in Primary Visual Cortex

PubMed Central

Hussain Shuler, Marshall G.; Shouval, Harel Z.

2015-01-01

Many actions performed by animals and humans depend on an ability to learn, estimate, and produce temporal intervals of behavioral relevance. Exemplifying such learning of cued expectancies is the observation of reward-timing activity in the primary visual cortex (V1) of rodents, wherein neural responses to visual cues come to predict the time of future reward as behaviorally experienced in the past. These reward-timing responses exhibit significant heterogeneity in at least three qualitatively distinct classes: sustained increase or sustained decrease in firing rate until the time of expected reward, and a class of cells that reach a peak in firing at the expected delay. We elaborate upon our existing model by including inhibitory and excitatory units while imposing simple connectivity rules to demonstrate what role these inhibitory elements and the simple architectures play in sculpting the response dynamics of the network. We find that simply adding inhibition is not sufficient for obtaining the different distinct response classes, and that a broad distribution of inhibitory projections is necessary for obtaining peak-type responses. Furthermore, although changes in connection strength that modulate the effects of inhibition onto excitatory units have a strong impact on the firing rate profile of these peaked responses, the network exhibits robustness in its overall ability to predict the expected time of reward. Finally, we demonstrate how the magnitude of expected reward can be encoded at the expected delay in the network and how peaked responses express this reward expectancy. SIGNIFICANCE STATEMENT Heterogeneity in single-neuron responses is a common feature of neuronal systems, although sometimes, in theoretical approaches, it is treated as a nuisance and seldom considered as conveying a different aspect of a signal. In this study, we focus on the heterogeneous responses in the primary visual cortex of rodents trained with a predictable delayed reward time. We describe under what conditions this heterogeneity can arise by self-organization, and what information it can convey. This study, while focusing on a specific system, provides insight onto how heterogeneity can arise in general while also shedding light onto mechanisms of reinforcement learning using realistic biological assumptions. PMID:26377457

A relational leadership perspective on unit-level safety climate.

PubMed

Thompson, Debra N; Hoffman, Leslie A; Sereika, Susan M; Lorenz, Holly L; Wolf, Gail A; Burns, Helen K; Minnier, Tamra E; Ramanujam, Rangaraj

2011-11-01

This study compared nursing staff perceptions of safety climate in clinical units characterized by high and low ratings of leader-member exchange (LMX) and explored characteristics that might account for differences. Frontline nursing leaders' actions are critical to ensure patient safety. Specific leadership behaviors to achieve this goal are underexamined. The LMX perspective has shown promise in nonhealthcare settings as a means to explain safety climate perceptions. Cross-sectional survey of staff (n = 711) and unit directors from 34 inpatient units in an academic medical center was conducted. Significant differences were found between high and low LMX scoring units on supervisor safety expectations, organizational learning-continuous improvement, total communication, feedback and communication about errors, and nonpunitive response to errors. The LMX perspective can be used to identify differences in perceptions of safety climate among nursing staff. Future studies are needed to identify strategies to improve staff safety attitudes and behaviors. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Effects of locus coeruleus stimulation on the responses of SI neurons of the rat to controlled natural and electrical stimulation of the skin.

PubMed

Snow, P J; Andre, P; Pompeiano, O

1999-02-01

1. The effects of microstimulation of the locus coeruleus (LC) region on the spontaneous discharge and the response of SI neurons to natural and electrical stimulation of the skin have been investigated in 26 urethane anesthetized Sprague-Dawley rats. In particular, one or two air puffs, 5-10 msec in duration, 1-2 psi, usually separated by an interval of 40 msec, were applied on the hairy skin of the wrist or the forepaw at the presentation rate of 1/sec. For units unresponsive to air puffs, similar presentation of low intensity electrical stimuli (0.2-5.0 V, 0.2-0.4 msec pulses) were applied through two needles inserted on the most effective area of the skin. Both natural and electrical stimulations of the skin were applied under control conditions, as well as 50 msec after a 250 msec train of 0.3 msec pulses at 40 Hz. 20-30 microA applied stereotaxically to the LC complex through a tungsten microelectrode. 2. Not all cortical units exhibited spontaneous discharge. Most of the units, however, which were spontaneously active, were inhibited by electrical stimulation of the LC complex, while the remaining ones were excited. The sites of stimulation, which included either the LC proper or the locus subcoeruleus, were identified following both anatomical and physiological criteria. 3. SI neurons recorded at sites between 400 and 950 microns below the surface of the cortex, thus being most likely granule cells of layers III and IV, responded to cutaneous stimuli with spikes which occurred with a latency of 20-30 msec in response to single air puffs and a latency of 15-20 msec in response to single electrical pulses to the skin. In both instances the response to the second stimulus applied at the interstimulus interval of 40 msec was markedly reduced or abolished due to postexcitatory inhibition following the response to the first stimulus (in-field inhibition). In contrast, units particularly located at or below 1000 microns from the cortical surface, which were of very large size probably corresponding to large layer V pyramidal cells, were often difficult to activate with air puffs applied at the centre of the receptive field (RF) and were submitted to electrical stimulation of the skin. 4. Among the 59 isolated SI units tested either to air puffs (45 neurons) or to electrical skin stimulation (14 neurons), 15 units (i.e., 25.4%) were facilitated, while 12 units (i.e., 20.3%) were inhibited following stimulation of the LC complex. 5. A marked feature of the facilitatory effects which usually involved the predominant response to the first air puff, but also the smaller response to the second puff, was that the increase in the number of spikes per stimulus was accompanied by a temporal focusing of the responses characterized by a clear tightening of the latency and narrowing of the peak of activity, which was often accompanied by some level of tonic inhibition of the background discharge. Thus, LC stimulation increased the signal-to-noise ratio of SI neuronal responses to skin stimulation. When inhibitory effects were induced by LC stimulation, they clearly affected the unit response to the first air puff, which was severely depressed. However, the response to the second puff could be facilitated, suggesting that LC stimulation might have produced inhibition of those inhibitory interneurons responsible for the postexcitatory inhibition of the units under examination. Evidence for spatial focusing of the response was not easily documented. In some units, however, LC stimulation produced either facilitation of the responses to puffs at the receptive field center and inhibition of the responses to puffs at the edge at the receptive field or vice versa. 6. Since the LC complex contains in the rat a predominant population of noradrenergic neurons, it is likely that the effects described above were mainly due to activation of these noradrenergic neurons. 7. (ABSTRACT TRUNCATED)

Evaluation of an LED (Light-Emitting Diode) high-mounted signal lamp

NASA Astrophysics Data System (ADS)

Olson, P. L.

1987-02-01

Two studies are described evaluating high-mounted stoplights using light-emitting diodes (LEDs) compared with conventional incandescent units. The first of these studies obtained ratings from subjects who drove one car and followed another car that was equipped with the test lamps. The results indicate that the subjects generally preferred the LEDs to the conventional lamp. The second study was a laboratory evaluation of the attention-getting capabilities of LED and incandescent stoplights. Under all conditions tested subjects responded faster to the LED units. The response time advantage for the LED units increased with more difficult viewing conditions, such as high levels of illumination and long viewing distance. The results of these investigations are discussed in terms of the applicability of the LED technology to high mounted stoplights on motor vehicles.

A prospective randomized study of Chop versus Chop plus alpha-2B interferon in patients with intermediate and high grade non-Hodgkin's lymphoma: the International Oncology Study Group NHL1 Study .

PubMed

Giles, F J; Shan, J; Advani, S H; Akan, H; Aydogdu, I; Aziz, Z; Azim, H A; Bapsy, P P; Buyukkececi, F; Chaimongkol, B; Chen, P M; Cheong, S K; Ferhanoglu, B; Hamza, R; Khalid, H M; Intragumtornchai, T; Kim, S W; Kim, S Y; Koc, H; Kumar, L; Kumar, R; Lei, K I; Lekhakula, A; Muthalib, A; Patel, M; Poovalingam, V P; Prayoonwiwat, W; Rana, F; Reksodiputro, A H; Ruff, P; Sagar, T G; Schwarer, A P; Song, H S; Suh, C W; Suharti, C; Supindiman, I; Tee, G Y; Thamprasit, T; Villalon, A H; Wickham, N R; Wong, J E; Yalcin, A; Jootar, S

2000-12-01

The addition of a brief alpha interferon regimen to each CHOP induction cycle, plus one year of alpha interferon thrice weekly maintenance therapy, has no early effect on response rates or survival in patients with Intermediate or High grade cell NHL. The CHOP (Cyclophosphamide, Adriamycin. Vincristine, Prednisone) regimen is the most widely used first-line therapy for patients with Intermediate or High Grade (IG/HG) non-Hodgkin's lymphoma (NHL). Alpha 2b interferon (INF) enhances response rates and improves survival in low-grade NHL. The International Oncology Study Group (IOSG) conducted a prospective randomized study comparing CHOP alone or combined with INF in patients with IG/HG-NHL. The primary study aim was to compare the objective response rates in these patient cohorts. Patients with a confirmed diagnosis of measurable NHL of International Working Formulation (IWF) groups D to H histology were randomized to receive CHOP alone or CHOP with 5Mu INF s.c. for 5 days on days 22 to 26 of each 28 day cycle with INF 5 million units (Mu) given three times per week subcutaneously for 52 weeks in those patients who responded to CHOP plus INF. The overall response rates were equivalent in both groups: CHOP alone (214 patients) 81% (complete 55%, partial 26%); CHOP plus INF (221 patients) 80% (complete 54%, partial 26%). At 36 months, the actuarial survival rate was equivalent in both groups. There is no apparent early advantage in terms of response or survival conferred by adding the study INF regimen to CHOP therapy for patients with IG/HG-NHL.

Management of hypothermia for perinatal asphyxia in Austria - a survey of current practice standards.

PubMed

Gerstl, N; Youssef, C; Cardona, F; Klebermass-Schrehof, K; Grill, A; Weninger, M; Berger, A; Olischar, M

2015-01-01

Therapeutic hypothermia (HT) has been shown to reduce the risk of death or disability and increase the rate of survival free of -disability at 18-24 months of age in hypoxic-ischemic encephalopathy (HIE). The aim of this study was to take a national survey which (a) evaluated the practice of therapeutic HT for perinatal asphyxia in Austria, (b) evaluated the current clinical management of neonatal HIE and (c) evaluated the need for a national perinatal asphyxia and HT registry. In January 2013, a questionnaire was sent out to the clinical heads of all neonatal level-II and level-III units in Austria. We received replies from all 30 level II and level III units in Austria (response rate 100%). 19 units (63%) answered that they applied HT, 11 units (37%) said they transferred patients for cooling to other units, 3 of those 11 units (27%) said they applied cooling during transport. 25 units (83%) felt the necessity to establish a national registry. The results of this survey show that there is already a high implementation of therapeutic HT in Austria, but there remains a need for information, awareness and training. Problem areas tend to be in the transport of asphyxiated neonates, brain monitoring during cooling and follow-up of affected patients. We believe, that the establishment of national guidelines and a national register could increase awareness for the importance of therapeutic HT in neonatal HIE, thus improve the Austrian management of those infants. © Georg Thieme Verlag KG Stuttgart · New York.

Adrenergic and cholinergic activity contributes to the cardiovascular effects of lionfish (Pterois volitans) venom.

PubMed

Church, Jarrod E; Hodgson, Wayne C

2002-06-01

The aim of the present study was to further investigate the cardiovascular activity of Pterois volitans crude venom. Venom (0.6-18 microg protein/ml) produced dose- and endothelium-dependent relaxation in porcine coronary arteries that was potentiated by atropine (10nM), but significantly attenuated by the nitric oxide synthase inhibitor N(omega)-nitro-L-arginine (NOLA; 0.1mM), by prior exposure of the tissue to stonefish antivenom (SFAV, 3 units/ml, 10 min), or by removal of extracellular Ca(2+). In rat paced left atria, venom (10 microg protein/ml) produced a decrease, followed by an increase, in contractile force. Atropine (0.5 microM) abolished the decrease in force and potentiated the increase. Propranolol (5 microM) did not affect the decrease in force but significantly attenuated the increase. In spontaneously beating right atria, venom (10 microg protein/ml) produced an increase in rate that was significantly attenuated by propranolol (5 microM). Prior incubation with SFAV (0.3 units/microg protein, 10 min) abolished both the inotropic and chronotropic responses to venom. In the anaesthetised rat, venom (100 micro protein/kg, i.v.) produced a pressor response, followed by a sustained depressor response. Atropine (1mg/kg, i.v.) potentiated the pressor response. The further addition of prazosin (50 microg/kg, i.v.) restored the original response to venom. Prior administration of SFAV (100 units/kg, i.v., 10 min) significantly attenuated the in vivo response to venom. It is concluded that P. volitans venom produces its cardiovascular effects primarily by acting on muscarinic cholinergic receptors and adrenoceptors. As SFAV neutralised many of the effects of P. volitans venom, we suggest that the two venoms share a similar component(s). Copright 2002 Elsevier Science Ltd.

The Northern Forest Futures Project: A forward look at forest conditions in the northern United States

Treesearch

W. Keith Moser; Stephen R. Shifley

2012-01-01

Forests and forest ecosystems provide a critical array of benefits, from clean air and water to commercial products to open space. The forests and their ability to provide desired benefi ts constantly change in response to natural forces, human decisions, and human needs. The complexity and rate of change demand a rigorous evaluation of existing and emerging natural...

International trade of U.S. hardwood lumber and logs, 1990-2013

Treesearch

William G. Luppold; Matthew S. Bumgardner

2014-01-01

United States (U.S.) hardwood log and lumber exports surged in the early- and mid-1970s in response to the adoption of floating exchange rates. However, assessing these changes in international trade became difficult in the 1980s due to increased underreporting of hardwood lumber and log shipments between the U.S. and Canada. By 1990, these data problems were rectified...

Foundations and Public Information: Sunshine or Shadow? Preliminary Findings from a Study of the Public Information Accountability of the Country's Largest Foundations.

ERIC Educational Resources Information Center

Bruce, Ellen; And Others

The types of written information that the largest foundations in the United States voluntarily make available to the public were studied. Of the 208 foundations contacted, 150 were the largest grant-making foundations, 30 were the largest community foundations, and 28 were the largest corporate foundations. The response rate to written and…

Advanced Telecommunications in Rural America: The Challenge of Bringing Broadband Service to All Americans.

ERIC Educational Resources Information Center

National Telecommunications and Information Administration (DOC), Washington, DC.

This report, in response to a request by 10 U.S. Senators examines the status of broadband deployment in the United States. The rate of deployment of broadband services will be key to future economic growth, particularly in rural areas far from urban and world markets. This report finds that rural areas, especially remote areas outside of towns,…

Forest Inventory and Analysis (FIA) annual inventory answers the question: What is happening to pinyon-juniper woodlands?

Treesearch

John D. Shaw; Brytten E. Steed; Larry T. DeBlander

2005-01-01

Widespread mortality in the pinyon-juniper forest type is associated with several years of drought in the southwestern United States. A complex of drought, insects, and disease is responsible for pinyon mortality rates approaching 100% in some areas, while other areas have experienced little or no mortality. Implementation of the Forest Inventory and Analysis (FIA)...

Adoption of Alcohol-Based Handrub by United States Hospitals: A National Survey

PubMed Central

Mody, Lona; Saint, Sanjay; Kaufman, Samuel R.; Kowalski, Christine; Krein, Sarah L.

2009-01-01

The extent to which the use of alcohol-based handrub for hand hygiene has been adopted by US hospitals is unknown. A survey of infection control coordinators (response rate, 516 [72%] of 719) revealed that most hospitals (436 [84%] of 516) have adopted alcohol-based handrub. Leadership support and staff receptivity play a significant role in its adoption. PMID:18986300

A Study of United States Army Product Support Manager (PSM) Training

DTIC Science & Technology

2016-03-25

relevant policy and data associated with Product Support Manager (PSM) responsibilities, measure the current status of PSM training and selection, and...Year (FY) 16 (U.S. Department of Defense, 2015) which encompasses a need for processes, procedures, policies and regulations by which to accomplish...availability rates , and reduce operation and sustainment costs (C) Conduct appropriate cost analyses to validate the product support strategy

Trajectory and rate of desert vegetation response following cattle removal

Treesearch

Robert L. Minckley

2013-01-01

Cattle have grazed continuously over the past three centuries in the Sky Island region and most work has focused on how these grazers have affected riparian and grassland habitats. I examined the effects of grazing on a fuller spectrum of desert habitats that occur in the close proximity to the San Bernardino Valley of Mexico and the United States. Plots in each of...

Economics Majors in the U.S.: Their Characteristics, Educational and Career Goals, Reasons for Majoring, and Performance. Working Paper No. 82-W31.

ERIC Educational Resources Information Center

Siegfried, John J.; Raymond, Jennie E.

A survey of 1,080 senior economics majors at 48 colleges and universities in the United States is reported. Questionnaires were administered in classes, by mass mailings, or through economics clubs. Although institutions were selected to provide a representative distribution of respondents, variations in response rates created too few participants…

An assessment of training needs for the lumber manufacturing industry in the eastern United States

Treesearch

Joseph Denig; Scott Page; Yuhua Su; Karen Martinson

2008-01-01

A training needs assessment of the primary forest products industry was conducted for 33 eastern states. his publication presents in detail the statistical analysis of the study. Of the 2,570 lumber manufacturing companies, consisting of firms with more than six employees for the U.S. Department of Labor Standard Industrial Classification Code 2421, the response rate...

SUBTHALAMIC NUCLEUS NEURONS DIFFERENTIALLY ENCODE EARLY AND LATE ASPECTS OF SPEECH PRODUCTION.

PubMed

Lipski, W J; Alhourani, A; Pirnia, T; Jones, P W; Dastolfo-Hromack, C; Helou, L B; Crammond, D J; Shaiman, S; Dickey, M W; Holt, L L; Turner, R S; Fiez, J A; Richardson, R M

2018-05-22

Basal ganglia-thalamocortical loops mediate all motor behavior, yet little detail is known about the role of basal ganglia nuclei in speech production. Using intracranial recording during deep brain stimulation surgery in humans with Parkinson's disease, we tested the hypothesis that the firing rate of subthalamic nucleus neurons is modulated in sync with motor execution aspects of speech. Nearly half of seventy-nine unit recordings exhibited firing rate modulation, during a syllable reading task across twelve subjects (male and female). Trial-to-trial timing of changes in subthalamic neuronal activity, relative to cue onset versus production onset, revealed that locking to cue presentation was associated more with units that decreased firing rate, while locking to speech onset was associated more with units that increased firing rate. These unique data indicate that subthalamic activity is dynamic during the production of speech, reflecting temporally-dependent inhibition and excitation of separate populations of subthalamic neurons. SIGNIFICANCE STATEMENT The basal ganglia are widely assumed to participate in speech production, yet no prior studies have reported detailed examination of speech-related activity in basal ganglia nuclei. Using microelectrode recordings from the subthalamic nucleus during a single syllable reading task, in awake humans undergoing deep brain stimulation implantation surgery, we show that the firing rate of subthalamic nucleus neurons is modulated in response to motor execution aspects of speech. These results are the first to establish a role for subthalamic nucleus neurons in encoding of aspects of speech production, and they lay the groundwork for launching a modern subfield to explore basal ganglia function in human speech. Copyright © 2018 the authors.

Robust tactile sensory responses in finger area of primate motor cortex relevant to prosthetic control

NASA Astrophysics Data System (ADS)

Schroeder, Karen E.; Irwin, Zachary T.; Bullard, Autumn J.; Thompson, David E.; Bentley, J. Nicole; Stacey, William C.; Patil, Parag G.; Chestek, Cynthia A.

2017-08-01

Objective. Challenges in improving the performance of dexterous upper-limb brain-machine interfaces (BMIs) have prompted renewed interest in quantifying the amount and type of sensory information naturally encoded in the primary motor cortex (M1). Previous single unit studies in monkeys showed M1 is responsive to tactile stimulation, as well as passive and active movement of the limbs. However, recent work in this area has focused primarily on proprioception. Here we examined instead how tactile somatosensation of the hand and fingers is represented in M1. Approach. We recorded multi- and single units and thresholded neural activity from macaque M1 while gently brushing individual finger pads at 2 Hz. We also recorded broadband neural activity from electrocorticogram (ECoG) grids placed on human motor cortex, while applying the same tactile stimulus. Main results. Units displaying significant differences in firing rates between individual fingers (p  <  0.05) represented up to 76.7% of sorted multiunits across four monkeys. After normalizing by the number of channels with significant motor finger responses, the percentage of electrodes with significant tactile responses was 74.9%  ±  24.7%. No somatotopic organization of finger preference was obvious across cortex, but many units exhibited cosine-like tuning across multiple digits. Sufficient sensory information was present in M1 to correctly decode stimulus position from multiunit activity above chance levels in all monkeys, and also from ECoG gamma power in two human subjects. Significance. These results provide some explanation for difficulties experienced by motor decoders in clinical trials of cortically controlled prosthetic hands, as well as the general problem of disentangling motor and sensory signals in primate motor cortex during dextrous tasks. Additionally, examination of unit tuning during tactile and proprioceptive inputs indicates cells are often tuned differently in different contexts, reinforcing the need for continued refinement of BMI training and decoding approaches to closed-loop BMI systems for dexterous grasping.

The Politics of Obesity: A Current Assessment and Look Ahead

PubMed Central

Kersh, Rogan

2009-01-01

Context: The continuing rise in obesity rates across the United States has proved impervious to clinical treatment or public health exhortation, necessitating policy responses. Nearly a decade's worth of political debates may be hardening into an obesity issue regime, comprising established sets of cognitive frames, stakeholders, and policy options. Methods: This article is a survey of reports on recently published studies. Findings: Much of the political discussion regarding obesity is centered on two “frames,” personal-responsibility and environmental, yielding very different sets of policy responses. While policy efforts at the federal level have resulted in little action to date, state and/or local solutions such as calorie menu labeling and the expansion of regulations to reduce unhealthy foods at school may have more impact. Conclusions: Obesity politics is evolving toward a relatively stable state of equilibrium, which could make comprehensive reforms to limit rising obesity rates less feasible. Therefore, to achieve meaningful change, rapid-response research identifying a set of promising reforms, combined with concerted lobbying action, will be necessary. PMID:19298424

Peripheral amiodarone-related phlebitis: an institutional nursing guideline to reduce patient harm.

PubMed

Spiering, Mary

2014-01-01

Intravenous amiodarone is one of the most widely used antiarrythmics for the treatment of atrial fibrillation with rapid ventricular response. Peripheral amiodarone infusion, however, often causes pain during infusion and subsequent phlebitis.Data collection on a cardiac telemetry unit revealed a high rate of phlebitis. A multidisciplinary team developed and implemented amiodarone peripheral infusion guidelines. The pre-guideline phlebitis rate was 85% and post-guideline rate was 38%, representing a 47% change or improvement. An additional finding was that the severity of phlebitis was reduced, as well. The results of this study suggest that the implementation of a peripheral amiodarone infusion guideline reduced the incidence and severity of amiodarone-related phlebitis in the cardiac population.

Continuous recording of pulmonary artery pressure in unrestricted subjects.

PubMed Central

Ikram, H; Richards, A M; Hamilton, E J; Nicholls, M G

1984-01-01

Continuous ambulatory pulmonary artery pressures were recorded using a conventional No 5 French Goodale-Lubin filled catheter linked to the Oxford Medilog system of a portable transducer-perfusion unit and miniaturised recorder. Data retrieval and analysis were performed using a PB2 Medilog playback unit linked to a PDP 11 computer system. The total system has a frequency response linear to 8 Hz allowing accurate pressure recording over the full range of heart rates. Ten recordings in 10 patients yielded artefact free data for 80% or more of the recorded period. This inexpensive reliable method allows pulmonary artery pressures to be recorded in unrestricted subjects. Images PMID:6704262

Do Changes in Hospital Outpatient Payments Affect the Setting of Care?

PubMed Central

He, Daifeng; Mellor, Jennifer M

2013-01-01

Objective To examine whether decreases in Medicare outpatient payment rates under the Outpatient Prospective Payment System (OPPS) caused outpatient care to shift toward the inpatient setting. Data Sources/Study Setting Hospital inpatient and outpatient discharge files from the Florida Agency for Health Care Administration from 1997 through 2008. Study Design This study focuses on inguinal hernia repair surgery, one of the most commonly performed surgical procedures in the United States. We estimate multivariate regressions of inguinal hernia surgery counts in the outpatient setting and in the inpatient setting. The key explanatory variable is the time-varying Medicare payment rate specific to the procedure and hospital. Control variables include time-varying hospital and county characteristics and hospital and year-fixed effects. Principal Findings Outpatient hernia surgeries fell in response to OPPS-induced rate cuts. The volume of inpatient hernia repair surgeries did not increase in response to reductions in the outpatient reimbursement rate. Conclusions Potential substitution from the outpatient setting to the inpatient setting does not pose a serious threat to Medicare's efforts to contain hospital outpatient costs. PMID:23701048

Modulation of jaw muscle spindle afferent activity following intramuscular injections with hypertonic saline.

PubMed

Ro, J Y; Capra, N F

2001-05-01

Transient noxious chemical stimulation of small diameter muscle afferents modulates jaw movement-related responses of caudal brainstem neurons. While it is likely that the effect is mediated from the spindle afferents in the mesencephalic nucleus (Vmes) via the caudally projecting Probst's tract, the mechanisms of pain induced modulations of jaw muscle spindle afferents is not known. In the present study, we tested the hypothesis that jaw muscle nociceptors gain access to muscle spindle afferents in the same muscle via central mechanisms and alter their sensitivity. Thirty-five neurons recorded from the Vmes were characterized as muscle spindle afferents based on their responses to passive jaw movements, muscle palpation, and electrical stimulation of the masseter nerve. Each cell was tested by injecting a small volume (250 microl) of either 5% hypertonic and/or isotonic saline into the receptor-bearing muscle. Twenty-nine units were tested with 5% hypertonic saline, of which 79% (23/29) showed significant modulation of mean firing rates (MFRs) during one or more phases of ramp-and-hold movements. Among the muscle spindle primary-like units (n = 12), MFRs of 4 units were facilitated, five reduced, two showed mixed responses and one unchanged. In secondary-like units (n = 17), MFRs of 9 were facilitated, three reduced and five unchanged. Thirteen units were tested with isotonic saline, of which 77% showed no significant changes of MFRs. Further analysis revealed that the hypertonic saline not only affected the overall output of muscle spindle afferents, but also increased the variability of firing and altered the relationship between afferent signal and muscle length. These results demonstrated that activation of muscle nociceptors significantly affects proprioceptive properties of jaw muscle spindles via central neural mechanisms. The changes can have deleterious effects on oral motor function as well as kinesthetic sensibility.

Application of Quality Assurance Strategies in Diagnostics and Clinical Support Services in Iranian Hospitals

PubMed Central

Aghaei Hashjin, Asgar; Kringos, Dionne; Ravaghi, Hamid; Manoochehri, Jila; Gorji, Hassan Abolghasem; Klazinga, Niek S.

2015-01-01

Background: Iran has a widespread diagnostics and clinical support services (DCSS) network that plays a crucial role in providing diagnostic and clinical support services to both inpatient and outpatient care. However, very little is known on the application of quality assurance (QA) policies in DCSS units. This study explores the extent of application of eleven QA strategies in DCSS units within Iranian hospitals and its association with hospital characteristics. Methods: A descriptive cross-sectional study was conducted in 2009/2010. Data were collected from 554 DCSS units among 84 hospitals. Results: The average reported application rate for the QA strategies ranged from 57%-94% in the DCSS units. Most frequently reported were checking drugs expiration dates (94%), pharmacopoeia availability (92%), equipment calibration (87%) and identifying responsibilities (86%). Least reported was external auditing of the DCSS (57%). The clinical chemistry and microbiology laboratories (84%), pharmacies, blood bank services (83%) reported highest average application rates across all questioned QA strategies. Lowest application rates were reported in human tissue banks (50%). There was no significant difference between the reported application rates in DCSS in the general/specialized, teaching/research, nonteaching/research hospitals with the exception of pharmacies and radiology departments. They reported availability of a written QA plan significantly more often in research hospitals. Nearly all QA strategies were reported to be applied significantly more often in the DCSS of Social Security Organization (SSO) and private-for-profit hospitals than in governmental hospitals. Conclusion: There is still room for strengthening the managerial cycle of QA systems and accountability in the DCSS in Iranian hospitals. Getting feedback, change and learning through application of specific QA strategies (eg, external/internal audits) can be improved. Both the effectiveness of QA strategies in practice, and the application of these strategies in outpatient DCSS units require further policy attention. PMID:26673175

Application of Quality Assurance Strategies in Diagnostics and Clinical Support Services in Iranian Hospitals.

PubMed

Aghaei Hashjin, Asgar; Kringos, Dionne; Ravaghi, Hamid; Manoochehri, Jila; Gorji, Hassan Abolghasem; Klazinga, Niek S

2015-05-20

Iran has a widespread diagnostics and clinical support services (DCSS) network that plays a crucial role in providing diagnostic and clinical support services to both inpatient and outpatient care. However, very little is known on the application of quality assurance (QA) policies in DCSS units. This study explores the extent of application of eleven QA strategies in DCSS units within Iranian hospitals and its association with hospital characteristics. A descriptive cross-sectional study was conducted in 2009/2010. Data were collected from 554 DCSS units among 84 hospitals. The average reported application rate for the QA strategies ranged from 57%-94% in the DCSS units. Most frequently reported were checking drugs expiration dates (94%), pharmacopoeia availability (92%), equipment calibration (87%) and identifying responsibilities (86%). Least reported was external auditing of the DCSS (57%). The clinical chemistry and microbiology laboratories (84%), pharmacies, blood bank services (83%) reported highest average application rates across all questioned QA strategies. Lowest application rates were reported in human tissue banks (50%). There was no significant difference between the reported application rates in DCSS in the general/specialized, teaching/research, nonteaching/research hospitals with the exception of pharmacies and radiology departments. They reported availability of a written QA plan significantly more often in research hospitals. Nearly all QA strategies were reported to be applied significantly more often in the DCSS of Social Security Organization (SSO) and private-for-profit hospitals than in governmental hospitals. There is still room for strengthening the managerial cycle of QA systems and accountability in the DCSS in Iranian hospitals. Getting feedback, change and learning through application of specific QA strategies (eg, external/internal audits) can be improved. Both the effectiveness of QA strategies in practice, and the application of these strategies in outpatient DCSS units require further policy attention. © 2015 by Kerman University of Medical Sciences.

Assessing managerial information needs: Modification and evaluation of the Hospital Shift Leaders' Information Needs Questionnaire.

PubMed

Peltonen, Laura-Maria; Lundgrén-Laine, Heljä; Siirala, Eriikka; Löyttyniemi, Eliisa; Aantaa, Riku; Salanterä, Sanna

2018-03-01

The aims were (1) to evaluate the modified version of the Intensive Care Unit Information Need Questionnaire for the broader hospital setting, and (2) to describe the differences in respondents' managerial activities and information needs according to the position held by the respondent and the type of hospital unit. Information systems do not support managerial decision-making sufficiently and information needed in the day-to-day operations management in hospital units is unknown. An existing questionnaire was modified and evaluated. Shift leaders, that is, the nurses and physicians responsible for the day-to-day operations management in hospital units were reached using purposive sampling (n = 258). The questionnaire ascertained the importance of information. Cronbach's α ranged from .85-.96 for the subscales. Item - total correlations showed good explanatory power. Managerial activities and information needs differed between respondents in different positions, although all shared about one-third of important information needs. The response rate was 26% (n = 67). The validity and reliability of the questionnaire were good. Attention should be paid to the positions of shift leaders when developing information systems. The questionnaire can be used to determine important information when developing information systems to support day-to-day operations management in hospitals. © 2018 John Wiley & Sons Ltd.

Improving Pediatric Cancer Care Disparities Across the United States-Mexico Border: Lessons Learned from a Transcultural Partnership between San Diego and Tijuana.

PubMed

Aristizabal, Paula; Fuller, Spencer; Rivera, Rebeca; Beyda, David; Ribeiro, Raul C; Roberts, William

2015-01-01

In 2007, the 5-year survival rate for children with acute leukemia in Baja California, Mexico was estimated at 10% (vs. 88% in the United States). In response, stakeholders at St. Jude Children's Research Hospital, Rady Children's Hospital San Diego, and the Hospital General de Tijuana (HGT) implemented a transcultural partnership to establish a pediatric oncology program. The aim was to improve clinical outcomes and overall survival for children in Baja California. An initial needs assessment evaluation was performed and a culturally sensitive, comprehensive, 5-year plan was designed and implemented. After six years, healthcare system accomplishments include the establishment of a fully functional pediatric oncology unit with 60 new healthcare providers (vs. five in 2007). Patient outcome improvements include a rise in 5-year survival for leukemia from 10 to 43%, a rise in new cases diagnosed per year from 21 to 70, a reduction in the treatment abandonment rate from 10% to 2%, and a 45% decrease in the infection rate. More than 600 patients have benefited from this program. Knowledge sharing has taken place between teams at the HGT and Rady Children's Hospital San Diego. Further, one of the most significant outcomes is that the HGT has transitioned into a regional referral center and now mentors other hospitals in Mexico. Our results show that collaborative initiatives that implement long-term partnerships along the United States-Mexico border can effectively build local capacity and reduce the survival gap between children with cancer in the two nations. Long-term collaborative partnerships should be encouraged across other disciplines in medicine to further reduce health disparities across the United States-Mexico border.

Improving Pediatric Cancer Care Disparities Across the United States–Mexico Border: Lessons Learned from a Transcultural Partnership between San Diego and Tijuana

PubMed Central

Aristizabal, Paula; Fuller, Spencer; Rivera, Rebeca; Beyda, David; Ribeiro, Raul C.; Roberts, William

2015-01-01

In 2007, the 5-year survival rate for children with acute leukemia in Baja California, Mexico was estimated at 10% (vs. 88% in the United States). In response, stakeholders at St. Jude Children’s Research Hospital, Rady Children’s Hospital San Diego, and the Hospital General de Tijuana (HGT) implemented a transcultural partnership to establish a pediatric oncology program. The aim was to improve clinical outcomes and overall survival for children in Baja California. An initial needs assessment evaluation was performed and a culturally sensitive, comprehensive, 5-year plan was designed and implemented. After six years, healthcare system accomplishments include the establishment of a fully functional pediatric oncology unit with 60 new healthcare providers (vs. five in 2007). Patient outcome improvements include a rise in 5-year survival for leukemia from 10 to 43%, a rise in new cases diagnosed per year from 21 to 70, a reduction in the treatment abandonment rate from 10% to 2%, and a 45% decrease in the infection rate. More than 600 patients have benefited from this program. Knowledge sharing has taken place between teams at the HGT and Rady Children’s Hospital San Diego. Further, one of the most significant outcomes is that the HGT has transitioned into a regional referral center and now mentors other hospitals in Mexico. Our results show that collaborative initiatives that implement long-term partnerships along the United States–Mexico border can effectively build local capacity and reduce the survival gap between children with cancer in the two nations. Long-term collaborative partnerships should be encouraged across other disciplines in medicine to further reduce health disparities across the United States–Mexico border. PMID:26157788

Contributions to muscle force and EMG by combined neural excitation and electrical stimulation

NASA Astrophysics Data System (ADS)

Crago, Patrick E.; Makowski, Nathaniel S.; Cole, Natalie M.

2014-10-01

Objective. Stimulation of muscle for research or clinical interventions is often superimposed on ongoing physiological activity without a quantitative understanding of the impact of the stimulation on the net muscle activity and the physiological response. Experimental studies show that total force during stimulation is less than the sum of the isolated voluntary and stimulated forces, but the occlusion mechanism is not understood. Approach. We develop a model of efferent motor activity elicited by superimposing stimulation during a physiologically activated contraction. The model combines action potential interactions due to collision block, source resetting, and refractory periods with previously published models of physiological motor unit recruitment, rate modulation, force production, and EMG generation in human first dorsal interosseous muscle to investigate the mechanisms and effectiveness of stimulation on the net muscle force and EMG. Main results. Stimulation during a physiological contraction demonstrates partial occlusion of force and the neural component of the EMG, due to action potential interactions in motor units activated by both sources. Depending on neural and stimulation firing rates as well as on force-frequency properties, individual motor unit forces can be greater, smaller, or unchanged by the stimulation. In contrast, voluntary motor unit EMG potentials in simultaneously stimulated motor units show progressive occlusion with increasing stimulus rate. The simulations predict that occlusion would be decreased by a reverse stimulation recruitment order. Significance. The results are consistent with and provide a mechanistic interpretation of previously published experimental evidence of force occlusion. The models also predict two effects that have not been reported previously—voluntary EMG occlusion and the advantages of a proximal stimulation site. This study provides a basis for the rational design of both future experiments and clinical neuroprosthetic interventions involving either motor or sensory stimulation.

Contributions to muscle force and EMG by combined neural excitation and electrical stimulation

PubMed Central

Crago, Patrick E; Makowski, Nathaniel S; Cole, Natalie M

2014-01-01

Objective Stimulation of muscle for research or clinical interventions is often superimposed on ongoing physiological activity, without a quantitative understanding of the impact of the stimulation on the net muscle activity and the physiological response. Experimental studies show that total force during stimulation is less than the sum of the isolated voluntary and stimulated forces, but the occlusion mechanism is not understood. Approach We develop a model of efferent motor activity elicited by superimposing stimulation during a physiologically activated contraction. The model combines action potential interactions due to collision block, source resetting, and refractory periods with previously published models of physiological motor unit recruitment, rate modulation, force production, and EMG generation in human first dorsal interosseous muscle to investigate the mechanisms and effectiveness of stimulation on the net muscle force and EMG. Main Results Stimulation during a physiological contraction demonstrates partial occlusion of force and the neural component of the EMG, due to action potential interactions in motor units activated by both sources. Depending on neural and stimulation firing rates as well as on force-frequency properties, individual motor unit forces can be greater, smaller, or unchanged by the stimulation. In contrast, voluntary motor unit EMG potentials in simultaneously stimulated motor units show progressive occlusion with increasing stimulus rate. The simulations predict that occlusion would be decreased by a reverse stimulation recruitment order. Significance The results are consistent with and provide a mechanistic interpretation of previously published experimental evidence of force occlusion. The models also predict two effects that have not been reported previously - voluntary EMG occlusion and the advantages of a proximal stimulation site. This study provides a basis for the rational design of both future experiments and clinical neuroprosthetic interventions involving either motor or sensory stimulation. PMID:25242203

Physiological responses to ocean acidification and warming synergistically reduce condition of the common cockle Cerastoderma edule.

PubMed

Ong, E Z; Briffa, M; Moens, T; Van Colen, C

2017-09-01

The combined effect of ocean acidification and warming on the common cockle Cerastoderma edule was investigated in a fully crossed laboratory experiment. Survival of the examined adult organisms remained high and was not affected by elevated temperature (+3 °C) or lowered pH (-0.3 units). However, the morphometric condition index of the cockles incubated under high pCO 2 conditions (i.e. combined warming and acidification) was significantly reduced after six weeks of incubation. Respiration rates increased significantly under low pH, with highest rates measured under combined warm and low pH conditions. Calcification decreased significantly under low pH while clearance rates increased significantly under warm conditions and were generally lower in low pH treatments. The observed physiological responses suggest that the reduced food intake under hypercapnia is insufficient to support the higher energy requirements to compensate for the higher costs for basal maintenance and growth in future high pCO 2 waters. Copyright © 2017 Elsevier Ltd. All rights reserved.

Recreational Boats and Turtles: Behavioral Mismatches Result in High Rates of Injury

PubMed Central

Lester, Lori A.; Avery, Harold W.; Harrison, Andrew S.; Standora, Edward A.

2013-01-01

Recreational boats are a dominant feature of estuarine waters in the United States. Boat strike injury and mortality may have a detrimental effect on populations of diamondback terrapins (Malaclemys terrapin), a keystone species in estuarine ecosystems. In Barnegat Bay, New Jersey, 11% of terrapins (n = 2,644) have scars consistent with injuries from boats. Conservative estimates of injury rates from boats increased from 2006 to 2011. When exposed to playback recordings of approaching boat engines of varying sizes and speeds in situ, terrapins did not significantly change their behavior in response to sounds of boat engines of different sizes. The lack of behavioral response of terrapins to boat sounds helps explain high rates of injury and mortality of terrapins and may threaten the viability of terrapin populations. Boater education courses that discuss impacts of boats to wildlife, combined with closure of areas of high terrapin densities to boating, are necessary to protect terrapins and other aquatic species from injury and mortality caused by motorized boats. PMID:24349269

Hepatitis C treatment among racial and ethnic groups in the IDEAL trial.

PubMed

Muir, A J; Hu, K-Q; Gordon, S C; Koury, K; Boparai, N; Noviello, S; Albrecht, J K; Sulkowski, M S; McCone, J

2011-04-01

Previous studies of chronic hepatitis C virus (HCV) treatment have demonstrated variations in response among racial and ethnic groups including poorer efficacy rates among African American and Hispanic patients. The individualized dosing efficacy vs flat dosing to assess optimaL pegylated interferon therapy (IDEAL) trial enrolled 3070 patients from 118 United States centres to compare treatment with peginterferon (PEG-IFN) alfa-2a and ribavirin (RBV) and two doses of PEG-IFN alfa-2b and RBV. This analysis examines treatment response among the major racial and ethnic groups in the trial. Overall, sustained virologic response (SVR) rates were 44% for white, 22% for African American, 38% for Hispanic and 59% for Asian American patients. For patients with undetectable HCV RNA at treatment week 4, the positive predictive value of SVR was 86% for white, 92% for African American, 83% for Hispanic and 89% for Asian American patients. The positive predictive values of SVR in those with undetectable HCV RNA at treatment week 12 ranged from 72% to 81%. Multivariate regression analysis using baseline characteristics demonstrated that treatment regimen was not a predictor of SVR. Despite wide-ranging SVR rates among the different racial and ethnic groups, white and Hispanic patients had similar SVR rates. In all groups, treatment response was largely determined by antiviral activity in the first 12 weeks of treatment. Therefore, decisions regarding HCV treatment should consider the predictive value of the early on-treatment response, not just baseline characteristics, such as race and ethnicity. © 2010 Blackwell Publishing Ltd.

Hybrid response surface methodology-artificial neural network optimization of drying process of banana slices in a forced convective dryer.

PubMed

Taheri-Garavand, Amin; Karimi, Fatemeh; Karimi, Mahmoud; Lotfi, Valiullah; Khoobbakht, Golmohammad

2018-06-01

The aim of the study is to fit models for predicting surfaces using the response surface methodology and the artificial neural network to optimize for obtaining the maximum acceptability using desirability functions methodology in a hot air drying process of banana slices. The drying air temperature, air velocity, and drying time were chosen as independent factors and moisture content, drying rate, energy efficiency, and exergy efficiency were dependent variables or responses in the mentioned drying process. A rotatable central composite design as an adequate method was used to develop models for the responses in the response surface methodology. Moreover, isoresponse contour plots were useful to predict the results by performing only a limited set of experiments. The optimum operating conditions obtained from the artificial neural network models were moisture content 0.14 g/g, drying rate 1.03 g water/g h, energy efficiency 0.61, and exergy efficiency 0.91, when the air temperature, air velocity, and drying time values were equal to -0.42 (74.2 ℃), 1.00 (1.50 m/s), and -0.17 (2.50 h) in the coded units, respectively.

Neuron activity in rat hippocampus and motor cortex during discrimination reversal.

PubMed

Disterhoft, J F; Segal, M

1978-01-01

Chronic unit activity and gross movement were recorded from rats during two discrimination reversals in a classical appetitive conditioning situation. The anticipatory movement decreased in response to the former CS+ tone and increased to the previous CS- tone after each reversal. Hippocampus and motor cortex were differently related to these two kinds of behavioral change. Response rates of hippocampal neurons were more closely related to the increased movement response to the former CS- which now signaled food. Motor cortex neuron responses were more closely correlated with the decrease in movement responses to the former CS+ which became neutral after the reversal. It appeared that hippocampal neurons could have been involved in one cognitive aspect of the situation, motor cortex neurons in another. The data were related to current functional concepts of these brain regions.

Carbon balance and productivity of Lemna gibba, a candidate plant for CELSS

NASA Technical Reports Server (NTRS)

Gale, J.; Smernoff, D. T.; Macler, B. A.; Macelroy, R. D.

1989-01-01

The photosynthesis and productivity of Lemna gibba is analyzed for CELSS based plant growth. Net photosynthesis of Lemna gibba is determined as a function of incident photosynthetic photon flux (PPF), with the light coming from above, below, or from both directions. Light from below is about 75 percent as effective as from above when the stand is sparse, but much less so with dense stands. High rates of photosynthesis are measured at 750 micromol / sq m per sec PPF and 1500 micromol/ mol CO2 at densities up to 660 g fresh weight (FW)/ sq m with young cultures. The analysis includes diagrams illustrating the net photosynthesis response to bilateral lighting of a sparse stand of low assimilate Lemna gibba; the effect of stand density on the net photosynthesis response to bilateral lighting of high assimilate Lemna gibba; the net photosynthesis response to ambient CO2 of sparse stands of Lemna gibba; and the time course of net photosynthesis and respiration per unit chamber and per unit dry weight of Lemna gibba.

Efficacy and tolerability of micafungin monotherapy for candidemia and deep-seated candidiasis in adults with cancer.

PubMed

Farmakiotis, Dimitrios; Tarrand, Jeffrey J; Kontoyiannis, Dimitrios P

2014-06-01

The response rate among 58 patients with cancer and candidemia or deep-seated candidiasis treated with micafungin monotherapy was 81%. Intensive care unit (ICU) stay, concomitant nonfungal infections, and acute kidney injury were significantly associated with the 30-day crude mortality rate. Severe neutropenia was an independent predictor of micafungin failure. The efficacy and safety of micafungin in cancer patients with invasive candidiasis were comparable to those reported for patients without malignancy and for cancer patients treated with caspofungin. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

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

Wolfe, R.R.; Peters, E.J.; Klein, S.

In this study the rate of lipolysis (fatty acid and glycerol release into blood) has been quantified in both normal weight and obese volunteers after both 15 and 87 h of fasting. In each study, the basal rate and subsequent response to epinephrine infusion were determined. The rate of appearance (R/sub a/) of free fatty acids (FFA) and glycerol were quantified by infusion of (1- TC)palmitate and D-5-glycerol, respectively. Substrate flux rates per unit of body fat mass and lean body mass were calculated from total body water measurements using H2 YO dilution. In normal volunteers, the basal R/sub a/more » FFA and R/sub a/ glycerol rose markedly with 87 h of fasting, whereas the increases were more modest in the obese subjects. However, the rate of mobilization of fat, in relation to the lean body mass, was higher in the obese subjects than in the normal subjects after 15 h of fasting, and the values were similar in both groups after 87 h of fasting. There was an increased lipolytic response to epinephrine after fasting in both groups. This increased sensitivity may have resulted from the enhancement of fatty acid-triglyceride substrate cycling that occurred after fasting.« less

Prolonged mechanical ventilation in Canadian intensive care units: a national survey.

PubMed

Rose, Louise; Fowler, Robert A; Fan, Eddy; Fraser, Ian; Leasa, David; Mawdsley, Cathy; Pedersen, Cheryl; Rubenfeld, Gordon

2015-02-01

We sought to describe prevalence and care practices for patients experiencing prolonged mechanical ventilation (PMV), defined as ventilation for 21 or more consecutive days and medical stability. We provided the survey to eligible units via secure Web link to a nominated unit champion from April to November 2012. Weekly telephone and e-mail reminders were sent for 6 weeks. Response rate was 215 (90%) of 238 units identifying 308 patients requiring PMV on the survey day occupying 11% of all Canadian ventilator-capable beds. Most units (81%) used individualized plans for both weaning and mobilization. Weaning and mobilization protocols were available in 48% and 38% of units, respectively. Of those units with protocols, only 25% reported weaning guidance specific to PMV, and 11% reported mobilization content for PMV. Only 30% of units used specialized mobility equipment. Most units referred to speech language pathologists (88%); use of communication technology was infrequent (11%). Only 29% routinely referred to psychiatry/psychology, and 17% had formal discharge follow-up services. Prolonged mechanical ventilation patients occupied 11% of Canadian acute care ventilator bed capacity. Most units preferred an individualized approach to weaning and mobilization with considerable variation in weaning methods, protocol availability, access to specialized rehabilitation equipment, communication technology, psychiatry, and discharge follow-up. Copyright © 2014 Elsevier Inc. All rights reserved.

Postharvest response of oranges of ethylene

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

Aharoni, Y.; Lattar, F.S.; Monselise, S.P.

1969-01-01

Since the effect of ethylene on the respiration rate of young unripe oranges has not yet been described, experiments were carried out to study the respiratory response of such fruits to ethylene. Oranges (Citrus sinensis (L.) Osbeck) of the Washington navel, Shamouti and Valencia varieties, growing on a sandy loam near Rehovot, Israel, were picked in June, July, September, December and January. Immediately after picking, they were weighed, placed in glass jars, and stored at 20/sup 0/. Each experiment comprised 12 jars, 4 for each variety. A constant stream (200 ml/min) of air containing 20 ppm of ethylene was runmore » through the jars. The respiration rate was measured by the amount of CO/sub 2/ evolved by the fruits, and based on a fresh weight unit. The results show that in all 3 varieties, ethylene caused an immediate rise in respiration rate, at all stages of development tested, regardless of whether it was applied from the beginning of the test or after a certain period of storage in air. The pattern of response to ethylene of young unripe oranges (picked in June, July, and September) was therefore similar to that of ripe ones (picked in December and January).« less

Sensitivity of cell-based biosensors to environmental variables.

PubMed

Gilchrist, Kristin H; Giovangrandi, Laurent; Whittington, R Hollis; Kovacs, Gregory T A

2005-01-15

Electrically active living cells cultured on extracellular electrode arrays are utilized to detect biologically active agents. Because cells are highly sensitive to environmental conditions, environmental fluctuations can elicit cellular responses that contribute to the noise in a cell-based biosensor system. Therefore, the characterization and control of environmental factors such as temperature, pH, and osmolarity is critical in such a system. The cell-based biosensor platform described here utilizes the measurement of action potentials from cardiac cells cultured on electrode arrays. A recirculating fluid flow system is presented for use in dose-response experiments that regulates temperature within +/-0.2 degrees C, pH to within +/-0.05 units, and allows no significant change in osmolarity. Using this system, the relationship between the sensor output parameters and environmental variation was quantified. Under typical experimental conditions, beat rate varied approximately 10% per degree change in temperature or per 0.1 unit change in pH. Similar relationships were measured for action potential amplitude, duration, and conduction velocity. For the specific flow system used in this work, the measured environmental sensitivity resulted in an overall beat rate variation of +/-4.7% and an overall amplitude variation of +/-3.3%. The magnitude of the noise due to environmental sensitivity has a large impact on the detection capability of the cell-based system. The significant responses to temperature, pH, and osmolarity have important implications for the use of living cells in detection systems and should be considered in the design and evaluation of such systems.

Patient safety culture in obstetrics and gynecology and neonatology units: the nurses' and the midwives' opinion.

PubMed

Ribeliene, Janina; Blazeviciene, Aurelija; Nadisauskiene, Ruta Jolanta; Tameliene, Rasa; Kudreviciene, Ausrele; Nedzelskiene, Irena; Macijauskiene, Jurate

2018-04-22

Patients treated in health care facilities that provide services in the fields of obstetrics, gynecology, and neonatology are especially vulnerable. Large multidisciplinary teams of physicians, multiple invasive and noninvasive diagnostic and therapeutic procedures, and the use of advanced technologies increase the probability of adverse events. The evaluation of knowledge about patient safety culture among nurses and midwives working in such units and the identification of critical areas at a health care institution would reduce the number of adverse events and improve patient safety. The aim of the study was to evaluate the opinion of nurses and midwives working in clinical departments that provide services in the fields of obstetrics, gynecology, and neonatology about patient safety culture and to explore potential predictors for the overall perception of safety. We used the Hospital Survey on Patient Safety Culture (HSOPSC) to evaluate nurses' and midwives' opinion about patient safety issues. The overall response rate in the survey was 100% (n = 233). The analysis of the dimensions of safety on the unit level showed that the respondents' most positive evaluations were in the Organizational Learning - Continuous Improvement (73.2%) and Feedback and Communication about Error (66.8%) dimensions, and the most negative evaluations in the Non-punitive Response to Error (33.5%) and Staffing (44.6%) dimensions. On the hospital level, the evaluation of the safety dimensions ranged between 41.4 and 56.8%. The percentage of positive responses in the outcome dimensions Frequency of Events Reported was 82.4%. We found a significant association between the outcome dimension Frequency of Events Reported and the Hospital Management Support for Patient Safety and Feedback and Communication about Error Dimensions. On the hospital level, the critical domains in health care facilities that provide services in the fields of obstetrics, gynecology, and neonatology were Teamwork Across Hospital Units, and on the unit level - Communication Openness, Teamwork Within Units, Non-punitive Response to Error, and Staffing. The remaining domains were seen as having a potential for improvement.

The fetal heart rate collaborative practice project: situational awareness in electronic fetal monitoring-a Kaiser Permanente Perinatal Patient Safety Program Initiative.

PubMed

MacEachin, S Rachel; Lopez, Connie M; Powell, Kimberly J; Corbett, Nancy L

2009-01-01

Electronic fetal monitoring has historically been interpreted with wide variation between and within disciplines on the obstetric healthcare team. This leads to inconsistent decision making in response to tracing interpretation. To implement a multidisciplinary electronic fetal monitoring training program, utilizing the best evidence available, enabling standardization of fetal heart rate interpretation to promote patient safety. Local multidisciplinary expertise along with an outside consultant collaborated over a series of meetings to create a multimedia instructional electronic fetal monitoring training program. After production was complete, a series of conferences attended by nurses, certified nurse midwives, and physician champions, from each hospital, attended to learn how to facilitate training at their own perinatal units. All healthcare personnel across the Kaiser Permanente perinatal program were trained in NICHD nomenclature, emergency response, interpretation guidelines, and how to create local collaborative practice agreements. Metrics for program effectiveness were measured through program evaluations from attendees, the Safety Attitudes Questionnaire. Program evaluations rendered very positive scores from both physicians and clinicians. Comparing baseline to 4 years later, the perception of safety from the staff has increased over 10% in 5 out of the 6 factors analyzed. Active participation from all disciplines in this training series has highlighted the importance of teamwork and communication. The Fetal Heart Rate Collaborative Practice Project continues to evolve utilizing other educational modalities, such as online EFM education and unit-based interdisciplinary tracing reviews.

A standard methodology for the analysis, recording, and control of verbal behavior

PubMed Central

Drash, Philip W.; Tudor, Roger M.

1991-01-01

Lack of a standard methodology has been one of the major obstacles preventing advancement of behavior analytic research in verbal behavior. This article presents a standard method for the analysis, recording, and control of verbal behavior that overcomes several major methodological problems that have hindered operant research in verbal behavior. The system divides all verbal behavior into four functional response classes, correct, error, no response, and inappropriate behavior, from which all vocal responses of a subject may be classified and consequated. The effects of contingencies of reinforcement on verbal operants within each category are made immediately visible to the researcher as changes in frequency of response. Incorporating frequency of response within each category as the unit of response allows both rate and probability of verbal response to be utilized as basic dependent variables. This method makes it possible to record and consequate verbal behavior in essentially the same way as any other operant response. It may also facilitate an experimental investigation of Skinner's verbal response categories. PMID:22477629

Race, ethnicity, and linguistic isolation as determinants of participation in public health surveillance surveys.

PubMed

Link, Michael W; Mokdad, Ali H; Stackhouse, Herbert F; Flowers, Nicole T

2006-01-01

To plan, implement, and evaluate programs designed to improve health conditions among racial and ethnic minority populations in the United States, public health officials and researchers require valid and reliable health surveillance data. Monitoring chronic disease and behavioral risk factors among such populations, however, is challenging. This study assesses the effects of race, ethnicity, and linguistic isolation on rates of participation in the Behavioral Risk Factor Surveillance System (BRFSS). County-level data from the 2003 BRFSS survey and 2000 U.S. census were used to examine the effects of race, ethnicity, and linguistic isolation on six measures of survey participation (i.e., rates of resolution, screening, cooperation, response, language barriers, and refusal). Participation rates were significantly lower in counties with higher percentages of black people and people who did not speak English. Response rates decreased by 4.6% in counties with the highest concentration of black residents compared with counties with few black residents. Likewise, response rates decreased by approximately 7% in counties in which a larger percentage of the population spoke only Spanish or another Indo-European language compared with counties in which all residents spoke English. The negative relationship between the percentage of Spanish-only-speaking households and participation rates is troubling given that the BRFSS is conducted in both Spanish and English. The findings also indicate that more needs to be done to improve participation among other minorities. Researchers are investigating several ways of addressing disparities in participation rates, such as using postsurvey adjustments, developing more culturally appropriate data-collection procedures, and offering surveys in multiple languages.

The reef-building coral Siderastrea siderea exhibits parabolic responses to ocean acidification and warming

PubMed Central

Castillo, Karl D.; Ries, Justin B.; Bruno, John F.; Westfield, Isaac T.

2014-01-01

Anthropogenic increases in atmospheric CO2 over this century are predicted to cause global average surface ocean pH to decline by 0.1–0.3 pH units and sea surface temperature to increase by 1–4°C. We conducted controlled laboratory experiments to investigate the impacts of CO2-induced ocean acidification (pCO2 = 324, 477, 604, 2553 µatm) and warming (25, 28, 32°C) on the calcification rate of the zooxanthellate scleractinian coral Siderastrea siderea, a widespread, abundant and keystone reef-builder in the Caribbean Sea. We show that both acidification and warming cause a parabolic response in the calcification rate within this coral species. Moderate increases in pCO2 and warming, relative to near-present-day values, enhanced coral calcification, with calcification rates declining under the highest pCO2 and thermal conditions. Equivalent responses to acidification and warming were exhibited by colonies across reef zones and the parabolic nature of the corals' response to these stressors was evident across all three of the experiment's 30-day observational intervals. Furthermore, the warming projected by the Intergovernmental Panel on Climate Change for the end of the twenty-first century caused a fivefold decrease in the rate of coral calcification, while the acidification projected for the same interval had no statistically significant impact on the calcification rate—suggesting that ocean warming poses a more immediate threat than acidification for this important coral species. PMID:25377455

Interdisciplinary Team Huddles for Fetal Heart Rate Tracing Review.

PubMed

Thompson, Lisa; Krening, Cynthia; Parrett, Dolores

2018-06-01

To address an increase in unexpected poor outcomes in term neonates, our team developed a goal of high reliability and improved fetal safety in the culture of the Labor and Delivery nursing department. We implemented interdisciplinary reviews of fetal heart rate, along with a Category II fetal heart rate management algorithm and a fetal heart rate assessment rapid response alert to call for unscheduled reviews when needed. Enhanced communication between nurses and other clinicians supported an interdisciplinary approach to fetal safety, and we observed an improvement in health outcomes for term neonates. We share our experience with the intention of making our methods available to any labor and delivery unit team committed to safe, high-quality care and service excellence. Copyright © 2018 AWHONN. Published by Elsevier Inc. All rights reserved.

Violence-related firearm deaths among residents of metropolitan areas and cities---United States, 2006--2007.

PubMed

2011-05-13

Violence-related firearm deaths remain an important public health concern in the United States. During 2006--2007, a total of 25,423 firearm homicides and 34,235 firearm suicides occurred among U.S. residents. These national totals include 4,166 firearm homicides and 1,446 firearm suicides among youths aged 10--19 years; the rate of firearm homicides among youths slightly exceeded the rate among persons of all ages. This report presents statistics on firearm homicides and firearm suicides for major metropolitan areas and cities, with an emphasis on youths aged 10--19 years in recognition of the importance of early prevention efforts. It integrates analyses conducted by CDC in response to requests for detailed information, arising from a heightened focus on urban violence by the media, the public, and policymakers over the past year. Firearm homicides and suicides and annual rates were tabulated for the 50 largest U.S. metropolitan statistical areas (MSAs) and their central cities for 2006--2007, using data from the National Vital Statistics System and the U.S. Census Bureau. Firearm homicide rates in approximately two thirds of the MSAs exceeded the national rate, and 86% of cities had rates higher than those of their MSAs. The youth firearm homicide rate exceeded the all-ages rate in 80% of the MSAs and in 88% of the cities. Firearm suicide rates in just over half of the MSAs were below the national rate, and 55% of cities had rates below those of their MSAs. Youth firearm suicide rates in the MSAs and cities were collectively low compared with all-ages rates. Such variations in firearm homicide and firearm suicide rates, with respect to both urbanization and age, should be considered in the continuing development of prevention programs directed at reducing firearm violence.

Carbon tetrachloride degradation: Effect of microbial growth substrate and vitamin B{sub 12} content

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

Zou, S.; Stensel, H.D.; Ferguson, J.F.

2000-05-01

Microbial degradation kinetics of carbon tetrachloride (CT) under reducing conditions were investigated for different cultures, fed with 1,2-propanediol, dextrose, propionalde-hyde, or acetate and nitrate, in the anaerobic step of an anaerobic/aerobic operation sequence. Methanogenesis was inhibited due to the aerobic step. CT biodegradation rates followed first-order kinetics with respect to CT concentration and biomass and were not affected by the presence of growth substrate. CT degradation rates increased linearly with higher intracellular vitamin B{sub 12} content. The culture fed 1,2-propanediol had the highest vitamin B{sub 12} content, which was 3.8, 4.7, and 16 times that of the propionaldehyde-,dextrose-, and acetate-fedmore » cultures, respectively, and its first-order degradation rate constant was 2.8, 4.5, 6.0 times that for those cultures, respectively. No CT degradation occurred with culture liquid, suggesting that intracellular factors were responsible for CT degradation. The propanediol culture was able to sustain a constant CT degradation rate for a 16-day test period without substrate addition. Compared to a propanediol-fed culture grown only under anaerobic conditions, the propanediol culture grown under the sequential anaerobic/aerobic condition resulted in more biomass growth and a greater CT degradation rate per unit of propanediol fed, although its CT degradation rate per unit of biomass was lower.« less

A longitudinal analysis of nursing specialty certification by Magnet® status and patient unit type.

PubMed

Boyle, Diane K; Gajewski, Byron J; Miller, Peggy A

2012-12-01

The objective of this study was to examine nursing specialty certification trends by Magnet® status and unit type. Research exploring organizational and unit attributes associated with higher specialty certification rates is timely given the beginning evidence that certification is associated with lower patient adverse events. The sample included 6047 units in 1249 National Database of Nursing Quality Indicators hospitals. Hierarchical linear modeling was used to predict growth in percentage of specialty-certified RNs within each unit type and Magnet status. Data (Bayesian Information Criteria = 224 583.30) demonstrated significant growth in specialty certification rates over time (P < .0001). Magnet-designated organizations had significantly different starting certification rates (P = .0002) and rates of change (P = .0002). Unit types also had significantly different starting certification rates (P < .0001) and different rates of change (P < .0001). Magnet recognition is associated with increases in specialty certification rates. Certification rates have risen faster in unit types such as pediatric critical care than in unit types such as adult step-down and adult surgical.

Keepin' It Real and Relevant: Providing a Culturally Responsive Education to Pregnant and Parenting Teens

ERIC Educational Resources Information Center

Roxas, Kevin

2008-01-01

Although teen pregnancy and birth rates in the United States declined for ten straight years during the 1990s and were less than half of comparative figures from 1957, the year of the all-time high of teen pregnancy, nearly one in ten teenage young women still became pregnant in 2001, with half of these young women giving birth. Teen pregnancy…

Specific Impulse and Mass Flow Rate Error

NASA Technical Reports Server (NTRS)

Gregory, Don A.

2005-01-01

Specific impulse is defined in words in many ways. Very early in any text on rocket propulsion a phrase similar to .specific impulse is the thrust force per unit propellant weight flow per second. will be found.(2) It is only after seeing the mathematics written down does the definition mean something physically to scientists and engineers responsible for either measuring it or using someone.s value for it.

Reliability of Pressure Ulcer Rates: How Precisely Can We Differentiate Among Hospital Units, and Does the Standard Signal‐Noise Reliability Measure Reflect This Precision?

PubMed Central

Cramer, Emily

2016-01-01

Abstract Hospital performance reports often include rankings of unit pressure ulcer rates. Differentiating among units on the basis of quality requires reliable measurement. Our objectives were to describe and apply methods for assessing reliability of hospital‐acquired pressure ulcer rates and evaluate a standard signal‐noise reliability measure as an indicator of precision of differentiation among units. Quarterly pressure ulcer data from 8,199 critical care, step‐down, medical, surgical, and medical‐surgical nursing units from 1,299 US hospitals were analyzed. Using beta‐binomial models, we estimated between‐unit variability (signal) and within‐unit variability (noise) in annual unit pressure ulcer rates. Signal‐noise reliability was computed as the ratio of between‐unit variability to the total of between‐ and within‐unit variability. To assess precision of differentiation among units based on ranked pressure ulcer rates, we simulated data to estimate the probabilities of a unit's observed pressure ulcer rate rank in a given sample falling within five and ten percentiles of its true rank, and the probabilities of units with ulcer rates in the highest quartile and highest decile being identified as such. We assessed the signal‐noise measure as an indicator of differentiation precision by computing its correlations with these probabilities. Pressure ulcer rates based on a single year of quarterly or weekly prevalence surveys were too susceptible to noise to allow for precise differentiation among units, and signal‐noise reliability was a poor indicator of precision of differentiation. To ensure precise differentiation on the basis of true differences, alternative methods of assessing reliability should be applied to measures purported to differentiate among providers or units based on quality. © 2016 The Authors. Research in Nursing & Health published by Wiley Periodicals, Inc. PMID:27223598

Nitrogen deposition and forest carbon sequestration: a quantitative synthesis from plot to global scales

NASA Astrophysics Data System (ADS)

Goodale, C. L.; Thomas, R. Q.; Dentener, F. J.; Adams, M.; Baron, J.; Emmett, B.; Evans, C. B.; Fernandez, I. J.; Gundersen, P.; Hagedorn, F.; Kulmatiski, A.; Lovett, G. M.; McNulty, S.; Melvin, A. M.; Moldan, F.; Ollinger, S. V.; Schleppi, P.; Weiss, M.

2009-12-01

Atmospheric nitrogen deposition has long been proposed as a driver of terrestrial carbon sequestration, but its quantitative effect remains poorly constrained. Global models, observations along N deposition gradients, and plot-level forest N-addition experiments provide a range of estimates of the amount of C sequestered in response to added N. Synthesis of results from 48 multi-year N-addition studies in temperate forests show responses ranging from +53 to -95 kg C of live tree production per unit of N addition. Negative effects on live tree C occurred in stands with low rates of biomass accumulation, and occurred more rapidly with higher N application rates. More positive effects occurred in younger stands, and with greater efficiency of C gain at lower N addition rates. Observations of tree growth along N deposition gradients in Europe and the eastern U.S. produced broadly similar tree growth responses (19-56 kg C/kg N) as the N addition experiments. Soil C response increased with N addition rate, and averaged 4 + 12 kg C/kg N. These surface soil responses suggest modest suppression of soil decomposition induced by added N in some but not all sites due to several possible mechanisms, none of which are yet considered in global models. Global-scale estimates of N deposition effects on forest C sequestration have ranged from 0.1 to 2.0 Pg C/y depending on assumptions on the rate of N deposition to forests, its fate, and the C:N ratios of recipient C pools. A new group of biogeochemistry models designed for coupling with global climate models all simulate relatively limited terrestrial C sinks from atmospheric N deposition alone (0.2 - 0.4 PgC/y), more in combination with rising atmospheric CO2. Future model projections should benefit from rigorous comparisons with the range of observed C responses reviewed here.

Higher Crash and Near-Crash Rates in Teenaged Drivers With Lower Cortisol Response

PubMed Central

Ouimet, Marie Claude; Brown, Thomas G.; Guo, Feng; Klauer, Sheila G.; Simons-Morton, Bruce G.; Fang, Youjia; Lee, Suzanne E.; Gianoulakis, Christina; Dingus, Thomas A.

2014-01-01

IMPORTANCE Road traffic crashes are one of the leading causes of injury and death among teenagers worldwide. Better understanding of the individual pathways to driving risk may lead to better-targeted intervention in this vulnerable group. OBJECTIVE To examine the relationship between cortisol, a neurobiological marker of stress regulation linked to risky behavior, and driving risk. DESIGN, SETTING, AND PARTICIPANTS The Naturalistic Teenage Driving Study was designed to continuously monitor the driving behavior of teenagers by instrumenting vehicles with kinematic sensors, cameras, and a global positioning system. During 2006–2008, a community sample of 42 newly licensed 16-year-old volunteer participants in the United States was recruited and driving behavior monitored. It was hypothesized in teenagers that higher cortisol response to stress is associated with (1) lower crash and near-crash (CNC) rates during their first 18 months of licensure and (2) faster reduction in CNC rates over time. MAIN OUTCOMES AND MEASURES Participants’ cortisol response during a stress-inducing task was assessed at baseline, followed by measurement of their involvement in CNCs and driving exposure during their first 18 months of licensure. Mixed-effect Poisson longitudinal regression models were used to examine the association between baseline cortisol response and CNC rates during the follow-up period. RESULTS Participants with a higher baseline cortisol response had lower CNC rates during the follow-up period (exponential of the regression coefficient, 0.93; 95%CI, 0.88–0.98) and faster decrease in CNC rates over time (exponential of the regression coefficient, 0.98; 95%, CI, 0.96–0.99). CONCLUSIONS AND RELEVANCE Cortisol is a neurobiological marker associated with teenaged-driving risk. As in other problem-behavior fields, identification of an objective marker of teenaged-driving risk promises the development of more personalized intervention approaches. PMID:24710522

[Specific neurology emergency training of medical residents in Spain].

PubMed

Morales Ortiz, A; Martín González, M R; Frank García, A; Hernández Pérez, M A; Rodríguez-Antigüedad, A; Jiménez Hernández, M D; Delgado Bona, G; Peinazo Arias, M; Gallardo Corral, E; Martínez Vila, E; Martínez Villa, E; Matias Guiu, J

2010-01-01

Training in emergency neurological illness is very important for the neurologist today. The Neurology National Commission has decided to obtain information on the work duties of neurologist residents in the different neurology units of the hospitals of our country and the supervision of the training in urgent pathology. A survey of adult neurology program directors to find out if their hospital fulfils the program criteria for the residents duty work. A response rate of 98.5% was obtained. In 47% of the neurology training units a neurologist supervised resident duty work 24 hours a day. In the rest of the neurology training units they did not fulfil all the training program criteria. We analysed the differences between the neurologist training units, and there are great differences between the hospitals and all regions and communities in our country. Only 65% of neurology residents do their education in neurology units who fulfill the national program criteria on training on urgent neurology pathology There is too much diversity in resident duty work in neurologist training units and not all the units meet the national training program requirements. Copyright © 2010 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

The impact of fellowships on surgical resident training in a multispecialty cohort in Australia and New Zealand.

PubMed

Petrushnko, Wilson; Perry, Will; Fraser-Kirk, Grant; Ctercteko, Grahame; Adusumilli, Sanjay; O'Grady, Gregory

2015-12-01

Fellowships in surgery are increasing in number, and concerns have been raised regarding their impact on resident training. Although fellows may contribute to resident education and training, they also compete for operative and other experience. This study aimed to quantify the impact of fellowships on resident training in a binational multispecialty cohort. The operative case volumes and primary operator rates of surgery trainees (residents) in Australia and New Zealand were compared between units with and without fellows. Trainees also were surveyed using Likert Scales to assess quality of operative and other experience in units with and without fellows. Data from 911 trainees over 2 terms was analyzed; survey response rate 42%. Of all trainees, 42% worked with fellows. Trainees in units without fellows were involved in more major (P = .03) and minor (P < .0001) cases. Primary operator rates were comparable, but trainees in units without fellows were less often assistants, reported an increased quality of elective operating experience, and reported more favorable completion of learning objectives (all P < .05). These findings were consistent between tertiary and nontertiary hospitals. Thematic analysis showed positive benefits of fellows in teaching, training and mentorship, but negative impacts on case exposure, competition for operating, and clinical experience. Fellows may assist in the teaching and training of residents, but residents working with fellows experience a decreased quantity of operative experience that may impact several aspects of the quality of training. Surgical educators must actively balance the learning needs of fellows and residents. Copyright © 2015 Elsevier Inc. All rights reserved.

Nature and incidence of severe limbal stem cell deficiency in Australia and New Zealand.

PubMed

Bobba, Samantha; Di Girolamo, Nick; Mills, Richard; Daniell, Mark; Chan, Elsie; Harkin, Damien G; Cronin, Brendan G; Crawford, Geoffrey; McGhee, Charles; Watson, Stephanie

2017-03-01

This study aimed to determine the nature and incidence of severe limbal stem cell deficiency (LSCD) in Australia and New Zealand. A 1-year pilot surveillance study with a 1-year follow-up period was conducted in association with the Australian and New Zealand Ophthalmic Surveillance Unit. The study included patients reported by practising ophthalmologists on the Surveillance Unit's database. Ophthalmologists were provided with a definition of severe limbal stem cell deficiency, contacted on a monthly basis by the Unit and asked to report newly diagnosed cases. Severe LSCD was defined as at least 6 clock hours of whorl-like epitheliopathy, an opaque epithelium arising from the limbus, late fluorescein staining of the involved epithelium and superficial corneal neovascularization or conjunctivalization. On average, 286 report cards were sent by the Surveillance Unit to practising ophthalmologists each month (total 3429 over 12 months) and the Unit received an average of 176 responses per month (total 2111; 62% response rate). During the 1-year study period from April 2013 to March 2014, 14 positive cases were reported to the Unit. A range of underlying aetiologies were implicated, with contact lens over-wear and cicatrizing conjunctivitis being the most common (n = 3). This surveillance study is the first worldwide to document the incidence of limbal stem cell deficiency; however, because of study design limitations, it is likely to have been under-reported. It provides novel data on the demographics, clinical conditions and management of patients with limbal stem cell deficiency as reported by treating ophthalmologists. © 2016 Royal Australian and New Zealand College of Ophthalmologists.

Current Status of the Blue Butterfly in Fukushima Research.

PubMed

Otaki, Joji M; Taira, Wataru

2018-02-14

Adverse biological impacts of the Fukushima nuclear accident have been revealed using the pale grass blue butterfly, Zizeeria maha, since 2012, which were often considered incompatible with the conventional understanding of radiation biology. This discrepancy likely originates from different system conditions and methodologies. In this article, we first respond to comments from the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) regarding our study; "technical errors" in unit usage and mathematical models noted by UNSCEAR are not errors but reflect our research philosophy not to introduce theoretical assumptions associated with unit conversion and mathematical fit. Second, we review our recent studies to support the original 2012 conclusions. Because the high morphological abnormality rate and small body size detected in Fukushima in 2011 have already ceased, likely through adaptive evolution, their present geographical distributions were investigated throughout Japan. Local populations showing relatively high abnormality rates and small body sizes were rare and basically restricted to Miyagi and its northern populations excluding the Fukushima populations, supporting the causal involvement of the accident. Lastly, we stress the importance of understanding the whole picture of the biological impacts of the Fukushima accident. In addition to the direct radiation impacts, indirect impacts through unknown radiation-associated mechanisms, such as immunological responses to insoluble particulate matter and nutritional deficiencies in plants and animals, would be in effect. Further environmental studies beyond conventional radiation biology and physics are necessary to understand the complex responses of organisms, including humans, to the Fukushima nuclear accident. © The American Genetic Association 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Status of Microsurgical Simulation Training in Plastic Surgery: A Survey of United States Program Directors.

PubMed

Al-Bustani, Saif; Halvorson, Eric G

2016-06-01

Various simulation models for microsurgery have been developed to overcome the limitations of Halstedian training on real patients. We wanted to assess the status of microsurgery simulation in plastic surgery residency programs in the United States. Data were analyzed from responses to a survey sent to all plastic surgery program directors in the United States, asking for type of simulation, quality of facilities, utilization by trainees, evaluation of trainee sessions, and perception of the relevance of simulation. The survey response rate was 50%. Of all programs, 69% provide microsurgical simulation and 75% of these have a laboratory with microscope and 52% provide live animal models. Half share facilities with other departments. The quality of facilities is rated as good or great in 89%. Trainee utilization is once every 3 to 6 months in 82% of programs. Only in 11% is utilization monthly. Formal evaluation of simulation sessions is provided by 41% of programs. All program directors agree simulation is relevant to competence in microsurgery, 60% agree simulation should be mandatory, and 43% require trainees to complete a formal microsurgery course prior to live surgery. There seems to be consensus that microsurgical simulation improves competence, and the majority of program directors agree it should be mandatory. Developing and implementing standardized simulation modules and assessment tools for trainees across the nation as part of a comprehensive competency-based training program for microsurgery is an important patient safety initiative that should be considered. Organizing with other departments to share facilities may improve their quality and hence utilization.

Estimating and preventing hospital internal turnover of newly licensed nurses: A panel survey.

PubMed

Kovner, Christine T; Djukic, Maja; Fatehi, Faridaben K; Fletcher, Jason; Jun, Jin; Brewer, Carol; Chacko, Thomas

2016-08-01

Registered nurse job turnover is an ongoing problem in the USA resulting in significant financial costs to both organizations and society. Most research has focused on organizational turnover with few studies about internal or unit-level turnover. Turnover of new nurses in hospitals has particular importance as almost 80% of new nurses work in hospitals and have higher turnover rates when compared to experienced nurses. This paper focuses on new nurses' unit-level turnover rates in hospitals. The purpose of this study is to: (1) identify factors that predict new nurses staying in the same units, positions, and job titles to inform unit-level retention strategies, and (2) examine the changes in work environment perceptions over time between nurses who remain in the same unit, position, and title to those who changed unit, position and/or title. A panel survey design was used to analyze changes over time. Participants were newly licensed registered nurses who were licensed for the first time between August 1st, 2004 and July 31st, 2005. The nurses came from metropolitan statistical areas or rural areas that were nested to reflect a nationally representative USA sample (58% response rate). The analytic sample for this study was 1335. Data were collected in January 2006 and 2007 following the Dillman total design approach. All potential respondents received paper surveys and non-responders received repeated mailings. Using multinomial regression the five variables with the largest effects on unit retention were (1) variety (positive), (2) having another job for pay (negative), (3) first basic degree (having a bachelors or higher degree increased the probability of staying), (4) negative affectivity (positive), and (5) job satisfaction (positive). Nurses who changed unit, and/or position, and/or title reported more positive change scores on a variety of work attitudes. Almost 30% of new nurses working in hospitals leave their unit, and/or position, and/or title during their first year of work. Our results point to the variables on which managers can focus to improve unit-level retention of new nurses. Although participants were from a nationally representative sample of nurses who were newly licensed in 2004-2005, with the geographical shifts in the USA population in the last 10 years the sample may not be geographically representative of new nurses who graduated in 2015. Copyright © 2016. Published by Elsevier Ltd.

Music intervention to prevent delirium among older patients admitted to a trauma intensive care unit and a trauma orthopaedic unit.

PubMed

Johnson, Kari; Fleury, Julie; McClain, Darya

2018-08-01

Evaluate music listening for delirium prevention among patients admitted to a Trauma Intensive Care and Trauma Orthopaedic Unit. The Roy Adaptation Model provided the theoretical framework focusing on modifying contextual stimuli. Randomised controlled trial, 40 patients aged 55 and older. Participants randomly assigned to receive music listening or usual care for 60 minutes, twice a day, over three days. Pre-recorded self-selected music using an iPod and headsets, with slow tempo, low pitch and simple repetitive rhythms to alter physiologic responses. Heart rate, respiratory rate, systolic and diastolic blood pressure, confusion assessment method. Repeated measures ANOVA, F(4, 134) = 4.75, p = .001, suggested statistically significant differences in heart rate pre/post music listening, and F(1, 37) = 10.44, p = .003 in systolic blood pressure pre/post music listening. Post-hoc analysis reported changes at three time periods of statistical significance; (p = .010), (p = .005) and (p = .039) and a change in systolic blood pressure pre/post music listening; (p = .001) of statistical significance. All participants screened negative for delirium. Music addresses pathophysiologic mechanisms that contribute to delirium; neurotransmitter imbalance, inflammation and acute physiologic stressors. Music to prevent delirium is one of few that provide support in a critical care setting. Copyright © 2018 Elsevier Ltd. All rights reserved.

Acclimation of isoprene emission and photosynthesis to growth temperature in hybrid aspen: resolving structural and physiological controls.

PubMed

Rasulov, Bahtijor; Bichele, Irina; Hüve, Katja; Vislap, Vivian; Niinemets, Ülo

2015-04-01

Acclimation of foliage to growth temperature involves both structural and physiological modifications, but the relative importance of these two mechanisms of acclimation is poorly known, especially for isoprene emission responses. We grew hybrid aspen (Populus tremula x P. tremuloides) under control (day/night temperature of 25/20 °C) and high temperature conditions (35/27 °C) to gain insight into the structural and physiological acclimation controls. Growth at high temperature resulted in larger and thinner leaves with smaller and more densely packed chloroplasts and with lower leaf dry mass per area (MA). High growth temperature also led to lower photosynthetic and respiration rates, isoprene emission rate and leaf pigment content and isoprene substrate dimethylallyl diphosphate pool size per unit area, but to greater stomatal conductance. However, all physiological characteristics were similar when expressed per unit dry mass, indicating that the area-based differences were primarily driven by MA. Acclimation to high temperature further increased heat stability of photosynthesis and increased activation energies for isoprene emission and isoprene synthase rate constant. This study demonstrates that temperature acclimation of photosynthetic and isoprene emission characteristics per unit leaf area were primarily driven by structural modifications, and we argue that future studies investigating acclimation to growth temperature must consider structural modifications. © 2014 John Wiley & Sons Ltd.

Decreasing IV Infiltrates in the Pediatric Patient--System-Based Improvement Project.

PubMed

Major, Tracie Wilt; Huey, Tricia K

2016-01-01

Intravenous infiltrates pose tremendous risk for the hospitalized pediatric patient. Infiltrate events increase hospital-acquired harm, the number of painful procedures, use of supplies, length of stay, and nursing time; it threatens relationships essential in patient- and family-centered care. The goal of this quality improvement project was to achieve a 10% decrease in the baseline infiltrate rate on two inpatient units and in the overall infiltrate rate across all of the pediatric units. A Lean Six Sigma methodology was used to guide project activities. Improvement strategies focused on evidence-based education, intravenous (IV) catheter securement, and family engagement. A comparative purposive sample was used to evaluate the pre- and post-implementation period to determine if desired project success measures were achieved. Data analysis revealed positive results across all units, with the number of events (n = 51 pre; n = 19 post) and the infiltration rates (13.5 pre; 7.1 post) decreasing over a three-month period. A decrease was also noted in the overall percent of IVs that infiltrated in the first 24 hours (45% pre; 42% post). A statistically significant increase (t = 15.16; p < 0.001) was noted in nurses' education pre- and post-assessment survey scores. The family engagement strategy revealed overall parental responses to be 88% positive. By decreasing infiltrates, quality of care improved, resulting in the delivery of safe, effective, and patient-centered IV therapy.

Voltage gating by molecular subunits of Na+ and K+ ion channels: higher-dimensional cubic kinetics, rate constants, and temperature.

PubMed

Fohlmeister, Jürgen F

2015-06-01

The structural similarity between the primary molecules of voltage-gated Na and K channels (alpha subunits) and activation gating in the Hodgkin-Huxley model is brought into full agreement by increasing the model's sodium kinetics to fourth order (m(3) → m(4)). Both structures then virtually imply activation gating by four independent subprocesses acting in parallel. The kinetics coalesce in four-dimensional (4D) cubic diagrams (16 states, 32 reversible transitions) that show the structure to be highly failure resistant against significant partial loss of gating function. Rate constants, as fitted in phase plot data of retinal ganglion cell excitation, reflect the molecular nature of the gating transitions. Additional dimensions (6D cubic diagrams) accommodate kinetically coupled sodium inactivation and gating processes associated with beta subunits. The gating transitions of coupled sodium inactivation appear to be thermodynamically irreversible; response to dielectric surface charges (capacitive displacement) provides a potential energy source for those transitions and yields highly energy-efficient excitation. A comparison of temperature responses of the squid giant axon (apparently Arrhenius) and mammalian channel gating yields kinetic Q10 = 2.2 for alpha unit gating, whose transitions are rate-limiting at mammalian temperatures; beta unit kinetic Q10 = 14 reproduces the observed non-Arrhenius deviation of mammalian gating at low temperatures; the Q10 of sodium inactivation gating matches the rate-limiting component of activation gating at all temperatures. The model kinetics reproduce the physiologically large frequency range for repetitive firing in ganglion cells and the physiologically observed strong temperature dependence of recovery from inactivation. Copyright © 2015 the American Physiological Society.

How Ebola impacts social dynamics in gorillas: a multistate modelling approach.

PubMed

Genton, Céline; Pierre, Amandine; Cristescu, Romane; Lévréro, Florence; Gatti, Sylvain; Pierre, Jean-Sébastien; Ménard, Nelly; Le Gouar, Pascaline

2015-01-01

Emerging infectious diseases can induce rapid changes in population dynamics and threaten population persistence. In socially structured populations, the transfers of individuals between social units, for example, from breeding groups to non-breeding groups, shape population dynamics. We suggest that diseases may affect these crucial transfers. We aimed to determine how disturbance by an emerging disease affects demographic rates of gorillas, especially transfer rates within populations and immigration rates into populations. We compared social dynamics and key demographic parameters in a gorilla population affected by Ebola using a long-term observation data set including pre-, during and post-outbreak periods. We also studied a population of undetermined epidemiological status in order to assess whether this population was affected by the disease. We developed a multistate model that can handle transition between social units while optimizing the number of states. During the Ebola outbreak, social dynamics displayed increased transfers from a breeding to a non-breeding status for both males and females. Six years after the outbreak, demographic and most of social dynamics parameters had returned to their initial rates, suggesting a certain resilience in the response to disruption. The formation of breeding groups increased just after Ebola, indicating that environmental conditions were still attractive. However, population recovery was likely delayed because compensatory immigration was probably impeded by the potential impact of Ebola in the surrounding areas. The population of undetermined epidemiological status behaved similarly to the other population before Ebola. Our results highlight the need to integrate social dynamics in host-population demographic models to better understand the role of social structure in the sensitivity and the response to disease disturbances. © 2014 The Authors. Journal of Animal Ecology © 2014 British Ecological Society.

Women's experiences of transfer from primary maternity unit to tertiary hospital in New Zealand: part of the prospective cohort Evaluating Maternity Units study.

PubMed

Grigg, Celia P; Tracy, Sally K; Schmied, Virginia; Monk, Amy; Tracy, Mark B

2015-12-18

There is worldwide debate regarding the appropriateness and safety of different birthplaces for well women. The Evaluating Maternity Units (EMU) study's primary objective was to compare clinical outcomes for well women intending to give birth in either a tertiary level maternity hospital or a freestanding primary level maternity unit. Little is known about how women experience having to change their birthplace plans during the antenatal period or before admission to a primary unit, or transfer following admission. This paper describes and explores women's experience of these changes-a secondary aim of the EMU study. This paper utilised the six week postpartum survey data, from the 174 women from the primary unit cohort affected by birthplace plan change or transfer (response rate 73%). Data were analysed using descriptive statistics and thematic analysis. The study was undertaken in Christchurch, New Zealand, which has an obstetric-led tertiary maternity hospital and four freestanding midwife-led primary maternity units (2010-2012). The 702 study participants were well, pregnant women booked to give birth in one of these facilities, all of whom received continuity of midwifery care, regardless of their intended or actual birthplace. Of the women who had to change their planned place of birth or transfer the greatest proportion of women rated themselves on a Likert scale as unbothered by the move (38.6%); 8.8% were 'very unhappy' and 7.6% 'very happy' (quantitative analysis). Four themes were identified, using thematic analysis, from the open ended survey responses of those who experienced transfer: 'not to plan', control, communication and 'my midwife'. An interplay between the themes created a cumulatively positive or negative effect on their experience. Women's experience of transfer in labour was generally positive, and none expressed stress or trauma with transfer. The women knew of the potential for change or transfer, although it was not wanted or planned. When they maintained a sense control, experienced effective communication with caregivers, and support and information from their midwife, the transfer did not appear to be experienced negatively. The model of continuity of midwifery care in New Zealand appeared to mitigate the negative aspects of women's experience of transfer and facilitate positive birth experiences.

Comparing transfusion reaction rates for various plasma types: a systematic review and meta-analysis/regression.

PubMed

Saadah, Nicholas H; van Hout, Fabienne M A; Schipperus, Martin R; le Cessie, Saskia; Middelburg, Rutger A; Wiersum-Osselton, Johanna C; van der Bom, Johanna G

2017-09-01

We estimated rates for common plasma-associated transfusion reactions and compared reported rates for various plasma types. We performed a systematic review and meta-analysis of peer-reviewed articles that reported plasma transfusion reaction rates. Random-effects pooled rates were calculated and compared between plasma types. Meta-regression was used to compare various plasma types with regard to their reported plasma transfusion reaction rates. Forty-eight studies reported transfusion reaction rates for fresh-frozen plasma (FFP; mixed-sex and male-only), amotosalen INTERCEPT FFP, methylene blue-treated FFP, and solvent/detergent-treated pooled plasma. Random-effects pooled average rates for FFP were: allergic reactions, 92/10 5 units transfused (95% confidence interval [CI], 46-184/10 5 units transfused); febrile nonhemolytic transfusion reactions (FNHTRs), 12/10 5 units transfused (95% CI, 7-22/10 5 units transfused); transfusion-associated circulatory overload (TACO), 6/10 5 units transfused (95% CI, 1-30/10 5 units transfused); transfusion-related acute lung injury (TRALI), 1.8/10 5 units transfused (95% CI, 1.2-2.7/10 5 units transfused); and anaphylactic reactions, 0.8/10 5 units transfused (95% CI, 0-45.7/10 5 units transfused). Risk differences between plasma types were not significant for allergic reactions, TACO, or anaphylactic reactions. Methylene blue-treated FFP led to fewer FNHTRs than FFP (risk difference = -15.3 FNHTRs/10 5 units transfused; 95% CI, -24.7 to -7.1 reactions/10 5 units transfused); and male-only FFP led to fewer cases of TRALI than mixed-sex FFP (risk difference = -0.74 TRALI/10 5 units transfused; 95% CI, -2.42 to -0.42 injuries/10 5 units transfused). Meta-regression demonstrates that the rate of FNHTRs is lower for methylene blue-treated compared with FFP, and the rate of TRALI is lower for male-only than for mixed-sex FFP; whereas no significant differences are observed between plasma types for allergic reactions, TACO, or anaphylactic reactions. Reported transfusion reaction rates suffer from high heterogeneity. © 2017 AABB.

Symptom changes in five dimensions of the Positive and Negative Syndrome Scale in refractory psychosis.

PubMed

Woodward, Todd S; Jung, Kwanghee; Smith, Geoffrey N; Hwang, Heungsun; Barr, Alasdair M; Procyshyn, Ric M; Flynn, Sean W; van der Gaag, Mark; Honer, William G

2014-12-01

Refractory psychosis units currently have little information regarding which symptoms profiles should be expected to respond to treatment. In the current study, we provide this information using structural equation modeling of Positive and Negative Syndrome Scale (PANSS) ratings at admission and discharge on a sample of 610 patients admitted to a treatment refractory psychosis program at a Canadian tertiary care unit between 1990 and 2011. The hypothesized five-dimensional structure of the PANSS fit the data well at both admission and discharge, and the latent variable scores are reported as a function of symptom dimension and diagnostic category. The results suggest that, overall, positive symptoms (POS) responded to treatment better than all other symptoms dimensions, but for the schizoaffective and bipolar groups, greater response on POS was observed relative to the schizophrenia and major depression groups. The major depression group showed the most improvement on negative symptoms and emotional distress, and the bipolar group showed the most improvement on disorganization. Schizophrenia was distinct from schizoaffective disorder in showing reduced treatment response on all symptom dimensions. These results can assist refractory psychosis units by providing information on how PANSS symptom dimensions respond to treatment and how this depends on diagnostic category.

Six-port optical switch for cluster-mesh photonic network-on-chip

NASA Astrophysics Data System (ADS)

Jia, Hao; Zhou, Ting; Zhao, Yunchou; Xia, Yuhao; Dai, Jincheng; Zhang, Lei; Ding, Jianfeng; Fu, Xin; Yang, Lin

2018-05-01

Photonic network-on-chip for high-performance multi-core processors has attracted substantial interest in recent years as it offers a systematic method to meet the demand of large bandwidth, low latency and low power dissipation. In this paper we demonstrate a non-blocking six-port optical switch for cluster-mesh photonic network-on-chip. The architecture is constructed by substituting three optical switching units of typical Spanke-Benes network to optical waveguide crossings. Compared with Spanke-Benes network, the number of optical switching units is reduced by 20%, while the connectivity of routing path is maintained. By this way the footprint and power consumption can be reduced at the expense of sacrificing the network latency performance in some cases. The device is realized by 12 thermally tuned silicon Mach-Zehnder optical switching units. Its theoretical spectral responses are evaluated by establishing a numerical model. The experimental spectral responses are also characterized, which indicates that the optical signal-to-noise ratios of the optical switch are larger than 13.5 dB in the wavelength range from 1525 nm to 1565 nm. Data transmission experiment with the data rate of 32 Gbps is implemented for each optical link.

Recruitment and rate coding organisation for soleus motor units across entire range of voluntary isometric plantar flexions.

PubMed

Oya, Tomomichi; Riek, Stephan; Cresswell, Andrew G

2009-10-01

Unlike upper limb muscles, it remains undocumented as to how motor units in the soleus muscle are organised in terms of recruitment range and discharge rates with respect to their recruitment and de-recruitment thresholds. The possible influence of neuromodulation, such as persistent inward currents (PICs) on lower limb motor unit recruitment and discharge rates has also yet to be reported. To address these issues, electromyographic (EMG) activities from the soleus muscle were recorded using selective branched-wire intramuscular electrodes during ramp-and-hold contractions with intensities up to maximal voluntary contraction (MVC). The multiple single motor unit activities were then derived using a decomposition technique. The onset-offset hysteresis of motor unit discharge, i.e. a difference between recruitment and de-recruitment thresholds, as well as PIC magnitude calculated by a paired motor unit analysis were used to examine the neuromodulatory effects on discharge behaviours, such as minimum firing rate, peak firing rate and degree of increase in firing rate. Forty-two clearly identified motor units from five subjects revealed that soleus motor units are recruited progressively from rest to contraction strengths close to 95% of MVC, with low-threshold motor units discharging action potentials slower at their recruitment and with a lower peak rate than later recruited high-threshold units. This observation is in contrast to the 'onion skin phenomenon' often reported for the upper limb muscles. Based on positive correlations of the peak discharge rates, initial rates and recruitment order of the units with the magnitude of the onset-offset hysteresis and not PIC contribution, we conclude that discharge behaviours among motor units appear to be related to a variation in an intrinsic property other than PICs.

Invasion vs insurgency: US Navy/Marine Corps forward surgical care during Operation Iraqi Freedom.

PubMed

Brethauer, Stacy A; Chao, Alex; Chambers, Lowell W; Green, Donald J; Brown, Carlos; Rhee, Peter; Bohman, Harold R

2008-06-01

The transition from maneuver warfare to insurgency warfare has changed the mechanism and severity of combat wounds treated by US Marine Corps forward surgical units in Iraq. Case series comparison. Forward Resuscitative Surgical System units in Iraq. Three hundred thirty-eight casualties treated during the invasion of Iraq in 2003 (Operation Iraqi Freedom I [OIF I]) and 895 casualties treated between March 2004 and February 2005 (OIF II). Definitive and damage control procedures for acute combat casualties. Mechanism of injury, procedures performed, time to presentation, and killed in action (KIA) and died of wounds (DOW) rates. More major injuries occurred per patient (2.4 vs 1.6) during OIF II. There were more casualties with fragment wounds (61% vs 48%; P = .03) and a trend toward fewer gunshot wounds (33% vs 43%; P = .15) during OIF II. More damage control laparotomies (P = .04) and more soft tissue debridements (P < .001) were performed during OIF II. The median time to presentation for critically injured US casualties during OIF I and OIF II were 30 and 59 minutes, respectively. The KIA rate increased from 13.5% to 20.2% and the DOW rate increased from 0.88% to 5.5% for US personnel in the First Marine Expeditionary Force area of responsibility. The transition from maneuver to insurgency warfare has changed the type and severity of casualties treated by US Marine Corps forward surgical units in Iraq. Improvised explosive devices, severity and number of injuries per casualty, longer transport times, and higher KIA and DOW rates represent major differences between periods. Further data collection is necessary to determine the association between transport times and mortality rates.

Hospital variation in time to defibrillation after in-hospital cardiac arrest.

PubMed

Chan, Paul S; Nichol, Graham; Krumholz, Harlan M; Spertus, John A; Nallamothu, Brahmajee K

2009-07-27

Delays to defibrillation are associated with worse survival after in-hospital cardiac arrest, but the degree to which hospitals vary in defibrillation response times and hospital predictors of delays remain unknown. Using hierarchical models, we evaluated hospital variation in rates of delayed defibrillation (>2 minutes) and its impact on survival among 7479 adult inpatients with cardiac arrests at 200 hospitals within the National Registry of Cardiopulmonary Resuscitation. Adjusted rates of delayed defibrillation varied substantially among hospitals (range, 2.4%-50.9%), with hospital-level effects accounting for a significant amount of the total variation in defibrillation delays after adjusting for patient factors. We found a 46% greater odds of patients with identical covariates getting delayed defibrillation at one randomly selected hospital compared with another. Among traditional hospital factors evaluated, however, only bed volume (reference category: <200 beds; 200-499 beds: odds ratio [OR], 0.62 [95% confidence interval {CI}, 0.48-0.80]; >or=500 beds: OR, 0.74 [95% CI, 0.53-1.04]) and arrest location (reference category: intensive care unit; telemetry unit: OR, 1.92 [95% CI, 1.65-2.22]; nonmonitored unit: OR, 1.90 [95% CI, 1.61-2.24]) were associated with differences in rates of delayed defibrillation. Wide variation also existed in adjusted hospital rates of survival to discharge (range, 5.3%-49.6%), with higher survival among hospitals in the top-performing quartile for defibrillation time (compared with the bottom quartile: OR for top quartile, 1.41 [95% CI, 1.11-1.77]). Rates of delayed defibrillation vary widely among hospitals but are largely unexplained by traditional hospital factors. Given its association with improved survival, future research is needed to better understand best practices in the delivery of defibrillation at top-performing hospitals.

ACCCN national nursing workforce survey of intensive care units.

PubMed

Williams, S; Ogle, K R; Leslie, G

2001-05-01

A descriptive study was designed and implemented by the Australian College of Critical Care Nurses (ACCCN) Workforce Planning Advisory Committee to capture data pertaining to workforce issues of intensive care nurses. All intensive care units (ICUs) within Australia were mailed a self reporting survey. Despite a low response rate (52 per cent) and difficulty reported by respondents in gaining the appropriate data requested, the results revealed an interesting snapshot of the intensive care nursing workforce. Types of services offered by units varied considerably; paid overtime hours were low (< 2 per cent of total hours worked) and use of both part-time and agency staff was also low (10 per cent of total hours worked). Private hospitals utilised a greater proportion of part-time and agency nursing staff than public hospitals (20:10 per cent). The turnover rate for registered nursing staff was estimated at 18 per cent, with education, skill acquisition and improved communication reported as the major incentives used by managers to attract and retain staff. This study demonstrated that valuable data are currently uncaptured and recommends a more refined process of a national database to record and manage this important information for future workforce planning.

Suspended biofilm carrier and activated sludge removal of acidic pharmaceuticals.

PubMed

Falås, P; Baillon-Dhumez, A; Andersen, H R; Ledin, A; la Cour Jansen, J

2012-03-15

Removal of seven active pharmaceutical substances (ibuprofen, ketoprofen, naproxen, diclofenac, clofibric acid, mefenamic acid, and gemfibrozil) was assessed by batch experiments, with suspended biofilm carriers and activated sludge from several full-scale wastewater treatment plants. A distinct difference between nitrifying activated sludge and suspended biofilm carrier removal of several pharmaceuticals was demonstrated. Biofilm carriers from full-scale nitrifying wastewater treatment plants, demonstrated considerably higher removal rates per unit biomass (i.e. suspended solids for the sludges and attached solids for the carriers) of diclofenac, ketoprofen, gemfibrozil, clofibric acid and mefenamic acid compared to the sludges. Among the target pharmaceuticals, only ibuprofen and naproxen showed similar removal rates per unit biomass for the sludges and biofilm carriers. In contrast to the pharmaceutical removal, the nitrification capacity per unit biomass was lower for the carriers than the sludges, which suggests that neither the nitrite nor the ammonia oxidizing bacteria are primarily responsible for the observed differences in pharmaceutical removal. The low ability of ammonia oxidizing bacteria to degrade or transform the target pharmaceuticals was further demonstrated by the limited pharmaceutical removal in an experiment with continuous nitritation and biofilm carriers from a partial nitritation/anammox sludge liquor treatment process. Copyright © 2011 Elsevier Ltd. All rights reserved.

The effects of prostaglandin E2 on the firing rate activity of thermosensitive and temperature insensitive neurons in the ventromedial preoptic area of the rat hypothalamus.

PubMed

Ranels, Heather J; Griffin, John D

2003-02-21

In response to an immune system challenge with lipopolysaccharide (LPS), recent work has shown that Fos immunoreactivity is displayed by neurons in the ventromedial preoptic area of the hypothalamus (VMPO). In addition, neurons in this region show distinct axonal projections to the anterior perifornical area (APFx) and the paraventricular nucleus (PVN). It has been hypothesized that neurons within the VMPO integrate their local responses to temperature with changes in firing activity that result from LPS induced production of prostaglandin E(2) (PGE(2)). This may be an important mechanism by which the set-point regulation of thermoeffector neurons in the APFx and PVN is altered, resulting in hyperthermia. To characterize the firing rate activity of VMPO neurons, single-unit recordings were made of neuronal extracellular activity in rat hypothalamic tissue slices. Based on the slope of firing rate as a function of tissue temperature, neurons were classified as either warm sensitive or temperature insensitive. Neurons were then treated with PGE(2) (200 nM) while tissue temperature was held at a constant level ( approximately 36 degrees C). The majority of temperature insensitive neurons responded to PGE(2) with an increase in firing rate activity, while warm sensitive neurons showed a reduction in firing rate. This suggests that both warm sensitive and temperature insensitive neurons in the VMPO may play critical and contrasting roles in the production of a fever during an acute phase response to infection.

Tonometer disinfection practice in the United Kingdom: a national survey.

PubMed

Hillier, R J; Kumar, N

2008-08-01

To assess current tonometer disinfection practice in the UK, and compare with published recommendations. Every ophthalmology unit with training recognition in the UK was contacted (n=155). A senior nurse at each institution completed a telephone questionnaire regarding local tonometer disinfection practice. The response rate was 100%. Thirty-five units (23%) reported exclusive use of disposable tonometer heads and were excluded from further analysis. One hundred and twenty units (77%) used either reusable or a combination of reusable and disposable tonometer heads. Where reusable heads were used, 80 units (67%) immersed them in a chlorine-based solution such as sodium hypochlorite or sodium dichloroisocyanurate. Others used isopropyl alcohol (18 units), hydrogen peroxide (12 units), chloramine (5 units), chlorhexidine (4 units) and peracetic acid (1 unit). Where a chlorine-based agent was used, the concentration of available chlorine ranged from 125 to 30 000 p.p.m., with 50 units (63%) using a concentration of less than 5 000 p.p.m. (i.e., inadequate based on published recommendations). Where the tonometer head was immersed in disinfectant between patients (n=101), 29 units (29%) provided just one tonometer head per practitioner, making adequate soak time between patients unlikely. Every unit replenished the disinfectant at least daily, deemed sufficient for most agents. However, hydrogen peroxide solutions should be replenished twice daily, which did not take place in nine units. This survey reveals disparity between current tonometer disinfection practice and published international recommendations, with some institutions using practices that may render patients susceptible to transmissible infection.

The nurse work environment, job satisfaction and turnover rates in rural and urban nursing units.

PubMed

Baernholdt, Marianne; Mark, Barbara A

2009-12-01

The aim of the present study was to determine whether there are differences in hospital characteristics, nursing unit characteristics, the nurse work environment, job satisfaction and turnover rates in rural and urban nursing units. Research in urban hospitals has found an association between the nurse work environment and job satisfaction and turnover rates, but this association has not been examined in rural hospitals. Rural and urban nursing units were compared in a national random sample of 97 United States hospitals (194 nursing units) with between 99 and 450 beds. Significant differences were found between hospital and nursing unit characteristics and the nurse work environment in rural and urban nursing units. Both nursing unit characteristics and the work environment were found to have a significant influence on nurse job satisfaction and turnover rates. Job satisfaction and turnover rates in rural and urban nursing units are associated with both nursing unit characteristics and the work environment. Both rural and urban hospitals can improve nurse job satisfaction and turnover rates by changing unit characteristics, such as creating better support services and a work environment that supports autonomous nursing practice. Rural hospitals can also improve the work environment by providing nurses with more educational opportunities.

The prehomosexual male child in three societies: the United States, Guatemala, Brazil.

PubMed

Whitam, F L

1980-04-01

The question raised by this article is: do the several behavioral indicators of male homosexuality, which emerge in childhood, appear cross-culturally, or are they limited to American society? These indicators are interest in toys of the opposite sex, cross-dressing, preference for girls' games and activities, preference for the company of women, being regarded as a sissy, and preference for boys in childhood sex play. Data on indicators were obtained from male homosexuals in three societies--the United States, Guatemala, and Brazil--and compared with responses of heterosexuals. It is concluded that the behavioral indicators do occur in these three societies and occur at about the same rate.

Enhancement of Pyrometallurgical Teaching Using Excel Simulation Models

NASA Astrophysics Data System (ADS)

Grimsey, Eric J.

Steady state Excel models for a copper flash smelter and an iron blast furnace are used to enhance the teaching of pyrometallurgical smelting principles within a fourth year level process engineering unit delivered at the Western Australian School of Mines. A lecture/workshop approach has been adopted in which student teams undertake process simulation assignments that illustrate the multifaceted responses of process outputs to variation of inputs, the objectives being to reinforce their understanding of smelting principles. The approach has proven to be popular with students, as evidenced by the consistently high ratings the unit has received through student feedback. This paper provides an overview of the teaching approach and process models used.

A passively controlled appendage deployment system for the San Marco D/L spacecraft

NASA Technical Reports Server (NTRS)

Lang, W. E.; Frisch, H. P.; Schwartz, D. A.

1984-01-01

The analytical simulation of deployment dynamics of these two axis concepts as well as the evolution of practical designs for the add on deployable inertia boom units is described. With the boom free to swing back in response to Coriolis forces as well as outwards in response to centrifugal forces, the kinematics of motion are complex but admit the possibility of absorbing deployment energy in frictional or other damping devices about the radial axis, where large amplitude motions can occur and where the design envelope allows more available volume. An acceptable range is defined for frictional damping for any given spin rate. Inadequate damping allows boom motions which strike the spacecraft; excessive damping causes the boom to swing out and latch with damaging violence. The acceptable range is a design parameter and must accommodate spin rate tolerance and also the tolerance and repeatability of the damping mechanisms.

Study on Mine Emergency Mechanism based on TARP and ICS

NASA Astrophysics Data System (ADS)

Xi, Jian; Wu, Zongzhi

2018-01-01

By analyzing the experiences and practices of mine emergency in China and abroad, especially the United States and Australia, normative principle, risk management principle and adaptability principle of constructing mine emergency mechanism based on Trigger Action Response Plans (TARP) and Incident Command System (ICS) are summarized. Classification method, framework, flow and subject of TARP and ICS which are suitable for the actual situation of domestic mine emergency are proposed. The system dynamics model of TARP and ICS is established. The parameters such as evacuation ratio, response rate, per capita emergency capability and entry rate of rescuers are set up. By simulating the operation process of TARP and ICS, the impact of these parameters on the emergency process are analyzed, which could provide a reference and basis for building emergency capacity, formulating emergency plans and setting up action plans in the emergency process.

Combining agreement and frequency rating scales to optimize psychometrics in measuring behavioral health functioning.

PubMed

Marfeo, Elizabeth E; Ni, Pengsheng; Chan, Leighton; Rasch, Elizabeth K; Jette, Alan M

2014-07-01

The goal of this article was to investigate optimal functioning of using frequency vs. agreement rating scales in two subdomains of the newly developed Work Disability Functional Assessment Battery: the Mood & Emotions and Behavioral Control scales. A psychometric study comparing rating scale performance embedded in a cross-sectional survey used for developing a new instrument to measure behavioral health functioning among adults applying for disability benefits in the United States was performed. Within the sample of 1,017 respondents, the range of response category endorsement was similar for both frequency and agreement item types for both scales. There were fewer missing values in the frequency items than the agreement items. Both frequency and agreement items showed acceptable reliability. The frequency items demonstrated optimal effectiveness around the mean ± 1-2 standard deviation score range; the agreement items performed better at the extreme score ranges. Findings suggest an optimal response format requires a mix of both agreement-based and frequency-based items. Frequency items perform better in the normal range of responses, capturing specific behaviors, reactions, or situations that may elicit a specific response. Agreement items do better for those whose scores are more extreme and capture subjective content related to general attitudes, behaviors, or feelings of work-related behavioral health functioning. Copyright © 2014 Elsevier Inc. All rights reserved.

A Common Fluence Threshold for First Positive and Second Positive Phototropism in Arabidopsis thaliana1

PubMed Central

Janoudi, Abdul; Poff, Kenneth L.

1990-01-01

The relationship between the amount of light and the amount of response for any photobiological process can be based on the number of incident quanta per unit time (fluence rate-response) or on the number of incident quanta during a given period of irradiation (fluence-response). Fluence-response and fluence rate-response relationships have been measured for second positive phototropism by seedlings of Arabidopsis thaliana. The fluence-response relationships exhibit a single limiting threshold at about 0.01 micromole per square meter when measured at fluence rates from 2.4 × 10−5 to 6.5 × 10−3 micromoles per square meter per second. The threshold values in the fluence rateresponse curves decrease with increasing time of irradiation, but show a common fluence threshold at about 0.01 micromole per square meter. These thresholds are the same as the threshold of about 0.01 micromole per square meter measured for first positive phototropism. Based on these data, it is suggested that second positive curvature has a threshold in time of about 10 minutes. Moreover, if the times of irradiation exceed the time threshold, there is a single limiting fluence threshold at about 0.01 micromole per square meter. Thus, the limiting fluence threshold for second positive phototropism is the same as the fluence threshold for first positive phototropism. Based on these data, we suggest that this common fluence threshold for first positive and second positive phototropism is set by a single photoreceptor pigment system. PMID:11537470

Fluid bolus therapy in critically ill children: a survey of practice among paediatric intensive care doctors in Australia and New Zealand.

PubMed

Gelbart, Ben; Schlapbach, Luregn; Ganeshalingham, Anusha; Ganu, Subodh; Erickson, Simon; Oberender, Felix; Hoq, Monsurul; Williams, Gary; George, Shane; Festa, Marino

2018-06-01

Fluid bolus therapy (FBT) is a widely used intervention in paediatric critical illness. The aim of this study was to describe the attitudes and practices towards FBT of paediatric intensive care doctors in Australia and New Zealand. An internet-based survey of paediatric intensive care doctors in Australia and New Zealand between 7 and 30 November 2016. Paediatric intensive care units with greater than 400 admissions annually. Paediatric intensive care specialists and junior medical staff. Preferences for FBT and markers of fluid responsiveness. There were 106/175 respondents (61%); 0.9% saline and 4% albumin are used frequently or almost always by 86% and 57% of respondents respectively. The preferred volume and duration were 10 mL/kg in less than 10 minutes. The highest rated markers of fluid responsiveness were heart rate and blood pressure - rated as "good" or "very good" by 75% and 58% of respondents respectively. Central venous saturations and serum lactate were the highest rated biochemical markers. The most frequently expected magnitude of change for heart rate and blood pressure was 6-15% by 89% and 76% of respondents respectively. The preferred fluid composition for sepsis, trauma, traumatic brain injury and acute lung injury was 0.9% saline, and 4% albumin for post-operative cardiac surgery. Paediatric intensive care doctors prefer 0.9% saline and 4% albumin for FBT. Heart rate and blood pressure are the most preferred markers to assess fluid responsiveness. Preferences for FBT in specific conditions exist.

Critical target and dose and dose-rate responses for the induction of chromosomal instability by ionizing radiation

NASA Technical Reports Server (NTRS)

Limoli, C. L.; Corcoran, J. J.; Milligan, J. R.; Ward, J. F.; Morgan, W. F.

1999-01-01

To investigate the critical target, dose response and dose-rate response for the induction of chromosomal instability by ionizing radiation, bromodeoxyuridine (BrdU)-substituted and unsubstituted GM10115 cells were exposed to a range of doses (0.1-10 Gy) and different dose rates (0.092-17.45 Gy min(-1)). The status of chromosomal stability was determined by fluorescence in situ hybridization approximately 20 generations after irradiation in clonal populations derived from single progenitor cells surviving acute exposure. Overall, nearly 700 individual clones representing over 140,000 metaphases were analyzed. In cells unsubstituted with BrdU, a dose response was found, where the probability of observing delayed chromosomal instability in any given clone was 3% per gray of X rays. For cells substituted with 25-66% BrdU, however, a dose response was observed only at low doses (<1.0 Gy); at higher doses (>1.0 Gy), the incidence of chromosomal instability leveled off. There was an increase in the frequency and complexity of chromosomal instability per unit dose compared to cells unsubstituted with BrdU. The frequency of chromosomal instability appeared to saturate around approximately 30%, an effect which occurred at much lower doses in the presence of BrdU. Changing the gamma-ray dose rate by a factor of 190 (0.092 to 17.45 Gy min(-1)) produced no significant differences in the frequency of chromosomal instability. The enhancement of chromosomal instability promoted by the presence of the BrdU argues that DNA comprises at least one of the critical targets important for the induction of this end point of genomic instability.

A survey of interventional radiology for the management of obstetric haemorrhage in the United Kingdom.

PubMed

Webster, V J; Stewart, R; Stewart, P

2010-07-01

Massive haemorrhage remains a leading cause of maternal death worldwide. Interventional radiology can be used to prevent or treat life-threatening haemorrhage, but evidence for its efficacy is limited to case series predominantly from large tertiary centres. The current availability of interventional radiology for management of obstetric haemorrhage in the UK is unknown. A postal questionnaire on the use of interventional radiology was sent to the lead clinician for obstetric anaesthesia in 226 UK maternity units. The response rate was 72%; 74 respondents (46%) had considered and 51 (31%) used interventional radiology for control of obstetric haemorrhage. Its use was primarily confined to large tertiary obstetric units and limited by availability of equipment and staff. Interventional radiology to assist in the management of obstetric haemorrhage is not uniformly available in the UK and experience remains limited. Access to this resource is subject to striking local variability and influenced by the size and nature of the hospital supporting the delivery unit. 2010 Elsevier Ltd. All rights reserved.

The hydrogeology of complex lens conditions in Qatar

NASA Astrophysics Data System (ADS)

Lloyd, J. W.; Pike, J. G.; Eccleston, B. L.; Chidley, T. R. E.

1987-01-01

The emirate of Qatar lies on a peninsula extending northward from the mainland of Saudi Arabia into the Arabian Gulf. The peninsula is underlain by sedimentary rocks ranging from late Cretaceous to Holocene age but only two Lower Tertiary units are identified as aquifers. The groundwater distribution in these units is seen to be controlled by facies distributions related to tectonically controlled sedimentation and subsequent dissolution. Dissolution has created permeability, in the Umm er Rhaduma limestones and in the overlying Rus anhydrites. In the latter case the dissolution has lead to extensive surface collapse which has provided a mechanism for recharge from runoff. Despite very low rainfall and high evaporation rates, recharge related to storm runoff has resulted in the establishment of a complex fresh groundwater lens in both aquifer units. The lens is constrained by saline groundwaters which in the lower unit are controlled by heads in eastern Saudi Arabia but in the upper unit by the Arabian Gulf sea level. Groundwater abstraction is shown to be distorting the fresh groundwater lens configuration, and estimates of the resultant flow responses affecting the lens are given.

An Overview of Patient Safety Climate in the VA

PubMed Central

Hartmann, Christine W; Rosen, Amy K; Meterko, Mark; Shokeen, Priti; Zhao, Shibei; Singer, Sara; Falwell, Alyson; Gaba, David M

2008-01-01

Objective To assess variation in safety climate across VA hospitals nationally. Study Setting Data were collected from employees at 30 VA hospitals over a 6-month period using the Patient Safety Climate in Healthcare Organizations survey. Study Design We sampled 100 percent of senior managers and physicians and a random 10 percent of other employees. At 10 randomly selected hospitals, we sampled an additional 100 percent of employees working in units with intrinsically higher hazards (high-hazard units [HHUs]). Data Collection Data were collected using an anonymous survey design. Principal Findings We received 4,547 responses (49 percent response rate). The percent problematic response—lower percent reflecting higher levels of patient safety climate—ranged from 12.0–23.7 percent across hospitals (mean=17.5 percent). Differences in safety climate emerged by management level, clinician status, and workgroup. Supervisors and front-line staff reported lower levels of safety climate than senior managers; clinician responses reflected lower levels of safety climate than those of nonclinicians; and responses of employees in HHUs reflected lower levels of safety climate than those of workers in other areas. Conclusions This is the first systematic study of patient safety climate in VA hospitals. Findings indicate an overall positive safety climate across the VA, but there is room for improvement. PMID:18355257

Enhanced responses of lumbar superficial dorsal horn neurons to intradermal PAR-2 agonist but not histamine in a mouse hindpaw dry skin itch model

PubMed Central

Akiyama, Tasuku; Carstens, Mirela Iodi

2011-01-01

Chronic itch is symptomatic of many skin conditions and systemic diseases. Little is known about pathophysiological alterations in itch-signaling neural pathways associated with chronic itch. We used a mouse model of hindpaw chronic dry skin itch to investigate properties of presumptive itch-signaling neurons. Neurons in the lumbar superficial dorsal horn ipsilateral to hindpaw dry skin treatment exhibited a high level of spontaneous activity that was inhibited by scratching the plantar surface. Most spontaneously active units exhibited further increases in firing rate following intradermal injection of an agonist of the protease-activated receptor PAR-2, or histamine. The large majority of pruritogen-responsive units also responded to capsaicin and allyl isothiocyanate. For neurons ipsilateral to dry skin treatment, responses elicited by the PAR-2 agonist, but not histamine or mechanical stimuli, were significantly larger compared with neurons ipsilateral to vehicle (water) treatment or neurons recorded in naïve (untreated) mice. The spontaneous activity may signal ongoing itch, while enhanced PAR-2 agonist-evoked responses may underlie hyperknesis (enhanced itch), both of which are symptomatic of many chronic itch conditions. The enhancement of neuronal responses evoked by the PAR-2 agonist, but not by histamine or mechanical stimuli, implies that the dry skin condition selectively sensitized PAR-2 agonist-sensitive primary afferent pruriceptors. PMID:21430273

Enhanced responses of lumbar superficial dorsal horn neurons to intradermal PAR-2 agonist but not histamine in a mouse hindpaw dry skin itch model.

PubMed

Akiyama, Tasuku; Carstens, Mirela Iodi; Carstens, E

2011-06-01

Chronic itch is symptomatic of many skin conditions and systemic diseases. Little is known about pathophysiological alterations in itch-signaling neural pathways associated with chronic itch. We used a mouse model of hindpaw chronic dry skin itch to investigate properties of presumptive itch-signaling neurons. Neurons in the lumbar superficial dorsal horn ipsilateral to hindpaw dry skin treatment exhibited a high level of spontaneous activity that was inhibited by scratching the plantar surface. Most spontaneously active units exhibited further increases in firing rate following intradermal injection of an agonist of the protease-activated receptor PAR-2, or histamine. The large majority of pruritogen-responsive units also responded to capsaicin and allyl isothiocyanate. For neurons ipsilateral to dry skin treatment, responses elicited by the PAR-2 agonist, but not histamine or mechanical stimuli, were significantly larger compared with neurons ipsilateral to vehicle (water) treatment or neurons recorded in naïve (untreated) mice. The spontaneous activity may signal ongoing itch, while enhanced PAR-2 agonist-evoked responses may underlie hyperknesis (enhanced itch), both of which are symptomatic of many chronic itch conditions. The enhancement of neuronal responses evoked by the PAR-2 agonist, but not by histamine or mechanical stimuli, implies that the dry skin condition selectively sensitized PAR-2 agonist-sensitive primary afferent pruriceptors.

General Aviation Activity and Avionics Survey. 1978

DTIC Science & Technology

1980-03-01

Sponsoing AencyCode Washington DC 20591 AS/220 _ 15. Supplementary Notes 16. Ab xtrect This report presents the results and a description of the 1978...the United States registered general aviation aircraft fleet, the dominant component of civil aviation in the U.S. The survey was based on a ...statistically selected sample of about 13.3 percent of the general aviation fleet and obtained a response rate of 74 percent. Survey results are based upon

Gravity Responsive NADH Oxidase of the Plasma Membrane

NASA Technical Reports Server (NTRS)

Morre, D. James (Inventor)

2002-01-01

A method and apparatus for sensing gravity using an NADH oxidase of the plasma membrane which has been found to respond to unit gravity and low centrifugal g forces. The oxidation rate of NADH supplied to the NADH oxidase is measured and translated to represent the relative gravitational force exerted on the protein. The NADH oxidase of the plasma membrane may be obtained from plant or animal sources or may be produced recombinantly.

United States Air Force Research Initiation Program for 1988. Volume 3

DTIC Science & Technology

1990-04-01

Assignment for Dr. Kenneth M. Sobel Flight Control Design 210-9MG-035 90 Comparative Burning Rates and Duplex Dr. Forrest Thomas (1987) Loads of Solid...Patterson Air Force Base. The test configuration has been designed for injecting fuel droplets in a well controlled laminar on well-characterized turbulent...its counter response may be significant, our system has thus achieved some measure of control over when non -critical processing is actually performed

Implementation of a symptomatic approach leads to increased efficiency of a cholera treatment unit.

PubMed

Ticona, Eduardo; Kirwan, Daniela E; Soria, Jaime; Gilman, Robert H

2014-09-01

Cholera is a disease of poverty that remains prevalent in resource-limited countries. The abrupt emergence of an epidemic frequently takes communities and health systems by surprise. Spread is rapid and initial mortality high: delays in organizing an appropriate response, lack of health worker training, and high patient numbers contribute to high rates of complications and deaths. © The American Society of Tropical Medicine and Hygiene.

Reliability of Pressure Ulcer Rates: How Precisely Can We Differentiate Among Hospital Units, and Does the Standard Signal-Noise Reliability Measure Reflect This Precision?

PubMed

Staggs, Vincent S; Cramer, Emily

2016-08-01

Hospital performance reports often include rankings of unit pressure ulcer rates. Differentiating among units on the basis of quality requires reliable measurement. Our objectives were to describe and apply methods for assessing reliability of hospital-acquired pressure ulcer rates and evaluate a standard signal-noise reliability measure as an indicator of precision of differentiation among units. Quarterly pressure ulcer data from 8,199 critical care, step-down, medical, surgical, and medical-surgical nursing units from 1,299 US hospitals were analyzed. Using beta-binomial models, we estimated between-unit variability (signal) and within-unit variability (noise) in annual unit pressure ulcer rates. Signal-noise reliability was computed as the ratio of between-unit variability to the total of between- and within-unit variability. To assess precision of differentiation among units based on ranked pressure ulcer rates, we simulated data to estimate the probabilities of a unit's observed pressure ulcer rate rank in a given sample falling within five and ten percentiles of its true rank, and the probabilities of units with ulcer rates in the highest quartile and highest decile being identified as such. We assessed the signal-noise measure as an indicator of differentiation precision by computing its correlations with these probabilities. Pressure ulcer rates based on a single year of quarterly or weekly prevalence surveys were too susceptible to noise to allow for precise differentiation among units, and signal-noise reliability was a poor indicator of precision of differentiation. To ensure precise differentiation on the basis of true differences, alternative methods of assessing reliability should be applied to measures purported to differentiate among providers or units based on quality. © 2016 The Authors. Research in Nursing & Health published by Wiley Periodicals, Inc. © 2016 The Authors. Research in Nursing & Health published by Wiley Periodicals, Inc.

Fertility and Childlessness in the United States.

PubMed

Baudin, Thomas; de la Croix, David

2015-06-01

We develop a theory of fertility, distinguishing its intensive margin from its extensive margin. The deep parameters are identified using facts from the 1990 US Census: (i) fertility of mothers decreases with education; (ii) childlessness exhibits a U-shaped relationship with education; (iii) the relationship between marriage rates and education is hump-shaped for women and increasing for men. We estimate that 2.5 percent of women were childless because of poverty and 8.1 percent because of high opportunity cost of childrearing. Over time, historical trends in total factor productivity and in education led to a U-shaped response in childlessness rates while fertility of mothers decreased.

Smoking and Looked-After Children: A Mixed-Methods Study of Policy, Practice, and Perceptions Relating to Tobacco Use in Residential Units

PubMed Central

Huddlestone, Lisa; Pritchard, Catherine; Ratschen, Elena

2016-01-01

Despite the implementation of smoke-free policies by local authorities and a statutory requirement to promote the health and well-being of looked-after children and young people in England, rates of tobacco use by this population are substantially higher than in the general youth population. A mixed-methods study, comprising a survey of residential care officers in 15 local authority-operated residential units and semi-structured, face-to-face interviews with residential carers in three local authority-operated residential units, was conducted in the East Midlands. Survey data were descriptively analysed; and interview data were transcribed and analysed using thematic framework analysis. Forty-two care officers (18% response rate) completed the survey, and 14 participated in the interviews. Despite reporting substantial awareness of smoke-free policies, a lack of adherence and enforcement became apparent, and levels of reported training in relation to smoking and smoking cessation were low (21%). Potential problems relating to wider tobacco-related harms, such as exploitative relationships; a reliance on tacit knowledge; and pessimistic attitudes towards LAC quitting smoking, were indicated. The findings highlight the need for the development of comprehensive strategies to promote adherence to and enforcement of local smoke-free policy within residential units for looked-after children and young people, and to ensure appropriate support pathways are in place for this population. PMID:27314373

Developing a neonatal workforce: role evolution and retention of advanced neonatal nurse practitioners

PubMed Central

Smith, S; Hall, M

2003-01-01

Background: Over the past decade more than 120 advanced neonatal nurse practitioners (ANNPs) have graduated from the Southampton based ANNP programme. Objectives: To determine the scope of practice and evolving role of ANNPs and to identify factors that may affect future recruitment and retention. Method: An open ended structured questionnaire on clinical role, working arrangements, retention and attrition, continuing education, and professional development was sent to 95 ANNPs. Results: A response rate of 83% was achieved. There was an attrition rate of 14%, with most ANNPs remaining in their original seconding unit. Factors considered to be important for role satisfaction included a well defined role, working within a team of ANNPs, appropriate remuneration, and evidence of unit support for both role definition and continuing professional development. Conclusions: Although ANNPs are expensive to both train and employ, this evidence suggests that there is a good return on the investment in terms of retention to the unit and the specialty. Their role incorporates many features of advanced nursing practice as well as providing "value added" neonatal care by merging traditional medical and nursing roles and crossing professional boundaries. In 2004 the manpower challenges for neonatal units will be even more acute; these data confirm that there are effective options available but they require long term strategic planning and investment. PMID:12937050

Time-related changes in firing rates are influenced by recruitment threshold and twitch force potentiation in the first dorsal interosseous.

PubMed

Miller, Jonathan D; Herda, Trent J; Trevino, Michael A; Sterczala, Adam J; Ciccone, Anthony B

2017-08-01

What is the central question of this study? The influences of motor unit recruitment threshold and twitch force potentiation on the changes in firing rates during steady-force muscular contractions are not well understood. What is the main finding and its importance? The behaviour of motor units during steady force was influenced by recruitment threshold, such that firing rates decreased for lower-threshold motor units but increased for higher-threshold motor units. In addition, individuals with greater changes in firing rates possessed greater twitch force potentiation. There are contradictory reports regarding changes in motor unit firing rates during steady-force contractions. Inconsistencies are likely to be the result of previous studies disregarding motor unit recruitment thresholds and not examining firing rates on a subject-by-subject basis. It is hypothesized that firing rates are manipulated by twitch force potentiation during contractions. Therefore, in this study we examined time-related changes in firing rates at steady force in relationship to motor unit recruitment threshold in the first dorsal interosseous and the influence of twitch force potentiation on such changes in young versus aged individuals. Subjects performed a 12 s steady-force contraction at 50% maximal voluntary contraction, with evoked twitches before and after the contraction to quantify potentiation. Firing rates, in relationship to recruitment thresholds, were determined at the beginning, middle and end of the steady force. There were no firing rate changes for aged individuals. For the young, firing rates decreased slightly for lower-threshold motor units but increased for higher-threshold motor units. Twitch force potentiation was greater for young than aged subjects, and changes in firing rates were correlated with twitch force potentiation. Thus, individuals with greater increases in firing rates of higher-threshold motor units and decreases in lower-threshold motor units possessed greater twitch force potentiation. Overall, changes in firing rates during brief steady-force contractions are dependent on recruitment threshold and explained in part by twitch force potentiation. Given that firing rate changes were measured in relationship to recruitment threshold, this study illustrates a more complete view of firing rate changes during steady-force contractions. © 2017 The Authors. Experimental Physiology © 2017 The Physiological Society.

Reducing patient mortality, length of stay and readmissions through machine learning-based sepsis prediction in the emergency department, intensive care unit and hospital floor units

PubMed Central

McCoy, Andrea

2017-01-01

Introduction Sepsis management is a challenge for hospitals nationwide, as severe sepsis carries high mortality rates and costs the US healthcare system billions of dollars each year. It has been shown that early intervention for patients with severe sepsis and septic shock is associated with higher rates of survival. The Cape Regional Medical Center (CRMC) aimed to improve sepsis-related patient outcomes through a revised sepsis management approach. Methods In collaboration with Dascena, CRMC formed a quality improvement team to implement a machine learning-based sepsis prediction algorithm to identify patients with sepsis earlier. Previously, CRMC assessed all patients for sepsis using twice-daily systemic inflammatory response syndrome screenings, but desired improvements. The quality improvement team worked to implement a machine learning-based algorithm, collect and incorporate feedback, and tailor the system to current hospital workflow. Results Relative to the pre-implementation period, the post-implementation period sepsis-related in-hospital mortality rate decreased by 60.24%, sepsis-related hospital length of stay decreased by 9.55% and sepsis-related 30-day readmission rate decreased by 50.14%. Conclusion The machine learning-based sepsis prediction algorithm improved patient outcomes at CRMC. PMID:29450295

Impact of Lightning-NO Emissions on Summertime U.S. Photochemistry as Determined Using the CMAQ Model with NLDN-Constrained Flash Rates

NASA Technical Reports Server (NTRS)

Allen, Dale; Pickering, Kenneth; Pinder, Robert; Koshak, William; Pierce, Thomas

2011-01-01

Lightning-NO emissions are responsible for 15-30 ppbv enhancements in upper tropospheric ozone over the eastern United States during the summer time. Enhancements vary from year to year but were particularly large during the summer of 2006, a period during which meteorological conditions were particularly conducive to ozone formation. A lightning-NO parameterization has been developed that can be used with the CMAQ model. Lightning-NO emissions in this scheme are assumed to be proportional to convective precipitation rate and scaled so that monthly average flash rates in each grid box match National Lightning Detection Network (NLDN) observed flash rates after adjusting for climatological intracloud to cloud-to-ground (IC/CG) ratios. The contribution of lightning-NO emissions to eastern United States NOx and ozone distributions during the summer of 2006 will be evaluated by comparing results of 12- km CMAQ simulations with and without lightning-NO emissions to measurements from the IONS field campaign and to satellite retrievals from the Tropospheric Emission Spectrometer (TES) and the Ozone Monitoring Instrument (OMI) aboard the Aura satellite. Special attention will be paid to the impact of the assumed vertical distribution of emissions on upper tropospheric NOx and ozone amounts.

Care and caring in the intensive care unit: Family members' distress and perceptions about staff skills, communication, and emotional support.

PubMed

Carlson, Eve B; Spain, David A; Muhtadie, Luma; McDade-Montez, Liz; Macia, Kathryn S

2015-06-01

Family members of intensive care unit (ICU) patients are sometimes highly distressed and report lower satisfaction with communication and emotional support from staff. Within a study of emotional responses to traumatic stress, associations between family distress and satisfaction with aspects of ICU care were investigated. In 29 family members of trauma patients who stayed in an ICU, we assessed symptoms of depression and posttraumatic stress disorder (PTSD) during ICU care. Later, family members rated staff communication, support, and skills and their overall satisfaction with ICU care. Ratings of staff competence and skills were significantly higher than ratings of frequency of communication, information needs being met, and support. Frequency of communication and information needs being met were strongly related to ratings of support (rs = .75-.77) and staff skills (rs = .77-.85), and aspects of satisfaction and communication showed negative relationships with symptoms of depression (rs = -.31 to -.55) and PTSD (rs = -.17 to -.43). Although satisfaction was fairly high, family member distress was negatively associated with several satisfaction variables. Increased understanding of the effects of traumatic stress on family members may help staff improve communication and increase satisfaction of highly distressed family members. Published by Elsevier Inc.

Foliar ozone injury on different-sized Prumus serotina Ehrh. trees

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

Fredericksen, T.S.; Skelly, J.M.; Steiner, K.C.

1995-06-01

Black cherry (Prunus serotina Ehrh.) is a common tree species in the eastern U.S. that is highly sensitive to ozone relative to other associated deciduous tree species. Because of difficulties in conducting exposure-response experiments on large trees, air pollution studies have often utilized seedlings and extrapolated the results to predict the potential response of larger forest trees. However, physiological differences between seedlings and mature forest trees may alter responses to air pollutants. A comparative study of seedling, sapling, and canopy black cherry trees was conducted to determine the response of different-sized trees to known ozone exposures and amounts of ozonemore » uptake. Apparent foliar sensitivity to ozone, observed as a dark adaxial leaf stipple, decreased with increasing tree size. An average of 46% of seedling leaf area was symptomatic by early September, compared to 15% - 20% for saplings and canopy trees. In addition to visible symptoms, seedlings also appeared to have greater rates of early leaf abscission than larger trees. Greater sensitivity (i.e., foliar symptoms) per unit exposure with decreasing tree size was closely correlated with rates of stomatal conductance. However, after accounting for differences in stomatal conductance, sensitivity appeared to increase with tree size.« less

Do survivors of acute neurologic injury remember their stay in the neuroscience intensive care unit?

PubMed

Hocker, Sara; Anderson, Heidi L; McMahon, Katherine E; Wijdicks, Eelco F M

2013-06-01

Patients in medical, surgical, and trauma intensive care units (ICUs) are at risk for later development of symptoms of post-traumatic stress disorder (PTSD). Because acute brain injury can impair recall; we sought to show that neuroscience patients undergoing prolonged neuroscience ICU admission have limited memory of their ICU stay and thus are less likely to develop symptoms of PTSD. We surveyed patients >18 years admitted for 10 days or more to our neuroscience ICU over a 10-year period. The survey response rate was 50.5% (47/93). Forty percent (19/47) of respondents presented with coma. Recall of details of the ICU admission was limited. Fewer than 10% of patients who required mechanical ventilation recalled being on a ventilator. Only five patients (11%) had responses suggestive of possible post-traumatic stress syndrome. The most commonly experienced symptoms following discharge were difficulty sleeping, difficulty with concentration, and memory loss. Patients requiring prolonged neuroscience ICU admission do not appear to be traumatized by their ICU stay.

Consumer preferences for the predictive genetic test for Alzheimer disease.

PubMed

Huang, Ming-Yi; Huston, Sally A; Perri, Matthew

2014-04-01

The purpose of this study was to assess consumer preferences for predictive genetic testing for Alzheimer disease in the United States. A rating conjoint analysis was conducted using an anonymous online survey distributed by Qualtrics to a general population panel in April 2011 in the United States. The study design included three attributes: Accuracy (40%, 80%, and 100%), Treatment Availability (Cure is available/Drug for symptom relief but no cure), and Anonymity (Anonymous/Not anonymous). A total of 12 scenarios were used to elicit people's preference, assessed by an 11-point scale. The respondents also indicated their highest willingness-to-pay (WTP) for each scenario through open-ended questions. A total of 295 responses were collected over 4 days. The most important attribute for the aggregate model was Accuracy, contributing 64.73% to the preference rating. Treatment Availability and Anonymity contributed 20.72% and 14.59%, respectively, to the preference rating. The median WTP for the highest-rating scenario (Accuracy 100%, a cure is available, test result is anonymous) was $100 (mean = $276). The median WTP for the lowest-rating scenario (40% accuracy, no cure but drugs for symptom relief, not anonymous) was zero (mean = $34). The results of this study highlight attributes people find important when making the hypothetical decision to obtain an AD genetic test. These results should be of interests to policy makers, genetic test developers and health care providers.

Leadership and business education in orthopaedic residency training programs.

PubMed

Kiesau, Carter D; Heim, Kathryn A; Parekh, Selene G

2011-01-01

Leadership and business challenges have become increasingly present in the practice of medicine. Orthopaedic residency programs are at the forefront of educating and preparing orthopaedic surgeons. This study attempts to quantify the number of orthopaedic residency programs in the United States that include leadership or business topics in resident education program and to determine which topics are being taught and rate the importance of various leadership characteristics and business topics. A survey was sent to all orthopaedic department chairpersons and residency program directors in the United States via e-mail. The survey responses were collected using a survey collection website. The respondents rated the importance of leadership training for residents as somewhat important. The quality of character, integrity, and honesty received the highest average rating among 19 different qualities of good leaders in orthopaedics. The inclusion of business training in resident education was also rated as somewhat important. The topic of billing and coding received the highest average rating among 14 different orthopaedically relevant business topics. A variety of topics beyond the scope of clinical practice must be included in orthopaedic residency educational curricula. The decreased participation of newly trained orthopaedic surgeons in leadership positions and national and state orthopaedic organizations is concerning for the future of orthopaedic surgery. Increased inclusion of leadership and business training in resident education is important to better prepare trainees for the future.

Predictors of In-Hospital Mortality After Rapid Response Team Calls in a 274 Hospital Nationwide Sample.

PubMed

Shappell, Claire; Snyder, Ashley; Edelson, Dana P; Churpek, Matthew M

2018-07-01

Despite wide adoption of rapid response teams across the United States, predictors of in-hospital mortality for patients receiving rapid response team calls are poorly characterized. Identification of patients at high risk of death during hospitalization could improve triage to intensive care units and prompt timely reevaluations of goals of care. We sought to identify predictors of in-hospital mortality in patients who are subjects of rapid response team calls and to develop and validate a predictive model for death after rapid response team call. Analysis of data from the national Get with the Guidelines-Medical Emergency Team event registry. Two-hundred seventy four hospitals participating in Get with the Guidelines-Medical Emergency Team from June 2005 to February 2015. 282,710 hospitalized adults on surgical or medical wards who were subjects of a rapid response team call. None. The primary outcome was death during hospitalization; candidate predictors included patient demographic- and event-level characteristics. Patients who died after rapid response team were older (median age 72 vs 66 yr), were more likely to be admitted for noncardiac medical illness (70% vs 58%), and had greater median length of stay prior to rapid response team (81 vs 47 hr) (p < 0.001 for all comparisons). The prediction model had an area under the receiver operating characteristic curve of 0.78 (95% CI, 0.78-0.79), with systolic blood pressure, time since admission, and respiratory rate being the most important variables. Patients who die following rapid response team calls differ significantly from surviving peers. Recognition of these factors could improve postrapid response team triage decisions and prompt timely goals of care discussions.

Impact of the 2004-2005 Influenza Vaccine Shortage on Immunization Practices in Long-Term Care Facilities

PubMed Central

Mody, Lona; Langa, Kenneth M.; Malani, Preeti N.

2012-01-01

Objective To assess the response of long-term care facilities (LTCFs) to the 2004-2005 influenza vaccine shortage and the impact on resident and healthcare worker (HCW) immunization rates. Methods A 12-item questionnaire was sent to 824 randomly selected LTCFs in December 2004. The following 2 open-ended questions were also asked: “How did you cope with the vaccine shortage?” and “Who helped you get your supply?” Immunization rates reported by LTCF administrators for 2003-2003 and 2003-2004 were compared with those for 2004-2005. Immunization rates were defined as the proportion of all eligible residents and HCWs who received influenza vaccine. Results Responses were received from 380 LTCFs (46.3%), which had a total of 38,447 beds. Resident mean influenza immunization rates (±SD) decreased from 85% ± 15.3% in 2002-2003 and 85.1% ± 15.3% in 2003-2004 to 81.9% ± 19.4% in the 2004-2005 influenza season (P = .025). The immunization rates among HCWs also decreased from 51% in 2002-2003 and 2003-2004 to 38.4% in 2004-2005 (P < .001). In response to one of the open-ended questions, 96 facilities (25.3%) reported that they obtained vaccine from 2 or more sources. Eight percent commented on specific intensified infection control efforts, and only 2.3% commented on emergency preparedness. Conclusions The influenza vaccine shortage in 2004-2005 impacted immunization practices of LTCFs across the United States, leading to decreases in both resident and HCW vaccination rates. The significant decrease in vaccination rates in LTCFs is of concern and has broad implications for policy makers working on emergency preparedness for a possible pandemic of influenza. PMID:16622817

A national survey of obstetric early warning systems in the United Kingdom: five years on.

PubMed

Isaacs, R A; Wee, M Y K; Bick, D E; Beake, S; Sheppard, Z A; Thomas, S; Hundley, V; Smith, G B; van Teijlingen, E; Thomas, P W

2014-07-01

The Confidential Enquiries into Maternal Deaths in the UK have recommended obstetric early warning systems for early identification of clinical deterioration to reduce maternal morbidity and mortality. This survey explored early warning systems currently used by maternity units in the UK. An electronic questionnaire was sent to all 205 lead obstetric anaesthetists under the auspices of the Obstetric Anaesthetists' Association, generating 130 (63%) responses. All respondents reported use of an obstetric early warning system, compared with 19% in a similar survey in 2007. Respondents agreed that the six most important physiological parameters to record were respiratory rate, heart rate, temperature, systolic and diastolic blood pressure and oxygen saturation. One hundred and eighteen (91%) lead anaesthetists agreed that early warning systems helped to prevent obstetric morbidity. Staffing pressures were perceived as the greatest barrier to their use, and improved audit, education and training for healthcare professionals were identified as priority areas. © 2014 The Association of Anaesthetists of Great Britain and Ireland.

A Simple Network Architecture Accounts for Diverse Reward Time Responses in Primary Visual Cortex.

PubMed

Huertas, Marco A; Hussain Shuler, Marshall G; Shouval, Harel Z

2015-09-16

Many actions performed by animals and humans depend on an ability to learn, estimate, and produce temporal intervals of behavioral relevance. Exemplifying such learning of cued expectancies is the observation of reward-timing activity in the primary visual cortex (V1) of rodents, wherein neural responses to visual cues come to predict the time of future reward as behaviorally experienced in the past. These reward-timing responses exhibit significant heterogeneity in at least three qualitatively distinct classes: sustained increase or sustained decrease in firing rate until the time of expected reward, and a class of cells that reach a peak in firing at the expected delay. We elaborate upon our existing model by including inhibitory and excitatory units while imposing simple connectivity rules to demonstrate what role these inhibitory elements and the simple architectures play in sculpting the response dynamics of the network. We find that simply adding inhibition is not sufficient for obtaining the different distinct response classes, and that a broad distribution of inhibitory projections is necessary for obtaining peak-type responses. Furthermore, although changes in connection strength that modulate the effects of inhibition onto excitatory units have a strong impact on the firing rate profile of these peaked responses, the network exhibits robustness in its overall ability to predict the expected time of reward. Finally, we demonstrate how the magnitude of expected reward can be encoded at the expected delay in the network and how peaked responses express this reward expectancy. Heterogeneity in single-neuron responses is a common feature of neuronal systems, although sometimes, in theoretical approaches, it is treated as a nuisance and seldom considered as conveying a different aspect of a signal. In this study, we focus on the heterogeneous responses in the primary visual cortex of rodents trained with a predictable delayed reward time. We describe under what conditions this heterogeneity can arise by self-organization, and what information it can convey. This study, while focusing on a specific system, provides insight onto how heterogeneity can arise in general while also shedding light onto mechanisms of reinforcement learning using realistic biological assumptions. Copyright © 2015 the authors 0270-6474/15/3512659-14$15.00/0.

[National survey of preoperative management and patient selection in ambulatory surgery centers].

PubMed

Papaceit, J; Olona, M; Ramón, C; García-Aguado, R; Rodríguez, R; Rull, M

2003-01-01

The objective of this study was to determine both the selection and preparation criteria in patients in various Spanish ambulatory surgery centers, as well as the impact of these criteria on their results. The results were compared according to the type of functional structure of the units (autonomous or integrated). We performed a cross sectional, descriptive study through postal survey. The survey contained the following items: type of unit, surgical procedures, selection criteria, preoperative assessment and management, and qualitative and quantitative indexes of the activity performed in 2000. A total of 123 units were included with a response rate of 39%. The selection criteria showed a high degree of consensus. The outpatient anesthesia clinic was used for preoperative assessment by 97.9% of the units. Most units routinely requested preoperative tests (hemostasis and hemogram by 89%; biochemical parameters by 72.9%) and to a lesser extent chest X-ray (33.3%) and electrocardiogram (35.4%). The introduction of procedures for the management of coexisting diseases was scarce (25-64.6%). Units using the outpatient anesthesia clinic in all patients had a lower cancellation rate (1.5% vs 4.4%). Autonomous units were significantly more likely to accept patients with high surgical-anesthetic risk than integrated units. Autonomous units also showed a significantly lower number of admissions (1.2% vs 1.9%, p = 0.003), mean stay (240 min vs 367 min, p = 0.002), and recovery time (150 min vs 212 min, p = 0.001) than integrated units. No statistically significant differences were found in the remaining parameters. Scientifically based protocols for patient selection, preoperative assessment and perioperative management of distinct processes and for the rational use of laboratory tests should be more widely used. The need for an outpatient anesthesia clinic for preoperative assessment was notable. The results of our survey indicate that better results in performance indexes are achieved in autonomous ambulatory surgery units than in integrated units. Given the possibility of defining and validating quality standards, further multicenter studies should be performed.

Dynamic X-ray diffraction imaging of the ferroelectric response in bismuth ferrite

DOE PAGES

Laanait, Nouamane; Saenrang, Wittawat; Zhou, Hua; ...

2017-03-21

In this study, X-ray diffraction imaging is rapidly emerging as a powerful technique by which one can capture the local structure of crystalline materials at the nano- and meso-scale. Here, we present investigations of the dynamic structure of epitaxial monodomain BiFeO 3 thin-films using a novel full-field Bragg diffraction imaging modality. By taking advantage of the depth penetration of hard X-rays and their exquisite sensitivity to the atomic structure, we imaged in situ and in operando, the electric field-driven structural responses of buried BiFeO 3 epitaxial thin-films in micro-capacitor devices, with sub-100 nm lateral resolution. These imaging investigations were carriedmore » out at acquisition frame rates that reached up to 20 Hz and data transfer rates of 40 MB/s, while accessing diffraction contrast that is sensitive to the entire three-dimensional unit cell configuration. We mined these large datasets for material responses by employing matrix decomposition techniques, such as independent component analysis. We found that this statistical approach allows the extraction of the salient physical properties of the ferroelectric response of the material, such as coercive fields and transient spatiotemporal modulations in their piezoelectric response, and also facilitates their decoupling from extrinsic sources that are instrument specific.« less

Measuring sexual orientation in adolescent health surveys: evaluation of eight school-based surveys.

PubMed

Saewyc, Elizabeth M; Bauer, Greta R; Skay, Carol L; Bearinger, Linda H; Resnick, Michael D; Reis, Elizabeth; Murphy, Aileen

2004-10-01

To examine the performance of various items measuring sexual orientation within 8 school-based adolescent health surveys in the United States and Canada from 1986 through 1999. Analyses examined nonresponse and unsure responses to sexual orientation items compared with other survey items, demographic differences in responses, tests for response set bias, and congruence of responses to multiple orientation items; analytical methods included frequencies, contingency tables with Chi-square, and ANOVA with least significant differences (LSD)post hoc tests; all analyses were conducted separately by gender. In all surveys, nonresponse rates for orientation questions were similar to other sexual questions, but not higher; younger students, immigrants, and students with learning disabilities were more likely to skip items or select "unsure." Sexual behavior items had the lowest nonresponse, but fewer than half of all students reported sexual behavior, limiting its usefulness for indicating orientation. Item placement in the survey, wording, and response set bias all appeared to influence nonresponse and unsure rates. Specific recommendations include standardizing wording across future surveys, and pilot testing items with diverse ages and ethnic groups of teens before use. All three dimensions of orientation should be assessed where possible; when limited to single items, sexual attraction may be the best choice. Specific wording suggestions are offered for future surveys.

Dopamine cells respond to predicted events during classical conditioning: evidence for eligibility traces in the reward-learning network.

PubMed

Pan, Wei-Xing; Schmidt, Robert; Wickens, Jeffery R; Hyland, Brian I

2005-06-29

Behavioral conditioning of cue-reward pairing results in a shift of midbrain dopamine (DA) cell activity from responding to the reward to responding to the predictive cue. However, the precise time course and mechanism underlying this shift remain unclear. Here, we report a combined single-unit recording and temporal difference (TD) modeling approach to this question. The data from recordings in conscious rats showed that DA cells retain responses to predicted reward after responses to conditioned cues have developed, at least early in training. This contrasts with previous TD models that predict a gradual stepwise shift in latency with responses to rewards lost before responses develop to the conditioned cue. By exploring the TD parameter space, we demonstrate that the persistent reward responses of DA cells during conditioning are only accurately replicated by a TD model with long-lasting eligibility traces (nonzero values for the parameter lambda) and low learning rate (alpha). These physiological constraints for TD parameters suggest that eligibility traces and low per-trial rates of plastic modification may be essential features of neural circuits for reward learning in the brain. Such properties enable rapid but stable initiation of learning when the number of stimulus-reward pairings is limited, conferring significant adaptive advantages in real-world environments.

Evaluating Tablet Computers as a Survey Tool in Rural Communities

PubMed Central

Newell, Steve M.; Logan, Henrietta L.; Guo, Yi; Marks, John G.; Shepperd, James A.

2015-01-01

Purpose Although tablet computers offer advantages in data collection over traditional paper-and-pencil methods, little research has examined whether the 2 formats yield similar responses, especially with underserved populations. We compared the 2 survey formats and tested whether participants’ responses to common health questionnaires or perceptions of usability differed by survey format. We also tested whether we could replicate established paper-and-pencil findings via tablet computer. Methods We recruited a sample of low-income community members living in the rural southern United States. Participants were 170 residents (black = 49%; white = 36%; other races and missing data = 15%) drawn from 2 counties meeting Florida’s state statutory definition of rural with 100 persons or fewer per square mile. We randomly assigned participants to complete scales (Center for Epidemiologic Studies Depression Inventory and Regulatory Focus Questionnaire) along with survey format usability ratings via paper-and-pencil or tablet computer. All participants rated a series of previously validated posters using a tablet computer. Finally, participants completed comparisons of the survey formats and reported survey format preferences. Findings Participants preferred using the tablet computer and showed no significant differences between formats in mean responses, scale reliabilities, or in participants’ usability ratings. Conclusions Overall, participants reported similar scales responses and usability ratings between formats. However, participants reported both preferring and enjoying responding via tablet computer more. Collectively, these findings are among the first data to show that tablet computers represent a suitable substitute among an underrepresented rural sample for paper-and-pencil methodology in survey research. PMID:25243953

Evaluating tablet computers as a survey tool in rural communities.

PubMed

Newell, Steve M; Logan, Henrietta L; Guo, Yi; Marks, John G; Shepperd, James A

2015-01-01

Although tablet computers offer advantages in data collection over traditional paper-and-pencil methods, little research has examined whether the 2 formats yield similar responses, especially with underserved populations. We compared the 2 survey formats and tested whether participants' responses to common health questionnaires or perceptions of usability differed by survey format. We also tested whether we could replicate established paper-and-pencil findings via tablet computer. We recruited a sample of low-income community members living in the rural southern United States. Participants were 170 residents (black = 49%; white = 36%; other races and missing data = 15%) drawn from 2 counties meeting Florida's state statutory definition of rural with 100 persons or fewer per square mile. We randomly assigned participants to complete scales (Center for Epidemiologic Studies Depression Inventory and Regulatory Focus Questionnaire) along with survey format usability ratings via paper-and-pencil or tablet computer. All participants rated a series of previously validated posters using a tablet computer. Finally, participants completed comparisons of the survey formats and reported survey format preferences. Participants preferred using the tablet computer and showed no significant differences between formats in mean responses, scale reliabilities, or in participants' usability ratings. Overall, participants reported similar scales responses and usability ratings between formats. However, participants reported both preferring and enjoying responding via tablet computer more. Collectively, these findings are among the first data to show that tablet computers represent a suitable substitute among an underrepresented rural sample for paper-and-pencil methodology in survey research. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.

Controls on Characteristics of Event-based Catchment Flood Response over Continental United States

NASA Astrophysics Data System (ADS)

Shen, X.; Mei, Y.; Nikolopoulos, E. I.; Anagnostou, E. N.

2017-12-01

Understanding the primary drivers of regional flood characteristics is of utmost importance for the development of flood early warning system. Many studies have dedicated their efforts on this topic, but the majority of these works is limited in terms of either the size of event population or the extent of their study domain. This prevents us from drawing a comprehensive understanding of the primary factors controlling the variability of catchment flood response across different hydroclimatic regimes and basin geomorphologies. In this study, we render an exhaustive analysis that includes the effect of climate, hydrometeorology, geomorphology, land cover and initial wetness conditions on the catchment's flood response for 318,000 flood events distributed across 5,900 catchments (basin scales ranging from 1 to 106 km2) of the Continental United States (CONUS) over a 10-year (2002 to 2013) period. Event runoff coefficients, response time lag and hydrograph shape are used as diagnostic variables to represent catchment flood response. Our results indicate different distributions of runoff coefficient over different climate regions and seasons. The magnitude of runoff coefficient increases as function of initial basin wetness condition and rainfall depth. Opposite patterns are found for the actual evapotranspiration rate and baseflow index. On the other hand, response time lag is controlled by the relief ratio of the basins and the mean flow length of the events; hydrograph shape reveals increasing trend with soil moisture condition and relief ratio.

Bidirectional Response of Runoff to Changes in Snowmelt Rate, Timing, and Amount

NASA Astrophysics Data System (ADS)

Barnhart, T. B.; Molotch, N. P.; Tague, C.

2016-12-01

The mountain snowpack is important for runoff generation across the western United States and for one sixth of Earth's population. Climate change induced near surface warming alters the amount of precipitation that falls as snow causing changes in the amount, rate, and timing of snowmelt. Recent work links snowmelt rate to streamflow production across the western United States. Snowmelt rate has also been linked to snowpack magnitude and snowmelt timing. This work seeks to disentangle the relationships between snowmelt rate, timing, and amount to reveal the dominant streamflow generating factor and the physical mechanism through which snowmelt becomes runoff. We use co-located observations of evapotranspiration and snowmelt from Niwot Ridge, CO (3023 m), the Valles Caldera, NM (3030 m), and Providence Creek, CA (2015 m) as well as the Regional Hydro-Ecologic Simulation System (RHESSys) to assess the linkage between snowmelt rate, amount, timing, and runoff. We conducted 100,000 RHESSys simulations at each site varying the timing, amount, and rate of snowmelt based on the observational record. Analyses of observational data show that years with large peak SWE partition more snowmelt to runoff than to evapotranspiration (r2=0.82, p=0.005). For example water year 2011 with a peak SWE of 0.43 m and a snowmelt rate of 0.62 cm d-1 partitioned 34% of snowmelt to ET. Conversely, water year 2006 with a peak SWE of 0.32 m and a snowmelt rate of 0.1 cm d-1 partitioned 54% of snowmelt to ET. Our simulation results show a bidirectional response between snowmelt rate and timing and runoff efficiency where early, slow snowmelt results in a low runoff efficiency while early, rapid snowmelt results in high runoff efficiency because of a mismatch in water availability and demand (a). Simulation results show a strong relationship between runoff efficiency and snowmelt suggesting that rapid snowmelt is better able to bring the root zone to field capacity and move water to the shallow groundwater system. Indeed, there is strong correspondence between runoff efficiency and root zone drainage showing that rapid snowmelt is better able to generate runoff than slow snowmelt by inducing recharge below the root zone (b). Furthermore, as climate warming decreases the mountain snowpack and causes earlier snowmelt, runoff is likely to decrease.

Behavior of motor units in human biceps brachii during a submaximal fatiguing contraction.

PubMed

Garland, S J; Enoka, R M; Serrano, L P; Robinson, G A

1994-06-01

The activity of 50 single motor units was recorded in the biceps brachii muscle of human subjects while they performed submaximal isometric elbow flexion contractions that were sustained to induce fatigue. The purposes of this study were to examine the influence of fatigue on motor unit threshold force and to determine the relationship between the threshold force of recruitment and the initial interimpulse interval on the discharge rates of single motor units during a fatiguing contraction. The discharge rate of most motor units that were active from the beginning of the contraction declined during the fatiguing contraction, whereas the discharge rates of most newly recruited units were either constant or increased slightly. The absolute threshold forces of recruitment and derecruitment decreased, and the variability of interimpulse intervals increased after the fatigue task. The change in motor unit discharge rate during the fatigue task was related to the initial rate, but the direction of the change in discharge rate could not be predicted from the threshold force of recruitment or the variability in the interimpulse intervals. The discharge rate of most motor units declined despite an increase in the excitatory drive to the motoneuron pool during the fatigue task.

The impact of overtime and long work hours on occupational injuries and illnesses: new evidence from the United States

PubMed Central

Dembe, A; Erickson, J; Delbos, R; Banks, S

2005-01-01

Aims: To analyse the impact of overtime and extended working hours on the risk of occupational injuries and illnesses among a nationally representative sample of working adults from the United States. Methods: Responses from 10 793 Americans participating in the National Longitudinal Survey of Youth (NLSY) were used to evaluate workers' job histories, work schedules, and occurrence of occupational injury and illness between 1987 and 2000. A total of 110 236 job records were analysed, encompassing 89 729 person-years of accumulated working time. Aggregated incidence rates in each of five exposure categories were calculated for each NLSY survey period. Multivariate analytical techniques were used to estimate the relative risk of long working hours per day, extended hours per week, long commute times, and overtime schedules on reporting a work related injury or illness, after adjusting for age, gender, occupation, industry, and region. Results: After adjusting for those factors, working in jobs with overtime schedules was associated with a 61% higher injury hazard rate compared to jobs without overtime. Working at least 12 hours per day was associated with a 37% increased hazard rate and working at least 60 hours per week was associated with a 23% increased hazard rate. A strong dose-response effect was observed, with the injury rate (per 100 accumulated worker-years in a particular schedule) increasing in correspondence to the number of hours per day (or per week) in the workers' customary schedule. Conclusions: Results suggest that job schedules with long working hours are not more risky merely because they are concentrated in inherently hazardous industries or occupations, or because people working long hours spend more total time "at risk" for a work injury. Strategies to prevent work injuries should consider changes in scheduling practices, job redesign, and health protection programmes for people working in jobs involving overtime and extended hours. PMID:16109814

The impact of overtime and long work hours on occupational injuries and illnesses: new evidence from the United States.

PubMed

Dembe, A E; Erickson, J B; Delbos, R G; Banks, S M

2005-09-01

To analyse the impact of overtime and extended working hours on the risk of occupational injuries and illnesses among a nationally representative sample of working adults from the United States. Responses from 10,793 Americans participating in the National Longitudinal Survey of Youth (NLSY) were used to evaluate workers' job histories, work schedules, and occurrence of occupational injury and illness between 1987 and 2000. A total of 110,236 job records were analysed, encompassing 89,729 person-years of accumulated working time. Aggregated incidence rates in each of five exposure categories were calculated for each NLSY survey period. Multivariate analytical techniques were used to estimate the relative risk of long working hours per day, extended hours per week, long commute times, and overtime schedules on reporting a work related injury or illness, after adjusting for age, gender, occupation, industry, and region. After adjusting for those factors, working in jobs with overtime schedules was associated with a 61% higher injury hazard rate compared to jobs without overtime. Working at least 12 hours per day was associated with a 37% increased hazard rate and working at least 60 hours per week was associated with a 23% increased hazard rate. A strong dose-response effect was observed, with the injury rate (per 100 accumulated worker-years in a particular schedule) increasing in correspondence to the number of hours per day (or per week) in the workers' customary schedule. Results suggest that job schedules with long working hours are not more risky merely because they are concentrated in inherently hazardous industries or occupations, or because people working long hours spend more total time "at risk" for a work injury. Strategies to prevent work injuries should consider changes in scheduling practices, job redesign, and health protection programmes for people working in jobs involving overtime and extended hours.

Noise over-exposure alters long-term somatosensory-auditory processing in the dorsal cochlear nucleus – possible basis for tinnitus-related hyperactivity?

PubMed Central

Dehmel, Susanne; Pradhan, Shashwati; Koehler, Seth; Bledsoe, Sanford; Shore, Susan

2012-01-01

The dorsal cochlear nucleus (DCN) is the first neural site of bimodal auditory-somatosensory integration. Previous studies have shown that stimulation of somatosensory pathways results in immediate suppression or enhancement of subsequent acoustically-evoked discharges. In the unimpaired auditory system suppression predominates. However, damage to the auditory input pathway leads to enhancement of excitatory somatosensory inputs to the cochlear nucleus, changing their effects on DCN neurons (Zeng et al., 2009; Shore et al., 2008). Given the well described connection between the somatosensory system and tinnitus in patients we sought to determine if plastic changes in long lasting bimodal somatosensory-auditory processing accompany tinnitus. Here we demonstrate for the first time in vivo long-term effects of somatosensory inputs on acoustically-evoked discharges of DCN neurons in guinea pigs. The effects of trigeminal nucleus stimulation are compared between normal-hearing animals and animals overexposed with narrow band noise and behaviorally tested for tinnitus. The noise exposure resulted in a temporary threshold shift (TTS) in auditory brainstem responses but a persistent increase in spontaneous and sound-evoked DCN unit firing rates and increased steepness of rate-level functions (RLFs). Rate increases were especially prominent in buildup units. The long-term somatosensory enhancement of sound-evoked responses was strengthened while suppressive effects diminished in noise-exposed animals, especially those that developed tinnitus. Damage to the auditory nerve (ANF) is postulated to trigger compensatory long-term synaptic plasticity of somatosensory inputs that might be an important underlying mechanism for tinnitus generation. PMID:22302808

Sepsis in the Pediatric Cardiac Intensive Care Unit

PubMed Central

Wheeler, Derek S.; Jeffries, Howard E.; Zimmerman, Jerry J.; Wong, Hector R.; Carcillo, Joseph A.

2012-01-01

The survival rate for children with congenital heart disease (CHD) has increased significantly coincident with improved techniques in cardiothoracic surgery, cardiopulmonary bypass, and myocardial protection, and post-operative care. Cardiopulmonary bypass, likely in combination with ischemia-reperfusion injury, hypothermia, and surgical trauma, elicits a complex, systemic inflammatory response that is characterized by activation of the complement cascade, release of endotoxin, activation of leukocytes and the vascular endothelium, and release of pro-inflammatory cytokines. This complex inflammatory state causes a transient immunosuppressed state, which may increase the risk of hospital-acquired infection in these children. Postoperative sepsis occurs in nearly 3% of children undergoing cardiac surgery and significantly increases length of stay in the pediatric cardiac intensive care unit as well as the risk for mortality. Herein, we review the epidemiology, pathobiology, and management of sepsis in the pediatric cardiac intensive care unit. PMID:22337571

Ground-water recharge in humid areas of the United States: A summary of Ground-Water Resources Program studies, 2003-2006

USGS Publications Warehouse

Delin, Geoffrey N.; Risser, Dennis W.

2007-01-01

Increased demands on water resources by a growing population and recent droughts have raised awareness about the adequacy of ground-water resources in humid areas of the United States. The spatial and temporal variability of ground-water recharge are key factors that need to be quantified to determine the sustainability of ground-water resources. Ground-water recharge is defined herein as the entry into the saturated zone of water made available at the water-table surface, together with the associated flow away from the water table within the saturated zone (Freeze and Cherry, 1979). In response to the need for better estimates of ground-water recharge, the Ground-Water Resources Program (GWRP) of the U.S. Geological Survey (USGS) began an initiative in 2003 to estimate ground-water recharge rates in the relatively humid areas of the United States.

Violent Death Rates: The US Compared with Other High-income OECD Countries, 2010.

PubMed

Grinshteyn, Erin; Hemenway, David

2016-03-01

Violent death is a serious problem in the United States. Previous research showing US rates of violent death compared with other high-income countries used data that are more than a decade old. We examined 2010 mortality data obtained from the World Health Organization for populous, high-income countries (n = 23). Death rates per 100,000 population were calculated for each country and for the aggregation of all non-US countries overall and by age and sex. Tests of significance were performed using Poisson and negative binomial regressions. US homicide rates were 7.0 times higher than in other high-income countries, driven by a gun homicide rate that was 25.2 times higher. For 15- to 24-year-olds, the gun homicide rate in the United States was 49.0 times higher. Firearm-related suicide rates were 8.0 times higher in the United States, but the overall suicide rates were average. Unintentional firearm deaths were 6.2 times higher in the United States. The overall firearm death rate in the United States from all causes was 10.0 times higher. Ninety percent of women, 91% of children aged 0 to 14 years, 92% of youth aged 15 to 24 years, and 82% of all people killed by firearms were from the United States. The United States has an enormous firearm problem compared with other high-income countries, with higher rates of homicide and firearm-related suicide. Compared with 2003 estimates, the US firearm death rate remains unchanged while firearm death rates in other countries decreased. Thus, the already high relative rates of firearm homicide, firearm suicide, and unintentional firearm death in the United States compared with other high-income countries increased between 2003 and 2010. Copyright © 2016 Elsevier Inc. All rights reserved.

Commercial Health Plan Coverage of Selected Treatments for Opioid Use Disorders from 2003 to 2014.

PubMed

Reif, Sharon; Creedon, Timothy B; Horgan, Constance M; Stewart, Maureen T; Garnick, Deborah W

2017-01-01

Opioid use disorders (OUDs) are receiving significant attention in the U.S. as a public health crisis. Access to treatment for OUDs is essential and was expected to improve following implementation of the federal parity law and the Affordable Care Act. This study examines changes in coverage and management of treatments for OUDs (opioid treatment programs (OTPs) as a covered service benefit, buprenorphine as a pharmacy benefit) before, during, and after parity and ACA implementation. Data are from three rounds of a nationally representative survey conducted with commercial health plans regarding behavioral health services in benefit years 2003, 2010, and 2014. Data were weighted to be representative of health plans' commercial products in the continental United States (2003 weighted N = 7,469, 83% response rate; 2010 N = 8,431, 89% response rate; and 2014 N = 6,974, 80% response rate). Results showed treatment for OUDs was covered by nearly all health plan products in each year of the survey, but the types and patterns varied by year. Prior authorization requirements for OTPs have decreased over time. Despite the promise of expanded access to OUD treatment suggested by parity and the ACA, improved health plan coverage for treatment of OUDs, while essential, is not sufficient to address the opioid crisis.

Commercial Health Plan Coverage of Selected Treatments for Opioid Use Disorders from 2003 to 2014

PubMed Central

Reif, Sharon; Creedon, Timothy B.; Horgan, Constance M.; Stewart, Maureen T.; Garnick, Deborah W.

2018-01-01

Opioid use disorders (OUDs) are receiving significant attention as a public health crisis. Access to treatment for OUDs is essential and was expected to improve following implementation of the federal parity law and the Affordable Care Act. This study examines changes in coverage and management of treatments for OUDs (opioid treatment programs (OTPs) as a covered service benefit, buprenorphine as a pharmacy benefit) before, during and after parity and ACA implementation. Data are from three rounds of a nationally representative survey conducted with commercial health plans regarding behavioral health services in benefit years 2003, 2010, and 2014. Data were weighted to be representative of health plans’ commercial products in the continental United States (2003 weighted N= 7,469, 83% response rate; 2010 N=8,431, 89% response rate; and 2014 N=6,974, 80% response rate). Results showed treatment for OUDs was covered by nearly all health plan products in each year of the survey, but the types and patterns varied by year. Prior authorization requirements for OTPs have decreased over time. Despite the promise of expanded access to OUD treatment suggested by parity and the ACA, improved health plan coverage for treatment of OUDs, while essential, is not sufficient to address the opioid crisis. PMID:28350229

Congenital and nosocomial sepsis in infants born in a regional perinatal unit: cause, outcome, and white blood cell response.

PubMed

Ohlsson, A; Vearncombe, M

1987-02-01

The incidence, cause, and outcome of sepsis and the white blood cell response were studied in 6315 infants born in a regional perinatal unit. The incidence of neonatal sepsis was 6.5 per 1000 live births. Congenital sepsis (12 cases) was overwhelming, with associated maternal infection (92%), neutropenia (75%), and high rate of mortality (50%). The most common organism was Escherichia coli (58%). Gestational age and birth weight were similar in survivors and nonsurvivors. There was a strong correlation between total white blood cell count and both mature and immature neutrophil counts in survivors but this correlation decreased substantially in neonates that died. Analysis of variance indicated that the means for polymorphonuclear leukocyte and immature neutrophil counts were significantly higher in survivors. Nosocomial sepsis (38 cases) occurred in premature low birth weight infants receiving invasive, intensive care. The most common organism was Staphylococcus epidermidis (76%). Total white blood cell, polymorphonuclear leukocyte, and immature neutrophil counts rose significantly in response to sepsis. None died. Prevention of congenital sepsis requires methods to detect early maternal-fetal infection. Providing granulocytes to neutropenic neonates with congenital sepsis might improve outcome.

Recruitment of faster motor units is associated with greater rates of fascicle strain and rapid changes in muscle force during locomotion

PubMed Central

Lee, Sabrina S. M.; de Boef Miara, Maria; Arnold, Allison S.; Biewener, Andrew A.; Wakeling, James M.

2013-01-01

SUMMARY Animals modulate the power output needed for different locomotor tasks by changing muscle forces and fascicle strain rates. To generate the necessary forces, appropriate motor units must be recruited. Faster motor units have faster activation–deactivation rates than slower motor units, and they contract at higher strain rates; therefore, recruitment of faster motor units may be advantageous for tasks that involve rapid movements or high rates of work. This study identified motor unit recruitment patterns in the gastrocnemii muscles of goats and examined whether faster motor units are recruited when locomotor speed is increased. The study also examined whether locomotor tasks that elicit faster (or slower) motor units are associated with increased (or decreased) in vivo tendon forces, force rise and relaxation rates, fascicle strains and/or strain rates. Electromyography (EMG), sonomicrometry and muscle-tendon force data were collected from the lateral and medial gastrocnemius muscles of goats during level walking, trotting and galloping and during inclined walking and trotting. EMG signals were analyzed using wavelet and principal component analyses to quantify changes in the EMG frequency spectra across the different locomotor conditions. Fascicle strain and strain rate were calculated from the sonomicrometric data, and force rise and relaxation rates were determined from the tendon force data. The results of this study showed that faster motor units were recruited as goats increased their locomotor speeds from level walking to galloping. Slow inclined walking elicited EMG intensities similar to those of fast level galloping but different EMG frequency spectra, indicating that recruitment of the different motor unit types depended, in part, on characteristics of the task. For the locomotor tasks and muscles analyzed here, recruitment patterns were generally associated with in vivo fascicle strain rates, EMG intensity and tendon force. Together, these data provide new evidence that changes in motor unit recruitment have an underlying mechanical basis, at least for certain locomotor tasks. PMID:22972893

Recruitment of faster motor units is associated with greater rates of fascicle strain and rapid changes in muscle force during locomotion.

PubMed

Lee, Sabrina S M; de Boef Miara, Maria; Arnold, Allison S; Biewener, Andrew A; Wakeling, James M

2013-01-15

Animals modulate the power output needed for different locomotor tasks by changing muscle forces and fascicle strain rates. To generate the necessary forces, appropriate motor units must be recruited. Faster motor units have faster activation-deactivation rates than slower motor units, and they contract at higher strain rates; therefore, recruitment of faster motor units may be advantageous for tasks that involve rapid movements or high rates of work. This study identified motor unit recruitment patterns in the gastrocnemii muscles of goats and examined whether faster motor units are recruited when locomotor speed is increased. The study also examined whether locomotor tasks that elicit faster (or slower) motor units are associated with increased (or decreased) in vivo tendon forces, force rise and relaxation rates, fascicle strains and/or strain rates. Electromyography (EMG), sonomicrometry and muscle-tendon force data were collected from the lateral and medial gastrocnemius muscles of goats during level walking, trotting and galloping and during inclined walking and trotting. EMG signals were analyzed using wavelet and principal component analyses to quantify changes in the EMG frequency spectra across the different locomotor conditions. Fascicle strain and strain rate were calculated from the sonomicrometric data, and force rise and relaxation rates were determined from the tendon force data. The results of this study showed that faster motor units were recruited as goats increased their locomotor speeds from level walking to galloping. Slow inclined walking elicited EMG intensities similar to those of fast level galloping but different EMG frequency spectra, indicating that recruitment of the different motor unit types depended, in part, on characteristics of the task. For the locomotor tasks and muscles analyzed here, recruitment patterns were generally associated with in vivo fascicle strain rates, EMG intensity and tendon force. Together, these data provide new evidence that changes in motor unit recruitment have an underlying mechanical basis, at least for certain locomotor tasks.

The Dose–Response Relationship Between Tobacco Education Advertising and Calls to Quitlines in the United States, March–June, 2012

PubMed Central

Alexander, Robert L.; Shafer, Paul; Mann, Nathan; Malarcher, Ann; Zhang, Lei

2015-01-01

Introduction We estimated changes in call volume in the United States in response to increases in advertising doses of the Tips From Former Smokers (Tips) campaign, the first federal national tobacco education campaign, which aired for 12 weeks from March 19 to June 10, 2012. We also measured the effectiveness of ad taglines that promoted calls directly with a quitline number (1-800-QUIT-NOW) and indirectly with a cessation help website (Smokefree.gov). Methods Multivariate regressions estimated the weekly number of calls to 1–800-QUIT-NOW by area code as a function of weekly market-level gross rating points (GRPs) from CDC’s Tips campaign in 2012. The number of quitline calls attributable solely to Tips was predicted. Results For quitline-tagged ads, an additional 100 television GRPs per week was associated with an increase of 89 calls per week in a typical area code in the United States (P < .001). The same unit increase in advertising GRPs for ads tagged with Smokefree.gov was associated with an increase of 29 calls per week in any given area code (P < .001). We estimated that the Tips campaign was responsible for more than 170,000 additional calls to 1–800-QUIT-NOW during the campaign and that it would have generated approximately 140,000 additional calls if all ads were tagged with 1–800-QUIT-NOW. Conclusion For campaign planners, these results make it possible to estimate 1) the likely impact of tobacco prevention media buys and 2) the additional quitline capacity needed at the national level should future campaigns of similar scale use 1–800-QUIT-NOW taglines exclusively. PMID:26542143

The Dose-Response Relationship Between Tobacco Education Advertising and Calls to Quitlines in the United States, March-June, 2012.

PubMed

Davis, Kevin C; Alexander, Robert L; Shafer, Paul; Mann, Nathan; Malarcher, Ann; Zhang, Lei

2015-11-05

We estimated changes in call volume in the United States in response to increases in advertising doses of the Tips From Former Smokers (Tips) campaign, the first federal national tobacco education campaign, which aired for 12 weeks from March 19 to June 10, 2012. We also measured the effectiveness of ad taglines that promoted calls directly with a quitline number (1-800-QUIT-NOW) and indirectly with a cessation help website (Smokefree.gov). Multivariate regressions estimated the weekly number of calls to 1-800-QUIT-NOW by area code as a function of weekly market-level gross rating points (GRPs) from CDC's Tips campaign in 2012. The number of quitline calls attributable solely to Tips was predicted. For quitline-tagged ads, an additional 100 television GRPs per week was associated with an increase of 89 calls per week in a typical area code in the United States (P < .001). The same unit increase in advertising GRPs for ads tagged with Smokefree.gov was associated with an increase of 29 calls per week in any given area code (P < .001). We estimated that the Tips campaign was responsible for more than 170,000 additional calls to 1-800-QUIT-NOW during the campaign and that it would have generated approximately 140,000 additional calls if all ads were tagged with 1-800-QUIT-NOW. For campaign planners, these results make it possible to estimate 1) the likely impact of tobacco prevention media buys and 2) the additional quitline capacity needed at the national level should future campaigns of similar scale use 1-800-QUIT-NOW taglines exclusively.

Cosmetic surgery growth and correlations with financial indices: a comparative study of the United Kingdom and United States from 2002-2011.

PubMed

Nassab, Reza; Harris, Paul

2013-05-01

Over the past 10 years, there has been significant fluctuation in the yearly growth rates for cosmetic surgery procedures in both the United States and the United Kingdom. The authors compare cosmetic surgical procedure rates in the United Kingdom and United States with the macroeconomic climate of each region to determine whether there is a direct relationship between cosmetic surgery rates and economic health. The authors analyzed annual cosmetic surgery statistics from the British Association of Aesthetic Plastic Surgeons and the American Society for Aesthetic Plastic Surgery for 2002-2011 against economic indices from both regions, including the gross domestic product (GDP), consumer prices indices (CPI), and stock market reports. There was a 285.9% increase in the United Kingdom and a 1.1% increase in the United States in the number of procedures performed between 2002 and 2011. There were significant positive correlations between the number of cosmetic procedures performed in the United Kingdom and both the GDP (r = 0.986, P < .01) and CPI (r = 0.955, P < .01). Analysis of the US growth rates failed to show a significant relationship with any indices. UK interest rates showed a significant negative correlation (r = -0.668, P < .05) with procedures performed, whereas US interest rates showed a significant positive correlation. Data from the United States and United Kingdom suggest 2 very different growth patterns in the number of cosmetic surgeries being performed as compared with the economy in each region. Economic indices are accurate indicators of numbers of procedures being performed in the United Kingdom, whereas rates in the United States seem independent of those factors.

Motor control for a brushless DC motor

NASA Technical Reports Server (NTRS)

Peterson, William J. (Inventor); Faulkner, Dennis T. (Inventor)

1985-01-01

This invention relates to a motor control system for a brushless DC motor having an inverter responsively coupled to the motor control system and in power transmitting relationship to the motor. The motor control system includes a motor rotor speed detecting unit that provides a pulsed waveform signal proportional to rotor speed. This pulsed waveform signal is delivered to the inverter to thereby cause an inverter fundamental current waveform output to the motor to be switched at a rate proportional to said rotor speed. In addition, the fundamental current waveform is also pulse width modulated at a rate proportional to the rotor speed. A fundamental current waveform phase advance circuit is controllingly coupled to the inverter. The phase advance circuit is coupled to receive the pulsed waveform signal from the motor rotor speed detecting unit and phase advance the pulsed waveform signal as a predetermined function of motor speed to thereby cause the fundamental current waveform to be advanced and thereby compensate for fundamental current waveform lag due to motor winding reactance which allows the motor to operate at higher speeds than the motor is rated while providing optimal torque and therefore increased efficiency.

The role of prostaglandins and the hypothalamus in thermoregulation in the lizard, Phrynocephalus przewalskii (Agamidae).

PubMed

Liu, Chongbin; Li, Rende; Liu, Zhonghu; Yin, Shuming; Wang, Ziren

2006-05-01

Typically, small lizards rely heavily on behavioral thermoregulation rather than physiological mechanisms to control their rates of warming and cooling. We tested the hypothesis that prostaglandins participate in mediating the cardiovascular response to heating and cooling and temperature regulating neurons in the hypothalamus of the small lizard Phrynocephalus przewalskii. In vivo and in vitro treatments, heart rates (HRs) were all found to be higher during heating than during cooling, hysteresis was distinct below 30 and 26 degrees Celsius, respectively. In vivo, as administration of COX inhibitor, there were no differences in HR between heating and cooling at any body temperature and administration of agonist prostaglandins only produced a significant effect on HR below 25 degrees Celsius. Single-unit activity was recorded extracellularly in vitro with microelectrodes, found the firing rate of the continuous unit increased 23% when the temperature of the artificial cerebrospinal fluid dropped from 30-20 degrees Celsius. We conclude that prostaglandins appear to play only a limited role in modulating heart activity in Phrynocephalus przewalskii and suggest that cold-sensitive neurons in the preoptic and anterior hypothalamus (PO/AH) are involved in thermoregulatory control during heating or cooling.

Urine output on an intensive care unit: case-control study.

PubMed

Solomon, Anthony W; Kirwan, Christopher J; Alexander, Neal D E; Nimako, Kofi; Jurukov, Angela; Forth, Rebecca J; Rahman, Tony M

2010-12-14

To compare urine output between junior doctors in an intensive care unit and the patients for whom they are responsible. Case-control study. General intensive care unit in a tertiary referral hospital. 18 junior doctors responsible for clerking patients on weekday day shifts in the unit from 23 March to 23 April 2009 volunteered as "cases." Controls were the patients in the unit clerked by those doctors. Exclusion criteria (for both groups) were pregnancy, baseline estimated glomerular filtration rate <15 ml/min/1.73 m(2), and renal replacement therapy. Oliguria (defined as mean urine output <0.5 ml/kg/hour over six or more hours of measurement) and urine output (in ml/kg/hour) as a continuous variable. Doctors were classed as oliguric and "at risk" of acute kidney injury on 19 (22%) of 87 shifts in which urine output was measured, and oliguric to the point of being "in injury" on one (1%) further shift. Data were available for 208 of 209 controls matched to cases in the data collection period; 13 of these were excluded because the control was receiving renal replacement therapy. Doctors were more likely to be oliguric than their patients (odds ratio 1.99, 95% confidence interval 1.08 to 3.68, P=0.03). For each additional 1 ml/kg/hour mean urine output, the odds ratio for being a case rather than a control was 0.27 (0.12 to 0.58, P=0.001). Mortality among doctors was astonishingly low, at 0% (0% to 18%). Managing our own fluid balance is more difficult than managing it in our patients. We should drink more water. Modifications to the criteria for acute kidney injury could be needed for the assessment of junior doctors in an intensive care unit.

Neurophysiology training in the Neurology Specialist Education Program in Spain.

PubMed

Rodríguez-Antigüedad, A; Matías-Guiu, J; Hernández-Pérez, M A; Jiménez Hernández, M D; Martín González, M R; Morales Ortiz, A; Delgado, G; Frank, A; López de Silanes, C; Martínez-Vila, E

2011-06-01

The training period in neurophysiology is a substantial part of the Neurology Specialist Program in Spain. The National Neurology Committee (La Comisión Nacional de Neurología (CNN), which is the body reporting to the Ministries of Health and Education, must ensure compliance to the Program. During the first trimester of 2008, the CNN sent a questionnaire, in which there was a question asking about this training period, to each of the managers of the 69 teaching units accredited for neurology training in Spain, for them to answer. Of the 69 questionnaires issued, 49 were received completed, which was a response rate of 71%. The neurophysiology training period of the neurology specialist program in Spain was carried out in the same hospital in 44 teaching unit (90%): the remaining 5 sent their neurology trainees to 4 different hospitals. The Unit that carried out the neurophysiology training period was incorporated into the Neurology Department in 27 (55%) cases, and the formula was mixed in 3 (6%). A total of 69% of tutors were satisfied with the training, but was 90% in the hospitals where the unit was integrated into Neurology, and was 65% where this relationship did not exist. The neurologists in training were informed about EEG in 49% of education units, performed EMG/ENG 57%, and informed about evoked potentials in 35% after their training period. Although the level of satisfaction is high, the level of responsibility assumed by the neurologists in training during their rotation into neurophysiology does not appear to comply to the demands laid out in the training program, particularly in these units not integrated into Neurology Departments. Copyright © 2010 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

Motor unit firing rates and synchronisation affect the fractal dimension of simulated surface electromyogram during isometric/isotonic contraction of vastus lateralis muscle.

PubMed

Mesin, Luca; Dardanello, Davide; Rainoldi, Alberto; Boccia, Gennaro

2016-12-01

During fatiguing contractions, many adjustments in motor units behaviour occur: decrease in muscle fibre conduction velocity; increase in motor units synchronisation; modulation of motor units firing rate; increase in variability of motor units inter-spike interval. We simulated the influence of all these adjustments on synthetic EMG signals in isometric/isotonic conditions. The fractal dimension of the EMG signal was found mainly influenced by motor units firing behaviour, being affected by both firing rate and synchronisation level, and least affected by muscle fibre conduction velocity. None of the calculated EMG indices was able to discriminate between firing rate and motor units synchronisation. Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.

Disturbances of motor unit rate modulation are prevalent in muscles of spastic-paretic stroke survivors

PubMed Central

Heckman, C. J.; Powers, R. K.; Rymer, W. Z.; Suresh, N. L.

2014-01-01

Stroke survivors often exhibit abnormally low motor unit firing rates during voluntary muscle activation. Our purpose was to assess the prevalence of saturation in motor unit firing rates in the spastic-paretic biceps brachii muscle of stroke survivors. To achieve this objective, we recorded the incidence and duration of impaired lower- and higher-threshold motor unit firing rate modulation in spastic-paretic, contralateral, and healthy control muscle during increases in isometric force generated by the elbow flexor muscles. Impaired firing was considered to have occurred when firing rate became constant (i.e., saturated), despite increasing force. The duration of impaired firing rate modulation in the lower-threshold unit was longer for spastic-paretic (3.9 ± 2.2 s) than for contralateral (1.4 ± 0.9 s; P < 0.001) and control (1.1 ± 1.0 s; P = 0.005) muscles. The duration of impaired firing rate modulation in the higher-threshold unit was also longer for the spastic-paretic (1.7 ± 1.6 s) than contralateral (0.3 ± 0.3 s; P = 0.007) and control (0.1 ± 0.2 s; P = 0.009) muscles. This impaired firing rate of the lower-threshold unit arose, despite an increase in the overall descending command, as shown by the recruitment of the higher-threshold unit during the time that the lower-threshold unit was saturating, and by the continuous increase in averages of the rectified EMG of the biceps brachii muscle throughout the rising phase of the contraction. These results suggest that impairments in firing rate modulation are prevalent in motor units of spastic-paretic muscle, even when the overall descending command to the muscle is increasing. PMID:24572092

Enhanced visual responses in the superior colliculus in an animal model of attention-deficit hyperactivity disorder and their suppression by D-amphetamine.

PubMed

Clements, K M; Devonshire, I M; Reynolds, J N J; Overton, P G

2014-08-22

Attention-deficit hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder characterized by overactivity, impulsiveness and attentional problems, including an increase in distractibility. A structure that is intimately linked with distractibility is the superior colliculus (SC), a midbrain sensory structure which plays a particular role in the production of eye and head movements. Although others have proposed the involvement of such diverse elements as the frontal cortex and forebrain noradrenaline in ADHD, given the role of the colliculus in distractibility and the increased distractibility in ADHD, we have proposed that distractibility in ADHD arises due to collicular sensory hyper-responsiveness. To further investigate this possibility, we recorded the extracellular activity (multi-unit (MUA) and local field potential (LFP)) in the superficial visual layers of the SC in an animal model of ADHD, the New Zealand genetically hypertensive (GH) rat, in response to wholefield light flashes. The MUA and LFP peak amplitude and summed activity within a one-second time window post-stimulus were both significantly greater in GH rats than in Wistar controls, across the full range of stimulus intensities. Given that baseline firing rate did not differ between the strains, this suggests that the signal-to-noise ratio is elevated in GH animals. D-Amphetamine reduced the peak amplitude and summed activity of the multi-unit response in Wistar animals. It also reduced the peak amplitude and summed activity of the multi-unit response in GH animals, at higher doses bringing it down to levels that were equivalent to those of Wistar animals at baseline. The present results provide convergent evidence that a collicular dysfunction (sensory hyper-responsiveness) is present in ADHD, and that it may underlie the enhanced distractibility. In addition, D-amphetamine - a widely used treatment in ADHD - may have one of its loci of therapeutic action at the level of the colliculus. Copyright © 2014 IBRO. Published by Elsevier Ltd. All rights reserved.

Do Differences in Risk Factors Explain the Lower Rates of Coronary Heart Disease in Japanese Versus U.S. Women?

PubMed Central

Willcox, Bradley J.; Usui, Takeshi; Carr, John Jeffrey; Barinas-Mitchell, Emma J.M.; Masaki, Kamal H.; Watanabe, Makoto; Tracy, Russell P.; Bertolet, Marianne H.; Evans, Rhobert W.; Nishimura, Kunihiko; Sutton-Tyrrell, Kim; Kuller, Lewis H.; Miyamoto, Yoshihiro

2013-01-01

Abstract Background Mortality from coronary heart disease (CHD) in women in Japan is one of the lowest in developed countries. In an attempt to shed some light on possible reasons of lower CHD in women in Japan compared with the United States, we extensively reviewed and analyzed existing national data and recent literature. Methods We searched recent epidemiological studies that reported incidence of acute myocardial infarction (AMI) and examined risk factors for CHD in women in Japan. Then, we compared trends in risk factors between women currently aged 50–69 years in Japan and the United States, using national statistics and other available resources. Results Recent epidemiological studies have clearly shown that AMI incidence in women in Japan is lower than that reported from other countries, and that lipids, blood pressure (BP), diabetes, smoking, and early menopause are independent risk factors. Comparing trends in risk factors between women in Japan and the United States, current levels of serum total cholesterol are higher in women in Japan and levels have been similar at least since 1990. Levels of BP have been higher in in Japan for the past 3 decades. Prevalence of type 2 diabetes has been similar in Japanese and white women currently aged 60–69 for the past 2 decades. In contrast, rates of cigarette smoking, although low in women in both countries, have been lower in women in Japan. Conclusions Differences in risk factors and their trends are unlikely to explain the difference in CHD rates in women in Japan and the United States. Determining the currently unknown factors responsible for low CHD mortality in women in Japan may lead to new strategy for CHD prevention. PMID:24073782

Comparison of sympathetic nerve responses to neck and forearm isometric exercise

NASA Technical Reports Server (NTRS)

Steele, S. L. Jr; Ray, C. A.

2000-01-01

PURPOSE: Although the autonomic and cardiovascular responses to arm and leg exercise have been studied, the sympathetic adjustments to exercise of the neck have not. The purpose of the present study was twofold: 1) to determine sympathetic and cardiovascular responses to isometric contractions of the neck extensors and 2) to compare sympathetic and cardiovascular responses to isometric exercise of the neck and forearm. METHODS: Muscle sympathetic nerve activity (MSNA), mean arterial pressure (MAP), and heart rate were measured in nine healthy subjects while performing isometric neck extension (INE) and isometric handgrip (IHG) in the prone position. After a 3-min baseline period, subjects performed three intensities of INE for 2.5 min each: 1) unloaded (supporting head alone), 2) 10% maximal voluntary contraction (MVC), and 3) 30% MVC, then subjects performed two intensities (10% and 30% MVC) of IHG for 2.5 min. RESULTS: Supporting the head by itself did not significantly change any of the variables. During [NE, MAP significantly increased by 10 +/- 2 and 31 +/- 4 mm Hg and MSNA increased by 67 +/- 46 and 168 +/- 36 units/30 s for 10% and 30% MVC, respectively. IHG and INE evoked similar responses at 10% MVC, but IHG elicited higher peak MAP and MSNA at 30% MVC (37 +/- 7 mm Hg (P < 0.05) and 300 +/- 48 units/30 s (P < 0.01) for IHG, respectively). CONCLUSIONS: The data indicate that INE can elicit marked increases in MSNA and cardiovascular responses but that it evokes lower peak responses as compared to IHG. We speculate that possible differences in muscle fiber type composition, muscle mass, and/or muscle architecture of the neck and forearm are responsible for these differences in peak responses.

Initial hydrologic and geomorphic response following a wildfire in the Colorado front range

USGS Publications Warehouse

Moody, J.A.; Martin, D.A.

2001-01-01

A wildfire in May 1996 burned 4690 hectares in two watersheds forested by ponderosa pine and Douglas fir in a steep, mountainous landscape with a summer, convective thunderstorm precipitation regime. The wildfire lowered the erosion threshold in the watersheds, and consequently amplified the subsequent erosional response to shorter time interval episodic rainfall and created both erosional and depositional features in a complex pattern throughout the watersheds. The initial response during the first four years was an increase in runoff and erosion rates followed by decreases toward pre-fire rates. The maximum unit-area peak discharge was 24 m3 s-1 km-2 for a rainstorm in 1996 with a rain intensity of 90 mm h-1. Recovery to pre-fire conditions seems to have occured by 2000 because for a maximum 30-min rainfall intensity of 50 mm h-1, the unit-area peak discharge in 1997 was 6.6 m3 s-1 km-2, while in 2000 a similar intensity produced only 0.11 m3 s-1 km-2. Rill erosion accounted for 6 per cent, interrill erosion for 14 per cent, and drainage erosion for 80 per cent of the initial erosion in 1996. This represents about a 200-fold increase in erosion rates on hillslopes which had a recovery or relaxation time of about three years. About 67 per cent of the initially eroded sediment is still stored in the watersheds after four years with an estimated residence time greater than 300 years. This residence time is much greater than the fire recurrence interval so erosional and depositional features may become legacies from the wildfire and may affect landscape evolution by acting as a new set of initial conditions for subsequent wildfire and flood sequences. Published in 2001 by John Wiley and Sons, Ltd.

Perceived effects of attending physician workload in academic medical intensive care units: a national survey of training program directors.

PubMed

Ward, Nicholas S; Read, Richard; Afessa, Bekele; Kahn, Jeremy M

2012-02-01

Increases in the size and number of American intensive care units have not been accompanied by a comparable increase in the critical care physician workforce, raising concerns that intensivists are becoming overburdened by workload. This is especially concerning in academic intensive care units where attending physicians must couple teaching duties with patient care. We performed an in-person and electronic survey of the membership of the Association of Pulmonary and Critical Care Medicine Program Directors, soliciting information about patient workload, other hospital and medical education duties, and perceptions of the workplace and teaching environment of their intensive care units. Eighty-four out of a total 121 possible responses were received from program directors or their delegates, resulting in a response rate of 69%. The average daily (SD) census (as perceived by the respondents) was 18.8 ± 8.9 patients, and average (SD) maximum service size recalled was 24.1 ± 9.9 patients. Twenty-seven percent reported no policy setting an upper limit for the daily census. Twenty-eight percent of respondents felt the average census was "too many" and 71% felt the maximum size was "too many." The median (interquartile range) patient-to-attending physician ratio was 13 (10-16). When categorized according to this median, respondents from intensive care units with high patient/physician ratios (n = 31) perceived significantly more time constraints, more stress, and difficulties with teaching trainees than respondents with low patient/physician ratios (n = 40). The total number of non-nursing healthcare workers per patient was similar in both groups, suggesting that having more nonattending physician staff does not alleviate perceptions of overwork and stress in the attending physician. Academic intensive care unit physicians that direct fellowship programs frequently perceived being overburdened in the intensive care unit. Understaffing intensive care units with attending physicians may have a negative impact on teaching, patient care, and workforce stability.

Responses of neurons in the caudal medullary lateral tegmental field to visceral inputs and vestibular stimulation in vertical planes

PubMed Central

Moy, Jennifer D.; Miller, Daniel J.; Catanzaro, Michael F.; Boyle, Bret M.; Ogburn, Sarah W.; Cotter, Lucy A.; McCall, Andrew A.

2012-01-01

The dorsolateral reticular formation of the caudal medulla, or the lateral tegmental field (LTF), has been classified as the brain's “vomiting center”, as well as an important region in regulating sympathetic outflow. We examined the responses of LTF neurons in cats to rotations of the body that activate vestibular receptors, as well as to stimulation of baroreceptors (through mechanical stretch of the carotid sinus) and gastrointestinal receptors (through the intragastric administration of the emetic compound copper sulfate). Approximately half of the LTF neurons exhibited graviceptive responses to vestibular stimulation, similar to primary afferents innervating otolith organs. The other half of the neurons had complex responses, including spatiotemporal convergence behavior, suggesting that they received convergent inputs from a variety of vestibular receptors. Neurons that received gastrointestinal and baroreceptor inputs had similar complex responses to vestibular stimulation; such responses are expected for neurons that contribute to the generation of motion sickness. LTF units with convergent baroreceptor and vestibular inputs may participate in producing the cardiovascular system components of motion sickness, such as the changes in skin blood flow that result in pallor. The administration of copper sulfate often modulated the gain of responses of LTF neurons to vestibular stimulation, particularly for units whose spontaneous firing rate was altered by infusion of drug (median of 459%). The present results raise the prospect that emetic signals from the gastrointestinal tract modify the processing of vestibular inputs by LTF neurons, thereby affecting the probability that vomiting will occur as a consequence of motion sickness. PMID:22955058

Gaze pursuit responses in nucleus reticularis tegmenti pontis of head-unrestrained macaques.

PubMed

Suzuki, David A; Betelak, Kathleen F; Yee, Robert D

2009-01-01

Eye-head gaze pursuit-related activity was recorded in rostral portions of the nucleus reticularis tegmenti pontis (rNRTP) in alert macaques. The head was unrestrained in the horizontal plane, and macaques were trained to pursue a moving target either with their head, with the eyes stationary in the orbits, or with their eyes, with their head voluntarily held stationary in space. Head-pursuit-related modulations in rNRTP activity were observed with some cells exhibiting increases in firing rate with increases in head-pursuit frequency. For many units, this head-pursuit response appeared to saturate at higher frequencies (>0.6 Hz). The response phase re:peak head-pursuit velocity formed a continuum, containing cells that could encode head-pursuit velocity and those encoding head-pursuit acceleration. The latter cells did not exhibit head position-related activity. Sensitivities were calculated with respect to peak head-pursuit velocity and averaged 1.8 spikes/s/deg/s. Of the cells that were tested for both head- and eye-pursuit-related activity, 86% exhibited responses to both head- and eye-pursuit and therefore carried a putative gaze-pursuit signal. For these gaze-pursuit units, the ratio of head to eye response sensitivities averaged approximately 1.4. Pursuit eccentricity seemed to affect head-pursuit response amplitude even in the absence of a head position response per se. The results indicated that rNRTP is a strong candidate for the source of an active head-pursuit signal that projects to the cerebellum, specifically to the target-velocity and gaze-velocity Purkinje cells that have been observed in vermal lobules VI and VII.

Progress toward national estimates of police use of force

PubMed Central

Garner, Joel H.; Malega, Ronald W.; Maxwell, Christopher D.

2018-01-01

This research builds on three decades of effort to produce national estimates of the amount and rate of force used by law enforcement officers in the United States. Prior efforts to produce national estimates have suffered from poor and inconsistent measurements of force, small and unrepresentative samples, low survey and/or item response rates, and disparate reporting of rates of force. The present study employs data from a nationally representative survey of state and local law enforcement agencies that has a high survey response rate as well as a relatively high rate of reporting uses of force. Using data on arrests for violent offenses and the number of sworn officers to impute missing data on uses of force, we estimate a total of 337,590 use of physical force incidents among State and local law enforcement agencies during 2012 with a 95 percent confidence interval of +/- 10,470 incidents or +/- 3.1 percent. This article reports the extent to which the number and rate of force incidents vary by the type and size of law enforcement agencies. Our findings demonstrate the willingness of a large proportion of law enforcement agencies to voluntarily report the amount of force used by their officers and the relative strengths and weaknesses of the Law Enforcement Management and Administrative Statistics (LEMAS) program to produce nationally representative information about police behavior. PMID:29447295

VAR and generalized impulse response analysis of manufacturing unit labor costs

NASA Astrophysics Data System (ADS)

Ewing, Bradley T.; Thompson, Mark A.

2008-04-01

This paper examines the relationship among manufacturing unit labor costs in the United States, United Kingdom, and Canada. The analysis is conducted within the context of an economic system utilizing the recently developed method of generalized impulse response analysis to simulate the responses of the cost series to disturbances. The results indicate that, while unit labor costs do not share a common stochastic trend, there are significant responses in the unit labor costs of each country to shocks in the costs of other countries that are not captured by standard interpretation of the multiple-equation model results. The findings indicate the presence of significant linkages among unit labor costs in the countries studied. The results are consistent with the economic environment of manufacturing operations being characterized by a competitive, integrated marketplace.

Comparing Past and Future Elevational vs. Latitudinal Migrations in Mountains of the Western U.S

NASA Astrophysics Data System (ADS)

Cole, K. L.; Ironside, K.; Cobb, N.

2009-12-01

During the early Holocene, plant species of the western United States responded to the warming post-glacial temperatures by migrating to higher elevations and to more northerly latitudes. Models of species response to warmer climates assume similar processes will occur in the future but the rates and extent of these future migrations are unknown. Hypothetically, the rates of elevational and latitudinal migrations should differ depending upon the importance of spatial distance in determining the resulting migration rate. The diverse topography of the western United States presents an ideal laboratory for comparing these past elevational vs. latitudinal species movements. Abundant fossil records allow comparisons between these rates following rapidly warming periods in the past such as occurred in the early Holocene. At that time, species often equilibrated to the new temperature regime rapidly where they were only required to migrate a short distance uphill. But the same species required many thousands of years to subsequently approach their northern latitudinal boundaries. Further, the upper limits and lower limits for a species often did not move synchronously, yielding additional information on the dynamics of response to rapid warming for that particular species. We calibrated the available temperature space for several dominant forest tree species of the mountains of the interior western U.S. and then calculated their early Holocene rates of migration relative to geographic space. Next we were able to compare these estimations to the observations of each species recent historical autecological response to disturbances. For many species their paleoecological rates of change were consistent with observations of their dynamics over the last century. A few species, such as the wind dispersed Populus tremuloides, re-populate disturbed areas so rapidly that they have no discernable migration delay. Other species, such as Pinus ponderosa, can expand rapidly at a rate approximating 250 to 500 m/year. But even at such a rapid rate, they would only be able to expand a total of 45 km by the end of this century. And, because of their maturation time, this could constitute only three generations. Lastly, many species of interior semi-arid regions, such as Pseudotsuga menziesii and Pinus edulis, expand at rates of less than 100 m/yr. Finally, we applied calculated migration rates to modeled areas of future potential climate for each species. We generated these areas of future potential distribution using a selection of AR4 GCMs that were applied to species-specific climate models developed from late Twentieth Century correlations between climate and species ranges. Our results demonstrate that the incorporation of these migration rates greatly change the distributions that could be expected over the next 500 years. The effect of such migration rates have not been considered in models of future carbon balance, yet their history suggests that their importance may outweigh many other variables. Models incorporating migration should be even more important in the projection of future distributions of boreal species across expansive Arctic regions.

[Natural history, diagnosis and treatment of chronic hepatitis B and C in hemodialysis patients].

PubMed

Nicolardi, Erica; Grieco, Antonio; Rapaccini, Gian Ludovico; Pompili, Maurizio

2010-01-01

Chronic hepatitis B and C are important causes of liver disease in hemodialysis units. The most important route of transmission is the inapparent parenteral route; known risk factors are the high prevalence of HBV and HCV infections in hemodialysis units, previous blood transfusions, long-term dialysis treatment, frequent changes of hemodialysis unit, and previous renal transplants. The source, time and duration of infection are often difficult to ascertain. The studies investigating the natural history of viral hepatitis in hemodialysis patients are few and limited by a short follow-up, but they show an independent and negative impact on survival due to an increased risk of liver cirrhosis and hepatocellular carcinoma. The treatment options include conventional or pegylated interferon (alone or in association with ribavirin) and the nucleoside/nucleotide analogs. The aim of treatment is viral eradication or persistent suppression of viral replication. The altered pharmacokinetics, the increased risk of drug-related toxicity, and the need for renal transplant complicate the management of antiviral therapy. In patients with chronic HBV infection and active replication the most common approach is persistent suppression of viral replication using nucleoside/nucleotide analogs. As regards hepatitis C, several clinical trials evaluating conventional interferon monotherapy have shown higher sustained virological response and dropout rates in dialysis patients than in patients with normal kidney function. Data about pegylated interferon as monotherapy or in association with ribavirin are promising but limited. Hemodialyzed patients obtaining a sustained virological response often maintain the response after kidney transplantation.

Patient and family/friend satisfaction in a sample of Jordanian Critical Care Units.

PubMed

Mosleh, S; Alja'afreh, M; Lee, A J

2015-12-01

The aim of the study was to assess the validity of family members/friends as proxies by comparing perceptions of satisfaction with care and decision making between critically ill patients and their family/friends. A comparative, descriptive cross-sectional study. Seven Critical Care Units across four public and military hospitals in the centre and southern regions of Jordan. A modified version of the Family Satisfaction-ICU (FS-ICU) questionnaire was distributed to Critical Care Unit (CCU) patients before hospital discharge. In addition, up to two family members/close friends were also asked to complete the questionnaire. A total of 213 patients (response rate 72%) and 246 family members/friends (response rate 79%) completed and returned the questionnaire. Although the majority of family members/friends and patients were satisfied with overall care, patients were generally significantly less satisfied (mean (SD) care subscale 75.6 (17.8) and 70.9 (17.3), respectively, (p=0.005). When individual items were examined, significant differences in nursing care (family/friends 80.1 (20.7) versus patient 75.9 (22.2), p=0.038) and inclusion in decision making (family/friends 53.9 (33.2) versus patient 62.0 (34.2), p=0.010) were found. The study showed a degree of congruence between patients and their family members/friends in relation to their satisfaction with the CCU experience. Thus, views of family/friends may serve as a proxy in assessing care and decision making processes of critically ill patients. Appropriate training of the critical care team and provision of strategies to address the concerns of patients' families are needed to improve overall patient satisfaction. Copyright © 2015 Elsevier Ltd. All rights reserved.

The ALMA Band 3 (84-116 GHz) receiver production plan

NASA Astrophysics Data System (ADS)

Yeung, Keith; Claude, Stéphane; Loop, David

2008-07-01

The NRC Herzberg Institute of Astrophysics (NRC-HIA) is currently responsible to contribute Band 3 (84-116 GHz) receivers to the international ALMA project - a partnership involving North America, Europe and, now, Asia. Not only are the technical requirements for these receivers far more stringent than those for any existing radio astronomy receivers operating at these frequencies, but the delivery schedule for these receivers is equally challenging. Since the Asian partnership joined the ALMA project in 2006, NRC-HIA has been asked to deliver an additional 11 cartridges, for a total of 73 units. Some of these new cartridges will be used for the ALMA Compact Array (ACA) and others as spares. Moreover, the project has also requested that these additional cartridges be delivered in the same time period as the original 62 units. To meet this requirement, production must increase from the existing rate of one unit every four weeks to one every two, taxing the existing production infrastructure at NRC-HIA. Additional test facilities and human resources must be planned to sustain the required production rate over the next several years. Industrial involvement is one of the important elements in our production plan. In order to supplement the existing human resources at NRC-HIA, we are planning to outsource a number of low-risk and labor-intensive tasks to industry. However, NRC-HIA will retain overall project management responsibility and will conduct all the cartridge integration and acceptance test activities in-house. This paper focuses on the resource estimation, planning and project management required to deliver the Band 3 receivers to the ALMA project on time and on budget.

Snowball sampling by mail: application to a survey of smokers in the general population.

PubMed

Etter, J F; Perneger, T V

2000-02-01

In a series of surveys intended for current and former smokers but sent to a random sample of the general population, we asked never smokers and smokers who did not wish to participate to transmit the questionnaire to any ever smoker they knew. We compared participants who received the questionnaire directly from us (original participants) to participants who received it from an addressee (secondary participants). Questionnaires on smoking were mailed to 3300 residents of Geneva (Switzerland) in 1997, and returned by 1167 people (35%). The final sample consisted of similar numbers of original participants (n = 578, primary response rate = 18% of total sample, or about 46% of ever smokers) and secondary participants (n = 566). Original participants were 1.7 years older than secondary participants (P = 0.03) and were more likely to be men (50% versus 43%, P = 0.009). Proportions of current smokers, stages of change, confidence in ability to quit smoking, cigarettes per day and attempts to quit smoking were similar in the two groups. Secondary participants had lower self-efficacy scores (-0.30 standard deviation (SD) units, P < 0.03), and they derived more pleasure from smoking (+0.25 SD units, P = 0.04). Among ex-smokers, direct participants were less active than secondary participants in coping with the temptation to smoke (-0.58 SD units, P = 0.002). Associations between smoking-related variables were similar in original and secondary participants. Allowing non-eligible addressees to transmit the questionnaire to someone else doubled the response rate, produced moderate bias on some variables only and had no detectable impact on associations between smoking-related variables.

State Budgets, Unit Allocations, and Unit Emissions Rates

EPA Pesticide Factsheets

This Technical Support Document (TSD) provides information that supports EPA’s determination of state emissions budgets, unit-level allocations, direct control rate limits, and new unit set-asides for the Transport Rule proposal.

Developing and Pilot Testing a Spanish Translation of CollaboRATE for Use in the United States.

PubMed

Forcino, Rachel C; Bustamante, Nitzy; Thompson, Rachel; Percac-Lima, Sanja; Elwyn, Glyn; Pérez-Arechaederra, Diana; Barr, Paul J

2016-01-01

Given the need for access to patient-facing materials in multiple languages, this study aimed to develop and pilot test an accurate and understandable translation of CollaboRATE, a three-item patient-reported measure of shared decision-making, for Spanish-speaking patients in the United States (US). We followed the Translate, Review, Adjudicate, Pre-test, Document (TRAPD) survey translation protocol. Cognitive interviews were conducted with Spanish-speaking adults within an urban Massachusetts internal medicine clinic. For the pilot test, all patients with weekday appointments between May 1 and May 29, 2015 were invited to complete CollaboRATE in either English or Spanish upon exit. We calculated the proportion of respondents giving the best score possible on CollaboRATE and compared scores across key patient subgroups. Four rounds of cognitive interviews with 26 people were completed between January and April 2015. Extensive, iterative refinements to survey items between interview rounds led to final items that were generally understood by participants with diverse educational backgrounds. Pilot data collection achieved an overall response rate of 73 percent, with 606 (49%) patients completing Spanish CollaboRATE questionnaires and 624 (51%) patients completing English CollaboRATE questionnaires. The proportion of respondents giving the best score possible on CollaboRATE was the same (86%) for both the English and Spanish versions of the instrument. Our translation method, guided by emerging best practices in survey and health measurement translation, encompassed multiple levels of review. By conducting four rounds of cognitive interviews with iterative item refinement between each round, we arrived at a Spanish language version of CollaboRATE that was understandable to a majority of cognitive interview participants and was completed by more than 600 pilot questionnaire respondents.

Empowerment in nurse leader groups in middle management: a quantitative comparative investigation.

PubMed

Spencer, Caroline; McLaren, Susan

2017-01-01

The aim was to investigate structural empowerment in nurse leaders in middle management positions. Objectives were to determine levels of empowerment of nurse leaders and to compare levels of empowerment between nurse leader groups. Access to formal and informal power, opportunity, resources, information and support are determinants of structural empowerment. Empowerment of nurse leaders in middle management positions is vital given their roles in enabling nursing teams to deliver high-quality care, benefitting both patient and workforce outcomes. Quantitative component of a mixed methods study using survey principles. The Conditions of Work Effectiveness Questionnaire II was distributed to the total population (n = 517) of nurse leaders in an NHS Foundation Trust in England. Nurse leader groups comprised unit leaders (sisters, matrons) and senior staff nurses. Quantitative data entered on spss v 17/18, were analysed using descriptive and inferential statistics. Overall, the unit response rate was 44·1% (n = 228). Levels of total and global empowerment were moderate and moderate to high respectively. Groups did not differ significantly on these parameters or on five elements of total empowerment, but significantly higher scores were found for unit leaders' access to information. Significantly higher scores were found for senior staff nurses on selected aspects of informal power and access to resources, but scores were significantly lower than unit leaders for components of support. A moderately empowered population of nurse leaders differed in relation to access to information, aspects of support, resources and informal power, reflecting differences in roles, spheres of responsibility, hierarchical position and the constraints on empowerment imposed on unit leaders by financial and resource pressures. Empowerment of nurse leaders in middle management is vital in enabling nursing teams to deliver high-quality care. Roles, spheres of responsibility, hierarchical position and constraints imposed by financial and resource pressures influence nurse leader empowerment. Administrative support is needed to sustain practice engagement. © 2016 John Wiley & Sons Ltd.

Psychometric properties of the Norwegian version of the Safety Attitudes Questionnaire (SAQ), Generic version (Short Form 2006).

PubMed

Deilkås, Ellen T; Hofoss, Dag

2008-09-22

How to protect patients from harm is a question of universal interest. Measuring and improving safety culture in care giving units is an important strategy for promoting a safe environment for patients. The Safety Attitudes Questionnaire (SAQ) is the only instrument that measures safety culture in a way which correlates with patient outcome. We have translated the SAQ to Norwegian and validated the translated version. The psychometric properties of the translated questionnaire are presented in this article. The questionnaire was translated with the back translation technique and tested in 47 clinical units in a Norwegian university hospital. SAQ's (the Generic version (Short Form 2006) the version with the two sets of questions on perceptions of management: on unit management and on hospital management) were distributed to 1911 frontline staff. 762 were distributed during unit meetings and 1149 through the postal system. Cronbach alphas, item-to-own correlations, and test-retest correlations were calculated, and response distribution analysis and confirmatory factor analysis were performed, as well as early validity tests. 1306 staff members completed and returned the questionnaire: a response rate of 68%. Questionnaire acceptability was good. The reliability measures were acceptable. The factor structure of the responses was tested by confirmatory factor analysis. 36 items were ascribed to seven underlying factors: Teamwork Climate, Safety Climate, Stress Recognition, Perceptions of Hospital Management, Perceptions of Unit Management, Working conditions, and Job satisfaction. Goodness-of-Fit Indices showed reasonable, but not indisputable, model fit. External validity indicators - recognizability of results, correlations with "trigger tool"-identified adverse events, with patient satisfaction with hospitalization, patient reports of possible maltreatment, and patient evaluation of organization of hospital work - provided preliminary validation. Based on the data from Akershus University Hospital, we conclude that the Norwegian translation of the SAQ showed satisfactory internal psychometric properties. With data from one hospital only, we cannot draw strong conclusions on its external validity. Further validation studies linking the SAQ-scores to patient outcome data should be performed.

Job strain and the risk of disability pension due to musculoskeletal disorders, depression or coronary heart disease: a prospective cohort study of 69,842 employees.

PubMed

Mäntyniemi, Anne; Oksanen, Tuula; Salo, Paula; Virtanen, Marianna; Sjösten, Noora; Pentti, Jaana; Kivimäki, Mika; Vahtera, Jussi

2012-08-01

Observational studies suggest that high job strain is a risk factor for retirement on health grounds, but few studies have analysed specific diagnoses. We examined job strain's association with all-cause and cause-specific disability pensions. Survey responses to questions about job strain from 48,598 (response rate, 68%) public sector employees in Finland from 2000 to 2002 were used to determine work unit- and occupation-based scores. These job strain scores were assigned to all the 69,842 employees in the same work units or occupations. All participants were linked to the disability pension register of the Finnish Centre of Pensions with no loss to follow-up. Cox proportional hazard models were used to calculate HRs and their 95% CIs for disability pensions adjusted by demographic, work unit characteristics and baseline health in analyses stratified by sex and socioeconomic position. During a mean follow-up of 4.6 years, 2572 participants (4%) were granted a disability pension. A one-unit increase in job strain was associated with a 1.3- to 2.4-fold risk of requiring a disability pension due to musculoskeletal diseases in men, women and manual workers, depending on the measure of job strain (work unit or occupation based). The risk of disability pension due to cardiovascular diseases was increased in men with high job strain but not in women nor in any socioeconomic group. No consistent pattern was found for disability pension due to depression. High job strain is a risk factor for disability pension due to musculoskeletal diseases.

Sources and Levels of Stress among 70th Intelligence, Surveillance, and Reconnaissance Wing Intelligence Operators and Support Personnel

DTIC Science & Technology

2013-03-01

personnel had responses indicative of the syndrome of burnout (i.e., simultaneously reporting high exhaustion, high cynicism, and low professional...as well as levels of burnout , psychological distress, and post-traumatic stress disorder symptoms among United States Air Force 70th Intelligence...revealed lower rates of burnout and psychological distress among 70 ISRW personnel when compared to intelligence operators in other arenas of the 25th Air

U.S. Naval Unit Behavioral Health Needs Assessment Survey, Overview of Survey Items and Measures

DTIC Science & Technology

2014-05-20

Cohesion • Social Support • Assignment-Related Stressors • Physical Stressors • Traumatic Brain Injury • Physical Activity • Pain and Pain ...et al., 2011). Pain and Pain Medication Use To evaluate pain , a single question from the Brief Pain Inventory is included on NUBHNAS...Please rate your pain by indicating the one number that best describes your pain on average.” Responses: 0 = 0 (No pain ), 1 = 1, . . ., 10 = 10 ( Pain

Reassessment of Occupational Health Among U.S. Air Force Remotely Piloted Aircraft (Drone) Operators

DTIC Science & Technology

2017-04-05

As a result, the U.S. Air Force (USAF) School of Aerospace Medicine was requested to conduct a field survey to assess for general areas of health...services; and reasons for increased prescription and over-the-counter medication usage ). The purpose of this study was to reevaluate for changes in...major commands within the continental United States completed the web-based survey , resulting in an estimated 40% response rate. Statistical analyses

A Case Study On Human Capital Mismanagement In The United States Air Force

DTIC Science & Technology

2016-05-08

author(s) and do not reflect the official policy or position of the US government or the Department of Defense. In accordance with Air Force Instruction...The final category for this analysis encompasses the 2 Acquisition Managers (63A).3 These individuals do not necessarily hold technical degrees...orders of magnitude more engineers than they do rated officers, and are responsible for the institutional leadership and the management of the test

Development of a Lifespan-Based Novel Composite Person-Reported Outcome Measure using Data from the CINRG Duchenne Natural History Study

DTIC Science & Technology

2015-10-01

UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION REPORT NUMBER University of California, Davis Davis, CA...we created further sub- classifications that represent domains from the Performance of the Upper Limb (PUL) (Mayhew, Mazzone et al. 2013) and North...1-4 or 1-5 Likert- type response ratings representing level of difficulty of performing a specific task (eg. climbing stairs). Principle component

Control system for fluid heated steam generator

DOEpatents

Boland, J.F.; Koenig, J.F.

1984-05-29

A control system for controlling the location of the nucleate-boiling region in a fluid heated steam generator comprises means for measuring the temperature gradient (change in temperature per unit length) of the heating fluid along the steam generator; means for determining a control variable in accordance with a predetermined function of temperature gradients and for generating a control signal in response thereto; and means for adjusting the feedwater flow rate in accordance with the control signal.

Control system for fluid heated steam generator

DOEpatents

Boland, James F.; Koenig, John F.

1985-01-01

A control system for controlling the location of the nucleate-boiling region in a fluid heated steam generator comprises means for measuring the temperature gradient (change in temperature per unit length) of the heating fluid along the steam generator; means for determining a control variable in accordance with a predetermined function of temperature gradients and for generating a control signal in response thereto; and means for adjusting the feedwater flow rate in accordance with the control signal.

[Invasive meningococcal disease--management and treatment].

PubMed

Garlicki, Aleksander; Bociqga-Jasik, Monika; Kalinowska-Nowak, Anna

2008-01-01

Invasive meningococcal disease is life threatening disease and in fulminant cases mortality rate may be as high as 70%. Rapid introduction of treatment and monitoring on intensive care unit is crucial for prognosis. The understanding of patomechanism responsible for sepsis development allow to introduce supportive treatment including glicocorticoids and recombinant human activated protein C. Very important is suitable prophylaxis among risk groups with, additional considering vaccination in the case of infection caused by A, C, Y, W-135 serogroups.

Treatment Programs in the National Drug Abuse Treatment Clinical Trials Network

PubMed Central

McCarty, Dennis; Fuller, Bret; Kaskutas, Lee Ann; Wendt, William W.; Nunes, Edward V.; Miller, Michael; Forman, Robert; Magruder, Kathryn M.; Arfken, Cynthia; Copersino, Marc; Floyd, Anthony; Sindelar, Jody; Edmundson, Eldon

2008-01-01

Drug abuse treatment programs and university-based research centers collaborate to test emerging therapies for alcohol and drug disorders in the National Drug Abuse Treatment Clinical Trials Network (CTN). Programs participating in the CTN completed organizational (n = 106 of 112; 95% response rate) and treatment unit surveys (n = 348 of 384; 91% response rate) to describe the levels of care, ancillary services, patient demographics, patient drug use and co-occurring conditions. Analyses describe the corporations participating in the CTN and provide an exploratory assessment of variation in treatment philosophies. A diversity of treatment centers participate in the CTN; not for profit organizations with a primary mission of treating alcohol and drug disorders dominate. Compared to N-SSATS (National Survey of Substance Abuse Treatment Services), programs located in medical settings are over-represented and centers that are mental health clinics are under-represented. Outpatient, methadone, long-term residential and inpatient treatment units differed on patients served and services proved. Larger programs with higher counselor caseloads in residential settings reported more social model characteristics. Programs with higher social model scores were more likely to offer self-help meetings, vocational services and specialized services for women. Conversely, programs with accreditation had less social model influence. The CTN is an ambitious effort to engage community-based treatment organizations into research and more fully integrate research and practice. PMID:17875368

Metabolic principles of river basin organization.

PubMed

Rodriguez-Iturbe, Ignacio; Caylor, Kelly K; Rinaldo, Andrea

2011-07-19

The metabolism of a river basin is defined as the set of processes through which the basin maintains its structure and responds to its environment. Green (or biotic) metabolism is measured via transpiration and blue (or abiotic) metabolism through runoff. A principle of equal metabolic rate per unit area throughout the basin structure is developed and tested in a river basin characterized by large heterogeneities in precipitation, vegetation, soil, and geomorphology. This principle is suggested to have profound implications for the spatial organization of river basin hydrologic dynamics, including the minimization of energy expenditure known to control the scale-invariant characteristics of river networks over several orders of magnitude. Empirically derived, remarkably constant rates of average transpiration per unit area through the basin structure lead to a power law for the probability distribution of transpiration from a randomly chosen subbasin. The average runoff per unit area, evaluated for subbasins of a wide range of topological magnitudes, is also shown to be remarkably constant independently of size. A similar result is found for the rainfall after accounting for canopy interception. Allometric scaling of metabolic rates with size, variously addressed in the biological literature and network theory under the label of Kleiber's law, is similarly derived. The empirical evidence suggests that river basin metabolic activity is linked with the spatial organization that takes place around the drainage network and therefore with the mechanisms responsible for the fractal geometry of the network, suggesting a new coevolutionary framework for biological, geomorphological, and hydrologic dynamics.

A comparison of data obtained from service providers and service users to assess the quality of maternity care.

PubMed

Hundley, V; Penney, G; Fitzmaurice, A; van Teijlingen, E; Graham, W

2002-06-01

to compare data obtained from two sources, service providers and service users, regarding the maternity services in Scotland. an audit of maternity services involving site visits, staff interviews and a cross-sectional survey of service users. lead professionals in every consultant-led maternity unit in Scotland and all 1639 women giving birth in Scotland during a ten-day period. structured group interviews with service providers and a questionnaire survey of recently delivered women. professionals' and women's responses were cross-tabulated and differences in proportions were tested for statistical significance using the chi-square test. a total of 1137 women completed the questionnaire (response rate 69%). Overall, there was good agreement between professionals' and women's perceptions of the aspects of care studied. However, there were disparities in some areas. For example, staff in eight units reported mechanisms to ensure early distribution of a free national pregnancy book; however, in six of these units less than 75% of women actually received this book prior to their first hospital visit. Eighteen units reported that they offer a postnatal 'reunion meeting'; in ten of these units, less than 50% of women were aware of the reunion meeting. Eighteen units reported a policy of each woman having a lead professional or care co-ordinator; in three of these units, less than 50% of women perceived that they had a care co-ordinator and for most women, the profession (midwife, general practitioner or obstetrician) of their perceived co-ordinator differed from that expected on the basis of staff reports. There was some evidence overall that unit policies had a direct influence on women's responses. this study demonstrates the importance of using a range of complementary methods of data collection and of ascertaining both service users' and providers' views when assessing the quality of care. Further research is required to explore differences in service provider's and women's perceptions and how this information can be used to improve the quality of maternity care. The finding that service provision may influence women's preferences has important implications for service planning, in particular the introduction of new models of care, and this needs further exploration. Copyright 2002 Elsevier Science Ltd.

Corneal transplantation in the United Kingdom and Republic of Ireland.

PubMed Central

Vail, A; Gore, S M; Bradley, B A; Easty, D L; Rogers, C A

1993-01-01

The Corneal Transplant Follow up Study has registered 4560 corneal grafts performed in the United Kingdom and Republic of Ireland from July 1987 to June 1991. Rates of reported grafts doubled during that time. This increase was greater for surgeons and regions reporting fewer grafts, but was consistent across patient factors. Eleven of 428 consultants were responsible for over 25% of grafts, and their patients' characteristics differed significantly from others. Overall, reasons for grafting were visual only (77%), visual and other (16%), and non-visual (7%). Most frequent diagnoses were endothelial failure (38%), inflammation (26%), and keratoconus (20%). Age ranged from 2 months to 97 years, and differed markedly with diagnosis. Eighteen per cent of transplants were regrafts, and 40% were vascularised preoperatively. PMID:8218035

Accuracy of Monte Carlo photon transport simulation in characterizing brachytherapy dosimeter energy-response artefacts.

PubMed

Das, R K; Li, Z; Perera, H; Williamson, J F

1996-06-01

Practical dosimeters in brachytherapy, such as thermoluminescent dosimeters (TLD) and diodes, are usually calibrated against low-energy megavoltage beams. To measure absolute dose rate near a brachytherapy source, it is necessary to establish the energy response of the detector relative to that of the calibration energy. The purpose of this paper is to assess the accuracy of Monte Carlo photon transport (MCPT) simulation in modelling the absolute detector response as a function of detector geometry and photon energy. We have exposed two different sizes of TLD-100 (LiF chips) and p-type silicon diode detectors to calibrated 60Co, HDR source (192Ir) and superficial x-ray beams. For the Scanditronix electron-field diode, the relative detector response, defined as the measured detector readings per measured unit of air kerma, varied from 38.46 V cGy-1 (40 kVp beam) to 6.22 V cGy-1 (60Co beam). Similarly for the large and small chips the same quantity varied from 2.08-3.02 nC cGy-1 and 0.171-0.244 nC cGy-1, respectively. Monte Carlo simulation was used to calculate the absorbed dose to the active volume of the detector per unit air kerma. If the Monte Carlo simulation is accurate, then the absolute detector response, which is defined as the measured detector reading per unit dose absorbed by the active detector volume, and is calculated by Monte Carlo simulation, should be a constant. For the diode, the absolute response is 5.86 +/- 0.15 (V cGy-1). For TLDs of size 3 x 3 x 1 mm3 the absolute response is 2.47 +/- 0.07 (nC cGy-1) and for TLDs of 1 x 1 x 1 mm3 it is 0.201 +/- 0.008 (nC cGy-1). From the above results we can conclude that the absolute response function of detectors (TLDs and diodes) is directly proportional to absorbed dose by the active volume of the detector and is independent of beam quality.

[Views of final-year medical students at Damascus University about clinical skills acquired before graduation].

PubMed

Alourfi, Z; Hassan, R El Sayed; Koudsi, A

2012-06-01

Medical education in Syrian universities is facing many challenges that may affect the quality of the education and the standard of graduates. We therefore conducted a cross-sectional study using a self-administrated questionnaire with 76 items to investigate the perceptions of 290 final-year medical students regarding the confidence of performing some core clinical skills. A total of 271 responded (response rate 93.4%). Student responses differed. While confidence was highest for skills that do not require practice in the clinical skills laboratory, it was low for skills that need training in emergency and intensive care units, or when students were participating in patient care with partial responsibility. Our findings confirm the need for effective clinical laboratory training, student participation in emergency room shifts, and that students to be allowed to take some egree of responsibility.

Baseline Tumor Lipiodol Uptake after Transarterial Chemoembolization for Hepatocellular Carcinoma: Identification of a Threshold Value Predicting Tumor Recurrence.

PubMed

Matsui, Yusuke; Horikawa, Masahiro; Jahangiri Noudeh, Younes; Kaufman, John A; Kolbeck, Kenneth J; Farsad, Khashayar

2017-12-01

The aim of the study was to evaluate the association between baseline Lipiodol uptake in hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE) with early tumor recurrence, and to identify a threshold baseline uptake value predicting tumor response. A single-institution retrospective database of HCC treated with Lipiodol-TACE was reviewed. Forty-six tumors in 30 patients treated with a Lipiodol-chemotherapy emulsion and no additional particle embolization were included. Baseline Lipiodol uptake was measured as the mean Hounsfield units (HU) on a CT within one week after TACE. Washout rate was calculated dividing the difference in HU between the baseline CT and follow-up CT by time (HU/month). Cox proportional hazard models were used to correlate baseline Lipiodol uptake and other variables with tumor response. A receiver operating characteristic (ROC) curve was used to identify the optimal threshold for baseline Lipiodol uptake predicting tumor response. During the follow-up period (mean 5.6 months), 19 (41.3%) tumors recurred (mean time to recurrence = 3.6 months). In a multivariate model, low baseline Lipiodol uptake and higher washout rate were significant predictors of early tumor recurrence ( P = 0.001 and < 0.0001, respectively). On ROC analysis, a threshold Lipiodol uptake of 270.2 HU was significantly associated with tumor response (95% sensitivity, 93% specificity). Baseline Lipiodol uptake and washout rate on follow-up were independent predictors of early tumor recurrence. A threshold value of baseline Lipiodol uptake > 270.2 HU was highly sensitive and specific for tumor response. These findings may prove useful for determining subsequent treatment strategies after Lipiodol TACE.

Strain Rate Dependent Deformation and Strength Modeling of a Polymer Matrix Composite Utilizing a Micromechanics Approach. Degree awarded by Cincinnati Univ.

NASA Technical Reports Server (NTRS)

Goldberg, Robert K.

1999-01-01

Potential gas turbine applications will expose polymer matrix composites to very high strain rate loading conditions, requiring an ability to understand and predict the material behavior under extreme conditions. Specifically, analytical methods designed for these applications must have the capability of properly capturing the strain rate sensitivities and nonlinearities that are present in the material response. The Ramaswamy-Stouffer constitutive equations, originally developed to analyze the viscoplastic deformation of metals, have been modified to simulate the nonlinear deformation response of ductile, crystalline polymers. The constitutive model is characterized and correlated for two representative ductile polymers. Fiberite 977-2 and PEEK, and the computed results correlate well with experimental values. The polymer constitutive equations are implemented in a mechanics of materials based composite micromechanics model to predict the nonlinear, rate dependent deformation response of a composite ply. Uniform stress and uniform strain assumptions are applied to compute the effective stresses of a composite unit cell from the applied strains. The micromechanics equations are successfully verified for two polymer matrix composites. IM7/977-2 and AS4/PEEK. The ultimate strength of a composite ply is predicted with the Hashin failure criteria that were implemented in the composite micromechanics model. The failure stresses of the two composite material systems are accurately predicted for a variety of fiber orientations and strain rates. The composite deformation model is implemented in LS-DYNA, a commercially available transient dynamic explicit finite element code. The matrix constitutive equations are converted into an incremental form, and the model is implemented into LS-DYNA through the use of a user defined material subroutine. The deformation response of a bulk polymer and a polymer matrix composite are predicted by finite element analyses. The results compare reasonably well to experimental values, with some discrepancies. The discrepancies are at least partially caused by the method used to integrate the rate equations in the polymer constitutive model.

Prognostic significance of clinical presentation, induction and rescue treatment in 42 cases of canine centroblastic diffuse large B-cell multicentric lymphoma in the United Kingdom.

PubMed

Davies, O; Szladovits, B; Polton, G; Garden, O A; Leo, C; Lara-Garcia, A

2018-06-01

Canine lymphoma is a heterogeneous group of diseases and many previous studies have evaluated the response of a mixed population of lymphoma cases to one specific treatment protocol. The aim of this retrospective study was to describe the outcome and prognostic factors in 42 cases of multicentric centroblastic diffuse large B-cell lymphoma treated with either a COP-type (35%) or CHOP-type (64%) induction chemotherapy. The objective response rate to induction therapy was 94%; entire dogs had a greater rate of complete vs partial remissions than neutered dogs (P = .017). Median progression-free survival for the first remission (PFS1) was 182 days; absence of anaemia at diagnosis (P = .002) and pretreatment neutrophil:lymphocyte ratio (NLR) below 9.44 (P = .015) were independently predictive of longer PFS1. Fifty-eight percent of dogs received rescue protocols with an objective response rate of 81%; 31% of dogs received further rescue protocols (up to a total of 5) and the median number of protocols administered were 2. Median overall survival (OS) was 322 days, the 1-year survival rate was 38% and the 2-year survival rate was 9%. Lymphocyte:monocyte ratio above 1.43 (P = .031), NLR below 11.44 (P = .009), the combination of induction and rescue therapy (P = .030) and the total number of doxorubicin doses used (P = .002) were independently predictive of longer OS. Use of a COP-type protocol induction compared with CHOP did not undermine OS providing doxorubicin was used as rescue therapy. © 2017 John Wiley & Sons Ltd.

Spectral summation and facilitation in on- and off-responses for optimized representation of communication calls in mouse inferior colliculus.

PubMed

Akimov, Alexander G; Egorova, Marina A; Ehret, Günter

2017-02-01

Selectivity for processing of species-specific vocalizations and communication sounds has often been associated with the auditory cortex. The midbrain inferior colliculus, however, is the first center in the auditory pathways of mammals integrating acoustic information processed in separate nuclei and channels in the brainstem and, therefore, could significantly contribute to enhance the perception of species' communication sounds. Here, we used natural wriggling calls of mouse pups, which communicate need for maternal care to adult females, and further 15 synthesized sounds to test the hypothesis that neurons in the central nucleus of the inferior colliculus of adult females optimize their response rates for reproduction of the three main harmonics (formants) of wriggling calls. The results confirmed the hypothesis showing that average response rates, as recorded extracellularly from single units, were highest and spectral facilitation most effective for both onset and offset responses to the call and call models with three resolved frequencies according to critical bands in perception. In addition, the general on- and/or off-response enhancement in almost half the investigated 122 neurons favors not only perception of single calls but also of vocalization rhythm. In summary, our study provides strong evidence that critical-band resolved frequency components within a communication sound increase the probability of its perception by boosting the signal-to-noise ratio of neural response rates within the inferior colliculus for at least 20% (our criterion for facilitation). These mechanisms, including enhancement of rhythm coding, are generally favorable to processing of other animal and human vocalizations, including formants of speech sounds. © 2016 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

Combined Immunosuppression Impairs Immunogenicity to Tetanus and Pertussis Vaccination Among Patients with Inflammatory Bowel Disease.

PubMed

Dezfoli, Seper; Horton, Henry A; Thepyasuwan, Nattapaun; Berel, Dror; Targan, Stephan R; Vasiliauskas, Eric A; Dubinsky, Marla; Shih, David Q; Kaur, Manreet; McGovern, Dermot P B; Ippoliti, Andrew; Feldman, Edward J; Melmed, Gil Y

2015-08-01

Pertussis epidemics have recently emerged across the United States, prompting broad public health recommendations for adult Tdap vaccination (tetanus, diphtheria, acellular pertussis). The impact of immunosuppressive regimens for inflammatory bowel disease (IBD) on vaccine responses to the Tdap vaccine is not known. We performed a prospective controlled trial between April 2011 and March 2012. Adults with IBD were consecutively stratified based on therapeutic regimen into one of 5 groups: A: no IBD therapy or 5-aminosalicylates alone; B: maintenance biologic monotherapy; C: maintenance immunomodulator monotherapy; D: combined biologic and immunomodulator therapy; and E: healthy age-matched controls. Subjects received Tdap, and serum antibody levels against tetanus toxoid, pertussis toxoid, and filamentous hemagglutinin (FHA) were drawn just before and approximately 4 weeks after vaccination. The primary outcome was the booster response rate to each antigen. Secondary outcomes included the differences in pregeometric and postgeometric mean titers. A total of 98 subjects enrolled, and 84 completed the study. Tetanus response rates were 55%, 56%, 40%, 27%, and 63% across groups A to E, respectively. Group D rates were lower than those of group B (P = 0.02). Postvaccination pertussis toxoid responses were 59%, 72%, 47%, 45%, and 75%, while FHA responses were 86%, 72%, 80%, 64%, and 75% across groups A to E, respectively. Prevaccination and postvaccination geometric mean titer differences for FHA were lower in group D than those in group A (P = 0.05). Antibody responses to tetanus and pertussis vaccination may be affected by therapeutic drug regimen. Patients with IBD should optimally receive Tdap before starting immunomodulators, particularly when used in combination with anti-tumor necrosis factor alpha agents.

Promoting employee health by integrating health protection, health promotion, and continuous improvement: a longitudinal quasi-experimental intervention study.

PubMed

von Thiele Schwarz, Ulrica; Augustsson, Hanna; Hasson, Henna; Stenfors-Hayes, Terese

2015-02-01

To test the effects of integrating health protection and health promotion with a continuous improvement system (Kaizen) on proximal employee outcomes (health promotion, integration, and Kaizen) and distal outcomes (workability, productivity, self-rated health and self-rated sickness absence). Twelve units in a county hospital in Sweden were randomized to control or intervention groups using a quasiexperimental study design. All staff (approximately 500) provided self-ratings in questionnaires at baseline, and a 12- and 24-month follow-up (response rate, 79% to 87.5%). There was a significant increase in the proximal outcomes over time in the intervention group compared with the control group, and a trend toward improvement in the distal outcomes workability and productivity. Integration seems to promote staff engagement in health protection and promotion, as well as to improve their understanding of the link between work and health.

40 CFR 73.19 - Certain units with declining SO2 rates.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Certain units with declining SO2 rates... declining SO2 rates. (a) Eligibility. A unit is eligible for allowance allocations under this section if it... generator with nameplate capacity equal to or greater than 75 MWe; (3) Its 1985 actual SO2 emissions rate...

Stats of the States

MedlinePlus

... rates for fatal drug poisonings. Death Rates from Firearm Injuries: United States, 2013 - The latest state-based age-adjusted death rates for firearm-related fatalities. Death Rates from Homicide: United States, ...

Dose-response characteristics of an amorphous silicon EPID.

PubMed

Winkler, Peter; Hefner, Alfred; Georg, Dietmar

2005-10-01

Electronic portal imaging devices (EPIDs) were originally developed for the purpose of patient setup verification. Nowadays, they are increasingly used as dosimeters (e.g., for IMRT verification and linac-specific QA). A prerequisite for any clinical dosimetric application is a detailed understanding of the detector's dose-response behavior. The aim of this study is to investigate the dosimetric properties of an amorphous silicon EPID (Elekta IVIEWGT) with respect to three photon beam qualities: 6, 10, and 25 MV. The EPID showed an excellent temporal stability on short term as well as on long term scales. The stability throughout the day was strongly influenced by warming up, which took several hours and affected EPID response by 2.5%. Ghosting effects increased the sensitivity of the EPID. They became more pronounced with decreasing time intervals between two exposures as well as with increasing dose. Due to ghosting, changes in pixel sensitivity amounted up to 16% (locally) for the 25 MV photon beam. It was observed that the response characteristics of our EPID depended on dose as well as on dose rate. Doubling the dose rate increased the EPID sensitivity by 1.5%. This behavior was successfully attributed to a dose per frame effect, i.e., a nonlinear relationship between the EPID signal and the dose which was delivered to the panel between two successive readouts. The sensitivity was found to vary up to 10% in the range of 1 to 1000 monitor units. This variation was governed by two independent effects. For low doses, the EPID signal was reduced due to the linac's changing dose rate during startup. Furthermore, the detector reading was influenced by intrabeam variations of EPID sensitivity, namely, an increase of detector response during uniform exposure. For the beam qualities which were used, the response characteristics of the EPID did not depend on energy. Differences in relative dose-response curves resulted from energy dependent temporal output characteristics of the accelerator. If ghosting is prevented from affecting the results and all dose-response effects are properly corrected for, the EPID signal becomes independent of dose rate, dose, and exposure time.

Relationship between mosquito (Diptera: Culicidae) landing rates on a human subject and numbers captured using CO2-baited light traps.

PubMed

Barnard, D R; Knue, G J; Dickerson, C Z; Bernier, U R; Kline, D L

2011-06-01

Capture rates of insectary-reared female Aedes albopictus (Skuse), Anopheles quadrimaculatus Say, Culex nigripalpus Theobald, Culex quinquefasciatus Say and Aedes triseriatus (Say) in CDC-type light traps (LT) supplemented with CO2 and using the human landing (HL) collection method were observed in matched-pair experiments in outdoor screened enclosures. Mosquito responses were compared on a catch-per-unit-effort basis using regression analysis with LT and HL as the dependent and independent variables, respectively. The average number of mosquitoes captured in 1 min by LT over a 24-h period was significantly related to the average number captured in 1 min by HL only for Cx. nigripalpus and Cx. quinquefasciatus. Patterns of diel activity indicated by a comparison of the mean response to LT and HL at eight different times in a 24-h period were not superposable for any species. The capture rate efficiency of LT when compared with HL was ≤15% for all mosquitoes except Cx. quinquefasciatus (43%). Statistical models of the relationship between mosquito responses to each collection method indicate that, except for Ae. albopictus, LT and HL capture rates are significantly related only during certain times of the diel period. Estimates of mosquito activity based on observations made between sunset and sunrise were most precise in this regard for An. quadrimaculatus and Cx. nigripalpus, as were those between sunrise and sunset for Cx. quinquefasciatus and Ae. triseriatus.

Hybrid minimally invasive esophagectomy for cancer: impact on postoperative inflammatory and nutritional status.

PubMed

Scarpa, M; Cavallin, F; Saadeh, L M; Pinto, E; Alfieri, R; Cagol, M; Da Roit, A; Pizzolato, E; Noaro, G; Pozza, G; Castoro, C

2016-11-01

The purpose of this case-control study was to evaluate the impact of hybrid minimally invasive esophagectomy for cancer on surgical stress response and nutritional status. All 34 consecutive patients undergoing hybrid minimally invasive esophagectomy for cancer at our surgical unit between 2008 and 2013 were retrospectively compared with 34 patients undergoing esophagectomy with open gastric tubulization (open), matched for neoadjuvant therapy, pathological stage, gender and age. Demographic data, tumor features and postoperative course (including quality of life and systemic inflammatory and nutritional status) were compared. Postoperative course was similar in terms of complication rate. Length of stay in intensive care unit was shorter in patients undergoing hybrid minimally invasive esophagectomy (P = 0.002). In the first postoperative day, patients undergoing hybrid minimally invasive esophagectomy had lower C-reactive protein levels (P = 0.001) and white cell blood count (P = 0.05), and higher albumin serum level (P = 0.001). In this group, albumin remained higher also at third (P = 0.06) and seventh (P = 0.008) postoperative day, and C-reactive protein resulted lower at third post day (P = 0.04). Hybrid minimally invasive esophagectomy significantly improved the systemic inflammatory and catabolic response to surgical trauma, contributing to a shorter length of stay in intensive care unit. © 2015 International Society for Diseases of the Esophagus.

Effects of music intervention on physiological stress response and anxiety level of mechanically ventilated patients in China: a randomised controlled trial.

PubMed

Han, Lin; Li, Ji P; Sit, Janet W H; Chung, Loretta; Jiao, Zuo Y; Ma, Wei G

2010-04-01

To examine the effects of music intervention on the physiological stress response and the anxiety level among mechanically ventilated patients in intensive care unit. Despite the fact that previous studies have found music interventions to be effective in stress and anxiety reduction, effects of music on the Chinese population are inconclusive and warranted systematic study to evaluate its effect fully for a different Asian culture. A randomised placebo-controlled trial. A total of 137 patients receiving mechanical ventilation were randomly assigned to either music listening group, headphone group or control group. Outcome measures included the Chinese version of Spielberger State-Trait Anxiety Scale and physiological parameters (heart rate, respiratory rate, saturation of oxygen and blood pressure). Comparison of mean differences (pretest score-posttest score) showed significant differences in heart rate, respiratory rate, systolic blood pressure and diastolic blood pressure as well as the Chinese version of Spielberger State-Trait Anxiety Scale, but not in SaO(2) among the three groups (ranging from p < 0.001 to p = 0.007), of which greater mean differences were found in music listening group. A significant reduction in physiological stress response (heart rate and respiratory rate) over time was found in music listening group (p < 0.001 for both variables) and a significant increase in heart rate and respiratory rate over time in control group (p < 0.001 and p = 0.032), with no significant change over time in headphone group. Within group pretest-posttest comparison of the Chinese version of Spielberger State-Trait Anxiety Scale demonstrated a significant reduction in anxiety for the music listening group (p < 0.001) and headphone group (p < 0.001) but not the control group. Our findings confirm that short-term therapeutic effects of music listening results in substantial reduction in physiological stress responses arising from anxiety in mechanically ventilated patients. Music as a non-pharmacological nursing intervention can be used as complementary adjunct in the care of patients with low-energy states who tire easily, such as those requiring mechanical ventilator support.

Engaging Frontline Staff in Central Line-Associated Bloodstream Infection Prevention Practice in the Wake of Superstorm Sandy.

PubMed

Rosenberg, Rebecca E; Devins, Lea; Geraghty, Gail; Bock, Steven; Dugan, Christina A; Transou, Marjorie; Phillips, Michael; Lighter-Fisher, Jennifer

2015-10-01

Central venous catheters are crucial devices in the care of hospitalized children, both in and out of critical care units, but the concomitant risk of central line-associated bloodstream infection (CLABSI) affects 15,000 Americans annually. In 2012, CLABSI rates varied among units from 6.8/1,000 to 1.0/1,000 in a 109-bed children's service within NYU Langone Medical Center (NYULMC; New York City), a 1,069-bed tertiary care academic medical center. In response to variation in central line-related practices and infection prevention rates, a CLABSI Prevention Core Team began an effort to standardize central venous catheter (CVC) care across all pediatric units (ICU and non-ICU). Momentum in this quality improvement (QI) work was interrupted when Superstorm Sandy shuttered the flagship hospital, but the relatively decreased clinical load provided a "downtime" opportunity to address CLABSI prevention. The first phase of the collaborative effort, Booster 1, Planning/Initial Phase: Development of a Pediatric Central Venous Catheter Working Group, was followed by Booster 2, Maintenance/Sustaining Phase: Transitioning for Sustainability and Adopting Model for Improvement. Data in the subsequent 21 months after the temporary closure of the facility (January 2013-September 2014) showed an increase in maintenance bundle reliability. The inpatient CLABSI rate for patients<18 years decreased from an annual rate of 2.7/1,000 line days (2012) to 0.6/1,000 line days (2013) to 0.5/1,000 line days as of August 2014. There was a decrease in pediatric CLABSI events and no significant change in line days. Key elements contributing to initial success with evolving QI capacity and resources were likely multi-factorial, including staff and leadership engagement, culture change, consistent guidelines, and accountability by individuals and by our multidisciplinary core team.

Impact of Business Cycles on US Suicide Rates, 1928–2007

PubMed Central

Florence, Curtis S.; Quispe-Agnoli, Myriam; Ouyang, Lijing; Crosby, Alexander E.

2011-01-01

Objectives. We examined the associations of overall and age-specific suicide rates with business cycles from 1928 to 2007 in the United States. Methods. We conducted a graphical analysis of changes in suicide rates during business cycles, used nonparametric analyses to test associations between business cycles and suicide rates, and calculated correlations between the national unemployment rate and suicide rates. Results. Graphical analyses showed that the overall suicide rate generally rose during recessions and fell during expansions. Age-specific suicide rates responded differently to recessions and expansions. Nonparametric tests indicated that the overall suicide rate and the suicide rates of the groups aged 25 to 34 years, 35 to 44 years, 45 to 54 years, and 55 to 64 years rose during contractions and fell during expansions. Suicide rates of the groups aged 15 to 24 years, 65 to 74 years, and 75 years and older did not exhibit this behavior. Correlation results were concordant with all nonparametric results except for the group aged 65 to 74 years. Conclusions. Business cycles may affect suicide rates, although different age groups responded differently. Our findings suggest that public health responses are a necessary component of suicide prevention during recessions. PMID:21493938

A comparison of foetal and infant mortality in the United States and Canada.

PubMed

Ananth, Cande V; Liu, Shiliang; Joseph, K S; Kramer, Michael S

2009-04-01

Infant mortality rates are higher in the United States than in Canada. We explored this difference by comparing gestational age distributions and gestational age-specific mortality rates in the two countries. Stillbirth and infant mortality rates were compared for singleton births at >or=22 weeks and newborns weighing>or=500 g in the United States and Canada (1996-2000). Since menstrual-based gestational age appears to misclassify gestational duration and overestimate both preterm and postterm birth rates, and because a clinical estimate of gestation is the only available measure of gestational age in Canada, all comparisons were based on the clinical estimate. Data for California were excluded because they lacked a clinical estimate. Gestational age-specific comparisons were based on the foetuses-at-risk approach. The overall stillbirth rate in the United States (37.9 per 10,000 births) was similar to that in Canada (38.2 per 10,000 births), while the overall infant mortality rate was 23% (95% CI 19-26%) higher (50.8 vs 41.4 per 10,000 births, respectively). The gestational age distribution was left-shifted in the United States relative to Canada; consequently, preterm birth rates were 8.0 and 6.0%, respectively. Stillbirth and early neonatal mortality rates in the United States were lower at term gestation only. However, gestational age-specific late neonatal, post-neonatal and infant mortality rates were higher in the United States at virtually every gestation. The overall stillbirth rates (per 10,000 foetuses at risk) among Blacks and Whites in the United States, and in Canada were 59.6, 35.0 and 38.3, respectively, whereas the corresponding infant mortality rates were 85.6, 49.7 and 42.2, respectively. Differences in gestational age distributions and in gestational age-specific stillbirth and infant mortality in the United States and Canada underscore substantial differences in healthcare services, population health status and health policy between the two neighbouring countries.

Neonatal Intensive Care Unit Nurses Working in an Open Ward: Stress and Work Satisfaction.

PubMed

Lavoie-Tremblay, Mélanie; Feeley, Nancy; Lavigne, Geneviève L; Genest, Christine; Robins, Stéphanie; Fréchette, Julie

2016-01-01

There is some research on the impact of open-ward unit design on the health of babies and the stress experienced by parents and nurses in neonatal intensive care units. However, few studies have explored the factors associated with nurse stress and work satisfaction among nurses practicing in open-ward neonatal intensive care units. The purpose of this study was to examine what factors are associated with nurse stress and work satisfaction among nurses practicing in an open-ward neonatal intensive care unit. A cross-sectional correlational design was used in this study. Participants were nurses employed in a 34-bed open-ward neonatal intensive care unit in a major university-affiliated hospital in Montréal, Quebec, Canada. A total of 94 nurses were eligible, and 86 completed questionnaires (91% response rate). Descriptive statistics were computed to describe the participants' characteristics. To identify factors associated with nurse stress and work satisfaction, correlational analysis and multiple regression analyses were performed with the Nurse Stress Scale and the Global Work Satisfaction scores as the dependent variables. Different factors predict neonatal intensive care unit nurses' stress and job satisfaction, including support, family-centered care, performance obstacles, work schedule, education, and employment status. In order to provide neonatal intensive care units nurses with a supportive environment, managers can provide direct social support to nurses and influence the culture around teamwork.

Teaching technology to technologists.

PubMed

Lehrer, Rich

2008-01-01

The field of radiologic technology is in a transition period between the traditional film-based model and the digital-based model. To determine the extent to which educational programs accredited by the Joint Review Committee on Education in Radiologic Technology (JRCERT) are providing digital imaging-specific education. A survey regarding digital imaging instruction was administered electronically to program directors of 289 JRCERT-accredited educational programs in the United States. One hundred forty-four responses were received, for a response rate of 50%. The survey revealed that the majority of educational programs (73.6%) have added, modified or are already covering digital imaging topics, while other programs (21.5%) were in the planning stages of preparing coursework.

Resident smoking in long-term care facilities--policies and ethics.

PubMed Central

Kochersberger, G; Clipp, E C

1996-01-01

Objective: To characterize smoking behavior, facility policies related smoking, and administrators' views of smoking-related problems in Veterans Affairs nursing home care units nationwide. Methods: An anonymous mail survey of long-term care facilities was administered to 106 nursing home supervisors at VA Medical Centers with nursing home care units. The response rate was 82%. Results: Administrators from 106 VA nursing home units reported smoking rates ranging from 5% to 80% of long-term care residents, with an average of 22%. Half of the nursing homes had indoor smoking areas. Frequent complaints from nonsmokers about passive smoke exposure were reported in 23% of the nursing homes. The nursing administrators reported that patient safety was their greatest concern. Seventy- eight percent ranked health effects to the smokers themselves a "major concern," while 70% put health effects to exposed nonsmokers in that category. Smoking in the nursing home was described as a "right" by 59% of respondents and a ¿privilege¿ by 67%. Some individuals reported that smoking was both a right and a privilege. Conclusion: Smoking is relatively common among VA long-term care patients. The promotion of personal autonomy and individual resident rights stressed in the Omnibus Budget Reconciliation Act of 1987 may conflict with administrative concerns about the safety of nursing home smokers and those around them. PMID:8610194

The impact of simulated chronic nitrogen deposition on the biomass and N₂-fixation activity of two boreal feather moss-cyanobacteria associations.

PubMed

Gundale, Michael J; Bach, Lisbet H; Nordin, Annika

2013-01-01

Bryophytes achieve substantial biomass and play several key functional roles in boreal forests that can influence how carbon (C) and nitrogen (N) cycling respond to atmospheric deposition of reactive nitrogen (Nr). They associate with cyanobacteria that fix atmospheric N₂, and downregulation of this process may offset anthropogenic Nr inputs to boreal systems. Bryophytes also promote soil C accumulation by thermally insulating soils, and changes in their biomass influence soil C dynamics. Using a unique large-scale (0.1 ha forested plots), long-term experiment (16 years) in northern Sweden where we simulated anthropogenic Nr deposition, we measured the biomass and N₂-fixation response of two bryophyte species, the feather mosses Hylocomium splendens and Pleurozium schreberi. Our data show that the biomass declined for both species; however, N₂-fixation rates per unit mass and per unit area declined only for H. splendens. The low and high treatments resulted in a 29% and 54% reduction in total feather moss biomass, and a 58% and 97% reduction in total N₂-fixation rate per unit area, respectively. These results help to quantify the sensitivity of feather moss biomass and N₂ fixation to chronic Nr deposition, which is relevant for modelling ecosystem C and N balances in boreal ecosystems.

Diminished forearm vasomotor response to central hypervolemic loading in aerobically fit individuals

NASA Technical Reports Server (NTRS)

Shi, X.; Gallagher, K. M.; SMith, S. A.; Bryant, K. H.; Raven, P. B.; Blomqvist, C. G. (Principal Investigator)

1996-01-01

The aim of this study was to test the hypothesis that cardiopulmonary baroreflex control of forearm vascular resistance (FVR) during central hypervolemic loading was less sensitive in exercise trained high fit individuals (HF) compared to untrained average fit individuals (AF). Eight AF (age: 24 +/- 1 yr and weight: 78.9 +/- 1.7 kg) and eight HF (22 +/- 1 yr 79.5 +/- 2.4 kg) voluntarily participated in the investigation. Maximal aerobic power (determined on a treadmill), plasma volume and blood volume (Evans blue dilution method) were significantly greater in the HF than AF (60.8 +/- 0.7 vs. 41.2 +/- 1.9 ml.kg-1.min-1, 3.96 +/- 0.17 vs 3.36 +/- 0.08 1, and 6.33 +/- 0.23 vs 5.28 +/- 0.13 1). Baseline heart rate (HR), central venous pressure (CVP), mean arterial pressure (MAP, measured by an intraradial catheter or a Finapres finger cuff), forearm blood flow (FBF, plethysmography), and FVR, calculated from the ratio (MAP-CVP)/FBF, were not different between the HF and the AF. Lower body negative pressure (LBNP, -5, -10, -15, and -20 torr) and passive leg elevation (LE, 50 cm) combined with lower body positive pressure (LBPP, +5, +10, and +20 torr) were utilized to elicit central hypovolemia and hypervolemia, respectively. Range of CVP (from LBNP to LE+LBPP) was similar in the AF (from -3.9 to +1.9 mm Hg) and HF (from -4.0 to +2.2 mm Hg). However, FVR/CVP was significantly less in the HF (-1.8 +/- 0.1 unit.mm Hg-1) than AF (-34 +/- 0.1 unit.mm Hg-1). The FVR decrease in response to increase in CVP was significantly diminished in the HF (-1.46 +/- 0.45 unit.mm Hg-1) compared to the AF (-4.40 +/- 0.97 unit.mm Hg-1), and during LBNP induced unloading the FVR/CVP of the HF (-2.01 +/- 0.49 unit.mm Hg-1) was less (P < 0.08) than the AF (-3.28 +/- 0.69 unit.mm Hg-1). We concluded that the cardiopulmonary baroreceptor mediated FVR reflex response was significantly less sensitive to changes in CVP in individuals who practice exercise training.

A reanalysis of "Two types of asynchronous activity in networks of excitatory and inhibitory spiking neurons".

PubMed

Engelken, Rainer; Farkhooi, Farzad; Hansel, David; van Vreeswijk, Carl; Wolf, Fred

2016-01-01

Neuronal activity in the central nervous system varies strongly in time and across neuronal populations. It is a longstanding proposal that such fluctuations generically arise from chaotic network dynamics. Various theoretical studies predict that the rich dynamics of rate models operating in the chaotic regime can subserve circuit computation and learning. Neurons in the brain, however, communicate via spikes and it is a theoretical challenge to obtain similar rate fluctuations in networks of spiking neuron models. A recent study investigated spiking balanced networks of leaky integrate and fire (LIF) neurons and compared their dynamics to a matched rate network with identical topology, where single unit input-output functions were chosen from isolated LIF neurons receiving Gaussian white noise input. A mathematical analogy between the chaotic instability in networks of rate units and the spiking network dynamics was proposed. Here we revisit the behavior of the spiking LIF networks and these matched rate networks. We find expected hallmarks of a chaotic instability in the rate network: For supercritical coupling strength near the transition point, the autocorrelation time diverges. For subcritical coupling strengths, we observe critical slowing down in response to small external perturbations. In the spiking network, we found in contrast that the timescale of the autocorrelations is insensitive to the coupling strength and that rate deviations resulting from small input perturbations rapidly decay. The decay speed even accelerates for increasing coupling strength. In conclusion, our reanalysis demonstrates fundamental differences between the behavior of pulse-coupled spiking LIF networks and rate networks with matched topology and input-output function. In particular there is no indication of a corresponding chaotic instability in the spiking network.

The Hispanic Americans Baseline Alcohol Survey (HABLAS): rates and predictors of alcohol abuse and dependence across Hispanic national groups.

PubMed

Caetano, Raul; Ramisetty-Mikler, Suhasini; Rodriguez, Lori A

2008-05-01

The primary purpose of this article is to report 12-month prevalence rates and predictors of alcohol abuse and dependence among Mexican Americans, Cuban Americans, Puerto Ricans, and South/Central Americans living in the United States. Using a multistage cluster sample design, a total of 5,224 individuals 18 years of age and older were selected from the household population in five metropolitan areas of the United States: Miami, New York, Philadelphia, Houston, and Los Angeles. The survey weighted response rate was 76%. Personal interviews lasting an average of 1 hour were conducted in respondents' homes either in English or Spanish. There is considerable heterogeneity in rates of abuse and dependence across these national groups, with Mexican American and Puerto Rican men having higher rates than Cuban American and South/Central American men. The rates of dependence for Mexican American and Puerto Rican men are also higher than those for men in the U.S. general population. Further, although the highest rates of abuse and dependence are among those in their 20s, the rate decline with age is not as strong as in the U.S. population. Thus, Hispanics at older ages (40-49, 50-59) are at considerably more risk of dependence and its health consequences than the U.S. general population. This is particularly true of Puerto Rican and Mexican American men. Future analysis must take this heterogeneity into consideration by conducting national group-specific analysis. Prevention efforts must also be guided by these findings, which suggest that Puerto Ricans and Mexican Americans are at higher risk for abuse, dependence, and the associated consequences than the other two groups of U.S. Hispanics.

The Hispanic Americans Baseline Alcohol Survey (HABLAS): Rates and Predictors of Alcohol Abuse and Dependence Across Hispanic National Groups*

PubMed Central

CAETANO, RAUL; RAMISETTY-MIKLER, SUHASINI; RODRIGUEZ, LORI A.

2008-01-01

Objective The primary purpose of this article is to report 12-month prevalence rates and predictors of alcohol abuse and dependence among Mexican Americans, Cuban Americans, Puerto Ricans, and South/Central Americans living in the United States. Method Using a multistage cluster sample design, a total of 5,224 individuals 18 years of age and older were selected from the household population in five metropolitan areas of the United States: Miami, New York, Philadelphia, Houston, and Los Angeles. The survey weighted response rate was 76%. Personal interviews lasting an average of 1 hour were conducted in respondents’ homes either in English or Spanish. Results There is considerable heterogeneity in rates of abuse and dependence across these national groups, with Mexican American and Puerto Rican men having higher rates than Cuban American and South/Central American men. The rates of dependence for Mexican American and Puerto Rican men are also higher than those for men in the U.S. general population. Further, although the highest rates of abuse and dependence are among those in their 20s, the rate decline with age is not as strong as in the U.S. population. Thus, Hispanics at older ages (40–49, 50–59) are at considerably more risk of dependence and its health consequences than the U.S. general population. This is particularly true of Puerto Rican and Mexican American men. Conclusions Future analysis must take this heterogeneity into consideration by conducting national group-specific analysis. Prevention efforts must also be guided by these findings, which suggest that Puerto Ricans and Mexican Americans are at higher risk for abuse, dependence, and the associated consequences than the other two groups of U.S. Hispanics. PMID:18432387

The Changing Demographic Profile of the United States

DTIC Science & Technology

2006-05-05

3 Figure 3. Crude and Age-adjusted Death Rates : United States, 1950-2003...21 Appendix Table A. U.S. Population Growth Rates, Birth Rates, Death Rates , and Net Immigration Rates...P o p u la tio n Birth Rates Growth Rates Death Rates Net Immigration Rates Figure 2. Population Growth, Birth, Death, and Net Immigration Rates

Occupational formalin asthma.

PubMed Central

Hendrick, D J; Lane, D J

1977-01-01

Hypersensitivity to formalin used to sterilise artificial kidney machines was shown by inhalation provocation tests to be responsible for attacks of wheezing accompanied by productive cough in two members of the nursing staff of a haemodialysis unit. Three further members of the staff of 28 who were continually exposed to this substance occupationally had developed similar recurrent but less frequent episodes since joining the unit. Two underwent inhalation provocation tests with formalin which did not reproduce these symptoms.Single episodes of these symptoms had been noted by three additional staff members so that altogether eight (29%) had experienced attacks described as bronchitic since becoming exposed to formalin. We suggest that, while exposure to formalin did not seem to be directly responsible in all cases, it might have increased susceptibility to other provoking agents or induced a hyper-reactive responsiveness of the airways. The responses observed in the two nurses after inhalation provocation tests with fromalin were predominantly of airways obstruction. Wheezing began between two and three hours after exposure, and peak expiratory flow rates fell maximally by approximately 50%. Reactions persisted for 10 hours to 10 days depending on the exposure dose. A productive cough was a prominent feature. The sputum appeared to be mucopurulent, but culture produced a scanty growth of Haemophilus influenzae only, together with upper respiratory tract commensals. The cellular content was not homogeneous, neutrophil leucocytes and eosinophil leucocoytes variably dominating. Variable responses of neutrophil and eosinophil leucocytes were also seen in the peripheral blood. PMID:557329

36 CFR 223.64 - Appraisal on a lump-sum value or rate per unit of measure basis.

Code of Federal Regulations, 2010 CFR

2010-07-01

... costs or selling values subsequent to the rate redetermination which reduce conversion value to less... or rate per unit of measure basis. 223.64 Section 223.64 Parks, Forests, and Public Property FOREST... Contracts Appraisal and Pricing § 223.64 Appraisal on a lump-sum value or rate per unit of measure basis...

Characteristics of Biostatistics, Epidemiology, and Research Design Programs in Institutions with Clinical and Translational Science Awards

PubMed Central

Rahbar, Mohammad H.; Dickerson, Aisha S.; Ahn, Chul; Carter, Rickey E.; Hessabi, Manouchehr; Lindsell, Christopher J.; Nietert, Paul J.; Oster, Robert A.; Pollock, Brad H.; Welty, Leah J.

2016-01-01

Purpose To learn the size, composition, and scholarly output of Biostatistics, Epidemiology, and Research Design (BERD) units in U.S. academic health centers (AHCs). Method Each year for four years, the authors surveyed all BERD units in U.S. AHCs that were members of the Clinical and Translational Science Award (CTSA) Consortium. In 2010, 46 BERD units were surveyed; in 2011, 55; in 2012, 60; and in 2013, 61. Results Response rates to the 2010, 2011, 2012, and 2013 surveys were 93.5%, 98.2%, 98.3%, and 86.9%, respectively. Overall, the size of BERD units ranged from 3-86 individuals. The median FTE in BERD units remained similar and ranged from 3.0 to 3.5 FTEs over the years. BERD units reported more availability of doctoral-level biostatisticians than doctoral-level epidemiologists. In 2011, 2012, and 2013, more than a third of BERD units provided consulting support on 101 to 200 projects. A majority of BERD units reported that between 25% and 75% (in 2011) and 31%-70% (in 2012) of their consulting was to junior investigators. More than two thirds of BERD units reported their contributions to the submission of 20 or more non-BERD grant or contract applications annually. Nearly half of BERD units reported 1 to 10 manuscripts submitted annually with a BERD practitioner as the first or corresponding author. Conclusions The survey findings regarding BERD units provide a benchmark against which to compare BERD resources and may be particularly useful for institutions planning to develop new units to support programs such as the CTSA. PMID:27580435

Characteristics of Biostatistics, Epidemiology, and Research Design Programs in Institutions With Clinical and Translational Science Awards.

PubMed

Rahbar, Mohammad H; Dickerson, Aisha S; Ahn, Chul; Carter, Rickey E; Hessabi, Manouchehr; Lindsell, Christopher J; Nietert, Paul J; Oster, Robert A; Pollock, Brad H; Welty, Leah J

2017-02-01

To learn the size, composition, and scholarly output of biostatistics, epidemiology, and research design (BERD) units in U.S. academic health centers (AHCs). Each year for four years, the authors surveyed all BERD units in U.S. AHCs that were members of the Clinical and Translational Science Award (CTSA) Consortium. In 2010, 46 BERD units were surveyed; in 2011, 55; in 2012, 60; and in 2013, 61. Response rates to the 2010, 2011, 2012, and 2013 surveys were 93.5%, 98.2%, 98.3%, and 86.9%, respectively. Overall, the size of BERD units ranged from 3 to 86 individuals. The median FTE in BERD units remained similar and ranged from 3.0 to 3.5 FTEs over the years. BERD units reported more availability of doctoral-level biostatisticians than doctoral-level epidemiologists. In 2011, 2012, and 2013, more than a third of BERD units provided consulting support on 101 to 200 projects. A majority of BERD units reported that between 25% and 75% (in 2011) and 31% to 70% (in 2012) of their consulting was to junior investigators. More than two-thirds of BERD units reported their contributions to the submission of 20 or more non-BERD grant or contract applications annually. Nearly half of BERD units reported 1 to 10 manuscripts submitted annually with a BERD practitioner as the first or corresponding author. The findings regarding BERD units provide a benchmark against which to compare BERD resources and may be particularly useful for institutions planning to develop new units to support programs such as the CTSA.

The effects of earmuff on physiologic and motor responses in premature infants admitted in neonatal intensive care unit.

PubMed

Abdeyazdan, Zahra; Ghassemi, Sara; Marofi, Maryam

2014-03-01

Continuous high-intensity noise in the Neonatal Intensive Care Unit (NICU) is stressful for premature infants and its reduction is considered as a nursing care. This study aimed to evaluate the effects of earmuffs' use on the physiologic and motor responses of premature infants. This is a clinical trial conducted on 64 premature infants admitted to the NICU, who met the inclusion criteria, and were randomly assigned to study and control groups. Earmuffs were used for premature infants for 2 h in the morning and 2 h in the afternoon for two consecutive days to reduce the noise intensity in the busiest time of the NICU. The group with earmuff (study group) was compared with the control group receiving only routine care. Infants' physiologic and motor responses were observed before, during, immediately, and 1 h after the intervention. Analysis of covariance and repeated measure analysis of variance (ANOVA) were used to analyze the data. When infants wore the earmuffs, they had significantly higher mean arterial oxygen saturation, the less frequent motor response, and a decrease in their pulse and respiratory rate. Paying attention to environmental noise can help the patients, especially the neonates in the NICU, and can be considered as a nursing care. Wearing earmuffs can protect premature infants against noise in the NICU and improve their physiological and motor state.

Understanding Montane Snow Water Equivalent Response to Climate Change and Variability

NASA Astrophysics Data System (ADS)

Huning, L. S.; AghaKouchak, A.

2017-12-01

Large populations worldwide rely on the seasonal snowpack for the majority of their water resources. Warming temperatures and other hydrometeorological changes impact the timing, distribution, and amount of montane snow water equivalent (SWE). Therefore, developing an improved understanding of the historical response to changing atmospheric drivers across snow-dominated mountainous regions has significant societal value related to water resources management and environmental hazards (i.e. flooding and droughts) for a future warming climate. Utilizing multi-decadal snow data sets and a probabilistic risk model over mountain ranges such as the Sierra Nevada (USA), the response of snowpack characteristics (e.g. SWE/snowfall, peak SWE, day of peak SWE, melt rate, etc.) to unit changes in hydrometeorological quantities (e.g. air temperature, humidity, winds, etc.) is quantified. The likelihood that the amount of SWE will exceed specified amounts (e.g. long-term peak SWE value) is presented for a range of climatic conditions. This study compares hydrologic response of montane SWE across windward and leeward basins, elevational bands, and regions of differing physiographic characteristics to understand how projected global warming such as a unit increase in air temperature or changes in other hydrometeorological quantities impact SWE at different spatial scales (i.e. basin-wide and range-wide). It provides insight that can be used to understand vulnerabilities of the seasonal snowpack to changes in climatic and atmospheric conditions.

Mail merge can be used to create personalized questionnaires in complex surveys.

PubMed

Taljaard, Monica; Chaudhry, Shazia Hira; Brehaut, Jamie C; Weijer, Charles; Grimshaw, Jeremy M

2015-10-16

Low response rates and inadequate question comprehension threaten the validity of survey results. We describe a simple procedure to implement personalized-as opposed to generically worded-questionnaires in the context of a complex web-based survey of corresponding authors of a random sample of 300 published cluster randomized trials. The purpose of the survey was to gather more detailed information about informed consent procedures used in the trial, over and above basic information provided in the trial report. We describe our approach-which allowed extensive personalization without the need for specialized computer technology-and discuss its potential application in similar settings. The mail merge feature of standard word processing software was used to generate unique, personalized questionnaires for each author by incorporating specific information from the article, including naming the randomization unit (e.g., family practice, school, worksite), and identifying specific individuals who may have been considered research participants at the cluster level (family doctors, teachers, employers) and individual level (patients, students, employees) in questions regarding informed consent procedures in the trial. The response rate was relatively high (64%, 182/285) and did not vary significantly by author, publication, or study characteristics. The refusal rate was low (7%). While controlled studies are required to examine the specific effects of our approach on comprehension, quality of responses, and response rates, we showed how mail merge can be used as a simple but useful tool to add personalized fields to complex survey questionnaires, or to request additional information required from study authors. One potential application is in eliciting specific information about published articles from study authors when conducting systematic reviews and meta-analyses.

Modeling background radiation in Southern Nevada

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

Haber, Daniel A.; Burnley, Pamela C.; Adcock, Christopher T.

Aerial gamma ray surveys are an important tool for national security, scientific, and industrial interests in determining locations of both anthropogenic and natural sources of radioactivity. There is a relationship between radioactivity and geology and in the past this relationship has been used to predict geology from an aerial survey. The purpose of this project is to develop a method to predict the radiologic exposure rate of the geologic materials by creating a high resolution background model. The intention is for this method to be used in an emergency response scenario where the background radiation envi-ronment is unknown. Two studymore » areas in Southern Nevada have been modeled using geologic data, images from the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER), geochemical data, and pre-existing low resolution aerial surveys from the National Uranium Resource Evaluation (NURE) Survey. Using these data, geospatial areas that are homogenous in terms of K, U, and Th, referred to as background radiation units, are defined and the gamma ray exposure rate is predicted. The prediction is compared to data collected via detailed aerial survey by the Department of Energy's Remote Sensing Lab - Nellis, allowing for the refinement of the technique. By using geologic units to define radiation background units of exposed bedrock and ASTER visualizations to subdivide and define radiation background units within alluvium, successful models have been produced for Government Wash, north of Lake Mead, and for the western shore of Lake Mohave, east of Searchlight, NV.« less

Modeling background radiation in Southern Nevada

DOE PAGES

Haber, Daniel A.; Burnley, Pamela C.; Adcock, Christopher T.; ...

2017-02-06

Aerial gamma ray surveys are an important tool for national security, scientific, and industrial interests in determining locations of both anthropogenic and natural sources of radioactivity. There is a relationship between radioactivity and geology and in the past this relationship has been used to predict geology from an aerial survey. The purpose of this project is to develop a method to predict the radiologic exposure rate of the geologic materials by creating a high resolution background model. The intention is for this method to be used in an emergency response scenario where the background radiation envi-ronment is unknown. Two studymore » areas in Southern Nevada have been modeled using geologic data, images from the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER), geochemical data, and pre-existing low resolution aerial surveys from the National Uranium Resource Evaluation (NURE) Survey. Using these data, geospatial areas that are homogenous in terms of K, U, and Th, referred to as background radiation units, are defined and the gamma ray exposure rate is predicted. The prediction is compared to data collected via detailed aerial survey by the Department of Energy's Remote Sensing Lab - Nellis, allowing for the refinement of the technique. By using geologic units to define radiation background units of exposed bedrock and ASTER visualizations to subdivide and define radiation background units within alluvium, successful models have been produced for Government Wash, north of Lake Mead, and for the western shore of Lake Mohave, east of Searchlight, NV.« less

Increases in Drug and Opioid-Involved Overdose Deaths - United States, 2010-2015.

PubMed

Rudd, Rose A; Seth, Puja; David, Felicita; Scholl, Lawrence

2016-12-30

The U.S. opioid epidemic is continuing, and drug overdose deaths nearly tripled during 1999-2014. Among 47,055 drug overdose deaths that occurred in 2014 in the United States, 28,647 (60.9%) involved an opioid (1). Illicit opioids are contributing to the increase in opioid overdose deaths (2,3). In an effort to target prevention strategies to address the rapidly changing epidemic, CDC examined overall drug overdose death rates during 2010-2015 and opioid overdose death rates during 2014-2015 by subcategories (natural/semisynthetic opioids, methadone, heroin, and synthetic opioids other than methadone).* Rates were stratified by demographics, region, and by 28 states with high quality reporting on death certificates of specific drugs involved in overdose deaths. During 2015, drug overdoses accounted for 52,404 U.S. deaths, including 33,091 (63.1%) that involved an opioid. There has been progress in preventing methadone deaths, and death rates declined by 9.1%. However, rates of deaths involving other opioids, specifically heroin and synthetic opioids other than methadone (likely driven primarily by illicitly manufactured fentanyl) (2,3), increased sharply overall and across many states. A multifaceted, collaborative public health and law enforcement approach is urgently needed. Response efforts include implementing the CDC Guideline for Prescribing Opioids for Chronic Pain (4), improving access to and use of prescription drug monitoring programs, enhancing naloxone distribution and other harm reduction approaches, increasing opioid use disorder treatment capacity, improving linkage into treatment, and supporting law enforcement strategies to reduce the illicit opioid supply.

Newborn physiological responses to noise in the neonatal unit.

PubMed

Cardoso, Sandra Maria Schefer; Kozlowski, Lorena de Cássia; Lacerda, Adriana Bender Moreira de; Marques, Jair Mendes; Ribas, Angela

2015-01-01

The incorporation of technologies in the care of infants has contributed to increased survival; however, this has turned neonatal unit into a noisy environment. To evaluate the physiological and functional effects resulting from the exposure to noise on low-weight newborns in incubators in a neonatal unit. Prospective, observational, quantitative, exploratory, descriptive study. The adopted statistical method included tables of frequency, descriptive statistics, and Student's t-test, with a 0.05 level of significance. As data collection tools, the environmental noise and the noise inside of the incubator were evaluated, and the Assessment of Preterm Infant Behavior scale was used to assess premature newborn behavior and projected specifically to document the neurobehavioral functioning of preterm infants. The data collection occurred from September of 2012 to April of 2013; 61 low-weight newborns admitted in the neonatal unit and in incubators were observed. Significant differences in the variables heart rate and oxygen saturation were noted when newborns were exposed to noise. Low-weight neonates in incubators present physiological alterations when facing discomfort caused by environmental noise in neonatal units. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

GABAB receptor-mediated, layer-specific synaptic plasticity reorganizes gamma-frequency neocortical response to stimulation

PubMed Central

Ainsworth, Matthew; Lee, Shane; Kaiser, Marcus; Simonotto, Jennifer; Kopell, Nancy J.

2016-01-01

Repeated presentations of sensory stimuli generate transient gamma-frequency (30–80 Hz) responses in neocortex that show plasticity in a task-dependent manner. Complex relationships between individual neuronal outputs and the mean, local field potential (population activity) accompany these changes, but little is known about the underlying mechanisms responsible. Here we show that transient stimulation of input layer 4 sufficient to generate gamma oscillations induced two different, lamina-specific plastic processes that correlated with lamina-specific changes in responses to further, repeated stimulation: Unit rates and recruitment showed overall enhancement in supragranular layers and suppression in infragranular layers associated with excitatory or inhibitory synaptic potentiation onto principal cells, respectively. Both synaptic processes were critically dependent on activation of GABAB receptors and, together, appeared to temporally segregate the cortical representation. These data suggest that adaptation to repetitive sensory input dramatically alters the spatiotemporal properties of the neocortical response in a manner that may both refine and minimize cortical output simultaneously. PMID:27118845

Timescales of Land Surface Evapotranspiration Response

NASA Technical Reports Server (NTRS)

Scott, Russell; Entekhabi, Dara; Koster, Randal; Suarez, Max

1997-01-01

Soil and vegetation exert strong control over the evapotranspiration rate, which couples the land surface water and energy balances. A method is presented to quantify the timescale of this surface control using daily general circulation model (GCM) simulation values of evapotranspiration and precipitation. By equating the time history of evaporation efficiency (ratio of actual to potential evapotranspiration) to the convolution of precipitation and a unit kernel (temporal weighting function), response functions are generated that can be used to characterize the timescales of evapotranspiration response for the land surface model (LSM) component of GCMS. The technique is applied to the output of two multiyear simulations of a GCM, one using a Surface-Vegetation-Atmosphere-Transfer (SVAT) scheme and the other a Bucket LSM. The derived response functions show that the Bucket LSM's response is significantly slower than that of the SVAT across the globe. The analysis also shows how the timescales of interception reservoir evaporation, bare soil evaporation, and vegetation transpiration differ within the SVAT LSM.

GABAB receptor-mediated, layer-specific synaptic plasticity reorganizes gamma-frequency neocortical response to stimulation.

PubMed

Ainsworth, Matthew; Lee, Shane; Kaiser, Marcus; Simonotto, Jennifer; Kopell, Nancy J; Whittington, Miles A

2016-05-10

Repeated presentations of sensory stimuli generate transient gamma-frequency (30-80 Hz) responses in neocortex that show plasticity in a task-dependent manner. Complex relationships between individual neuronal outputs and the mean, local field potential (population activity) accompany these changes, but little is known about the underlying mechanisms responsible. Here we show that transient stimulation of input layer 4 sufficient to generate gamma oscillations induced two different, lamina-specific plastic processes that correlated with lamina-specific changes in responses to further, repeated stimulation: Unit rates and recruitment showed overall enhancement in supragranular layers and suppression in infragranular layers associated with excitatory or inhibitory synaptic potentiation onto principal cells, respectively. Both synaptic processes were critically dependent on activation of GABAB receptors and, together, appeared to temporally segregate the cortical representation. These data suggest that adaptation to repetitive sensory input dramatically alters the spatiotemporal properties of the neocortical response in a manner that may both refine and minimize cortical output simultaneously.

Gravimetric phenotyping of whole plant transpiration responses to atmospheric vapour pressure deficit identifies genotypic variation in water use efficiency.

PubMed

Ryan, Annette C; Dodd, Ian C; Rothwell, Shane A; Jones, Ros; Tardieu, Francois; Draye, Xavier; Davies, William J

2016-10-01

There is increasing interest in rapidly identifying genotypes with improved water use efficiency, exemplified by the development of whole plant phenotyping platforms that automatically measure plant growth and water use. Transpirational responses to atmospheric vapour pressure deficit (VPD) and whole plant water use efficiency (WUE, defined as the accumulation of above ground biomass per unit of water used) were measured in 100 maize (Zea mays L.) genotypes. Using a glasshouse based phenotyping platform with naturally varying VPD (1.5-3.8kPa), a 2-fold variation in WUE was identified in well-watered plants. Regression analysis of transpiration versus VPD under these conditions, and subsequent whole plant gas exchange at imposed VPDs (0.8-3.4kPa) showed identical responses in specific genotypes. Genotype response of transpiration versus VPD fell into two categories: 1) a linear increase in transpiration rate with VPD with low (high WUE) or high (low WUE) transpiration rate at all VPDs, 2) a non-linear response with a pronounced change point at low VPD (high WUE) or high VPD (low WUE). In the latter group, high WUE genotypes required a significantly lower VPD before transpiration was restricted, and had a significantly lower rate of transpiration in response to VPD after this point, when compared to low WUE genotypes. Change point values were significantly positively correlated with stomatal sensitivity to VPD. A change point in stomatal response to VPD may explain why some genotypes show contradictory WUE rankings according to whether they are measured under glasshouse or field conditions. Furthermore, this novel use of a high throughput phenotyping platform successfully reproduced the gas exchange responses of individuals measured in whole plant chambers, accelerating the identification of plants with high WUE. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Dose and dose rate extrapolation factors for malignant and non-malignant health endpoints after exposure to gamma and neutron radiation.

PubMed

Tran, Van; Little, Mark P

2017-11-01

Murine experiments were conducted at the JANUS reactor in Argonne National Laboratory from 1970 to 1992 to study the effect of acute and protracted radiation dose from gamma rays and fission neutron whole body exposure. The present study reports the reanalysis of the JANUS data on 36,718 mice, of which 16,973 mice were irradiated with neutrons, 13,638 were irradiated with gamma rays, and 6107 were controls. Mice were mostly Mus musculus, but one experiment used Peromyscus leucopus. For both types of radiation exposure, a Cox proportional hazards model was used, using age as timescale, and stratifying on sex and experiment. The optimal model was one with linear and quadratic terms in cumulative lagged dose, with adjustments to both linear and quadratic dose terms for low-dose rate irradiation (<5 mGy/h) and with adjustments to the dose for age at exposure and sex. After gamma ray exposure there is significant non-linearity (generally with upward curvature) for all tumours, lymphoreticular, respiratory, connective tissue and gastrointestinal tumours, also for all non-tumour, other non-tumour, non-malignant pulmonary and non-malignant renal diseases (p < 0.001). Associated with this the low-dose extrapolation factor, measuring the overestimation in low-dose risk resulting from linear extrapolation is significantly elevated for lymphoreticular tumours 1.16 (95% CI 1.06, 1.31), elevated also for a number of non-malignant endpoints, specifically all non-tumour diseases, 1.63 (95% CI 1.43, 2.00), non-malignant pulmonary disease, 1.70 (95% CI 1.17, 2.76) and other non-tumour diseases, 1.47 (95% CI 1.29, 1.82). However, for a rather larger group of malignant endpoints the low-dose extrapolation factor is significantly less than 1 (implying downward curvature), with central estimates generally ranging from 0.2 to 0.8, in particular for tumours of the respiratory system, vasculature, ovary, kidney/urinary bladder and testis. For neutron exposure most endpoints, malignant and non-malignant, show downward curvature in the dose response, and for most endpoints this is statistically significant (p < 0.05). Associated with this, the low-dose extrapolation factor associated with neutron exposure is generally statistically significantly less than 1 for most malignant and non-malignant endpoints, with central estimates mostly in the range 0.1-0.9. In contrast to the situation at higher dose rates, there are statistically non-significant decreases of risk per unit dose at gamma dose rates of less than or equal to 5 mGy/h for most malignant endpoints, and generally non-significant increases in risk per unit dose at gamma dose rates ≤5 mGy/h for most non-malignant endpoints. Associated with this, the dose-rate extrapolation factor, the ratio of high dose-rate to low dose-rate (≤5 mGy/h) gamma dose response slopes, for many tumour sites is in the range 1.2-2.3, albeit not statistically significantly elevated from 1, while for most non-malignant endpoints the gamma dose-rate extrapolation factor is less than 1, with most estimates in the range 0.2-0.8. After neutron exposure there are non-significant indications of lower risk per unit dose at dose rates ≤5 mGy/h compared to higher dose rates for most malignant endpoints, and for all tumours (p = 0.001), and respiratory tumours (p = 0.007) this reduction is conventionally statistically significant; for most non-malignant outcomes risks per unit dose non-significantly increase at lower dose rates. Associated with this, the neutron dose-rate extrapolation factor is less than 1 for most malignant and non-malignant endpoints, in many cases statistically significantly so, with central estimates mostly in the range 0.0-0.2.

Shape Selectivity of Middle Superior Temporal Sulcus Body Patch Neurons

PubMed Central

2017-01-01

Abstract Functional MRI studies in primates have demonstrated cortical regions that are strongly activated by visual images of bodies. The presence of such body patches in macaques allows characterization of the stimulus selectivity of their single neurons. Middle superior temporal sulcus body (MSB) patch neurons showed similar stimulus selectivity for natural, shaded, and textured images compared with their silhouettes, suggesting that shape is an important determinant of MSB responses. Here, we examined and modeled the shape selectivity of single MSB neurons. We measured the responses of single MSB neurons to a variety of shapes producing a wide range of responses. We used an adaptive stimulus sampling procedure, selecting and modifying shapes based on the responses of the neuron. Forty percent of shapes that produced the maximal response were rated by humans as animal-like, but the top shape of many MSB neurons was not judged as resembling a body. We fitted the shape selectivity of MSB neurons with a model that parameterizes shapes in terms of curvature and orientation of contour segments, with a pixel-based model, and with layers of units of convolutional neural networks (CNNs). The deep convolutional layers of CNNs provided the best goodness-of-fit, with a median explained explainable variance of the neurons’ responses of 77%. The goodness-of-fit increased along the convolutional layers’ hierarchy but was lower for the fully connected layers. Together with demonstrating the successful modeling of single unit shape selectivity with deep CNNs, the data suggest that semantic or category knowledge determines only slightly the single MSB neuron’s shape selectivity. PMID:28660250

Muscle vibration sustains motor unit firing rate during submaximal isometric fatigue in humans

PubMed Central

Griffin, L; Garland, S J; Ivanova, T; Gossen, E R

2001-01-01

In keeping with the ‘muscular wisdom hypothesis’, many studies have documented that the firing rate of the majority of motor units decreased during fatiguing isometric contractions. The present study investigated whether the application of periodic muscle vibration, which strongly activates muscle spindles, would alter the modulation of motor unit firing rate during submaximal fatiguing isometric contractions. Thirty-three motor units from the lateral head of the triceps brachii muscle were recorded from 10 subjects during a sustained isometric 20 % maximal voluntary contraction (MVC) of the elbow extensors. Vibration was interposed on the contraction for 2 s every 10 s. Twenty-two motor units were recorded from the beginning of the fatigue task. The discharge rate of the majority of motor units remained constant (12/22) or increased (4/22) with fatigue. Six motor units demonstrated a reduction in discharge rate that later returned toward initial values; these motor units had higher initial discharge rates than the other 16 motor units. In a second series of experiments, four subjects held a sustained isometric 20 % MVC for 2 min and then vibration was applied as above for the remainder of the contraction. In this case, motor units initially demonstrated a decrease in firing rate that increased after the vibration was applied. Thus muscle spindle disfacilitation of the motoneurone pool may be associated with the decline of motor unit discharge rate observed during the first 2 min of the contraction. In a third set of experiments, seven subjects performed the main experiment on one occasion and repeated the fatigue task without vibration on a second occasion. Neither the endurance time of the fatiguing contraction nor the MVC torque following fatigue was affected by the application of vibration. This finding calls into question the applicability of the muscular wisdom hypothesis to submaximal contractions. PMID:11559785