Geostatistics-based groundwater-level monitoring network design and its application to the Upper Floridan aquifer, USA.

PubMed

Bhat, Shirish; Motz, Louis H; Pathak, Chandra; Kuebler, Laura

2015-01-01

A geostatistical method was applied to optimize an existing groundwater-level monitoring network in the Upper Floridan aquifer for the South Florida Water Management District in the southeastern United States. Analyses were performed to determine suitable numbers and locations of monitoring wells that will provide equivalent or better quality groundwater-level data compared to an existing monitoring network. Ambient, unadjusted groundwater heads were expressed as salinity-adjusted heads based on the density of freshwater, well screen elevations, and temperature-dependent saline groundwater density. The optimization of the numbers and locations of monitoring wells is based on a pre-defined groundwater-level prediction error. The newly developed network combines an existing network with the addition of new wells that will result in a spatial distribution of groundwater monitoring wells that better defines the regional potentiometric surface of the Upper Floridan aquifer in the study area. The network yields groundwater-level predictions that differ significantly from those produced using the existing network. The newly designed network will reduce the mean prediction standard error by 43% compared to the existing network. The adoption of a hexagonal grid network for the South Florida Water Management District is recommended to achieve both a uniform level of information about groundwater levels and the minimum required accuracy. It is customary to install more monitoring wells for observing groundwater levels and groundwater quality as groundwater development progresses. However, budget constraints often force water managers to implement cost-effective monitoring networks. In this regard, this study provides guidelines to water managers concerned with groundwater planning and monitoring.

Learning from Top-Performing Managers.

ERIC Educational Resources Information Center

Brown, Paul L.

2000-01-01

Illustrates five criteria that can be used to identify the "best" managers in any organization: business results, employee attitudes, peer confirmation, upper-level manager appraisal, and customer satisfaction. Examines what top-performing managers say and do, and concludes that their thinking processes and their specific sets of skills…

The interactions of Canadian ethics consultants with health care managers and governing boards during times of crisis.

PubMed

Kaposy, Chris; Maddalena, Victor; Brunger, Fern; Pullman, Daryl; Singleton, Richard

2017-01-01

Health care organizations can be very complex, and are often the setting for crisis situations. In recent years, Canadian health care organizations have faced large-scale systemic medical errors, a nation-wide generic injectable drug shortage, iatrogenic infectious disease outbreaks, and myriad other crises. These situations often have an ethical component that ethics consultants may be able to address. Organizational leaders such as health care managers and governing boards have responsibilities to oversee and direct the response to crisis situations. This study investigates the nature and degree of involvement of Canadian ethics consultants in such situations. This qualitative study used semi-structured interviews with Canadian ethics consultants to investigate the nature of their interactions with upper-level managers and governing board members in health care organizations, particularly in times of organizational crisis. We used a purposive sampling technique to identify and recruit ethics consultants throughout Canada. We found variability in the interactions between ethics consultants and upper-level managers and governing boards. Some ethics consultants we interviewed did not participate in managing organizational crisis situations. Most ethics consultants reported that they had assisted in the management of some crises and that their participation was usually initiated by managers. Some ethics consultants reported the ability to bring issues to the attention of upper-level managers and indirectly to their governing boards. The interactions between managers and ethics consultants were characterized by varying degrees of collegiality. Ethics consultants reported participating in or chairing working groups, participating in incident management teams, and developing decision-making frameworks. Canadian ethics consultants tend to believe that they have valuable skills to offer in the management of organizational crisis situations. Most of the ethics consultants we interviewed believed that they play an important role in this regard.

Upper Limit for Regional Sea Level Projections

NASA Astrophysics Data System (ADS)

Jevrejeva, Svetlana; Jackson, Luke; Riva, Riccardo; Grinsted, Aslak; Moore, John

2016-04-01

With more than 150 million people living within 1 m of high tide future sea level rise is one of the most damaging aspects of warming climate. The latest Intergovernmental Panel on Climate Change report (AR5 IPCC) noted that a 0.5 m rise in mean sea level will result in a dramatic increase the frequency of high water extremes - by an order of magnitude, or more in some regions. Thus the flood threat to the rapidly growing urban populations and associated infrastructure in coastal areas are major concerns for society. Hence, impact assessment, risk management, adaptation strategy and long-term decision making in coastal areas depend on projections of mean sea level and crucially its low probability, high impact, upper range. With probabilistic approach we produce regional sea level projections taking into account large uncertainties associated with Greenland and Antarctica ice sheets contribution. We calculate the upper limit (as 95%) for regional sea level projections by 2100 with RCP8.5 scenario, suggesting that for the most coastlines upper limit will exceed the global upper limit of 1.8 m.

Planning for the Business of Education.

ERIC Educational Resources Information Center

Nutt, Andy

There are two levels of planning: strategic and operational. Strategic planning takes place at the upper levels of management and relates to the longrange objectives of an organization. Operational planning takes place at the middle, or lower, management echelon and deals with the implementation of strategic plans. It is the task of the chief…

Potentiometric Surface of the Upper Floridan Aquifer, West-Central Florida, May 2006

USGS Publications Warehouse

Ortiz, A.G.

2007-01-01

Introduction Hydrologic Conditions in West-Central Florida The Floridan aquifer system consists of the Upper and Lower Floridan aquifers separated by the middle confining unit. The middle confining unit and the Lower Floridan aquifer in west-central Florida generally contain highly mineralized water. The water-bearing units containing fresh water are herein referred to as the Upper Floridan aquifer. The Upper Floridan aquifer is the principal source of water in the Southwest Florida Water Management District and is used for major public supply, domestic use, irrigation, and brackish water desalination in coastal communities (Southwest Florida Water Management District, 2000). This map report shows the potentiometric surface of the Upper Floridan aquifer measured in May 2006. The potentiometric surface is an imaginary surface connecting points of equal altitude to which water will rise in tightly-cased wells that tap a confined aquifer system (Lohman, 1979). This map represents water-level conditions near the end of the dry season, when ground-water levels usually are at an annual low and withdrawals for agricultural use typically are high. The cumulative average rainfall of 50.23 inches for west-central Florida (from June 2005 through May 2006) was 2.82 inches below the historical cumulative average of 53.05 inches (Southwest Florida Water Management District, 2006). Historical cumulative averages are calculated from regional rainfall summary reports (1915 to most recent complete calendar year) and are updated monthly by the Southwest Florida Water Management District. This report, prepared by the U.S. Geological Survey in cooperation with the Southwest Florida Water Management District, is part of a semi-annual series of Upper Floridan aquifer potentiometric-surface map reports for west-central Florida. Potentiometric-surface maps have been prepared for January 1964, May 1969, May 1971, May 1973, May 1974, and for each May and September since 1975. Water-level data are collected in May and September each year to show the approximate annual low and high water-level conditions, respectively. Most of the water-level data for this map were collected by the U.S. Geological Survey during the period May 15-19, 2006. Supplemental water-level data were collected by other agencies and companies. A corresponding potentiometric-surface map was prepared for areas east and north of the Southwest Florida Water Management District boundary by the U.S. Geological Survey office in Altamonte Springs, Florida (Kinnaman, 2006). Most water-level measurements were made during a 5-day period; therefore, measurements do not represent a 'snapshot' of conditions at a specific time, nor do they necessarily coincide with the seasonal low water-level condition. Water-Level Changes Water levels in about 95 percent of the wells measured in May 2006 were lower than the May 2005 water levels (Ortiz and Blanchard, 2006). May 2006 water levels in 403 wells ranged from about 26 feet below to about 6 feet above May 2005 water levels (fig. 1). Significant water level declines occurred in eastern Manatee County, southwestern Polk County, southeastern Hillsborough County, and in all of Hardee County. The largest water level declines occurred in southwestern Hardee County. The largest water level rises occurred in south-central Pasco County, northeastern Levy County, northwestern Marion County, and along the gulf coast from Pasco County to Citrus County (fig. 1). Water levels in about 96 percent of the wells measured in May 2006 were lower than the September 2005 water levels (Ortiz, 2006). May 2006 water levels in 397 wells ranged from about 31 feet below to 3 feet above the September 2005 water levels. The largest water level decline was in west-central Hardee County and the largest rise in water levels was in south-central Pasco County.

Executive Suite: Feminine Style.

ERIC Educational Resources Information Center

Lynch, Edith M.

The author provides the reader an "inside look" at women's role in management by selecting 95 women in management as a sample to gather research on women executives through questionnaires, personal talks, and formal interviews. Although the book is mainly about women in the middle/upper levels of management, coverage is given also to…

Emergency Management Students' Perceptions of the Use of WebEOC[R] to Support Authentic Learning

ERIC Educational Resources Information Center

Johnson, Thomas

2012-01-01

This study investigates the use of software technology that is used by emergency management professionals to create an authentic learning environment in emergency and disaster management courses in the classroom. Participants were 235 upper-level students enrolled in residential and online emergency and disaster management courses at a mid-sized…

Potentiometric surface of the Upper Floridan aquifer, west-central Florida, September 2010

USGS Publications Warehouse

Ortiz, A.G.

2011-01-01

This report, prepared by the U.S. Geological Survey in cooperation with the Southwest Florida Water Management District, is part of a semi-annual series of Upper Floridan aquifer potentiometric-surface map reports for west-central Florida. Potentiometric surface maps have been prepared for January 1964, May 1969, May 1971, May 1973, May 1974, and for each May and September since 1975. Water-level data are collected in May and September each year to show the approximate annual low and high water-level conditions, respectively. This map report shows the potentiometric surface of the Upper Floridan aquifer measured in September 2010. The potentiometric surface is an imaginary surface connecting points of equal altitude to which water will rise in tightly-cased wells that tap a confined aquifer system (Lohman, 1979). This map represents water-level conditions near the end of the wet season, when groundwater levels usually are at an annual high and withdrawals for agricultural use typically are low. The cumulative average rainfall of 53.17 inches for west-central Florida (from October 2009 through September 2010) was 0.41 inches above the historical cumulative average of 52.76 inches (Southwest Florida Water Management District, 2010). Historical cumulative averages are calculated from regional rainfall summary reports (1915 to most recent complete calendar year) and are updated monthly by the Southwest Florida Water Management District.

Groundwater conditions and studies in the Brunswick–Glynn County area, Georgia, 2008

USGS Publications Warehouse

Cherry, Gregory S.; Peck, Michael F.; Painter, Jaime A.; Stayton, Welby L.

2010-01-01

The Upper Floridan aquifer is contaminated with saltwater in a 2-square-mile area of downtown Brunswick, Georgia. This contamination has limited development of the groundwater supply in the Glynn County area. Hydrologic, geologic, and water-quality data are needed to effectively manage water resources. Since 1959, the U.S. Geological Survey has conducted a cooperative water program with the City of Brunswick to monitor and assess the effect of groundwater development on saltwater contamination of the Floridan aquifer system. During calendar year 2008, the cooperative water program included continuous water-level recording of 12 wells completed in the Floridan, Brunswick, and surficial aquifer systems; collecting water levels from 21 wells to map the potentiometric surface of the Upper Floridan aquifer during July 2008; and collecting and analyzing water samples from 26 wells to map chloride concentrations in the Upper Floridan aquifer during July 2008. Equipment was installed on 3 wells for real-time water level and specific conductance monitoring. In addition, work was continued to refine an existing groundwater-flow model for evaluation of water-management scenarios.

Potentiometric surface of the upper Floridan Aquifer in the St. Johns River Water Management District and vicinity, Florida, May 1994

USGS Publications Warehouse

Schiffer, D.M.; O'Reilly, A. M.; Phelps, G.G.; Bradner, L.A.; Halford, K.J.; Spechler, R.M.

1994-01-01

This map depicts the potentiometric surface of the Upper Floridan aquifer in the St. Johns River Water Management District and vicinity for May 1994. The map is based on water-level measurements made at approximately 1,000 wells and several springs. Data on the map were contoured using 5-foot contour intervals in most areas. The potentiometric surface of this karstic aquifer generally reflects land surface topography. Potentiometric surface highs often correspond to topographic highs, which are areas of surficial recharge to the Upper Floridan aquifer. Springs within topographic lows along with areas of more diffuse upward leakage are natural zones of discharge. Municipal, agricultural, and industrial withdrawals have lowered the potentiometric surface in some areas. The potentiometric surface ranged from 125 feet above sea level in Polk County to 32 feet below sea level in Nassau County. Water levels in May 1994 generally were 0 to 3 feet lower than those measured in May 1993. Water levels in May 1994 in northeast Florida generally were 0 to 3 feet higher than in September 1993, except in the lower St. Johns River basin, where water levels were 0 to 4 feet lower than in September 1993. In the rest of the mapped area, water levels in May 1994 generally were 0 to 4 feet lower than those measured in September 1993.

Case management services for work related upper extremity disorders. Integrating workplace accommodation and problem solving.

PubMed

Shaw, W S; Feuerstein, M; Lincoln, A E; Miller, V I; Wood, P M

2001-08-01

A case manager's ability to obtain worksite accommodations and engage workers in active problem solving may improve health and return to work outcomes for clients with work related upper extremity disorders (WRUEDs). This study examines the feasibility of a 2 day training seminar to help nurse case managers identify ergonomic risk factors, provide accommodation, and conduct problem solving skills training with workers' compensation claimants recovering from WRUEDs. Eight procedural steps to this case management approach were identified, translated into a training workshop format, and conveyed to 65 randomly selected case managers. Results indicate moderate to high self ratings of confidence to perform ergonomic assessments (mean = 7.5 of 10) and to provide problem solving skills training (mean = 7.2 of 10) after the seminar. This training format was suitable to experienced case managers and generated a moderate to high level of confidence to use this case management approach.

Integrated case management for work-related upper-extremity disorders: impact of patient satisfaction on health and work status.

PubMed

Feuerstein, Michael; Huang, Grant D; Ortiz, Jose M; Shaw, William S; Miller, Virginia I; Wood, Patricia M

2003-08-01

An integrated case management (ICM) approach (ergonomic and problem-solving intervention) to work-related upper-extremity disorders was examined in relation to patient satisfaction, future symptom severity, function, and return to work (RTW). Federal workers with work-related upper-extremity disorder workers' compensation claims (n = 205) were randomly assigned to usual care or ICM intervention. Patient satisfaction was assessed after the 4-month intervention period. Questionnaires on clinical outcomes and ergonomic exposure were administered at baseline and at 6- and 12-months postintervention. Time from intervention to RTW was obtained from an administrative database. ICM group assignment was significantly associated with greater patient satisfaction. Regression analyses found higher patient satisfaction levels predicted decreased symptom severity and functional limitations at 6 months and a shorter RTW. At 12 months, predictors of positive outcomes included male gender, lower distress, lower levels of reported ergonomic exposure, and receipt of ICM. Findings highlight the utility of targeting workplace ergonomic and problem solving skills.

Gender Differences in the Management of Four Different Personnel Disputes with Male and Female Employees.

ERIC Educational Resources Information Center

Rossi, Ana; Todd-Mancillas, Wm. R.

A study compared male and female managers' preferences for using communication-based as opposed to power-centered strategies for resolving employer-employee disputes. Subjects, 40 male and 40 female middle and upper level managers, were interviewed and asked to report their preferred manner of resolving four different personnel problems: (1) an…

Marketing Higher Education in the 80's: "Aim for Service, Not Success, and Success Will Follow." Residual Marketing.

ERIC Educational Resources Information Center

Allen, Johnny Mac

Increasing competition in higher education for college students has given the term "enrollment management" wide acceptance in academia. Many factors are important to the success of enrollment management, including an informed enrollment management team of upper-level administrators committed to adopting a new philosophy in addition to…

Whole Farm Nutrient Management: Capstone Course on Environmental Management of Dairy Farms

ERIC Educational Resources Information Center

Albrecht, Gregory L.; Ketterings, Quirine M.; Czymmek, Karl J.; van Amburgh, Michael E.; Fox, Danny G.

2006-01-01

Whole Farm Nutrient Management is an upper-level, undergraduate course offered through the Department of Animal Science (AS) and Department of Crop and Soil Sciences (CSS) at Cornell University. The course (AS/CSS 412) is designed for students interested in agricultural careers and aims to help them develop a working knowledge of agricultural…

Population dynamics modeling of introduced smallmouth bass in the upper Colorado River basin

USGS Publications Warehouse

Breton, André R.; Winkelman, Dana L.; Bestgen, Kevin R.; Hawkins, John A.

2014-01-01

The purpose of these analyses was to identify an effective control strategy to further reduce smallmouth bass in the upper Colorado River basin from the current level. Our simulation results showed that “the surge”, an early to mid-summer increase in electrofishing effort targeting nest-guarding male smallmouth bass, should be made a core component of any future smallmouth bass management strategy in the upper basin. Immigration from off channel reservoirs is supporting smallmouth bass popualtions in the Yampa River and our modeling analyses suggest that smallmouth bass  in Little Yampa Canyon might go extinct in a few years under the present level of exploitation.

Potentiometric Surface of the Upper Floridan Aquifer in the St. Johns River Water Management District and Vicinity, Florida, May 2007

USGS Publications Warehouse

Kinnaman, Sandra L.; Dixon, Joann F.

2007-01-01

Introduction This map depicts the potentiometric surface of the Upper Floridan aquifer in the St. Johns River Water Management District and vicinity for May 2007. Potentiometric contours are based on water-level measurements collected at 566 wells during the period May 4-June 11 near the end of the dry season, however most of the water level data for this map were collected by the U.S. Geological Survey during the period May 21-25, 2007. Some contours are inferred from previous potentiometric-surface maps with larger well networks. The potentiometric surface of the carbonate Upper Floridan aquifer responds mainly to rainfall, and more locally, to ground-water withdrawals and spring flow. Potentiometric-surface highs generally correspond to topographic highs where the aquifer is recharged. Springs and areas of diffuse upward leakage naturally discharge water from the aquifer and are most prevalent along the St. Johns River. Areas of discharge are reflected by depressions in the potentiometric surface. Ground-water withdrawals locally have lowered the potentiometric surface. Ground water in the Upper Floridan aquifer generally flows from potentiometric highs to potentiometric lows in a direction perpendicular to the contours.

Effectiveness of an Afterschool-Based Aggression Management Program for Elementary Students

ERIC Educational Resources Information Center

Staecker, Emma; Puett, Eli; Afrassiab, Shayda; Ketcherside, Miranda; Azim, Sabiya; Rhodes, Darson; Wang, Anna

2016-01-01

A school-community partnership team implemented an aggression management curriculum in an afterschool program as an early-intervention strategy at the upper elementary level. Although statistically significant differences in physical or psychological aggression were not found, the partnership team gained a better understanding of evidence-based…

Mitigation and enhancement techniques for the Upper Mississippi River system and other large river systems

USGS Publications Warehouse

Schnick, Rosalie A.; Morton, John M.; Mochalski, Jeffrey C.; Beall, Jonathan T.

1982-01-01

Extensive information is provided on techniques that can reduce or eliminate the negative impact of man's activities (particularly those related to navigation) on large river systems, with special reference to the Upper Mississippi River. These techniques should help resource managers who are concerned with such river systems to establish sound environmental programs. Discussion of each technique or group of techniques include (1) situation to be mitigated or enhanced; (2) description of technique; (3) impacts on the environment; (4) costs; and (5) evaluation for use on the Upper Mississippi River Systems. The techniques are divided into four primary categories: Bank Stabilization Techniques, Dredging and Disposal of Dredged Material, Fishery Management Techniques, and Wildlife Management Techniques. Because techniques have been grouped by function, rather than by structure, some structures are discussed in several contexts. For example, gabions are discussed for use in revetments, river training structures, and breakwaters. The measures covered under Bank Stabilization Techniques include the use of riprap revetments, other revetments, bulkheads, river training structures, breakwater structures, chemical soil stabilizers, erosion-control mattings, and filter fabrics; the planting of vegetation; the creation of islands; the creation of berms or enrichment of beaches; and the control of water level and boat traffic. The discussions of Dredging and the Disposal of Dredged Material consider dredges, dredging methods, and disposal of dredged material. The following subjects are considered under Fishery Management Techniques: fish attractors; spawning structures; nursery ponds, coves, and marshes; fish screens and barriers; fish passage; water control structures; management of water levels and flows; wing dam modification; side channel modification; aeration techniques; control of nuisance aquatic plants; and manipulated of fish populations. Wildlife Management Techniques include treatments of artificial nest structures, island creation or development, marsh creation or development, greentree reservoirs and mast management, vegetation control, water level control, and revegetation.

Student perceptions of an upper-level, undergraduate human anatomy laboratory course without cadavers.

PubMed

Wright, Shirley J

2012-01-01

Several programs in health professional education require or are considering requiring upper-level human anatomy as prerequisite for their applicants. Undergraduate students are confronted with few institutions offering such a course, in part because of the expense and logistical issues associated with a cadaver-based human anatomy course. This study describes the development of and student reactions to an upper-level human anatomy laboratory course for undergraduate students that used a regional approach and contemporary, alternative teaching methods to a cadaver-based course. The alternative pedagogy to deliver the curriculum included use of commercially available, three-dimensional anatomical virtual dissection software, anatomical models coupled with a learning management system to offer Web-based learning, and a new laboratory manual with collaborative exercises designed to develop the student's anatomical skills and collaborative team skills. A Likert-scale survey with open-ended questions was used to ascertain student perceptions of the course and its various aspects. Students perceived that the noncadaver-based, upper-level human anatomy course with an engaging, regional approach is highly valuable in their learning of anatomy. anatomy. Copyright © 2012 American Association of Anatomists.

[Analysis for related factors of upper urinary tract deterioration in patients with spinal cord injury].

PubMed

Jing, Hua-fang; Liao, Li-min; Fu, Guang; Wu, Juan; Ju, Yan-he; Chen, Guo-qing

2014-08-18

To evaluate the related factors of upper urinary tract deterioration in spinal cord injured patients. Medical records of spinal cord injured patients from Jan.2002 to Sep.2009 were retrospectively reviewed. All the patients were divided into the upper urinary tract deterioration group and non-deterioration group according to the diagnostic criteria. Indexes such as demographic characteristic (gender, age), spinal cord injury information (cause, level, completeness), statuses of urinary tract system (bladder management, urine routine, urine culture, ultrasound, serum creatinine, fever caused by urinary tract infection) and urodynamics information(bladder compliance, bladder stability, bladder sensation, detrusor sphincter dyssynergia, detrusor leak point pressure, maximum cystometric capacity, relative safe bladder capacity, maximum flow rate, maximum urethra closure pressure) were compared between the two groups.Then Logistic regression analysis were performed. There was significantly difference between the two groups in spinal cord injury level(χ(2) = 8.840, P = 0.031),bladder management(χ(2) = 11.362, P = 0.045), urinary rutine(χ(2) = 17.983, P = 0.000), fever caused by urinary tract infection(χ(2)= 64.472, P = 0.000), bladder compliance(χ(2) = 6.531, P = 0.011), bladder sensation(χ(2) = 11.505, P = 0.009), maximum cystometric capacity(t = 2.209, P = 0.043), and detrusor-sphincter dyssynergia(χ(2) = 4.247, P = 0.039). The multiple-factor non-conditional Logistic regression analysis showed that bladder management (OR = 1.114, P = 0.006), fever caused by urinary tract infection(OR = 1.018,P = 0.000), bladder compliance (OR = 1.588, P = 0.040) and detrusor-sphincter dyssynergia(OR = 1.023, P = 0.034) were the key factors of upper urinary tract deterioration in spinal cord injured patients. Urinary tract infection, lower bladder compliance, detrusor-sphincter dyssynergia and unreasonable bladder management are the risk factors of upper urinary tract deterioration in spinal cord injured patients.

Web-based data acquisition and management system for GOSAT validation Lidar data analysis

NASA Astrophysics Data System (ADS)

Okumura, Hiroshi; Takubo, Shoichiro; Kawasaki, Takeru; Abdullah, Indra N.; Uchino, Osamu; Morino, Isamu; Yokota, Tatsuya; Nagai, Tomohiro; Sakai, Tetsu; Maki, Takashi; Arai, Kohei

2012-11-01

An web-base data acquisition and management system for GOSAT (Greenhouse gases Observation SATellite) validation lidar data analysis is developed. The system consists of data acquisition sub-system (DAS) and data management sub-system (DMS). DAS written in Perl language acquires AMeDAS ground-level meteorological data, Rawinsonde upper-air meteorological data, ground-level oxidant data, skyradiometer data, skyview camera images, meteorological satellite IR image data and GOSAT validation lidar data. DMS written in PHP language demonstrates satellite-pass date and all acquired data.

Understanding Climate Adaptation on Public Lands in the Upper Midwest: Implications for Monitoring and Tracking Progress

NASA Astrophysics Data System (ADS)

Anhalt-Depies, Christine M.; Knoot, Tricia Gorby; Rissman, Adena R.; Sharp, Anthony K.; Martin, Karl J.

2016-05-01

There are limited examples of efforts to systematically monitor and track climate change adaptation progress in the context of natural resource management, despite substantial investments in adaptation initiatives. To better understand the status of adaptation within state natural resource agencies, we utilized and problematized a rational decision-making framework to characterize adaptation at the level of public land managers in the Upper Midwest. We conducted in-depth interviews with 29 biologists and foresters to provide an understanding of managers' experiences with, and perceptions of, climate change impacts, efforts towards planning for climate change, and a full range of actions implemented to address climate change. While the majority of managers identified climate change impacts affecting their region, they expressed significant uncertainty in interpreting those signals. Just under half of managers indicated planning efforts are underway, although most planning is remote from local management. Actions already implemented include both forward-looking measures and those aimed at coping with current impacts. In addition, cross-scale dynamics emerged as an important theme related to the overall adaptation process. The results hold implications for tracking future progress on climate change adaptation. Common definitions or measures of adaptation (e.g., presence of planning documents) may need to be reassessed for applicability at the level of public land managers.

Understanding Climate Adaptation on Public Lands in the Upper Midwest: Implications for Monitoring and Tracking Progress.

PubMed

Anhalt-Depies, Christine M; Knoot, Tricia Gorby; Rissman, Adena R; Sharp, Anthony K; Martin, Karl J

2016-05-01

There are limited examples of efforts to systematically monitor and track climate change adaptation progress in the context of natural resource management, despite substantial investments in adaptation initiatives. To better understand the status of adaptation within state natural resource agencies, we utilized and problematized a rational decision-making framework to characterize adaptation at the level of public land managers in the Upper Midwest. We conducted in-depth interviews with 29 biologists and foresters to provide an understanding of managers' experiences with, and perceptions of, climate change impacts, efforts towards planning for climate change, and a full range of actions implemented to address climate change. While the majority of managers identified climate change impacts affecting their region, they expressed significant uncertainty in interpreting those signals. Just under half of managers indicated planning efforts are underway, although most planning is remote from local management. Actions already implemented include both forward-looking measures and those aimed at coping with current impacts. In addition, cross-scale dynamics emerged as an important theme related to the overall adaptation process. The results hold implications for tracking future progress on climate change adaptation. Common definitions or measures of adaptation (e.g., presence of planning documents) may need to be reassessed for applicability at the level of public land managers.

A Survey of Knowledge Management Skills Acquisition in an Online Team-Based Distributed Computing Course

ERIC Educational Resources Information Center

Thomas, Jennifer D. E.

2007-01-01

This paper investigates students' perceptions of their acquisition of knowledge management skills, namely thinking and team-building skills, resulting from the integration of various resources and technologies into an entirely team-based, online upper level distributed computing (DC) information systems (IS) course. Results seem to indicate that…

NARDAC Civilian DP Training: A Need for Management Attention.

DTIC Science & Technology

1982-12-01

POSITION DESCRIPTIONS ------------------------ 28 D. TRAINING ------------------------------------- 31 IV. NARDAC ORGANIZATIONAL DIAGNOSIS ------------------ 32...the production schedule. 31 IV. NARDAC ORGANIZATIONAL DIAGNOSIS The upper level manager of a highly sophisticated, production oriented ADP facility...14 September 1982. 22. Preziosi, R.C., " Organizational Diagnosis Questicnnaire", The 1990 Annual Handbook for Group Facilitators, p. 112, University

A Review of the Usefulness of R & D Management Techniques.

DTIC Science & Technology

1981-09-01

Logistics Air Force Institute of Technology, WAFB, OH I1. CONTROLLING OFFICE N-34E AND ADDRESS 12. REPORT DATE Department of Communication and Humanities...First, upper level managers sometimes fail to accurately translate their understanding of corporate objectives and goals into the technical envi...could also be classified as a "style" of management. A management technique according to John Argenti is "a recognized method of analyzing or solving a

Potentiometric Surface of the Upper Floridan Aquifer in the St. Johns River Water Management District and Vicinity, Florida, May 2005

USGS Publications Warehouse

Kinnaman, Sandra L.

2006-01-01

INTRODUCTION This map depicts the potentiometric surface of the upper Floridan aquifer in the St. Johns River Water Management District and vicinity for May 2005. Potentiometric contours are based on water level measurements collected at 598 wens during the period May 5 - 31, near the end of the dry season. Some contours are inferred from previous potentiometric-surface maps with larger well networks. The potentiometric surface of the carbonate upper Floridan aquifer responds mainly to rainfall, and more locally, to ground water withdrawals. Potentiometric-surface highs generally correspond to topographic highs where the aquifer is recharged. Springs and areas of diffuse upward leakage naturally discharge water from the aquifer and are most prevalent along the St. Johns River. Areas of discharge are reflected by depressions in the potentiometric surface. Ground water withdrawals locally have lowered the potentiometric surface. Ground water in the upper Floridan aquifer generally flows from potentiometric highs to potentiometric lows in a direction perpendicular to the contours.

Potentiometric Surface of the Upper Floridan Aquifer in the St. Johns River Water Management District and Vicinity, Florida, May 2009

USGS Publications Warehouse

Kinnaman, Sandra L.; Dixon, Joann F.

2009-01-01

This map depicts the potentiometric surface of the Upper Floridan aquifer in the St. Johns River Water Management District and vicinity for May 2009. Potentiometric contours are based on water-level measurements collected at 625 wells during the period May 14 - May 29, near the end of the dry season. Some contours are inferred from previous potentiometric-surface maps with larger well networks. The potentiometric surface of the carbonate Upper Floridan aquifer responds mainly to rainfall, and more locally, to groundwater withdrawals and spring flow. Potentiometric-surface highs generally correspond to topographic highs where the aquifer is recharged. Springs and areas of diffuse upward leakage naturally discharge water from the aquifer and are most prevalent along the St. Johns River. Areas of discharge are reflected by depressions in the potentiometric surface. Groundwater withdrawals locally have lowered the potentiometric surface. Groundwater in the Upper Floridan aquifer generally flows from potentiometric highs to potentiometric lows in a direction perpendicular to the contours.

Potentiometric Surface of the Upper Floridan Aquifer in the St. Johns River Water Management District and Vicinity, Florida, May 2006

USGS Publications Warehouse

Kinnaman, Sandra L.

2006-01-01

Introduction: This map depicts the potentiometric surface of the Upper Floridan aquifer in the St. Johns River Water Management District and vicinity for May 2006. Potentiometric contours are based on water-level measurements collected at 599 wells during the period May 14-31, near the end of the dry season. Some contours are inferred from previous potentiometric-surface maps with larger well networks. The potentiometric surface of the carbonate Upper Floridan aquifer responds mainly to rainfall, and more locally, to ground-water withdrawals and springflow. Potentiometric-surface highs generally correspond to topographic highs where the aquifer is recharged. Springs and areas of diffuse upward leakage naturally discharge water from the aquifer and are most prevalent along the St. Johns River. Areas of discharge are reflected by depressions in the potentiometric surface. Ground-water withdrawals locally have lowered the potentiometric surface. Ground water in the Upper Floridan aquifer generally flows from potentiometric highs to potentiometric lows in a direction perpendicular to the contours.

Potentiometric surface of the Upper Floridan aquifer in the St. Johns River water management district and vicinity, Florida, September 2005

USGS Publications Warehouse

Kinnaman, Sandra L.

2006-01-01

This map depicts the potentiometric surface of the Upper Floridan aquifer in the St. Johns River Water Management District and vicinity for September 2005. Potentiometric contours are based on water-level measurements collected at 643 wells during the period September 12-28, near the end of the wet season. Some contours are inferred from previous potentiometric-surface maps with larger well networks. The potentiometric surface of the carbonate Upper Floridan aquifer responds mainly to rainfall, and more locally, to ground-water withdrawals and springflow. Potentiometric-surface highs generally correspond to topographic highs where the aquifer is recharged. Springs and areas of diffuse upward leakage naturally discharge water from the aquifer and are most prevalent along the St. Johns River. Areas of discharge are reflected by depressions in the potentiometric surface. Ground-water withdrawals locally have lowered the potentiometric surface. Ground water in the Upper Floridan aquifer generally flows from potentiometric highs to potentiometric lows in a direction perpendicular to the contours.

Potentiometric Surface of the Upper Floridan Aquifer in the St. Johns River Water Management District and Vicinity, Florida, September 2006

USGS Publications Warehouse

Kinnaman, Sandra L.; Dixon, Joann F.

2007-01-01

Introduction This map depicts the potentiometric surface of the Upper Floridan aquifer in the St. Johns River Water Management District and vicinity for September 2006. Potentiometric contours are based on water-level measurements collected at 571 wells during the period September 11-29, near the end of the wet season. Some contours are inferred from previouspotentiometric-surface maps with larger well networks. The potentiometric surface of the carbonate Upper Floridan aquifer responds mainly to rainfall, and more locally, to ground-water withdrawals and spring flow. Potentiometric-surface highs generally correspond to topographic highs where the aquifer is recharged. Springs and areas of diffuse upward leakage naturally discharge water from the aquifer and are most prevalent along the St. Johns River. Areas of discharge are reflected by depressions in the potentiometric surface. Ground-water withdrawals locally have lowered the potentiometric surface. Ground water in the Upper Floridan aquifer generally flows from potentiometric highs to potentiometric lows in a direction perpendicular to the contours.

Potentiometric Surface of the Upper Floridan Aquifer in the St. Johns River Water Management District and Vicinity, Florida, September 2008

USGS Publications Warehouse

Kinnaman, Sandra L.; Dixon, Joann F.

2009-01-01

This map depicts the potentiometric surface of the Upper Floridan aquifer in the St. Johns River Water Management District and vicinity for September 2008. Potentiometric contours are based on water-level measurements collected at 589 wells during the period September 15-25, near the end of the wet season. Some contours are inferred from previous potentiometric-surface maps with larger well networks. The potentiometric surface of the carbonate Upper Floridan aquifer responds mainly to rainfall, and more locally, to ground-water withdrawals and spring flow. Potentiometric-surface highs generally correspond to topographic highs where the aquifer is recharged. Springs and areas of diffuse upward leakage naturally discharge water from the aquifer and are most prevalent along the St. Johns River. Areas of discharge are reflected by depressions in the potentiometric surface. Ground-water withdrawals locally have lowered the potentiometric surface. Ground water in the Upper Floridan aquifer generally flows from potentiometric highs to potentiometric lows in a direction perpendicular to the contours.

Potentiometric Surface of the Upper Floridan Aquifer in the St. Johns River Water Management District and Vicinity, Florida, September 2007

USGS Publications Warehouse

Kinnaman, Sandra L.; Dixon, Joann F.

2008-01-01

This map depicts the potentiometric surface of the Upper Floridan aquifer in the St. Johns River Water Management District and vicinity for September 2007. Potentiometric contours are based on water-level measurements collected at 554 wells during the period September 15-27, near the end of the wet season. Some contours are inferred from previous potentiometric-surface maps with larger well networks. The potentiometric surface of the carbonate Upper Floridan aquifer responds mainly to rainfall, and more locally, to ground-water withdrawals and spring flow. Potentiometric-surface highs generally correspond to topographic highs where the aquifer is recharged. Springs and areas of diffuse upward leakage naturally discharge water from the aquifer and are most prevalent along the St. Johns River. Areas of discharge are reflected by depressions in the potentiometric surface. Ground-water withdrawals locally have lowered the potentiometric surface. Ground water in the Upper Floridan aquifer generally flows from potentiometric highs to potentiometric lows in a direction perpendicular to the contours.

Improvement of web-based data acquisition and management system for GOSAT validation lidar data analysis

NASA Astrophysics Data System (ADS)

Okumura, Hiroshi; Takubo, Shoichiro; Kawasaki, Takeru; Abdullah, Indra Nugraha; Uchino, Osamu; Morino, Isamu; Yokota, Tatsuya; Nagai, Tomohiro; Sakai, Tetsu; Maki, Takashi; Arai, Kohei

2013-01-01

A web-base data acquisition and management system for GOSAT (Greenhouse gases Observation SATellite) validation lidar data-analysis has been developed. The system consists of data acquisition sub-system (DAS) and data management sub-system (DMS). DAS written in Perl language acquires AMeDAS (Automated Meteorological Data Acquisition System) ground-level local meteorological data, GPS Radiosonde upper-air meteorological data, ground-level oxidant data, skyradiometer data, skyview camera images, meteorological satellite IR image data and GOSAT validation lidar data. DMS written in PHP language demonstrates satellite-pass date and all acquired data. In this article, we briefly describe some improvement for higher performance and higher data usability. GPS Radiosonde upper-air meteorological data and U.S. standard atmospheric model in DAS automatically calculate molecule number density profiles. Predicted ozone density prole images above Saga city are also calculated by using Meteorological Research Institute (MRI) chemistry-climate model version 2 for comparison to actual ozone DIAL data.

Upper extremity weightlifting injuries: Diagnosis and management.

PubMed

Golshani, Kayvon; Cinque, Mark E; O'Halloran, Peter; Softness, Kenneth; Keeling, Laura; Macdonell, J Ryan

2018-03-01

Common upper extremity injuries in resistance training athletes include muscle strains, ligament sprains, pectoralis major tendon ruptures, distal biceps tendon ruptures, and chronic shoulder pain and capsulolabral injuries. While each injury is unique in its specific anatomic location and mechanism, each is preventable with proper exercise technique, safety and maintenance of muscle balance. Conservative treatment is the therapeutic modality of choice and these injuries generally resolve with workout modification, appropriate recovery, anti-inflammatory medication, and physical therapy. If conservative treatment fails, surgical intervention is often successful and can return the weightlifter to a level of performance near their pre-injury level.

When do business units benefit more from collective citizenship behavior of management teams? An upper echelons perspective.

PubMed

Liu, Wu; Gong, Yaping; Liu, Jun

2014-05-01

Drawing upon the notion of managerial discretion from upper echelons theory, we theorize which external contingencies moderate the relationship between collective organizational citizenship behavior (COCB) and unit performance. Focusing on business unit (BU) management teams, we hypothesize that COCB of BU management teams enhances BU performance and that this impact depends on environmental uncertainty and BU management-team decision latitude, 2 determinants of managerial discretion. In particular, the positive effect of COCB is stronger when environmental uncertainty or the BU management-team decision latitude is greater. Time-lagged data from 109 BUs of a telecommunications company support the hypotheses. Additional exploratory analysis shows that the positive moderating effect of environmental uncertainty is further amplified at higher levels of BU management-team decision latitude. Overall, this study extends the internally focused view in the micro OCB literature by introducing external contingencies for the COCB-unit-performance relationship. (c) 2014 APA, all rights reserved.

Sustainable Assessment for Large Science Classes: Non-Multiple Choice, Randomised Assignments through a Learning Management System

ERIC Educational Resources Information Center

Schultz, Madeleine

2011-01-01

This paper reports on the development of a tool that generates randomised, non-multiple choice assessment within the BlackBoard Learning Management System interface. An accepted weakness of multiple-choice assessment is that it cannot elicit learning outcomes from upper levels of Biggs' SOLO taxonomy. However, written assessment items require…

Is the inherent potential of maize roots efficient for soil phosphorus acquisition?

PubMed

Deng, Yan; Chen, Keru; Teng, Wan; Zhan, Ai; Tong, Yiping; Feng, Gu; Cui, Zhenling; Zhang, Fusuo; Chen, Xinping

2014-01-01

Sustainable agriculture requires improved phosphorus (P) management to reduce the overreliance on P fertilization. Despite intensive research of root adaptive mechanisms for improving P acquisition, the inherent potential of roots for efficient P acquisition remains unfulfilled, especially in intensive agriculture, while current P management generally focuses on agronomic and environmental concerns. Here, we investigated how levels of soil P affect the inherent potential of maize (Zea mays L.) roots to obtain P from soil. Responses of root morphology, arbuscular mycorrhizal colonization, and phosphate transporters were characterized and related to agronomic traits in pot and field experiments with soil P supply from deficiency to excess. Critical soil Olsen-P level for maize growth approximated 3.2 mg kg(-1), and the threshold indicating a significant environmental risk was about 15 mg kg(-1), which represented the lower and upper levels of soil P recommended in current P management. However, most root adaptations involved with P acquisition were triggered when soil Olsen-P was below 10 mg kg(-1), indicating a threshold for maximum root inherent potential. Therefore, to maintain efficient inherent potential of roots for P acquisition, we suggest that the target upper level of soil P in intensive agriculture should be reduced from the environmental risk threshold to the point maximizing the inherent potential of roots.

Is the Inherent Potential of Maize Roots Efficient for Soil Phosphorus Acquisition?

PubMed Central

Deng, Yan; Chen, Keru; Teng, Wan; Zhan, Ai; Tong, Yiping; Feng, Gu; Cui, Zhenling; Zhang, Fusuo; Chen, Xinping

2014-01-01

Sustainable agriculture requires improved phosphorus (P) management to reduce the overreliance on P fertilization. Despite intensive research of root adaptive mechanisms for improving P acquisition, the inherent potential of roots for efficient P acquisition remains unfulfilled, especially in intensive agriculture, while current P management generally focuses on agronomic and environmental concerns. Here, we investigated how levels of soil P affect the inherent potential of maize (Zea mays L.) roots to obtain P from soil. Responses of root morphology, arbuscular mycorrhizal colonization, and phosphate transporters were characterized and related to agronomic traits in pot and field experiments with soil P supply from deficiency to excess. Critical soil Olsen-P level for maize growth approximated 3.2 mg kg−1, and the threshold indicating a significant environmental risk was about 15 mg kg−1, which represented the lower and upper levels of soil P recommended in current P management. However, most root adaptations involved with P acquisition were triggered when soil Olsen-P was below 10 mg kg−1, indicating a threshold for maximum root inherent potential. Therefore, to maintain efficient inherent potential of roots for P acquisition, we suggest that the target upper level of soil P in intensive agriculture should be reduced from the environmental risk threshold to the point maximizing the inherent potential of roots. PMID:24594677

Do cervical epidural injections provide long-term relief in neck and upper extremity pain? A systematic review.

PubMed

Manchikanti, Laxmaiah; Nampiaparampil, Devi E; Candido, Kenneth D; Bakshi, Sanjay; Grider, Jay S; Falco, Frank J E; Sehgal, Nalini; Hirsch, Joshua A

2015-01-01

The high prevalence of chronic persistent neck pain not only leads to disability but also has a significant economic, societal, and health impact. Among multiple modalities of treatments prescribed in the management of neck and upper extremity pain, surgical, interventional and conservative modalities have been described. Cervical epidural injections are also common modalities of treatments provided in managing neck and upper extremity pain. They are administered by either an interlaminar approach or transforaminal approach. To determine the long-term efficacy of cervical interlaminar and transforaminal epidural injections in the treatment of cervical disc herniation, spinal stenosis, discogenic pain without facet joint pain, and post surgery syndrome. The literature search was performed from 1966 to October 2014 utilizing data from PubMed, Cochrane Library, US National Guideline Clearinghouse, previous systematic reviews, and cross-references. The evidence was assessed based on best evidence synthesis with Level I to Level V. There were 7 manuscripts meeting inclusion criteria. Of these, 4 assessed the role of interlaminar epidural injections for managing disc herniation or radiculitis, and 3 assessed these injections for managing central spinal stenosis, discogenic pain without facet joint pain, and post surgery syndrome. There were 4 high quality manuscripts. A qualitative synthesis of evidence showed there is Level II evidence for each etiology category. The evidence is based on one relevant, high quality trial supporting the efficacy of cervical interlaminar epidural injections for each particular etiology. There were no randomized trials available assessing the efficacy of cervical transforaminal epidural injections. Paucity of available literature, specifically conditions other than disc herniation. This systematic review with qualitative best evidence synthesis shows Level II evidence for the efficacy of cervical interlaminar epidural injections with local anesthetic with or without steroids, based on at least one high-quality relevant randomized control trial in each category for disc herniation, discogenic pain without facet joint pain, central spinal stenosis, and post surgery syndrome.

Strategic Management for Organizational Effectiveness. The Effect of Human Resource Planning on Retention and Related Issues. Volume 1.

DTIC Science & Technology

1984-12-01

elements which are tied together by * what he terms organizational processes. These elements are (1) the external environment, (2) employees and other...of individual employee need and organizational objectives (Hall, 1976; Walker, 1980). The objectives of human resources departments are the selection...level of upper management to the individual employee (Tichy, et al, -8- 1.: 1982, 1981; Galbraith, 1977). Human resource management, like other

A leader-follower-interactive method for regional water resources management with considering multiple water demands and eco-environmental constraints

NASA Astrophysics Data System (ADS)

Chen, Yizhong; Lu, Hongwei; Li, Jing; Ren, Lixia; He, Li

2017-05-01

This study presents the mathematical formulation and implementations of a synergistic optimization framework based on an understanding of water availability and reliability together with the characteristics of multiple water demands. This framework simultaneously integrates a set of leader-followers-interactive objectives established by different decision makers during the synergistic optimization. The upper-level model (leader's one) determines the optimal pollutants discharge to satisfy the environmental target. The lower-level model (follower's one) accepts the dispatch requirement from the upper-level one and dominates the optimal water-allocation strategy to maximize economic benefits representing the regional authority. The complicated bi-level model significantly improves upon the conventional programming methods through the mutual influence and restriction between the upper- and lower-level decision processes, particularly when limited water resources are available for multiple completing users. To solve the problem, a bi-level interactive solution algorithm based on satisfactory degree is introduced into the decision-making process for measuring to what extent the constraints are met and the objective reaches its optima. The capabilities of the proposed model are illustrated through a real-world case study of water resources management system in the district of Fengtai located in Beijing, China. Feasible decisions in association with water resources allocation, wastewater emission and pollutants discharge would be sequentially generated for balancing the objectives subject to the given water-related constraints, which can enable Stakeholders to grasp the inherent conflicts and trade-offs between the environmental and economic interests. The performance of the developed bi-level model is enhanced by comparing with single-level models. Moreover, in consideration of the uncertainty in water demand and availability, sensitivity analysis and policy analysis are employed for identifying their impacts on the final decisions and improving the practical applications.

Effect of culture and density on aboveground biomass allocation of 12 years old loblolly pine trees in the upper coastal plain and piedmont of Georgia and Alabama

Treesearch

Santosh Subedi; Dr. Michael Kane; Dr. Dehai Zhao; Dr. Bruce Borders; Dr. Dale Greene

2012-01-01

We destructively sampled a total of 192 12-year-old loblolly pine trees from four installations established by the Plantation Management Research Cooperative (PMRC) to analyze the effects of planting density and cultural intensity on tree level biomass allocation in the Piedmont and Upper Coastal Plain of Georgia and Alabama. Each installation had 12 plots, each plot...

Potentiometric surface of the upper Floridan Aquifer in the St. Johns River Water Management District and vicinity, Florida, September, 2004

USGS Publications Warehouse

Kinnaman, Sandra L.

2005-01-01

Introduction: This map depicts the potentiometric surface of the Upper Floridan aquifer in the St. Johns River Water Management District and vicinity in September 2004. Potentiometric contours are based on water-level measurements collected at 608 wells during the period September 14-October 1, near the end of the wet season. The shapes of some contours have been inferred from previous potentiometric-surface maps with larger well networks. The potentiometric surface of the carbonate Upper Floridan aquifer responds mainly to rainfall, and more locally, to ground-water withdrawals. Potentiometric-surface highs generally correspond to topographic highs where the aquifer is recharged. Springs and areas of diffuse upward leakage naturally discharge water from the aquifer and are most prevalent along the St. Johns River. Areas of discharge are reflected by depressions in the potentiometric surface. Ground-water withdrawals locally have lowered the potentiometric surface. Ground water in the Upper Floridan aquifer generally flows from potentiometric highs to potentiometric lows in a direction perpendicular to the contours.

Potentiometric Surface of the Upper Floridan Aquifer in the St. Johns River Water Management District and Vicinity, Florida, May, 2004

USGS Publications Warehouse

Kinnaman, Sandra L.; Knowles, Leel

2004-01-01

INTRODUCTION This map depicts the potentiometric surface of the Upper Floridan aquifer in the St. Johns River Water Management District and vicinity in May 2001. Potentiometric contours are based on water-level measurements collected at 684 wells during the period May 2 - 30, near the end of the dry season. The shapes of some contours have been inferred from previous potentiometric-surface maps with larger well networks. The potentiometric surface of the carbonate Upper Floridan aquifer responds mainly to rainfall, and more locally, to ground-water withdrawals. Potentiometric-surface highs generally correspond to topographic highs where the aquifer is recharged. Springs and areas of diffuse upward leakage naturally discharge water from the aquifer and are most prevalent along the St. Johns River. Areas of discharge are reflected by depressions in the potentiometric surface. Ground-water withdrawals locally have lowered the potentiometric surface. Ground water in the Upper Floridan aquifer generally flows from potentiometric highs to potentiometric lows in a direction perpendicular to the contours.

Potentiometric Surface of the Upper Floridan Aquifer in the St. Johns River Water Management District and Vicinity, May 2008

USGS Publications Warehouse

Kinnaman, Sandra L.; Dixon, Joann F.

2008-01-01

This map depicts the potentiometric surface of the Upper Floridan aquifer in the St. Johns River Water Management District and vicinity for May 2008. Potentiometric contours are based on water-level measurements collected at 567 wells during the period May 6-May 27, near the end of the dry season. Some contours are inferred from previous potentiometric-surface maps with larger well networks. The potentiometric surface of the carbonate Upper Floridan aquifer responds mainly to rainfall, and more locally, to ground-water withdrawals and spring flow. Potentiometric-surface highs generally correspond to topographic highs where the aquifer is recharged. Springs and areas of diffuse upward leakage naturally discharge water from the aquifer and are most prevalent along the St. Johns River. Areas of discharge are reflected by depressions in the potentiometric surface. Ground-water withdrawals locally have lowered the potentiometric surface. Ground water in the Upper Floridan aquifer generally flows from potentiometric highs to potentiometric lows in a direction perpendicular to the contours. Measured values of the potentiometric surface ranged from 7 feet below NGVD29 near Fernandina Beach, Florida, to 124 feet above NGVD29 in Polk County, Florida. The average water level of the network in May 2008 was about 1 foot lower than the average in September 2007 following below-average rainfall during the dry season of 2007-08. Seasonal differences in network average water levels generally range from 4 to 6 feet. For 457 wells with previous measurements, May 2008 levels ranged from about 19 feet below to about 11 feet above September 2007 water levels. The average water level of the network in May 2008 was about 1 foot higher than the average in May 2007. For 544 wells with previous measurements, May 2008 levels ranged from about 8 feet below to about 13 feet above May 2007 water levels. Long-term hydrographs of ground-water levels for continuous and periodic wells are available at internet site: http://waterdata.usgs.gov/fl/nwis/gw

Attributes and Characteristics That Contribute to Successful Female Leadership in Secondary Education

ERIC Educational Resources Information Center

Rouleau-Carroll, Linda K.

2014-01-01

The current research indicates that gender underrepresentation in upper management is a broad, global issue. According to data from the Iowa Department of Education (2010), most female principals (50.4%) are at the elementary level while only 23.7% female principals are at the secondary level and 76.3% males. The underrepresentation of females can…

Stand and individual tree growth of mature red oak after crop tree management in southern New England: 5-year results

Treesearch

Jeffrey S. Ward

2011-01-01

In winter 2003-04, four oak management study areas were established in Connecticut. Each study area had three 0.62-acre treatment plots: B-level thinning, crop tree, and unmanaged. Each plot was located within a 3- to 5-acre area with similar treatment. The mature red oak sawtimber stands had no prior management and were 80 to 112 years old; upper canopy oaks averaged...

Effects of nursing position on transformational leadership practices.

PubMed

Herman, Susan; Gish, Mary; Rosenblum, Ruth

2015-02-01

This study sought to identify significant differences in nursing leadership strengths by position title. Recent reports show aspects of transformational leadership (TL) related to position, age, and educational level. This study focuses on differentiating the strength of leadership practices across the range of nursing management positions. The Leadership Practices Inventory-Self-assessment survey, and a variety of demographic questions, were used to anonymously poll voluntary members of the Association of California Nurse Leaders. Nursing positions of director level and above were strongest in leadership practices. Those at manager and below were identified as needing additional leadership development. LPI-S subscales Enable Others to Act and Model the Way were strongest. Those at the manager level and below will benefit most from additional education and training. Even upper levels of management would gain from enhancing the LPI practices of Challenge the Process and Inspire a Shared Vision.

Education and training of future wetland scientists and managers

USGS Publications Warehouse

Wilcox, D.A.

2008-01-01

Wetland science emerged as a distinct discipline in the 1980s. In response, courses addressing various aspects of wetland science and management were developed by universities, government agencies, and private firms. Professional certification of wetland scientists began in the mid-1990s to provide confirmation of the quality of education and experience of persons involved in regulatory, management, restoration/construction, and research involving wetland resources. The education requirements for certification and the need for persons with specific wetland training to fill an increasing number of wetland-related positions identified a critical need to develop curriculum guidelines for an undergraduate wetland science and management major for potential accreditation by the Society of Wetland Scientists. That proposed major contains options directed toward either wetland science or management. Both options include required basic courses to meet the general education requirements of many universities, required upper-level specialized courses that address critical aspects of physical and biological sciences applicable to wetlands, and a minimum of four additional upper-level specialized courses that can be used to tailor a degree to students' interests. The program would be administered by an independent review board that would develop guidelines and evaluate university applications for accreditation. Students that complete the required coursework will fulfill the education requirements for professional wetland scientist certification and possess qualifications that make them attractive candidates for graduate school or entry-level positions in wetland science or management. Universities that offer this degree program could gain an advantage in recruiting highly qualified students with an interest in natural resources. Alternative means of educating established wetland scientists are likewise important, especially to provide specialized knowledge and experience or updates related to new management discoveries, policies, and regulations. ?? 2008 The Society of Wetland Scientists.

A forager–herder trade-off, from broad-spectrum hunting to sheep management at Aşıklı Höyük, Turkey

PubMed Central

Stiner, Mary C.; Buitenhuis, Hijlke; Duru, Güneş; Kuhn, Steven L.; Mentzer, Susan M.; Munro, Natalie D.; Pöllath, Nadja; Quade, Jay; Tsartsidou, Georgia; Özbaşaran, Mihriban

2014-01-01

Aşıklı Höyük is the earliest known preceramic Neolithic mound site in Central Anatolia. The oldest Levels, 4 and 5, spanning 8,200 to approximately 9,000 cal B.C., associate with round-house architecture and arguably represent the birth of the Pre-Pottery Neolithic in the region. Results from upper Level 4, reported here, indicate a broad meat diet that consisted of diverse wild ungulate and small animal species. The meat diet shifted gradually over just a few centuries to an exceptional emphasis on caprines (mainly sheep). Age-sex distributions of the caprines in upper Level 4 indicate selective manipulation by humans by or before 8,200 cal B.C. Primary dung accumulations between the structures demonstrate that ruminants were held captive inside the settlement at this time. Taken together, the zooarchaeological and geoarchaeological evidence demonstrate an emergent process of caprine management that was highly experimental in nature and oriented to quick returns. Stabling was one of the early mechanisms of caprine population isolation, a precondition to domestication. PMID:24778242

Evaluating changes to reservoir rule curves using historical water-level data

USGS Publications Warehouse

Mower, Ethan; Miranda, Leandro E.

2013-01-01

Flood control reservoirs are typically managed through rule curves (i.e. target water levels) which control the storage and release timing of flood waters. Changes to rule curves are often contemplated and requested by various user groups and management agencies with no information available about the actual flood risk of such requests. Methods of estimating flood risk in reservoirs are not easily available to those unfamiliar with hydrological models that track water movement through a river basin. We developed a quantile regression model that uses readily available daily water-level data to estimate risk of spilling. Our model provided a relatively simple process for estimating the maximum applicable water level under a specific flood risk for any day of the year. This water level represents an upper-limit umbrella under which water levels can be operated in a variety of ways. Our model allows the visualization of water-level management under a user-specified flood risk and provides a framework for incorporating the effect of a changing environment on water-level management in reservoirs, but is not designed to replace existing hydrological models. The model can improve communication and collaboration among agencies responsible for managing natural resources dependent on reservoir water levels.

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

PubMed

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

2015-03-01

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

Floodplains within reservoirs promote earlier spawning of white crappies Pomoxis annularis

USGS Publications Warehouse

Miranda, Leandro E.; Dagel, Jonah D.; Kaczka, Levi J.; Mower, Ethan; Wigen, S. L.

2015-01-01

Reservoirs impounded over floodplain rivers are unique because they may include within their upper reaches extensive shallow water stored over preexistent floodplains. Because of their relatively flat topography and riverine origin, floodplains in the upper reaches of reservoirs provide broad expanses of vegetation within a narrow range of reservoir water levels. Elsewhere in the reservoir, topography creates a band of shallow water along the contour of the reservoir where vegetation often does not grow. Thus, as water levels rise, floodplains may be the first vegetated habitats inundated within the reservoir. We hypothesized that shallow water in reservoir floodplains would attract spawning white crappies Pomoxis annularis earlier than reservoir embayments. Crappie relative abundance over five years in floodplains and embayments of four reservoirs increased as spawning season approached, peaked, and decreased as fish exited shallow water. Relative abundance peaked earlier in floodplains than embayments, and the difference was magnified with higher water levels. Early access to suitable spawning habitat promotes earlier spawning and may increase population fitness. Recognition of the importance of reservoir floodplains, an understanding of how reservoir water levels can be managed to provide timely connectivity to floodplains, and conservation of reservoir floodplains may be focal points of environmental management in reservoirs.

Endoscopic Management of Upper Urinary Tract Urothelial Carcinoma.

PubMed

Samson, Patrick; Smith, Arthur D; Hoenig, David; Okeke, Zeph

2018-05-01

Endoscopic management of upper tract urothelial carcinoma has become more popular over the last few decades as there has been an impetus for renal preservation in these patients. While radical nephroureterectomy has been the gold standard in treatment of this disease, ureteroscopic and percutaneous management has become a viable option for select patients. The literature on endoscopic management of upper urinary tract tumors was explored. Different management methods are discussed, both from published literature and experience of the authors of this chapter. We review the indications, details of the procedure, and troubleshooting methods in the endoscopic management of upper tract urothelial carcinoma. Imperative indications as well as controversial indications are discussed. The role and efficacy of adjuvant intrarenal topical agents are examined as well as the protocol for administering these agents. Follow-up protocols are also reviewed. In select patients, endoscopic management with ureteroscopy and/or percutaneous resection of upper tract urothelial tumors is appropriate and can preserve renal function while obtaining comparable oncologic control compared with radical surgery.

Management of the Upper Airway in Cystic Fibrosis

PubMed Central

Illing, Elisa A.; Woodworth, Bradford A.

2015-01-01

Purpose of Review Upper airway disease engenders significant morbidity for patients with cystic fibrosis and is increasingly recognized as having a much greater role in pulmonary outcomes and quality of life than originally believed. Widespread disparate therapeutic strategies for cystic fibrosis chronic rhinosinusitis underscore the absence of a standardized treatment paradigm. This review outlines the most recent evidence-based trends in the management of upper airway disease in cystic fibrosis. Recent Findings The unified airway theory proposes that the sinuses are a focus of initial bacterial colonization which seeds the lower airway and may play a large role in maintaining lung infections. Mounting evidence suggests more aggressive treatment of the sinuses may confer significant improvement in pulmonary disease and quality of life outcomes in cystic fibrosis patients. However, there is a lack of high-level evidence regarding medical and surgical management of cystic fibrosis chronic rhinosinusitis that makes generalizations difficult. Summary Well designed clinical trials with long-term follow-up concerning medical and surgical interventions for cystic fibrosis sinus disease are required to establish standardized treatment protocols, but increased interest in the sinuses as a bacterial reservoir for pulmonary infections has generated considerable attention. PMID:25250804

Mortality, movement and behaviour of native mussels during a planned water-level drawdown in the Upper Mississippi River

USGS Publications Warehouse

Newton, Teresa J.; Zigler, Steven J.; Gray, Brian R.

2015-01-01

Collectively, these data suggest that drawdowns can influence the mortality, movement and behaviour of mussels in the UMR. However, more information on spatial and temporal distributions of mussels is needed to better understand the magnitude of these effects. Results from this study are being used by resource managers to better evaluate the effects of this management tool on native mussel assemblages.

Single-specialty management and reconstruction of necrotizing fasciitis of the upper extremities: clinical and economic benefits from a case series.

PubMed

Mattison, Gennaya; Leis, Amber R; Gupta, Subhas C

2014-05-01

Patients with necrotizing fasciitis are managed with multiple prompt, radical surgical debridements and critical care support. Debridement and reconstruction are often provided by different surgical teams. Anecdotally, single-specialty management seemed to be a more efficient management strategy. This study aimed to investigate and compare the outcomes of management by plastic surgery versus multiple disciplines through a retrospective economic and clinical analysis of patients with necrotizing fasciitis treated over 8 years. We also present 3 index cases for which our service functioned as the primary management team. Necrotizing fasciitis cases evaluated and treated by our department, covering both Level I and Level II Trauma Centers, were reviewed for total charges, length of hospital stay, length of intensive care unit (ICU) stay, and number of procedures. The admission Acute Physiology and Chronic Health Evaluation II score was calculated for each patient. Three comparative index cases of upper extremity necrotizing fasciitis managed primarily by the plastic surgery team are presented in greater detail. Patients managed primarily by the plastic surgery service had equivalent Acute Physiology and Chronic Health Evaluation II scores to patients managed by multiple services for their necrotizing fasciitis, with the average score higher for patients managed by plastic surgery alone. In a case-matched series of upper extremity necrotizing fasciitis, the patients admitted directly to plastic surgery had shorter average lengths of hospital and ICU stays as well as decreased total number of procedures, resulting in decreased average total hospital charges. There were no amputations among the cases treated primarily by the plastic surgery. The patients also required smaller areas of reconstruction with skin grafting despite large initial areas of debridement compared to those whose reconstructive teams differed from the team performing the debridement. Improved economic and clinical outcomes-as indicated by the reduced lengths of overall and ICU stay, the reduced number of procedures, none of the cases requiring amputation, and the reduced need for skin grafting-may be attainable when the surgeon eventually performing the reconstruction is involved early in management. We propose that, in the interest of improving patient care, a closer collaboration should be established between the reconstructive and primary managing teams.

U.S. Air Force Engineering and Services Hardware Requirements

DOT National Transportation Integrated Search

1991-04-01

This document proposes a path to meet the communications-computer systems (CSC) requirements of Air Force Engineering and Services (E and S) in the mid-to-late 1990s. It reflects the philosophies that guide E and S upper- level management as it carri...

What Minority Employees Really Want.

ERIC Educational Resources Information Center

Mehta, Stephanie N.

2000-01-01

Selections for this list of the nation's best companies for minorities were made based on the company's commitment to diversity at every level, paying particular attention to the upper ranks of the companies. In these companies, ethnic minorities make up 22 percent of the officials and managers. (JOW)

Encouraging Equitable Enrollment.

ERIC Educational Resources Information Center

Hill, Stan

1997-01-01

Describes Project JUST (Join Underrepresented in Science and Technology), an initiative whose goal is to create an atmosphere of systemic change within an urban school district that results in minority students excelling in upper level math and science courses. Discusses leadership, governance, and management; a standards-based curriculum;…

Integrated health management and control of complex dynamical systems

NASA Astrophysics Data System (ADS)

Tolani, Devendra K.

2005-11-01

A comprehensive control and health management strategy for human-engineered complex dynamical systems is formulated for achieving high performance and reliability over a wide range of operation. Results from diverse research areas such as Probabilistic Robust Control (PRC), Damage Mitigating/Life Extending Control (DMC), Discrete Event Supervisory (DES) Control, Symbolic Time Series Analysis (STSA) and Health and Usage Monitoring System (HUMS) have been employed to achieve this goal. Continuous-domain control modules at the lower level are synthesized by PRC and DMC theories, whereas the upper-level supervision is based on DES control theory. In the PRC approach, by allowing different levels of risk under different flight conditions, the control system can achieve the desired trade off between stability robustness and nominal performance. In the DMC approach, component damage is incorporated in the control law to reduce the damage rate for enhanced structural durability. The DES controller monitors the system performance and, based on the mission requirements (e.g., performance metrics and level of damage mitigation), switches among various lower-level controllers. The core idea is to design a framework where the DES controller at the upper-level, mimics human intelligence and makes appropriate decisions to satisfy mission requirements, enhance system performance and structural durability. Recently developed tools in STSA have been used for anomaly detection and failure prognosis. The DMC deals with the usage monitoring or operational control part of health management, where as the issue of health monitoring is addressed by the anomaly detection tools. The proposed decision and control architecture has been validated on two test-beds, simulating the operations of rotorcraft dynamics and aircraft propulsion.

Process, policy, and implementation of pool-wide drawdowns on the Upper Mississippi River: a promising approach for ecological restoration of large impounded rivers

USGS Publications Warehouse

Kenow, Kevin P.; Gretchen Benjamin,; Tim Schlagenhaft,; Ruth Nissen,; Mary Stefanski,; Gary Wege,; Scott A. Jutila,; Newton, Teresa J.

2016-01-01

The Upper Mississippi River (UMR) has been developed and subsequently managed for commercial navigation by the U.S. Army Corps of Engineers (USACE). The navigation pools created by a series of lock and dams initially provided a complex of aquatic habitats that supported a variety of fish and wildlife. However, biological productivity declined as the pools aged. The River Resources Forum, an advisory body to the St. Paul District of the USACE, established a multiagency Water Level Management Task Force (WLMTF) to evaluate the potential of water level management to improve ecological function and restore the distribution and abundance of fish and wildlife habitat. The WLMTF identified several water level management options and concluded that summer growing season drawdowns at the pool scale offered the greatest potential to provide habitat benefits over a large area. Here we summarize the process followed to plan and implement pool-wide drawdowns on the UMR, including involvement of stakeholders in decision making, addressing requirements to modify reservoir operating plans, development and evaluation of drawdown alternatives, pool selection, establishment of a monitoring plan, interagency coordination, and a public information campaign. Three pool-wide drawdowns were implemented within the St. Paul District and deemed successful in providing ecological benefits without adversely affecting commercial navigation and recreational use of the pools. Insights are provided based on more than 17 years of experience in planning and implementing drawdowns on the UMR. 

Cultural intensity and planting density effects on individual tree stem growth, stand and crown attributes, and stand dynamics in thinned loblolly pine plantations during the age 12- to age 15- year period in the Upper Coastal Plain and Piedmont of the Southeastern United States

Treesearch

Evan Johnson; Michael Kane; Dehai Zhao; Robert Teskey

2015-01-01

Three existing loblolly pine (Pinus taeda L.) installations in the Plantation Management Research Cooperative's Upper Coastal Plain/Piedmont Culture Density Study were used to examine the effects of two cultural intensities, four initial planting densities, and their interactions on stem growth at the individual tree level from age 12 to 15 years and at the stand...

Program for advanced study in public science policy and administration

NASA Technical Reports Server (NTRS)

Rosenthal, A. H.

1976-01-01

The results and conclusions of the six-year effort concerned with the development and implementation of a university educational program intended to prepare scientists and engineers for upper-level management and administrative positions (as distinct from senior technical positions) were presented. This interdisciplinary program is at the graduate level, leading to a Master of Arts degree, and is given within a Division of Public Administration.

RESTSIM: A Simulation Model That Highlights Decision Making under Conditions of Uncertainty.

ERIC Educational Resources Information Center

Zinkhan, George M.; Taylor, James R.

1983-01-01

Describes RESTSIM, an interactive computer simulation program for graduate and upper-level undergraduate management, marketing, and retailing courses, which introduces naive users to simulation as a decision support technique, and provides a vehicle for studying various statistical procedures for evaluating simulation output. (MBR)

Development of water level regulation strategy for fish and wildlife, upper Mississippi River system

USGS Publications Warehouse

Lubinski, Kenneth S.; Carmody, G.; Wilcox, D.; Drazkowski, B.

1991-01-01

Water level regulation has been proposed as a tool for maintaining or enhancing fish and wildlife resources in navigation pools and associated flood plains of the Upper Mississippi River System. Research related to the development of water level management plans is being conducted under the Long Term Resource Monitoring Program. Research strategies include investigations of cause and effect relationships, spatial and temporal patterns of resource components, and alternative problem solutions. The principal hypothesis being tested states that water level fluctuations resulting from navigation dam operation create less than optimal conditions for the reproduction and growth of target aquatic macrophyte and fish species. Representative navigation pools have been selected to describe hydrologic, engineering, and legal constraints within which fish and wildlife objectives can be established. Spatial analyses are underway to predict the magnitude and location of habitat changes that will result from controlled changes in water elevation.

Integrating understanding of biophysical processes governing larval fish dispersal with basin-scale management decisions: lessons from the Missouri River, USA

NASA Astrophysics Data System (ADS)

Erwin, S. O.; Jacobson, R. B.; Fischenich, C. J.; Bulliner, E. A., IV; McDonald, R.; DeLonay, A. J.; Braaten, P.; Elliott, C. M.; Chojnacki, K.

2017-12-01

Management of the Missouri River—the longest river in the USA, with a drainage basin covering one sixth of the conterminous USA—is increasingly driven by the need to understand biophysical processes governing the dispersal of 8-mm long larval pallid sturgeon. In both the upper and lower basin, survival of larval sturgeon is thought to be a bottleneck limiting populations, but because of different physical processes at play, different modeling frameworks and resolutions are required to link management actions with population-level responses. In the upper basin, a series of impoundments reduce the length of river for the drifting larval sturgeon to complete their development. Downstream from the mainstem dams, recruitment is most likely diminished by channelization and reduced floodplain connectivity that limit the benthic habitat available for larval sturgeon to settle and initiate feeding. We present a synthesis of complementary field studies, laboratory observations, and numerical simulations that evaluate the physical processes related to larval dispersal of sturgeon in the Missouri River basin. In the upper basin, we use one-dimensional advection-dispersion models, calibrated with field experiments conducted in 2016-2017 using surrogate particles and tracers, to evaluate reservoir management alternatives. Results of field experimentation and numerical modeling show that proposed management alternatives in the upper basin may be limited by insufficient lengths of flowing river for drifting larvae to fully develop into their juvenile lifestage. In the intensively engineered lower basin, we employ higher resolution measurements and models to evaluate potential for channel reconfiguration and flow alteration to promote successful interception of drifting larvae into supportive benthic habitats for the initiation of feeding and transition to the juvenile life stage. We illustrate how refined understanding of small-scale biophysical process has been incorporated into the basin-scale management framework, thereby prompting a shift in restoration actions and design.

Management of work-relevant upper limb disorders: a review.

PubMed

Burton, A Kim; Kendall, Nicholas A S; Pearce, Brian G; Birrell, Lisa N; Bainbridge, L Christopher

2009-01-01

Upper limb disorders (ULDs) are clinically challenging and responsible for considerable work loss. There is a need to determine effective approaches for their management. To determine evidence-based management strategies for work-relevant ULDs and explore whether a biopsychosocial approach is appropriate. Literature review using a best evidence synthesis. Data from articles identified through systematic searching of electronic databases and citation tracking were extracted into evidence tables. The information was synthesized into high-level evidence statements, which were ordered into themes covering classification/diagnosis, epidemiology, associations/risks and management/treatment, focusing on return to work or work retention and taking account of distinctions between non-specific complaints and specific diagnoses. Neither biomedical treatment nor ergonomic workplace interventions alone offer an optimal solution; rather, multimodal interventions show considerable promise, particularly for occupational outcomes. Early return to work, or work retention, is an important goal for most cases and may be facilitated, where necessary, by transitional work arrangements. The emergent evidence indicates that successful management strategies require all the players to be on side and acting in a coordinated fashion; this requires engaging employers and workers to participate. The biopsychosocial model applies: biological considerations should not be ignored, but psychosocial factors are more influential for occupational outcomes. Implementation of interventions that address the full range of psychosocial issues will require a cultural shift in the way the relationship between upper limb complaints and work is conceived and handled. Dissemination of evidence-based messages can contribute to the needed cultural shift.

Work Dimensions Derived through Systematic Job Analysis of the General Work Inventory

DTIC Science & Technology

1987-01-01

describe position functions of an intangible nature"(p. 14). Tornow and Pinto (1976) developed the Management Position Description Questionnaire (MPDQ...were found in these factors and the factors developed by Tornow and Pinto (1976) for upper level managers. Such results indirectly validated Dowell...Personnel and Training Research Center, AFPTRC-TR-57-5. Tornow , W. W., & Pinto, P. (1976). The development of a managerial job taxonomy: a system for

Strategic PSYOP Management: A Marketing Management Approach

DTIC Science & Technology

2005-03-01

Armstrong, Gary & Kotler , Philip , (2005). Marketing: An Introduction. Upper Saddle River, New Jersey: Prentice Hall. Daft, Richard L., (2001). Essentials of...Briefing presented at the John F. Kennedy Special Warfare Center, Fort Bragg, North Carolina. Kotler , Philip , (2003). A Framework for Marketing...Management. Upper Saddle River, New Jersey: Prentice Hall. Kotler , Philip , & Armstrong, Gary, (2004). Principles of marketing. Upper Saddle River, New

A case report on buccal mucosa graft for upper ureteral stricture repair.

PubMed

Sabale, Vilas Pandurang; Thakur, Naveen; Kankalia, Sharad Kumar; Satav, Vikram Pramod

2016-01-01

Management of ureteric stricture especially long length upper one-third poses a challenging job for most urologists. With the successful use of buccal mucosa graft (BMG) for stricture urethra leads the foundation for its use in ureteric stricture also. A 35-year-old male diagnosedcase of left upper ureteric stricture, postureteroscopy with left percutaneous nephrostomy (PCN) in situ . Cysto-retrograde pyelography and nephrostogram done simultaneously suggestive of left upper ureteric stricture of 3 cm at L3 level. On exploration, diseased ureteral segment exposed, BMG harvested and sutured as onlay patch graft with supportive omental wrap. The treatment choice for upper ureteric long length stricture is inferior nephropexy, autotransplantation, or bowel interposition. With PCN in situ , inferior nephropexy becomes technically difficult, other two are morbid procedures. Use of BMG in this situation is technically better choice with all the advantages of buccal mucosa. Onlay BMG for ureteral stricture is technically easy, less morbid procedure and can be important choice in future.

Indirect Effects of Conservation Policies on the Coupled Human-Natural Ecosystem of the Upper Gulf of California

PubMed Central

Morzaria-Luna, Hem Nalini; Ainsworth, Cameron H.; Kaplan, Isaac C.; Levin, Phillip S.; Fulton, Elizabeth A.

2013-01-01

High bycatch of non-target species and species of conservation concern often drives the implementation of fisheries policies. However, species- or fishery-specific policies may lead to indirect consequences, positive or negative, for other species or fisheries. We use an Atlantis ecosystem model of the Northern Gulf of California to evaluate the effects of fisheries policies directed at reducing bycatch of vaquita (Phocoena sinus) on other species of conservation concern, priority target species, and metrics of ecosystem function and structure. Vaquita, a Critically Endangered porpoise endemic to the Upper Gulf of California, are frequently entangled by finfish gillnets and shrimp driftnets. We tested five fishery management scenarios, projected over 30 years (2008 to 2038), directed at vaquita conservation. The scenarios consider progressively larger spatial restrictions for finfish gillnets and shrimp driftnets. The most restrictive scenario resulted in the highest biomass of species of conservation concern; the scenario without any conservation measures in place resulted in the lowest. Vaquita experienced the largest population increase of any functional group; their biomass increased 2.7 times relative to initial (2008) levels under the most restrictive spatial closure scenario. Bycatch of sea lions, sea turtles, and totoaba decreased > 80% in shrimp driftnets and at least 20% in finfish gillnet fleets under spatial management. We found indirect effects on species and ecosystem function and structure as a result of vaquita management actions. Biomass and catch of forage fish declined, which could affect lower-trophic level fisheries, while other species such as skates, rays, and sharks increased in both biomass and catch. When comparing across performance metrics, we found that scenarios that increased ecosystem function and structure resulted in lower economic performance indicators, underscoring the need for management actions that consider ecological and economic tradeoffs as part of the integrated management of the Upper Gulf of California. PMID:23691155

Getting to the Truth

ERIC Educational Resources Information Center

Roach, Ronald

2006-01-01

In recent years, corporate executives and local bar association officials have increasingly questioned why so few of the nation's elite corporate law firms can claim significant racial and ethnic diversity among their partner or upper management ranks. Some organizations have even pledged to reward law firms that ensure high-level assignments for…

Bridging the Transition from Primary to Secondary School

ERIC Educational Resources Information Center

Howe, Alan, Ed.; Richards, Val, Ed.

2011-01-01

The transition from primary to secondary school can often be a difficult time for children, and managing the transition smoothly has posed a problem for teachers at both upper primary and lower secondary level. At a time when "childhood" recedes and "adulthood" beckons, the inequalities between individual children can widen,…

Discriminatory Air Pollution

ERIC Educational Resources Information Center

McCaull, Julian

1976-01-01

Described are the patterns of air pollution in certain large urban areas. Persons in poverty, in occupations below the management or professional level, in low-rent districts, and in black population are most heavily exposed to air pollution. Pollution paradoxically is largely produced by high energy consuming middle-and upper-class households.…

Hydrology of Polk County, Florida

USGS Publications Warehouse

Spechler, Rick M.; Kroening, Sharon E.

2007-01-01

Local water managers usually rely on information produced at the State and regional scale to make water-resource management decisions. Current assessments of hydrologic and water-quality conditions in Polk County, Florida, commonly end at the boundaries of two water management districts (South Florida Water Management District and the Southwest Florida Water Management District), which makes it difficult for managers to determine conditions throughout the county. The last comprehensive water-resources assessment of Polk County was published almost 40 years ago. To address the need for current countywide information, the U.S. Geological Survey began a 3?-year study in 2002 to update information about hydrologic and water-quality conditions in Polk County and identify changes that have occurred. Ground-water use in Polk County has decreased substantially since 1965. In 1965, total ground-water withdrawals in the county were about 350 million gallons per day. In 2002, withdrawals totaled about 285 million gallons per day, of which nearly 95 percent was from the Floridan aquifer system. Water-conservation practices mainly related to the phosphate-mining industry as well as the decrease in the number of mines in operation in Polk County have reduced total water use by about 65 million gallons per day since 1965. Polk County is underlain by three principal hydrogeologic units. The uppermost water-bearing unit is the surficial aquifer system, which is unconfined and composed primarily of clastic deposits. The surficial aquifer system is underlain by the intermediate confining unit, which grades into the intermediate aquifer system and consists of up to two water-bearing zones composed of interbedded clastic and carbonate rocks. The lowermost hydrogeologic unit is the Floridan aquifer system. The Floridan aquifer system, a thick sequence of permeable limestone and dolostone, consists of the Upper Floridan aquifer, a middle semiconfining unit, a middle confining unit, and the Lower Floridan aquifer. The Upper Floridan aquifer provides most of the water required to meet demand in Polk County. Data from about 300 geophysical and geologic logs were used to construct hydrogeologic maps showing the tops and thicknesses of the aquifers and confining units within Polk County. Thickness of the surficial aquifer system ranges from several feet thick or less in the extreme northwestern part of the county and along parts of the Peace River south of Bartow to more than 200 feet along the southern part of the Lake Wales Ridge in eastern Polk County. Thickness of the intermediate aquifer system/intermediate confining unit is highly variable throughout the county because of past erosional processes and sinkhole formation. Thickness of the unit ranges from less than 25 feet in the extreme northwestern part of the county to more than 300 feet in southwestern Polk County. The altitude of the top of the Upper Floridan aquifer in the county ranges from about 50 feet above National Geodetic Vertical Datum of 1929 (NGVD 29) in the northwestern part to more than 250 feet below NGVD 29 in the southern part. Water levels in the Upper Floridan aquifer fluctuate seasonally, increasing during the wet season (June through September) and decreasing during the rest of the year. Water levels in the Upper Floridan aquifer also can change from year to year, depending on such factors as pumpage and climatic variations. In the southwestern part of the county, fluctuations in water use related to phosphate mining have had a major impact on ground-water levels. Hydrographs of selected wells in southwestern Polk County show a general decline in water levels that ended in the mid-1970s. This water-level decline coincides with an increase in water use associated with phosphate mining. A substantial increase in water levels that began in the mid-1970s coincides with a period of decreasing water use in the county. Despite reductions in water use since 1970, howev

Detecting ecosystem performance anomalies for land management in the upper colorado river basin using satellite observations, climate data, and ecosystem models

USGS Publications Warehouse

Gu, Yingxin; Wylie, B.K.

2010-01-01

This study identifies areas with ecosystem performance anomalies (EPA) within the Upper Colorado River Basin (UCRB) during 2005-2007 using satellite observations, climate data, and ecosystem models. The final EPA maps with 250-m spatial resolution were categorized as normal performance, underperformance, and overperformance (observed performance relative to weather-based predictions) at the 90% level of confidence. The EPA maps were validated using "percentage of bare soil" ground observations. The validation results at locations with comparable site potential showed that regions identified as persistently underperforming (overperforming) tended to have a higher (lower) percentage of bare soil, suggesting that our preliminary EPA maps are reliable and agree with ground-based observations. The 3-year (2005-2007) persistent EPA map from this study provides the first quantitative evaluation of ecosystem performance anomalies within the UCRB and will help the Bureau of Land Management (BLM) identify potentially degraded lands. Results from this study can be used as a prototype by BLM and other land managers for making optimal land management decisions. ?? 2010 by the authors.

Detecting Ecosystem Performance Anomalies for Land Management in the Upper Colorado River Basin Using Satellite Observations, Climate Data, and Ecosystem Models

USGS Publications Warehouse

Gu, Yingxin; Wylie, Bruce K.

2010-01-01

This study identifies areas with ecosystem performance anomalies (EPA) within the Upper Colorado River Basin (UCRB) during 2005–2007 using satellite observations, climate data, and ecosystem models. The final EPA maps with 250-m spatial resolution were categorized as normal performance, underperformance, and overperformance (observed performance relative to weather-based predictions) at the 90% level of confidence. The EPA maps were validated using “percentage of bare soil” ground observations. The validation results at locations with comparable site potential showed that regions identified as persistently underperforming (overperforming) tended to have a higher (lower) percentage of bare soil, suggesting that our preliminary EPA maps are reliable and agree with ground-based observations. The 3-year (2005–2007) persistent EPA map from this study provides the first quantitative evaluation of ecosystem performance anomalies within the UCRB and will help the Bureau of Land Management (BLM) identify potentially degraded lands. Results from this study can be used as a prototype by BLM and other land managers for making optimal land management decisions.

Expert consensus on facilitators and barriers to return-to-work following surgery for non-traumatic upper extremity conditions: a Delphi study.

PubMed

Peters, S E; Johnston, V; Ross, M; Coppieters, M W

2017-02-01

This Delphi study aimed to reach consensus on important facilitators and barriers for return-to-work following surgery for non-traumatic upper extremity conditions. In Round 1, experts ( n = 42) listed 134 factors, which were appraised in Rounds 2 and 3. Consensus (⩾85% agreement) was achieved for 13 facilitators (high motivation to return-to-work; high self-efficacy for return-to-work and recovery; availability of modified/alternative duties; flexible return-to-work arrangements; positive coping skills; limited heavy work exertion; supportive return-to-work policies; supportive supervisor/management; no catastrophic thinking; no fear avoidance to return-to-work; no fear avoidance to pain/activity; return to meaningful work duties; high job satisfaction) and six barriers (mood disorder diagnosis; pain/symptoms at more than one musculoskeletal site; heavy upper extremity exertions at work; lack of flexible return-to-work arrangements; lack of support from supervisor/management; high level of pain catastrophizing). Future prognostic studies are required to validate these biopsychosocial factors to further improve return-to-work outcomes. V.

Prevention and management of infections associated with combat-related extremity injuries.

PubMed

Murray, Clinton K; Hsu, Joseph R; Solomkin, Joseph S; Keeling, John J; Andersen, Romney C; Ficke, James R; Calhoun, Jason H

2008-03-01

Orthopedic injuries suffered by casualties during combat constitute approximately 65% of the total percentage of injuries and are evenly distributed between upper and lower extremities. The high-energy explosive injuries, environmental contamination, varying evacuation procedures, and progressive levels of medical care make managing combat-related injuries challenging. The goals of orthopedic injury management are to prevent infection, promote fracture healing, and restore function. It appears that 2% to 15% of combat-related extremity injuries develop osteomyelitis, although lower extremity injuries are at higher risk of infections than upper extremity. Management strategies of combat-related injuries primarily focus on early surgical debridement and stabilization, antibiotic administration, and delayed primary closure. Herein, we provide evidence-based recommendations from military and civilian data to the management of combat-related injuries of the extremity. Areas of emphasis include the utility of bacterial cultures, antimicrobial therapy, irrigation fluids and techniques, timing of surgical care, fixation, antibiotic impregnated beads, wound closure, and wound coverage with negative pressure wound therapy. Most of the recommendations are not supported by randomized controlled trials or adequate cohorts studies in a military population and further efforts are needed to answer best treatment strategies.

Guidelines for endoscopic management of non-variceal upper gastrointestinal bleeding.

PubMed

Fujishiro, Mitsuhiro; Iguchi, Mikitaka; Kakushima, Naomi; Kato, Motohiko; Sakata, Yasuhisa; Hoteya, Shu; Kataoka, Mikinori; Shimaoka, Shunji; Yahagi, Naohisa; Fujimoto, Kazuma

2016-05-01

Japan Gastroenterological Endoscopy Society (JGES) has compiled a set of guidelines for endoscopic management of non-variceal upper gastrointestinal bleeding using evidence-based methods. The major cause of non-variceal upper gastrointestinal bleeding is peptic gastroduodenal ulcer bleeding. As a result, these guidelines mainly focus on peptic gastroduodenal ulcer bleeding, although bleeding from other causes is also overviewed. From the epidemiological aspect, in recent years in Japan, bleeding from drug-related ulcers has become predominant in comparison with bleeding from Helicobacter pylori (HP)-related ulcers, owing to an increase in the aging population and coverage of HP eradication therapy by national health insurance. As for treatment, endoscopic hemostasis, in which there are a variety of methods, is considered to be the first-line treatment for bleeding from almost all causes. It is very important to precisely evaluate the severity of the patient's condition and stabilize the patient's vital signs with intensive care for successful endoscopic hemostasis. Additionally, use of antisecretory agents is recommended to prevent rebleeding after endoscopic hemostasis, especially for gastroduodenal ulcer bleeding. Eighteen statements with evidence and recommendation levels have been made by the JGES committee of these guidelines according to evidence obtained from clinical research studies. However, some of the statements that are supported by a low level of evidence must be confirmed by further clinical research. © 2016 Japan Gastroenterological Endoscopy Society.

Aligning Best Practices to Develop Targeted Critical Thinking Skills and Habits

ERIC Educational Resources Information Center

Heft, Ilea E.; Scharff, Lauren F. V.

2017-01-01

This project evaluated the effectiveness of a course design within an upper-level biology course that incorporated what prior scholarship of teaching and learning (SoTL) research has suggested to be best practices for developing critical thinking skills while also managing the grading load on the instructor. These efforts centered on the…

The Research Proposal in Biomechanical and Biological Engineering Courses

ERIC Educational Resources Information Center

Harrison, Roger G.; Nollert, Matthias U.; Schmidtke, David W.; Sikavitsas, Vassilios I.

2006-01-01

Students in four biochemical and biological engineering courses for upper-­level undergraduates and graduate students were required to write a research proposal. Breaking the requirements down into segments (such as a summary with specific aims, rough draft, and final draft) due on different dates helped make the assignment more manageable for the…

The Relationships between Organizational Culture and Environmental Scanning: A Case Study.

ERIC Educational Resources Information Center

Miller, Jerry P.

1994-01-01

Based on interview and survey data from 220 upper- and middle-level managers within a Fortune 500 manufacturing firm, this case study describes how differences in organizational values influence the frequency with which decision makers use oral, written, and electronic sources of information for environmental scanning. (91 references) (LRW)

Creating a Learner-Centered Teaching Environment Using Student Choice in Assignments

ERIC Educational Resources Information Center

Hanewicz, Cheryl; Platt, Angela; Arendt, Anne

2017-01-01

Learner-centered teaching (LCT) has been found to be a more effective pedagogy for online students, as traditional teaching methods do not work well in online courses. Professors in an upper-level technology management class revised their online introductory course to incorporate cafeteria-style grading. This LCT approach allowed students to…

Role of residual renal function in phosphate control and anemia management in chronic hemodialysis patients.

PubMed

Penne, E Lars; van der Weerd, Neelke C; Grooteman, Muriel P C; Mazairac, Albert H A; van den Dorpel, Marinus A; Nubé, Menso J; Bots, Michiel L; Lévesque, Renée; ter Wee, Piet M; Blankestijn, Peter J

2011-02-01

There is increasing awareness that residual renal function (RRF) has beneficial effects in hemodialysis (HD) patients. The aim of this study was to investigate the role of RRF, expressed as GFR, in phosphate and anemia management in chronic HD patients. Baseline data of 552 consecutive patients from the Convective Transport Study (CONTRAST) were analyzed. Patients with a urinary output≥100 ml/24 h (n=295) were categorized in tertiles on the basis of degree of GFR and compared with anuric patients (i.e., urinary output<100 ml/24 h, n=274). Relations between GFR and serum phosphate and erythropoiesis-stimulating agent (ESA) index (weekly ESA dose per kg body weight divided by hematocrit) were analyzed with multivariable regression models. Phosphate levels were between 3.5 and 5.5 mg/dl in 68% of patients in the upper tertile (GFR>4.13 ml/min per 1.73 m2), as compared with 46% in anuric patients despite lower prescription of phosphate-binding agents. Mean hemoglobin levels were 11.9±1.2 g/dl with no differences between the GFR categories. The ESA index was 31% lower in patients in the upper tertile as compared with anuric patients. After adjustments for patient characteristics, patients in the upper tertile had significantly lower serum phosphate levels and ESA index as compared with anuric patients. This study suggests a strong relation between RRF and improved phosphate and anemia control in HD patients. Efforts to preserve RRF in HD patients could improve outcomes and should be encouraged.

A Survey of Factors Affecting Workplace Performance and Career Advancement of Black Women Administrators in Middle and Upper Level Management Positions in Community Colleges. Summary of Findings.

ERIC Educational Resources Information Center

Johnson, Marguerite; And Others

In 1991, a survey was conducted of 150 black female administrators at the department chair level and above at 65 community colleges in 19 states. The questionnaire solicited information on respondent characteristics, such as age, degrees, and salary, and their perceptions of the degree to which each of 20 variables positively or negatively…

Teaching strategies for assessing and managing urinary incontinence in older adults.

PubMed

Bradway, Christine; Cacchione, Pamela

2010-07-01

Urinary incontinence is common and affects many aspects of older adults' lives; therefore, it is essential that nursing faculty include this content in classroom and clinical teaching situations. This article describes innovative strategies for teaching upper-level nursing students (e.g., junior and senior undergraduates) about urinary incontinence in older adults, specifically, the relevant anatomy and physiology of continence and associated pathophysiology of urinary incontinence, risk factors and consequences, definitions and types, and effective nursing assessment and management strategies. Copyright 2010, SLACK Incorporated.

Surveying Mercury Levels in Hair, Blood and Urine of under 7-Year Old Children from a Coastal City in China

PubMed Central

Chen, Guixia; Chen, Xiaoxin; Yan, Chonghuai; Wu, Xingdong; Zeng, Guozhang

2014-01-01

Aim: The average mercury load in children under 7-years old was determined in a populated but not overly industrial coastal area in China. Methods: 395 blood samples, 1072 urine samples, and 581 hair samples were collected from 1076 children, aged 0 to 6 years, from eight representative communities of Xiamen, China. Mercury levels in the samples were surveyed. Results: The 95% upper limits of mercury in blood, urine, and hair for the children were 2.30, 1.50 and 2100.00 μg/kg, respectively. Levels tended to increase with age. Correlation analyses showed that mercury levels in blood and urine correlated with those in hair (n = 132), r = 0.49, p < 0.0001 and r = 0.20, p = 0.0008; however, blood mercury levels did not correlate with urine levels (n = 284), r = 0.07, p = 0.35. Conclusions: Surveying the average mercury load in children 0 to 6 years, and the 95% upper limit value of mercury in their blood, urine, and hair should help guide risk assessment and health management for children. PMID:25419876

The practical problem of improving quality in multicenter dialysis facilities.

PubMed

Balter, Paul

2003-01-01

Multifacility dialysis groups are frequently interested in improving overall quality and find that there are major differences between individual units. Upper management must consider what strategy is needed for the whole company and what strategy must be formulated by individual facilities. To make substantive changes, management must decide to adopt a new culture of true teamwork, drive out fear, and emphasize leadership and education both at the management level and in the individual unit. Both at the corporate and unit levels, leaders must be chosen who are able to recognize people who have the ability, the educational background, the enthusiasm, and the time to direct change. Empowering the individual units and individual employees to make changes and be enthusiastic about improvement is the key to success.

Water resources during drought conditions and postfire water quality in the upper Rio Hondo Basin, Lincoln County, New Mexico, 2010-13

USGS Publications Warehouse

Sherson, Lauren R.; Rice, Steven E.

2015-07-16

Changes in climate and increased groundwater and surface-water use are likely to affect the availability of water in the upper Rio Hondo Basin. Increased drought probably will increase the potential for wildfires, which can affect downstream water quality and increase flood potential. Climate-research predicted decreases in winter precipitation may have an adverse effect on the amount of groundwater recharge that occurs in the upper Rio Hondo Basin, given the predominance of winter precipitation recharge as indicated by the stable isotope results. Decreases in surface-water supplies because of persistent drought conditions and reductions in the quality of water because of the effects of wildfire may lead to a larger reliance on groundwater reserves in the upper Rio Hondo Basin. Decreasing water levels because of increasing groundwater withdrawal could reduce base flows in the Rio Bonito and Rio Ruidoso. Well organized and scientifically supported regional water-resources management will be necessary for dealing with the likely scenario of increases in demand coupled with decreases in supply in the upper Rio Hondo Basin.

Greenhouse gas emissions control in integrated municipal solid waste management through mixed integer bilevel decision-making.

PubMed

He, Li; Huang, G H; Lu, Hongwei

2011-10-15

Recent studies indicated that municipal solid waste (MSW) is a major contributor to global warming due to extensive emissions of greenhouse gases (GHGs). However, most of them focused on investigating impacts of MSW on GHG emission amounts. This study presents two mixed integer bilevel decision-making models for integrated municipal solid waste management and GHG emissions control: MGU-MCL and MCU-MGL. The MGU-MCL model represents a top-down decision process, with the environmental sectors at the national level dominating the upper-level objective and the waste management sectors at the municipal level providing the lower-level objective. The MCU-MGL model implies a bottom-up decision process where municipality plays a leading role. Results from the models indicate that: the top-down decisions would reduce metric tonne carbon emissions (MTCEs) by about 59% yet increase about 8% of the total management cost; the bottom-up decisions would reduce MTCE emissions by about 13% but increase the total management cost very slightly; on-site monitoring and downscaled laboratory experiments are still required for reducing uncertainty in GHG emission rate from the landfill facility. Copyright © 2011 Elsevier B.V. All rights reserved.

Endoscopic Treatment of Upper Tract Urothelial Carcinoma.

PubMed

Verges, Daniel P; Lallas, Costas D; Hubosky, Scott G; Bagley, Demetrius H

2017-04-01

This study aims to make the reader be aware of recent trends regarding the endoscopic management of upper tract urothelial carcinoma (UTUC) via review of the urologic literature over the past 5 years. Given the rare incidence of this disease, and the lack of level 1 evidence, systematic reviews and meta-analyses were also evaluated. Studies of importance are also considered and outlined in the annotated reference section. The PubMed database was queried using the following medical subject headings (MeSH terms): "carcinoma, transitional cell," "ureter," "ureteral neoplasms," "kidney pelvis," "endoscopy," "laser therapy," "ureteroscopy," "urologic surgical procedures," and "ureteroscopes." MeSH terms were linked together in varying combinations and limited to human studies in English. Given the relatively rare nature of upper tract urothelial carcinoma (UTUC), level 1 evidence regarding the efficacy of endoscopic treatment does not exist, even after 30+ years of experience. Rather, the literature available mostly is in the form of single institutional retrospective series consisting of relatively small numbers of patients with short to intermediate follow-up. Only within the last 3 years have published series with larger numbers of patients and mean follow-up over 5 years been made available. Even with these more robust experiences, comparisons among series are difficult given variable treatment and follow-up approaches. Most endoscopically managed UTUC will locally recur, especially with longer follow-up. Renal preservation rate is high, however, approaching 80% with follow-up well over 3 years. Patients with high-grade disease often fare poorly regardless of treatment modality. As such, endoscopic management for high-grade urothelial carcinoma should only be used in exceptional circumstances (i.e., in those patients medically unfit for NU or those with solitary kidneys wishing to avoid the morbidity of dialysis). No level 1 evidence exists for the routine use of intraluminal adjuvant therapy for UTUC (i.e., BCG and Mitomycin C) and multiple retrospective observational series claim there is no overt benefit. The recent formation of multiple international groups with interest in UTUC may eventually lead to the production of level 1 studies regarding optimal treatment; however, uniformity in treatment approach will likely still offer challenges.

Update of the ICUD-SIU consultation on upper tract urothelial carcinoma 2016: treatment of low-risk upper tract urothelial carcinoma.

PubMed

Mandalapu, Rao S; Remzi, Mesut; de Reijke, Theo M; Margulis, Vitaly; Palou, J; Kapoor, A; Yossepowitch, Ofer; Coleman, Jonathan; Traxer, Olivier; Anderson, J Kyle; Catto, James; de la Rosette, Jean; O'Brien, Timothy; Zlotta, Anthony; Matin, Surena F

2017-03-01

The conservative management of upper tract urothelial carcinoma (UTUC) has historically been offered to patients with imperative indications. The recent International Consultation on Urologic Diseases (ICUD) publication on UTUC stratified treatment allocations based on high- and low-risk groups. This report updates the conservative management of the low-risk group. The ICUD for low-risk UTUC working group performed a thorough review of the literature with an assessment of the level of evidence and grade of recommendation for a variety of published studies in this disease space. We update these publications and provide a summary of that original report. There are no prospective randomized controlled studies to support surgical management guidelines. A risk-stratified approach based on clinical, endoscopic, and biopsy assessment allows selection of patients who could benefit from kidney-preserving procedures with oncological outcomes potentially similar to radical nephroureterectomy with bladder cuff excision, with the added benefit of renal function preservation. These treatments are aided by the development of high-definition flexible digital URS, multi-biopsies with the aid of access sheaths and other tools, and promising developments in the use of adjuvant topical therapy. Recent developments in imaging, minimally invasive techniques, multimodality approaches, and adjuvant topical regimens and bladder cancer prevention raise the hope for improved risk stratification and may greatly improve the endoscopic treatment for low-risk UTUC.

Application of hydrologic tools and monitoring to support managed aquifer recharge decision making in the Upper San Pedro River, Arizona, USA

USGS Publications Warehouse

Lacher, Laurel J.; Turner, Dale S.; Gungle, Bruce W.; Bushman, Brooke M.; Richter, Holly E.

2014-01-01

The San Pedro River originates in Sonora, Mexico, and flows north through Arizona, USA, to its confluence with the Gila River. The 92-km Upper San Pedro River is characterized by interrupted perennial flow, and serves as a vital wildlife corridor through this semiarid to arid region. Over the past century, groundwater pumping in this bi-national basin has depleted baseflows in the river. In 2007, the United States Geological Survey published the most recent groundwater model of the basin. This model served as the basis for predictive simulations, including maps of stream flow capture due to pumping and of stream flow restoration due to managed aquifer recharge. Simulation results show that ramping up near-stream recharge, as needed, to compensate for downward pumping-related stress on the water table, could sustain baseflows in the Upper San Pedro River at or above 2003 levels until the year 2100 with less than 4.7 million cubic meters per year (MCM/yr). Wet-dry mapping of the river over a period of 15 years developed a body of empirical evidence which, when combined with the simulation tools, provided powerful technical support to decision makers struggling to manage aquifer recharge to support baseflows in the river while also accommodating the economic needs of the basin.

Antibiotics and Facial Fractures: Evidence-Based Recommendations Compared with Experience-Based Practice

PubMed Central

Mundinger, Gerhard S.; Borsuk, Daniel E.; Okhah, Zachary; Christy, Michael R.; Bojovic, Branko; Dorafshar, Amir H.; Rodriguez, Eduardo D.

2014-01-01

Efficacy of prophylactic antibiotics in craniofacial fracture management is controversial. The purpose of this study was to compare evidence-based literature recommendations regarding antibiotic prophylaxis in facial fracture management with expert-based practice. A systematic review of the literature was performed to identify published studies evaluating pre-, peri-, and postoperative efficacy of antibiotics in facial fracture management by facial third. Study level of evidence was assessed according to the American Society of Plastic Surgery criteria, and graded practice recommendations were made based on these assessments. Expert opinions were garnered during the Advanced Orbital Surgery Symposium in the form of surveys evaluating senior surgeon clinical antibiotic prescribing practices by time point and facial third. A total of 44 studies addressing antibiotic prophylaxis and facial fracture management were identified. Overall, studies were of poor quality, precluding formal quantitative analysis. Studies supported the use of perioperative antibiotics in all facial thirds, and preoperative antibiotics in comminuted mandible fractures. Postoperative antibiotics were not supported in any facial third. Survey respondents (n = 17) cumulatively reported their antibiotic prescribing practices over 286 practice years and 24,012 facial fracture cases. Percentages of prescribers administering pre-, intra-, and postoperative antibiotics, respectively, by facial third were as follows: upper face 47.1, 94.1, 70.6; midface 47.1, 100, 70.6%; and mandible 68.8, 94.1, 64.7%. Preoperative but not postoperative antibiotic use is recommended for comminuted mandible fractures. Frequent use of pre- and postoperative antibiotics in upper and midface fractures is not supported by literature recommendations, but with low-level evidence. Higher level studies may better guide clinical antibiotic prescribing practices. PMID:25709755

Civilian traumatic vascular injuries of the upper extremity:report of the Iranian national trauma project.

PubMed

Rasouli, Mohammad R; Moini, Majid; Khaji, Ali

2009-12-01

The determination of the pattern of traumatic vascular injuries of the upper extremity in Iran was the aim of this study. Data of the Iranian national trauma project were used to identify patients with upper extremity vascular injuries. This project was conducted in 8 major cities from 2000-2004. A total of 113 cases with 130 vascular injuries were found, including 2 axillary, 18 brachial, and 69 radial and ulnar arteries. In 91 cases (81%), penetrating trauma was responsible. Associated nerve and/or upper extremity fractures were seen in 20% and 18% of cases, respectively. End-to-end anastomosis, interposition of saphenous graft, and ligation were used for the management of 44%, 28%, and 17%, respectively, of brachial artery injuries. Ulnar and radial artery injuries had been either ligated (n = 36; 52%) or sutured (n = 33; 48%). Median, ulnar, and radial nerve injuries, except for one, had all been sutured primarily. No patients needed fasciotomy. Amputation and mortality resulting from associated injuries occurred in 3 (2.6%) and 5 (4.4%) patients, respectively. This study revealed that stabbings are the most frequent causes of these injuries in Iran, in spite of the management of patients in level 3 trauma centers; the rate of amputation is acceptable. However, this study does not provide limb functions of the patients.

Development of conceptual ecological models linking management of the Missouri River to pallid sturgeon population dynamics

USGS Publications Warehouse

Jacobson, Robert B.; Parsley, Michael J.; Annis, Mandy L.; Colvin, Michael E.; Welker, Timothy L.; James, Daniel A.

2015-01-01

This report documents the process of developing and refining conceptual ecological models (CEMs) for linking river management to pallid sturgeon (Scaphirhynchus albus) population dynamics in the Missouri River. The refined CEMs are being used in the Missouri River Pallid Sturgeon Effects Analysis to organize, document, and formalize an understanding of pallid sturgeon population responses to past and future management alternatives. The general form of the CEMs, represented by a population-level model and component life-stage models, was determined in workshops held in the summer of 2013. Subsequently, the Missouri River Pallid Sturgeon Effects Analysis team designed a general hierarchical structure for the component models, refined the graphical structure, and reconciled variation among the components and between models developed for the upper river (Upper Missouri & Yellowstone Rivers) and the lower river (Missouri River downstream from Gavins Point Dam). Importance scores attributed to the relations between primary biotic characteristics and survival were used to define a candidate set of working dominant hypotheses about pallid sturgeon population dynamics. These CEMs are intended to guide research and adaptive-management actions to benefit pallid sturgeon populations in the Missouri River.

Potentiometric surface of the Upper Floridan aquifer in the Ichetucknee springshed and vicinity, northern Florida, September 2003

USGS Publications Warehouse

Sepulveda, A. Alejandro; Katz, Brian G.; Mahon, Gary L.

2006-01-01

The Upper Floridan aquifer is a highly permeable unit of carbonate rock extending beneath most of Florida and parts of southern Alabama, Georgia, and South Carolina. The high permeability is due in a large part to the widening of fractures that developed over time and the formation of conduits within the aquifer through dissolution of the limestone. This process has also produced numerous karst features such as springs, sinking streams, and sinkholes in northern Florida. These dissolution features, whether expressed at the surface or not, greatly influence the direction of ground-water flow in the Ichetucknee springshed adjacent to the Ichetucknee River. Ground water generally flows southwestward in the springshed and discharges to the Ichetucknee or Santa Fe Rivers, or to the springs along those rivers. This map depicts the September 9-10, 2003, potentiometric surface of the Upper Floridan aquifer based on 94 water-level measurements made by the Suwannee River Water Management District. Ground-water levels in this watershed fluctuate in response to precipitation and due to the high degree of interconnection between the surface-water system and the aquifer.

Stratigraphic controls on seawater intrusion and implications for groundwater management, Dominguez Gap area of Los Angeles, California, USA

USGS Publications Warehouse

Nishikawa, T.; Siade, A.J.; Reichard, E.G.; Ponti, D.J.; Canales, A.G.; Johnson, T.A.

2009-01-01

Groundwater pumping has led to extensive water-level declines and seawater intrusion in coastal Los Angeles, California (USA). A SUTRA-based solute-transport model was developed to test the hydraulic implications of a sequence-stratigraphic model of the Dominguez Gap area and to assess the effects of water-management scenarios. The model is two-dimensional, vertical and follows an approximate flow line extending from the Pacific Ocean through the Dominguez Gap area. Results indicate that a newly identified fault system can provide a pathway for transport of seawater and that a stratigraphic boundary located between the Bent Spring and Upper Wilmington sequences may control the vertical movement of seawater. Three 50-year water-management scenarios were considered: (1) no change in water-management practices; (2) installation of a slurry wall; and (3) raising inland water levels to 7.6 m above sea level. Scenario 3 was the most effective by reversing seawater intrusion. The effects of an instantaneous 1-m sea-level rise were also tested using water-management scenarios 1 and 3. Results from two 100-year simulations indicate that a 1-m sea-level rise may accelerate seawater intrusion for scenario 1; however, scenario 3 remains effective for controlling seawater intrusion. ?? Springer-Verlag 2009.

Role of Residual Renal Function in Phosphate Control and Anemia Management in Chronic Hemodialysis Patients

PubMed Central

Penne, E. Lars; van der Weerd, Neelke C.; Grooteman, Muriel P.C.; Mazairac, Albert H.A.; van den Dorpel, Marinus A.; Nubé, Menso J.; Bots, Michiel L.; Lévesque, Renée; ter Wee, Piet M.

2011-01-01

Summary Background and objectives There is increasing awareness that residual renal function (RRF) has beneficial effects in hemodialysis (HD) patients. The aim of this study was to investigate the role of RRF, expressed as GFR, in phosphate and anemia management in chronic HD patients. Design, setting, participants, & measurements Baseline data of 552 consecutive patients from the Convective Transport Study (CONTRAST) were analyzed. Patients with a urinary output ≥100 ml/24 h (n = 295) were categorized in tertiles on the basis of degree of GFR and compared with anuric patients (i.e., urinary output <100 ml/24 h, n = 274). Relations between GFR and serum phosphate and erythropoiesis-stimulating agent (ESA) index (weekly ESA dose per kg body weight divided by hematocrit) were analyzed with multivariable regression models. Results Phosphate levels were between 3.5 and 5.5 mg/dl in 68% of patients in the upper tertile (GFR > 4.13 ml/min per 1.73 m2), as compared with 46% in anuric patients despite lower prescription of phosphate-binding agents. Mean hemoglobin levels were 11.9 ± 1.2 g/dl with no differences between the GFR categories. The ESA index was 31% lower in patients in the upper tertile as compared with anuric patients. After adjustments for patient characteristics, patients in the upper tertile had significantly lower serum phosphate levels and ESA index as compared with anuric patients. Conclusions This study suggests a strong relation between RRF and improved phosphate and anemia control in HD patients. Efforts to preserve RRF in HD patients could improve outcomes and should be encouraged. PMID:21030579

Hurdles at work: perceptions of hospital food handlers

PubMed Central

Bertin, Cilce Helena Figueiredo Preza; Rezende, Magda Andrade; Sigulem, Dirce Maria; Morais, Tania Beninga

2009-01-01

Background Food handlers have a very important role in preventing food contamination during its preparation and distribution. This responsibility is even greater in hospitals, since a large number of patients have low immunity and consequently food contamination by pathogenic bacteria could be particularly harmful. Therefore, a good working environment and periodic training should be provided to food handlers by upper management. Methods This study is qualitative research by means of focus group and thematic content analysis methodologies to examine, in detail, the statements by food handlers working in the milk and specific-diet kitchens in a hospital to understand the problems they face in the workplace. Results We found that food handlers are aware of the role they play in restoring patients' health; they consider it important to offer a good-quality diet. However, according to their perceptions, a number of difficulties prevent them from reaching this aim. These include: upper management not prioritizing human and material resources to the dietetic services when making resource allocation decisions; a perception that upper management considers their work to be of lesser importance; delayed overtime payments; lack of periodic training; managers lacking administrative skills; insufficient dietitian staff assistants, leading to overwork, at the same time as there is an excess of dietitians; unhealthy environmental working conditions – high temperature, high humidity, loud and constant noise level, poor ventilation; lack of food, and kitchen utensils and equipment; and relationship conflicts with chief dieticians and co-workers. Conclusion From these findings, improvement in staff motivation could be achieved by considering non-financial incentives, such as improvement in working conditions and showing appreciation and respect through supervision, training and performance appraisal. Management action, such as investments in intermediary management so that managers have the capacity to provide supportive supervision, as well as better use of performance appraisal and access to training, may help overcome the identified problems. PMID:19630982

PROPOSAL OF A CLINICAL CARE PATHWAY FOR THE MANAGEMENT OF ACUTE UPPER GASTROINTESTINAL BLEEDING.

PubMed

Franco, Matheus Cavalcante; Nakao, Frank Shigueo; Rodrigues, Rodrigo; Maluf-Filho, Fauze; Paulo, Gustavo Andrade de; Libera, Ermelindo Della

2015-12-01

Upper gastrointestinal bleeding implies significant clinical and economic repercussions. The correct establishment of the latest therapies for the upper gastrointestinal bleeding is associated with reduced in-hospital mortality. The use of clinical pathways for the upper gastrointestinal bleeding is associated with shorter hospital stay and lower hospital costs. The primary objective is the development of a clinical care pathway for the management of patients with upper gastrointestinal bleeding, to be used in tertiary hospital. It was conducted an extensive literature review on the management of upper gastrointestinal bleeding, contained in the primary and secondary information sources. The result is a clinical care pathway for the upper gastrointestinal bleeding in patients with evidence of recent bleeding, diagnosed by melena or hematemesis in the last 12 hours, who are admitted in the emergency rooms and intensive care units of tertiary hospitals. In this compact and understandable pathway, it is well demonstrated the management since the admission, with definition of the inclusion and exclusion criteria, passing through the initial clinical treatment, posterior guidance for endoscopic therapy, and referral to rescue therapies in cases of persistent or rebleeding. It was also included the care that must be taken before hospital discharge for all patients who recover from an episode of bleeding. The introduction of a clinical care pathway for patients with upper gastrointestinal bleeding may contribute to standardization of medical practices, decrease in waiting time for medications and services, length of hospital stay and costs.

U.S. Geological Survey Georgia Water Science Center and City of Brunswick- Glynn County Cooperative Water Program-Summary of Activities, July 2005 through June 2006

USGS Publications Warehouse

Cherry, Gregory S.

2007-01-01

Since 1959, the U.S. Geological Survey has conducted a cooperative water resources program (CWP) with the City of Brunswick and Glynn County in the Brunswick, Georgia, area. Since the late 1950s, the salinity of ground water in the Upper Floridan aquifer near downtown Brunswick, Georgia, has been increasing, and its occurrence has been detected across an area of increasing size. Pumping of the Upper Floridan aquifer near downtown Brunswick has lowered water levels in the aquifer and resulted in an upward hydraulic gradient between the highly saline parts of the Lower Floridan aquifer and the normally fresh Upper Floridan aquifer. Saltwater likely enters the Upper Floridan aquifer through localized, vertically oriented conduits of relatively high permeability and moves laterally in response to the distribution of stresses within the aquifer. The Brunswick-Glynn County CWP for fiscal year 2006 includes the operation and maintenance of 12 continuous water-level recorders. In addition, water-level data were collected from 52 wells and water from 70 wells was analyzed for chloride concentration during June 2005. Geophysical logs were obtained from one well to assess whether the cause of elevated chloride concentration could be due to leaky well casing. A summary of the Georgia Department of Natural Resources, Environmental Protection Division (GaEPD) Georgia Coastal Sound Science Initiative (CSSI) activities that directly benefit the CWP-Brunswick-Glynn County is included in this report. The GaEPD CSSI is a program of scientific and feasibility studies to support development of a final strategy to protect the Upper Floridan aquifer from saltwater contamination. These data presented in this report are needed by State and local authorities to manage water resources effectively in the coastal area of Georgia.

Acute upper gastrointestinal bleeding (UGIB) - initial evaluation and management.

PubMed

Khamaysi, Iyad; Gralnek, Ian M

2013-10-01

Acute upper gastrointestinal bleeding (UGIB) is the most common reason that the 'on-call' gastroenterologist is consulted. Despite the diagnostic and therapeutic capabilities of upper endoscopy, there is still significant associated morbidity and mortality in patients experiencing acute UGIB, thus this is a true GI emergency. Acute UGIB is divided into non-variceal and variceal causes. The most common type of acute UGIB is 'non-variceal' and includes diagnoses such as peptic ulcer (gastric and duodenal), gastroduodenal erosions, Mallory-Weiss tears, erosive oesophagitis, arterio-venous malformations, Dieulafoy's lesion, and upper GI tract tumours and malignancies. This article focuses exclusively on initial management strategies for acute upper GI bleeding. We discuss up to date and evidence-based strategies for patient risk stratification, initial patient management prior to endoscopy, potential causes of UGIB, role of proton pump inhibitors, prokinetic agents, prophylactic antibiotics, vasoactive pharmacotherapies, and timing of endoscopy. Copyright © 2013 Elsevier Ltd. All rights reserved.

Military Education: Improved Oversight and Management Needed for DOD's Fellowship and Training-with-Industry Programs. Report to Congressional Committees. GAO-12-367

ERIC Educational Resources Information Center

Farrell, Brenda S.

2012-01-01

The Department of Defense (DOD), which includes the military services, selects mid- to upper-career-level military officers to participate in fellowship and training-with-industry programs conducted at non-DOD organizations such as universities, think tanks, private corporations, federal agencies, and Congress. For some fellowships, the military…

Enhancing the Interdisciplinary Perspective in the Marketing Management Decision Process through an Applied, Integrated, Client Project

ERIC Educational Resources Information Center

Askim-Lovseth, Mary K.; O'Keefe, Timothy P.

2012-01-01

Businesses function within a cross-functional, integrative setting, and this necessitates providing a learning environment for students that is comparable to real-life work projects. Two upper-level university classes in marketing and information systems worked collaboratively with a snack food business to design and build a Web site based on a…

Water-quality, bed-sediment, and biological data, for streams in the upper Prickly Pear Creek watershed, Montana, 2001

USGS Publications Warehouse

Klein, Terry L.; Thamke, Joanna N.; Harper, David D.; Farag, Aïda M.; Nimick, David A.; Fey, David L.

2003-01-01

The upper Prickly Pear Creek watershed encompasses the upstream 15 miles of Prickly Pear Creek, south of Helena, Montana (fig. 1). The headwaters of Prickly Pear Creek and its tributaries (Beavertown Creek, Clancy Creek, Dutchman Creek, Golconda Creek, Lump Gulch, Spring Creek, and Warm Springs Creek) are primarily in the Helena National Forest, whereas the central part of the watershed primarily is within either Bureau of Land Management (BLM) or privately owned property. Three mining districts are present in the upper Prickly Pear Creek watershed: Alhambra, Clancy, and Colorado. Numerous prospects, adits, tailings piles, mills, dredge piles, and mines (mostly inactive) are located throughout the watershed. These districts contain polymetallic (Ag, Au, Cu, Pb, Zn) vein deposits and precious-metal (Au-Ag) vein and disseminated deposits that were exploited beginning in the 1860’s. Placer Au deposits in the major streams were extensively mined in the late 1800’s and early 1900’s.As part of a cooperative effort with Federal land management agencies, the U.S. Geological Survey (USGS) is currently using an integrated approach to investigate two mining impacted watersheds in the western United States (the Animas River in Colorado and the Boulder River in Montana). These studies provide the USDA Forest Service and BLM scientific data for implementing informed land-management decisions regarding cleanup of abandoned mine lands within each watershed. A similar integrated-science approach will be used to characterize the upper Prickly Pear Creek watershed with respect to water and streambed sediment chemistry, aquatic biota, and geologic framework. This integrated database presents data that will be used to identify important pathways of metals movement and biological impacts, thereby guiding resource management decisions of land-managers in several publications that are in preparation. Watershed-level characterization in terms of water quality, streambed sediment chemistry, and fish health will facilitate determinations of whether removal of contaminated materials or other cleanup activities are necessary, planning of short- and long-term restoration efforts, and development of a monitoring plan to document cleanup effectiveness.

Microclimatic variation between managed and unmanaged northern hardwood forests in Upper Michigan, USA.

Treesearch

Elizabeth A Nauertz; Thomas R. Crow; John Zasada; Ronald M. Teclaw

2004-01-01

Temperature, light, wind, and precipitation were measured in the understory of managed and unmanaged northern hardwood forests in the Upper Peninsula of Michigan from 1995 through 2001. These measurements provide a baseline of information to compare the microclimate under managed and unmanaged conditions. Extreme climatic events may influence growth and development...

Management of upper extremity dysfunction in people with Parkinson disease and Huntington disease: facilitating outcomes across the disease lifespan.

PubMed

Quinn, Lori; Busse, Monica; Dal Bello-Haas, Vanina

2013-01-01

Parkinson Disease (PD) and Huntington Disease (HD) are degenerative neurological diseases, which can result in impairments and activity limitations affecting the upper extremities from early in the disease process. The progressive nature of these diseases poses unique challenges for therapists aiming to effectively maximize physical functioning and minimize participation restrictions in these patient groups. Research is underway in both diseases to develop effective disease-modifying agents and pharmacological interventions, as well as mobility-focused rehabilitation protocols. Rehabilitation, and in particular task-specific interventions, has the potential to influence the upper extremity functional abilities of patients with these degenerative conditions. However to date, investigations of interventions specifically addressing upper extremity function have been limited in both PD, and in particular HD. In this paper, we provide an update of the known pathological features of PD and HD as they relate to upper extremity function. We further review the available literature on the use of outcome measures, and the clinical management of upper extremity function in both conditions. Due to the currently limited evidence base in both diseases, we recommend utilization of a clinical management framework specific for degenerative conditions that can serve as a guideline for disease management. Copyright © 2013. Published by Elsevier Inc.

Water-Table and Potentiometric-Surface Altitudes in the Upper Glacial, Magothy, and Lloyd Aquifers beneath Long Island, New York, March-April 2006

USGS Publications Warehouse

Monti, Jack; Busciolano, Ronald J.

2009-01-01

The U.S. Geological Survey (USGS), in cooperation with State and local agencies, systematically collects ground-water data at varying measurement frequencies to monitor the hydrologic situation on Long Island, New York. Each year during March and April, the USGS conducts a synoptic survey of hydrologic conditions to define the spatial distribution of the water table and potentiometric surfaces within the three main water-bearing units underlying Long Island - the upper glacial, Magothy, and Lloyd aquifers. These data and the maps constructed from them are commonly used in studies of Long Island's hydrology, and by water managers and suppliers for aquifer management and planning purposes. Water-level measurements made in 502 wells across Long Island during March-April 2006, were used to prepare the maps in this report. Measurements were made by the wetted-tape method to the nearest hundredth of a foot. Water-table and potentiometric-surface altitudes in these aquifers were contoured using these measurements. The water-table contours were interpreted using water-level data collected from 341 wells screened in the upper glacial aquifer and (or) shallow Magothy aquifer; the Magothy aquifer's potentiometric-surface contours were interpreted from measurements at 102 wells screened in the middle to deep Magothy aquifer and (or) contiguous and hydraulically connected Jameco aquifer; and the Lloyd aquifer's potentiometric-surface contours were interpreted from measurements at 59 wells screened in the Lloyd aquifer or contiguous and hydraulically connected North Shore aquifer. Many of the supply wells are in continuous operation and, therefore, were turned off for a minimum of 24 hours before measurements were made so that the water levels in the wells could recover to the level of the potentiometric head in the surrounding aquifer. Full recovery time at some of these supply wells can exceed 24 hours; therefore, water levels measured at these wells are assumed to be less accurate than those measured at observation wells, which are not pumped. In this report, all water-level altitudes are referenced to the National Geodetic Vertical Datum of 1929 (NGVD 29).

Halogen occultation experiment intergrated test plan

NASA Technical Reports Server (NTRS)

Mauldin, L. E., III; Butterfield, A. J.

1986-01-01

The test program plan is presented for the Halogen Occultation Experiment (HALOE) instrument, which is being developed in-house at the Langley Research Center for the Upper Atmosphere Research Satellite (UARS). This comprehensive test program was developed to demonstrate that the HALOE instrument meets its performance requirements and maintains integrity through UARS flight environments. Each component, subsystem, and system level test is described in sufficient detail to allow development of the necessary test setups and test procedures. Additionally, the management system for implementing this test program is given. The HALOE instrument is a gas correlation radiometer that measures vertical distribution of eight upper atmospheric constituents: O3, HC1, HF, NO, CH4, H2O, NO2, and CO2.

A national survey on the initial management of upper gastrointestinal bleeding.

PubMed

Liang, Peter S; Saltzman, John R

2014-01-01

To evaluate the initial management of upper gastrointestinal (GI) bleeding in the United States. Various guidelines have addressed the initial management of upper GI bleeding, but the extent to which these guidelines are followed in clinical practice is unknown. We conducted a national survey of emergency physicians, internists, and gastroenterologists practicing in hospitals affiliated with an ACGME-accredited gastroenterology fellowship. Participants rated their agreement and adherence to 9 preendoscopic quality indicators for the initial management of upper GI bleeding. Awareness, use, and barriers to the use of early prognostic risk scores were also assessed. A total of 1402 surveys were completed, with an estimated response rate of 11.3%. Gastroenterologists and trainees agreed with the quality indicators more than nongastroenterologists and attending physicians, respectively. There was no difference in the application of the quality indicators by specialty or clinical position. Among all physicians, 53% had ever heard of and 30% had ever used an upper GI bleeding risk score. More gastroenterologists than nongastroenterologists had heard of (82% vs. 44%, P<0.001) and used (51% vs. 23%, P<0.001) a risk score. There was no difference between attending physicians and trainees. Gastroenterologists and attending physicians more often cited lack of utility as a reason to not use risk scores, whereas nongastroenterologists and trainees more often cited lack of knowledge. Among emergency physicians, internists, and gastroenterologists in the United States, agreement with upper GI bleeding initial management guidelines was high but adherence--especially pertaining to the use of risk scores--was low.

Assessment of fractionated exhaled nitric oxide as a biomarker for the treatment of eosinophilic esophagitis

PubMed Central

Nguyen-Traxler, Ann; Lee, Erika M.; Yip, Jason S.; Weinstock, Joel V.; Chan, Walter W.; Ngo, Peter; Weinstein, Barbara J.; Bonis, Peter A.

2012-01-01

Diagnosis of eosinophilic esophagitis (EoE) and determination of response to therapy is based on histological assessment of the esophagus, which requires upper endoscopy. In children, in whom a dietary approach is commonly used, multiple endoscopies are needed, because foods are eliminated and then gradually reintroduced. Ideally, noninvasive methods could supplement or replace upper endoscopy to facilitate management. Fractionated exhaled nitric oxide (FeNO) has been proposed as a useful measure for monitoring disease activity in studies of patients with eosinophil-predominant asthma and in other atopic disorders. Thus, we evaluated whether FeNO levels could be a useful biomarker to assess the response to therapy in EoE patients. This study was designed to determine whether there is a change in FeNO levels during treatment with topical corticosteroids and whether changes correlated with clinical response. This was a prospective, multicenter study that enrolled nonasthmatic patients with established EoE. FeNO levels and symptom scores were measured at baseline, biweekly during 6-week swallowed fluticasone treatment, and 4 weeks posttreatment. Twelve patients completed the trial. We found a statistically significant difference between median pre- and posttreatment FeNO levels [20.3 ppb (16.0–29.0 ppb) vs 17.6 ppb (11.7–27.3 ppb), p=0.009]. However, neither the pretreatment FeNO level, a change of FeNO level after 2 weeks of treatment, nor the FeNO level at the end of treatment confidently predicted a clinical or histological response. Although our findings suggest nitric oxide possibly has a physiological role in EoE, our observations do not support a role of FeNo determination for management of EoE. PMID:23394511

Mass-storage management for distributed image/video archives

NASA Astrophysics Data System (ADS)

Franchi, Santina; Guarda, Roberto; Prampolini, Franco

1993-04-01

The realization of image/video database requires a specific design for both database structures and mass storage management. This issue has addressed the project of the digital image/video database system that has been designed at IBM SEMEA Scientific & Technical Solution Center. Proper database structures have been defined to catalog image/video coding technique with the related parameters, and the description of image/video contents. User workstations and servers are distributed along a local area network. Image/video files are not managed directly by the DBMS server. Because of their wide size, they are stored outside the database on network devices. The database contains the pointers to the image/video files and the description of the storage devices. The system can use different kinds of storage media, organized in a hierarchical structure. Three levels of functions are available to manage the storage resources. The functions of the lower level provide media management. They allow it to catalog devices and to modify device status and device network location. The medium level manages image/video files on a physical basis. It manages file migration between high capacity media and low access time media. The functions of the upper level work on image/video file on a logical basis, as they archive, move and copy image/video data selected by user defined queries. These functions are used to support the implementation of a storage management strategy. The database information about characteristics of both storage devices and coding techniques are used by the third level functions to fit delivery/visualization requirements and to reduce archiving costs.

A Case Study Investigating the Use of Facebook as a Learning Management System in Higher Education

ERIC Educational Resources Information Center

Gutschmidt, Adam M.

2012-01-01

This dissertation addresses the issue of using the social networking website, Facebook, for educational purposes by examining how it was used in an upper-level public relations course. Research on education suggests instructors should find ways for their students to take a more active approach in learning and can do so by having them engage in…

78 FR 36743 - Adoption of Final Environmental Assessment (UT-040-09-03) Prepared for the Upper Kanab Creek...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-19

... Assessment (UT-040-09-03) Prepared for the Upper Kanab Creek Watershed Vegetation Management Project AGENCY... (NRCS) announces its intent to adopt the Kanab Creek Watershed Vegetation Management Project EA, as... Management Project EA, request a copy of the EA, or submit comments on actions being taken by NRCS regarding...

Watercraft user characteristics, management preferences, and user encounters on the upper Delaware scenic and recreational river: 1979-1996

Treesearch

Stephen M. Bowes; Chad P. Dawson

1998-01-01

Recreational boaters on the National Park Service managed Upper Delaware Scenic and Recreational River were surveyed about their characteristics, management preferences, and user encounters. Field interviews were conducted from Memorial Day weekend through Labor Day weekend during the summer of 1996. A total of 650 boaters were contacted at public and commercial access...

77 FR 46770 - Notice of Availability of the Injury Assessment Plan for the Upper Columbia River Site, Washington

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-06

..., Upper Columbia River/Lake Roosevelt, c/o Bureau of Land Management, 1103 N. Fancher Road, Spokane Valley... the following locations: Bureau of Land Management, 1103 N. Fancher Road, Spokane Valley, WA 99212...

Sinus and adenoid inflammation in children with chronic rhinosinusitis and asthma.

PubMed

Anfuso, Antony; Ramadan, Hassan; Terrell, Andrew; Demirdag, Yesim; Walton, Cheryl; Skoner, David P; Piedimonte, Giovanni

2015-02-01

Chronic rhinosinusitis (CRS) and asthma frequently coexist in children and adults. However, the precise pathophysiologic mechanism of this interaction is still poorly understood, especially in children, owing to the lack of direct measurements of mucosal inflammation in the upper airways. To determine the pathophysiologic mechanism by analyzing the expression of a large array of inflammatory cytokines and chemokines in the sinus and adenoid tissues surgically removed from pediatric patients with CRS refractory to medical management. Twenty-eight children 2 to 12 years old diagnosed with CRS with or without asthma and 10 controls were included in this prospective, nonrandomized study. Mucosal expression of 40 inflammatory cytokines was measured with a multiplex assay and was normalized to total tissue protein. Compared with children with CRS and without asthma, children with CRS and asthma had significantly higher sinus levels of tumor necrosis factor-α and adenoid levels of epidermal growth factor, eotaxin, fibroblast growth factor-2, growth-related oncogene, and platelet-derived growth factor-AA. The inflammatory response in the upper airway mucosa of children with asthma and CRS was similar, but more severe, compared with children with CRS without asthma. This observation is consistent with the hypothesis that asthma in these patients is caused or exacerbated by severe upper airway disease and supports the concept that treating sinus disease is paramount in the management of chronic asthma in children using, for the first time, direct measurements of airway inflammation in children. Copyright © 2015 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

The South Georgia and the South Sandwich Islands MPA: protecting a biodiverse oceanic island chain situated in the flow of the antarctic circumpolar current.

PubMed

Trathan, Philip N; Collins, Martin A; Grant, Susie M; Belchier, Mark; Barnes, David K A; Brown, Judith; Staniland, Iain J

2014-01-01

South Georgia and the South Sandwich Islands (SGSSI) are surrounded by oceans that are species-rich, have high levels of biodiversity, important endemism and which also support large aggregations of charismatic upper trophic level species. Spatial management around these islands is complex, particularly in the context of commercial fisheries that exploit some of these living resources. Furthermore, management is especially complicated as local productivity relies fundamentally upon biological production transported from outside the area. The MPA uses practical management boundaries, allowing access for the current legal fisheries for Patagonian toothfish, mackerel icefish and Antarctic krill. Management measures developed as part of the planning process designated the whole SGSSI Maritime Zone as an IUCN Category VI reserve, within which a number of IUCN Category I reserves were identified. Multiple-use zones and temporal closures were also designated. A key multiple-use principle was to identify whether the ecological impacts of a particular fishery threatened either the pelagic or benthic domain.

Exploring the effectiveness of sustainable water management structures in the Upper Pungwe river basin

NASA Astrophysics Data System (ADS)

Nyikadzino, B.; Chibisa, P.; Makurira, H.

The study endeavoured to assess the effectiveness of stakeholder structures and their participation in sustainable water resources management in the Upper Pungwe river basin shared by Zimbabwe and Mozambique. The study sought to assess the level and effectiveness of stakeholder, gender and the vulnerable groups representation in sustainable water resources management as well as the whole stakeholder participation process. The study employed both qualitative and quantitative methods for data collection and analysis. Sampling data was obtained from 15 stakeholder representatives (councillors) constituting Pungwe Subcatchment Council, 30 water users ranging from small scale to large scale users and professionals in water resources management. Two different questionnaires and three structured interviews were administered during the study. Water permit database, financial reports and other source documents were also analysed. The study established that the sustainability and effectiveness of stakeholder structures and their participation in water resources management is being compromised by lack of stakeholder awareness. Water utilisation is very high in the subcatchment (99%) while women participation is still low (20%). The study therefore recommends the use of quotas for the participation of women in stakeholder structures. Stakeholder structures are encouraged to intensify stakeholder awareness on issues of river protection, efficient water use and pollution control. Further research is recommended to be carried out on the effectiveness of stakeholder structures in combating water pollution and enhancing river protection.

Conservative approach to tardive dyskinesia-induced neck and upper back pain.

PubMed

Reifsnyder, Jeremy W; Tettambel, Melicien A

2013-08-01

The management of schizophrenia typically involves the use of antipsychotics (neuroleptics). Use of such medications, however, can result in tardive dyskinesia, or the involuntary contracture of muscles, and associated symptomatic somatic dysfunction. The authors present a case of a 29-year-old woman who presented to a family medicine clinic for ongoing management of schizophrenia with noticeable tardive dyskinesia and complaints of neck and upper back pain. Conventional management of tardive dyskinesia involves either a change in or reduction of the offending antipsychotic. In the present case, the patient received osteopathic manipulative treatment in addition to conventional care for the management of her neck and upper back pain. Although not curative, osteopathic manipulative treatment can provide palliative relief for patients with tardive dyskinesia.

Dismounted Complex Blast Injury.

PubMed

Andersen, Romney C; Fleming, Mark; Forsberg, Jonathan A; Gordon, Wade T; Nanos, George P; Charlton, Michael T; Ficke, James R

2012-01-01

The severe Dismounted Complex Blast Injury (DCBI) is characterized by high-energy injuries to the bilateral lower extremities (usually proximal transfemoral amputations) and/or upper extremity (usually involving the non-dominant side), in addition to open pelvic injuries, genitourinary, and abdominal trauma. Initial resuscitation and multidisciplinary surgical management appear to be the keys to survival. Definitive treatment follows general principals of open wound management and includes decontamination through aggressive and frequent debridement, hemorrhage control, viable tissue preservation, and appropriate timing of wound closure. These devastating injuries are associated with paradoxically favorable survival rates, but associated injuries and higher amputation levels lead to more difficult reconstructive challenges.

Tuberculosis post-liver transplantation: a rare but complicated disease.

PubMed

Lu, W; Wai, C T; Da Costa, M; Tambyah, P A; Prabhakaran, K; Lee, K H

2005-03-01

Tuberculosis is a rare but serious complication after transplantation. We report a case and discuss its presentation and management. A 60-year-old Indonesian male presented initially with fever, acute confusion and rapidly progressive right upper lobe pneumonia 3.5 months post-liver transplant, and was diagnosed with pulmonary tuberculosis by positive sputum smear for acid-fast bacilli and tuberculosis culture. Standard anti-tuberculosis therapy was administered but was complicated by interaction with cyclosporine and drug-induced cholestasis. A high level of suspicion, prompt antituberculosis treatment and close follow-up are essential in management of post-transplant tuberculosis.

Maturation of enabling technologies for the next generation reignitable cryogenic upper stage

NASA Astrophysics Data System (ADS)

Mueller, Mark

Following the ESA decision in November 2008, a pre-development phase (Phase 1) of a future evolution of the Ariane 5 launcher (named Ariane 5 Midlife Evolution, A5ME) was started under Astrium Prime leadership. This upgraded version of the Ariane 5 launcher is based on an enhanced performance Upper Stage including the cryogenic re-ignitable VINCI engine. Thanks to this reignition capability, this new Upper Stage shall be "versatile" in the sense that it shall fulfil customer needs on a broader spectrum of orbits than the "standard" orbits (i.e. Geosynchronous Transfer Orbits, GTO) typically used for commercial telecommunications satellites. In order to meet the challenges of versatility, new technologies are currently being investigated. These technologies are mainly related -but not limited-to propellant management during the extended coasting phases with the related heat transfer into the tanks and the required multiple engine re-ignitions. Within the frame of the ESA Future Launchers Preparatory Programme (Period 2 Slice 1), the Cryogenic Upper Stage Technology project (CUST) aims to mature critical technologies to such a Technology Readiness Level (TRL) that they can be integrated into the baseline A5ME Upper Stage development schedule. In addition to A5ME application, these technologies can also be used on the future next generation European launcher. This paper shows the down-selection process implemented to identify the most crucial enabling technologies for a future versatile Upper Stage and gives a description of each technology finally selected for maturation in the frame of CUST. These include -amongst others-a Sandwich Common Bulkhead for the propellant tank, an external thermal insulation kit and various propellant management devices for the coasting phase. The paper also gives an overview on the related development and maturation plan including the tests to be conducted, as well as first results of the maturation activities themselves.

Energy-Water Nexus: Balancing the Tradeoffs between Two-Level Decision Makers

DOE PAGES

Zhang, Xiaodong; Vesselinov, Velimir Valentinov

2016-09-03

Energy-water nexus has substantially increased importance in the recent years. Synergistic approaches based on systems-analysis and mathematical models are critical for helping decision makers better understand the interrelationships and tradeoffs between energy and water. In energywater nexus management, various decision makers with different goals and preferences, which are often conflicting, are involved. These decision makers may have different controlling power over the management objectives and the decisions. They make decisions sequentially from the upper level to the lower level, challenging decision making in energy-water nexus. In order to address such planning issues, a bi-level decision model is developed, which improvesmore » upon the existing studies by integration of bi-level programming into energy-water nexus management. The developed model represents a methodological contribution to the challenge of sequential decisionmaking in energy-water nexus through provision of an integrated modeling framework/tool. An interactive fuzzy optimization methodology is introduced to seek a satisfactory solution to meet the overall satisfaction of the two-level decision makers. The tradeoffs between the two-level decision makers in energy-water nexus management are effectively addressed and quantified. Application of the proposed model to a synthetic example problem has demonstrated its applicability in practical energy-water nexus management. Optimal solutions for electricity generation, fuel supply, water supply including groundwater, surface water and recycled water, capacity expansion of the power plants, and GHG emission control are generated. In conclusion, these analyses are capable of helping decision makers or stakeholders adjust their tolerances to make informed decisions to achieve the overall satisfaction of energy-water nexus management where bi-level sequential decision making process is involved.« less

Energy-Water Nexus: Balancing the Tradeoffs between Two-Level Decision Makers

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

Zhang, Xiaodong; Vesselinov, Velimir Valentinov

Energy-water nexus has substantially increased importance in the recent years. Synergistic approaches based on systems-analysis and mathematical models are critical for helping decision makers better understand the interrelationships and tradeoffs between energy and water. In energywater nexus management, various decision makers with different goals and preferences, which are often conflicting, are involved. These decision makers may have different controlling power over the management objectives and the decisions. They make decisions sequentially from the upper level to the lower level, challenging decision making in energy-water nexus. In order to address such planning issues, a bi-level decision model is developed, which improvesmore » upon the existing studies by integration of bi-level programming into energy-water nexus management. The developed model represents a methodological contribution to the challenge of sequential decisionmaking in energy-water nexus through provision of an integrated modeling framework/tool. An interactive fuzzy optimization methodology is introduced to seek a satisfactory solution to meet the overall satisfaction of the two-level decision makers. The tradeoffs between the two-level decision makers in energy-water nexus management are effectively addressed and quantified. Application of the proposed model to a synthetic example problem has demonstrated its applicability in practical energy-water nexus management. Optimal solutions for electricity generation, fuel supply, water supply including groundwater, surface water and recycled water, capacity expansion of the power plants, and GHG emission control are generated. In conclusion, these analyses are capable of helping decision makers or stakeholders adjust their tolerances to make informed decisions to achieve the overall satisfaction of energy-water nexus management where bi-level sequential decision making process is involved.« less

H-GRASP: the feasibility of an upper limb home exercise program monitored by phone for individuals post stroke

PubMed Central

Simpson, Lisa A.; Eng, Janice J.; Chan, May

2017-01-01

Abstract Purpose: To investigate the feasibility of a phone-monitored home exercise program for the upper limb following stroke. Methods: A pre-post double baseline repeated measures design was used. Participants completed an 8-week home exercise program that included behavioural strategies to promote greater use of the affected upper limb. Participants were monitored weekly by therapists over the phone. The following feasibility outcomes were collected: Process (e.g. recruitment rate); Resources (e.g. exercise adherence rate); Management (e.g. therapist monitoring) and Scientific (e.g. safety, effect sizes). Clinical outcomes included: The Chedoke Arm and Hand Inventory, Motor Activity Log, grip strength and the Canadian Occupational Performance Measure. Results: Eight individuals with stroke were recruited and six participants completed the exercise program. All but one of the six participants met the exercise target of 60 minutes/day, 6 days/week. Participants were stable across the baseline period. The following post-treatment effect sizes were observed: CAHAI (0.944, p = 0.046); MALQ (0.789, p = 0.03) grip strength (0.947, p = 0.046); COPM (0.789, p = 0.03). Improvements were maintained at three and six month follow ups. Conclusions: Community dwelling individuals with stroke may benefit from a phone-monitored upper limb home exercise program that includes behavioural strategies that promote transfer of exercise gains into daily upper limb use.Implications for RehabilitationA repetitive, task-oriented home exercise program that utilizes telephone supervision may be an effective method for the treatment of the upper limb following strokeThis program is best suited for individuals with mild to moderate level impairment and experience a sufficient level of challenge from the exercisesAn exercise program that includes behavioural strategies may promote transfer of exercise gains into greater use of the affected upper limb during daily activities PMID:27017890

Dimensions of managerial work in hospital dietetic services.

PubMed

Palacio, J P; Spears, M C; Vaden, A G; Downey, R G

1985-07-01

The objective of this study was to identify underlying dimensions of the managerial work of hospital dietetic services professional staff. A survey instrument was developed on the basis of Mintzberg's role theory of management. Respondents were asked to rate 80 activity statements on the relative importance and time demand of each. Principal component analysis was used to determine whether items could be conceptualized meaningfully by a smaller number of components capable of accounting for interrelationships. Reliabilities and correlations were computed for the resulting managerial factor scores. Six factors were identified from the importance ratings: Upper Management, Interaction with Subordinates, Outside Activities, Quality Assurance, Communication Activities, and Personnel Activities. Similar dimensions were identified from the time-demand ratings. Findings from this analysis suggest that managers in different functional specialties and at various organizational levels tend to vary in their allocation of time and to stress different roles. As a person rises on the administrative ladder of responsibility, concentration on extramural affairs and involvement in planning are greater, and concern with specific operational problems decreases. The importance of conceptual skills was especially evident in upper administrative positions, as was the critical need for intergroup skills.

Effects of sea-level rise and pumpage elimination on saltwater intrusion in the Hilton Head Island area, South Carolina, 2004-2104

USGS Publications Warehouse

Payne, Dorothy F.

2010-01-01

Saltwater intrusion of the Upper Floridan aquifer has been observed in the Hilton Head area, South Carolina since the late 1970s and currently affects freshwater supply. Rising sea level in the Hilton Head Island area may contribute to the occurrence of and affect the rate of saltwater intrusion into the Upper Floridan aquifer by increasing the hydraulic gradient and by inundating an increasing area with saltwater, which may then migrate downward into geologic units that presently contain freshwater. Rising sea level may offset any beneficial results from reductions in groundwater pumpage, and thus needs to be considered in groundwater-management decisions. A variable-density groundwater flow and transport model was modified from a previously existing model to simulate the effects of sea-level rise in the Hilton Head Island area. Specifically, the model was used to (1) simulate trends of saltwater intrusion from predevelopment to the present day (1885-2004) and evaluate the conceptual model, (2) project these trends from the present day into the future based on different potential rates of sea-level change, and (3) evaluate the relative influences of pumpage and sea-level rise on saltwater intrusion. Four scenarios were simulated for 2004-2104: (1) continuation of the estimated sea-level rise rate over the last century, (2) a doubling of the sea-level rise, (3) a cessation of sea-level rise, and (4) continuation of the rate over the last century coupled with an elimination of all pumpage. Results show that, if present-day (year 2004) pumping conditions are maintained, the extent of saltwater in the Upper Floridan aquifer will increase, whether or not sea level continues to rise. Furthermore, if all pumpage is eliminated and sea level continues to rise, the simulated saltwater extent in the Upper Floridan aquifer is reduced. These results indicate that pumpage is a strong driving force for simulated saltwater intrusion, more so than sea-level rise at current rates. However, results must be considered in light of limitations in the model, including, but not limited to uncertainty in field data, the conceptual model, the physical properties and representation of the hydrogeologic framework, and boundary and initial conditions, as well as uncertainty in future conditions, such as the rate of sea-level rise.

Composition of the seed bank in drawdown areas of navigation pool 8 of the upper Mississippi river

USGS Publications Warehouse

Kenow, K.P.; Lyon, J.E.

2009-01-01

In an effort to enhance aquatic plant production and habitat diversity on the Upper Mississippi River (UMR), resource managers considered water level reduction as a management tool to increase the area of emergent and submersed aquatic vegetation by natural seed germination. To quantify the availability of seed, we assessed the potential seed bank of selected areas of Navigation Pool 8 of the UMR from substrate samples collected in spring 2000. We tested these samples for viable seed content under four hydrologic conditions: dry, moist, shallow flooded and submerged. Forty-seven species were identified in the seed bank, including 27 obligate wetland, 10 facultative wetland and 7 upland species. Dominant taxa within the seed bank included Sagittaria spp., Lindernia dubia, Zosterella dubia, Cyperus spp., Eragrostis spp. and Leersia oryzoides. Of the four hydrologic treatments, moist substrates had the greatest species diversity and were the most productive, yielding an average density of 1420 seedlings m-2. Emergent and submersed aquatic species were widely distributed, each type occurring in more than 90% of the samples. Timing of seedling germination varied among species and has implications for scheduling drawdowns to promote establishment of desired species. Seed bank results were correlated with the vegetation response on substrates exposed during a reduction of water levels of Pool 8 during summer 2001. Experimentally determining the composition and viability of seed banks from drawdown areas provides information useful in predicting the types of vegetation that may develop on exposed substrates. Further, these findings provide resource managers a better understanding of the potential for achieving desired vegetation response through water level reductions.

Oncoplastic Surgery for Upper/Upper Inner Quadrant Breast Cancer.

PubMed

Lin, Joseph; Chen, Dar-Ren; Wang, Yu-Fen; Lai, Hung-Wen

2016-01-01

Tumors located in the upper/upper inner quadrant of the breast warrant more attention. A small lesion relative to the size of breast in this location may be resolved by performing a level I oncoplastic technique. However, a wide excision may significantly reduce the overall quality of the breast shape by distorting the visible breast line. From June 2012 to April 2015, 36 patients with breast cancer located in the upper/upper inner quadrant underwent breast-conservation surgery with matrix rotation mammoplasty. According to the size and location of the tumor relative to the nipple-areola complex, 11 patients underwent matrix rotation with periareolar de-epithelialization (donut group) and the other 25 underwent matrix rotation only (non-donut group). The cosmetic results were self-assessed by questionnaires. The average weights of the excised breast lumps in the donut and non-donut groups were 104.1 and 84.5 g, respectively. During the 3-year follow-up period, local recurrence was observed in one case and was managed with nipple-sparing mastectomy followed by breast reconstruction with prosthetic implants. In total, 31 patients (88.6%) ranked their postoperative result as either acceptable or satisfactory. The treated breasts were also self-evaluated by 27 patients (77.1%) to be nearly identical to or just slightly different from the untreated side. Matrix rotation is an easy breast-preserving technique for treating breast cancer located in the upper/upper inner quadrant of the breast that requires a relatively wide excision. With this technique, a larger breast tumor could be removed without compromising the breast appearance.

Long-term productivity in traditional, organic and low-input management systems of the Upper Midwest

USDA-ARS?s Scientific Manuscript database

Traditional cropping practices in the Upper Midwest are marked by low-diversity and high tillage disturbance. Eight years of production were evaluated to determine potential benefits of adopting low-input and organic management practices on system productivity. Increased crop rotation diversity, red...

Laryngeal Trauma Following an Inhalation Injury: A Review and Case Report.

PubMed

Hogg, Gemma; Goswamy, Jay; Khwaja, Sadie; Khwaja, Nadeem

2017-05-01

The primary concern when managing a patient with inhalation injury is security of the airway. Airflow may be impeded by both edema of the upper airway and reduction of oxygen delivery to the lower respiratory tract. Although there has been much discussion regarding management of the latter, the focus of this article is the management of the former. This review aimed to determine the optimum management in burn victims with upper airway inhalation injury as an attempt to prevent laryngeal trauma leading to long-term voice disorders and upper airway dyspnea. We describe the case of a 57-year-old woman with significant inhalation injury and discuss the natural progression of her injuries and the laryngeal controversies surrounding her care. We conclude with advice on the optimal management of this condition based on our experience, combined with current best evidence. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

Determination of loblolly pine response to cultural treatments based on soil class, base productivity, and competition level

Treesearch

David Garrett; Michael Kane; Daniel Markewitz; Dehai Zhao

2015-01-01

The objective of this research is to better understand what factors drive loblolly pine (Pinus taeda L.) growth response to intensive culture in the University of Georgia Plantation Management Research Cooperative’s Culture x Density study in the Piedmont and Upper Coastal Plain. Twenty study sites were established ranging from southern Alabama to South Carolina in...

Report of the LSPI/NASA Workshop on Lunar Base Methodology Development

NASA Technical Reports Server (NTRS)

Nozette, Stewart; Roberts, Barney

1985-01-01

Groundwork was laid for computer models which will assist in the design of a manned lunar base. The models, herein described, will provide the following functions for the successful conclusion of that task: strategic planning; sensitivity analyses; impact analyses; and documentation. Topics addressed include: upper level model description; interrelationship matrix; user community; model features; model descriptions; system implementation; model management; and plans for future action.

Management of non variceal upper gastrointestinal bleeding: position statement of the Catalan Society of Gastroenterology.

PubMed

García-Iglesias, Pilar; Botargues, Josep-Maria; Feu Caballé, Faust; Villanueva Sánchez, Càndid; Calvet Calvo, Xavier; Brullet Benedi, Enric; Cánovas Moreno, Gabriel; Fort Martorell, Esther; Gallach Montero, Marta; Gené Tous, Emili; Hidalgo Rosas, José-Manuel; Lago Macía, Amelia; Nieto Rodríguez, Ana; Papo Berger, Michel; Planella de Rubinat, Montserrat; Saló Rich, Joan; Campo Fernández de Los Ríos, Rafel

2017-05-01

In recent years there have been advances in the management of non-variceal upper gastrointestinal bleeding that have helped reduce rebleeding and mortality. This document positioning of the Catalan Society of Digestologia is an update of evidence-based recommendations on management of gastrointestinal bleeding peptic ulcer. Copyright © 2016 Elsevier España, S.L.U., AEEH y AEG. All rights reserved.

Environmental management requirements/defensible costs project. Final report

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

NONE

1996-02-01

Lockheed Idaho Technologies Company (LITCO) used a systems engineering approach to develop the first formal requirements baseline for Idaho National Engineering Laboratory (INEL) Environmental Management (EM) Programs. The recently signed Settlement Agreement with the State of Idaho (Batt Agreement), along with dramatically reduced EM funding targets from Department of Energy (DOE) headquarters, drove the immediacy of this effort. Programs have linked top-level requirements to work scope to cost estimates. All EM work, grouped by decision units, was scrubbed by INEL EM programs and by an independent {open_quotes}Murder Board.{close_quotes} Direct participation of upper level management from LITCO and the DOE-Idaho Operationsmore » Office ensured best information and decisions. The result is a scrubbed down, defensible budget tied to top-level requirements for use in the upcoming DOE-Headquarters` budget workout, the Internal Review Board, the FY98 Activity Data Sheets submittal, and preparation of the FY97 control accounts and out-year plans. In addition to the remarkable accomplishments during the past eight weeks, major issues were identified and documented and follow-on tasks are underway which will lead to further improvements in INEL EM program management.« less

Description and interpretation of geologic materials from shotholes drilled for the Trans-Alaska Crustal Transect project, Copper River basin, Alaska, May 1985

USGS Publications Warehouse

Odum, J.K.; Yehle, L.A.; Schmoll, H.R.; Gilbert, Chuck

1986-01-01

This map shows the potentiometric surface of the Upper Floridan aquifer in the St. Johns River Water Management District and vicinity, Florida, for May 1986. The Upper Floridan aquifer is the principal source of potable water in the area. Water level measurements were made on approximately 1,000 wells and on several springs. The potentiometric surface is shown mostly by 5-foot contour intervals. In the Fernandina Beach area of Nassau County, a 30-ft. interval is used to show a deep cone of depression. The potentiometric surface ranged from 125 feet above sea level in Polk County to 75 feet below sea level in Nassau County. Water levels in most key wells ranged from 1 to 9 feet below the May average in response to the lack of recharge from rainfall and an attendant increase in pumpage. Many levels in the district were equal to or lower than the below average levels of May 1985. Declines of about a foot from May 1985 levels were common in the eastern half of the district. However, the largest declines from May 1985 levels, as much as 7 to 9 feet, were mostly in well fields along the coastline. Levels in many wells approached, and in a few wells exceeded, record lows. (USGS)

Observations Of General Learning Patterns In An Upper-Level Thermal Physics Course

NASA Astrophysics Data System (ADS)

Meltzer, David E.

2009-11-01

I discuss some observations from using interactive-engagement instructional methods in an upper-level thermal physics course over a two-year period. From the standpoint of the subject matter knowledge of the upper-level students, there was a striking persistence of common learning difficulties previously observed in students enrolled in the introductory course, accompanied, however, by some notable contrasts between the groups. More broadly, I comment on comparisons and contrasts regarding general pedagogical issues among different student sub-populations, for example: differences in the receptivity of lower- and upper-level students to diagrammatic representations; varying receptivity to tutorial-style instructional approach within the upper-level population; and contrasting approaches to learning among physics and engineering sub-populations in the upper-level course with regard to use of symbolic notation, mathematical equations, and readiness to employ verbal explanations.

System and method for inventorying multiple remote objects

DOEpatents

Carrender, Curtis L.; Gilbert, Ronald W.

2007-10-23

A system and method of inventorying multiple objects utilizing a multi-level or a chained radio frequency identification system. The system includes a master tag and a plurality of upper level tags and lower level tags associated with respective objects. The upper and lower level tags communicate with each other and the master tag so that reading of the master tag reveals the presence and absence of upper and lower level tags. In the chained RF system, the upper and lower level tags communicate locally with each other in a manner so that more remote tags that are out of range of some of the upper and lower level tags have their information relayed through adjacent tags to the master tag and thence to a controller.

System and method for inventorying multiple remote objects

DOEpatents

Carrender, Curtis L [Morgan Hill, CA; Gilbert, Ronald W [Morgan Hill, CA

2009-12-29

A system and method of inventorying multiple objects utilizing a multi-level or a chained radio frequency identification system. The system includes a master tag and a plurality of upper level tags and lower level tags associated with respective objects. The upper and lower level tags communicate with each other and the master tag so that reading of the master tag reveals the presence and absence of upper and lower level tags. In the chained RF system, the upper and lower level tags communicate locally with each other in a manner so that more remote tags that are out of range of some of the upper and lower level tags have their information relayed through adjacent tags to the master tag and thence to a controller.

[Conservative management of upper tract urinary fistulae using ureteral trans-vesico-parietal stent].

PubMed

Le Guilchet, T; Audenet, F; Hurel, S; Beaugerie, A; Fontaine, E; Terrier, N; Timsit, M O; Mejean, A

2016-03-01

Ureteral stents and ureteral catheters externalized through the urethra are not ideal solutions to manage complicated upper urinary tract fistulae. We sought an effective method of drainage, minimally invasive, reproducible allowing a rapid patient's discharge. Between November 2013 and February 2015, an ureteral stent was exteriorized in trans-vesico-parietal by an endoscopic and percutaneous access in patients with complicated upper urinary tract fistulae. Monitoring of tolerance, complications and urinary fistula healing was performed. Nine consecutive patients had an ureteral stent exteriorized in trans-vesico-parietal to manage complicated upper urinary tract fistulae. There was no failure in introducing the catheter, or postoperative complication. Catheters were left in place on average 36.1days (24-55). The patients were able to return home with the catheter in place in 77.8% of cases. The tolerance of the catheter was good. All fistulae were able to be treated conservatively at the end of the drainage period. Trans-vesico-parietal ureteral catheters enable efficient and reproducible conservative treatment of upper tract urinary fistulae regardless of their cause. 5. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Management of complex regional pain syndrome type I in upper extremity-evaluation of continuous stellate ganglion block and continuous infraclavicular brachial plexus block: a pilot study.

PubMed

Toshniwal, Gokul; Sunder, Rani; Thomas, Ronald; Dureja, G P

2012-01-01

Interventional pain management techniques play an important role in the multidisciplinary approach to management of complex regional pain syndrome (CRPS). In this preliminary study we compared the efficacy of continuous stellate ganglion (CSG) block with that of continuous infraclavicular brachial plexus (CIBP) block in management of CRPS type I of upper extremity. Thirty-three patients with CRPS type I of upper extremity were randomly assigned to either CSG or CIBP group. Patients were treated for 1 week with continuous infusion of 0.125% bupivacaine at 2and 5mL/h, respectively. Catheter was removed at 1 week and patients were followed up for 4 weeks. The outcome was evaluated in terms of neuropathic pain scale score (NPSS), edema scores (Grades 0-2), and range of motion (ROM) of all upper extremity joints (Grades 0-2). CIBP group showed statistically significant improvement in NPSS compared with CSG group during the first 12 hours after the procedures (P value <0.05). After 12 hours, the NPSS was comparable between the groups. At 4 weeks, both groups showed clinically significant improvement in edema score and ROM of all upper extremity joints when compared with the baseline. This preliminary study suggests that CIBP block and CSG block may be feasible and effective interventional techniques for the management of CRPS type I of upper extremities. Hence, we recommend a larger well-randomized, well-controlled, clinical trial to confirm our findings and determine if any significant difference exists between the groups in terms of long-term pain relief and functional restoration. Wiley Periodicals, Inc.

Infectious mononucleosis presenting as upper airway obstruction.

PubMed

Jain, Vivek; Singhi, Sunit; Desai, Ravi V

2003-01-01

Upper airway obstruction though a common complication of infectious mononucleosis is rarely considered in differential diagnosis of stridor. We report a three-year-old child who had upper airway obstruction due to infectious mononucleosis, managed conservatively with oxygen, intravenous fluids and steroids.

Assessing the dynamics of the upper soil layer relative to soil management practices

USDA-ARS?s Scientific Manuscript database

The upper layer of the soil is the critical interface between the soil and the atmosphere and is the most dynamic in response to management practices. One of the soil properties is the stability of the aggregates because this property controls infiltration of water and exchange of gases. An aggregat...

A pilot application of regional scale risk assessment to the forestry management of the upper Grand Ronde watershed, Oregon

Treesearch

Suzanne M. Anderson; Wayne G. Landis

2012-01-01

An issue in forestry management has been the integration of a variety of different information into a threat analysis or risk assessment. In this instance, regional scale risk assessment was applied to the Upper Grande Ronde watershed in eastern Oregon to examine the potential of risk assessment for use in the management of broad landscapes. The site was a focus of...

Grey fuzzy optimization model for water quality management of a river system

NASA Astrophysics Data System (ADS)

Karmakar, Subhankar; Mujumdar, P. P.

2006-07-01

A grey fuzzy optimization model is developed for water quality management of river system to address uncertainty involved in fixing the membership functions for different goals of Pollution Control Agency (PCA) and dischargers. The present model, Grey Fuzzy Waste Load Allocation Model (GFWLAM), has the capability to incorporate the conflicting goals of PCA and dischargers in a deterministic framework. The imprecision associated with specifying the water quality criteria and fractional removal levels are modeled in a fuzzy mathematical framework. To address the imprecision in fixing the lower and upper bounds of membership functions, the membership functions themselves are treated as fuzzy in the model and the membership parameters are expressed as interval grey numbers, a closed and bounded interval with known lower and upper bounds but unknown distribution information. The model provides flexibility for PCA and dischargers to specify their aspirations independently, as the membership parameters for different membership functions, specified for different imprecise goals are interval grey numbers in place of a deterministic real number. In the final solution optimal fractional removal levels of the pollutants are obtained in the form of interval grey numbers. This enhances the flexibility and applicability in decision-making, as the decision-maker gets a range of optimal solutions for fixing the final decision scheme considering technical and economic feasibility of the pollutant treatment levels. Application of the GFWLAM is illustrated with case study of the Tunga-Bhadra river system in India.

Potentiometric surface of the Upper Floridan aquifer, west-central Florida, May 2005

USGS Publications Warehouse

Ortiz, A.G.; Blanchard, R.A.

2006-01-01

The Floridan aquifer system consists of the Upper and Lower Floridan aquifers separated by the middle confining unit. The middle confining unit and the Lower Floridan aquifer in west-central Florida generally contain highly mineralized water. The water-bearing units containing freshwater are herein referred to as the Upper Floridan aquifer. The Upper Floridan aquifer is a highly productive aquifer and supplies more than 10 times the amount of water pumped from either the surficial aquifer system or the intermediate aquifer system in most of the study area (Duerr and others, 1988). This map report shows the potentiometric surface of the Upper Floridan aquifer measured in May 2005. The potentiometric surface is an imaginary surface connecting points of equal altitude to which water will rise in a tightly cased well that taps a confined aquifer system (Lohman, 1979). This map represents water-level conditions near the end of the dry season, when ground-water levels usually are at an annual low and withdrawals for agricultural use typically are high. The cumulative average rainfall of 67.27 inches for west-central Florida (from June 2004 through May 2005) was 14.20 inches above the historical cumulative average of 53.07 inches (Southwest Florida Water Management District (SWFWMD), 2005). The above average precipitation is attributed to the active hurrican season for Florida in 2004. Historical cumulative averages are calculated from regional rainfall summary reports (1915 to the most recent completed calendar year) and are updated monthly by the SWFWMD. This report, prepared by the U.S. Geological Survey (USGS) in cooperation with the SWFWMD, is part of a semiannual series of Upper Floridan aquifer potentiometric-surface map reports for west-central Florida. Potentiometric-surface maps have been prepared for January 1964, May 1969, May 1971, May 1973, May 1974, and for each May and September since 1975. Water-level data are collected in May and September each year to show the approximate annual low and high water-level conditions, respectively. Most of the water-level data for this map were collected by the USGS during May 23-27, 2005. Supplemental water-level data were collected by other agencies and companies. A corresponding potentiometric-surface map was prepared for areas east and north of the SWFWMD boundary by the USGS office in Altamonte Springs, Florida (Kinnaman, 2006). Most water-level measurements were made during a 5-day period; therefore, measurements do not represent a 'snapshot' of conditions at a specific time, nor do they necessarily coincide with the seasonal low water-level condition. Water levels in about 19 percent of the wells measured in May 2005 were lower than the May 2004 water levels (Blanchard and others, 2004). Data from 409 wells indicate that the May 2005 water levels ranged from about 5 feet below to about 18 feet above the May 2004 water levels (fig. 1). The largest water-level declines occurred in southwestern Hernando County, northeastern Hillsborough County, and parts of Hillsborough, Sumter, and Sarasota Counties. The largest water-level rises occurred in southeastern Hillsborough County, eastern Manatee County, and western Hardee County (fig. 1). Water levels in about 95 percent of the wells measured in May 2005 were lower than the September 2004 water levels (Blanchard and Seidenfeld, 2005). Data from 405 wells indicate that the May 2005 water levels ranged from about 22 feet below to 14 feet above the September 2004 water levels. The largest water-level decline was in east-central Manatee County and the largest water-level rise was in central Sarasota County.

On the Roles of Upper- versus Lower-level Thermal Forcing in Shifting the Eddy-Driven Jet

NASA Astrophysics Data System (ADS)

Zhang, Y.; Nie, Y.; Chen, G.; Yang, X. Q.

2017-12-01

One most drastic atmospheric change in the global warming scenario is the increase in temperature over tropical upper-troposphere and polar surface. The strong warming over those two area alters the spacial distributions of the baroclinicity in the upper-troposphere of subtropics and in the lower-level of subpolar region, with competing effects on the mid-latitude atmospheric circulation. The final destination of the eddy-driven jet in future climate could be "a tug of war" between the impacts of such upper- versus lower-level thermal forcing. In this study, the roles of upper- versus lower-level thermal forcing in shifting the eddy-driven jet are investigated using a nonlinear multi-level quasi-geostrophic channel model. All of our sensitivity experiments show that the latitudinal position of the eddy-driven jet is more sensitive to the upper-level thermal forcing. Such upper-level dominance over the lower-level forcing can be attributed to the different mechanisms through which eddy-driven jet responses to them. The upper-level thermal forcing induces a jet shift mainly by affecting the baroclinic generation of eddies, which supports the latitudinal shift of the eddy momentum flux convergence. The jet response to the lower-level thermal forcing, however, is strongly "eddy dissipation control". The lower-level forcing, by changing the baroclinicity in the lower troposphere, induces a direct thermal zonal wind response in the upper level thus modifies the nonlinear wave breaking and the resultant irreversible eddy mixing, which amplifies the latitudinal shift of the eddy-driven jet. Whether the eddy response is "generation control" or "dissipation control" may strongly depend on the eddy behavior in its baroclinic processes. Only the anomalous eddy generation that penetrates into the upper troposphere can have a striking impact on the eddy momentum flux, which pushes the jet shift more efficiently and dominates the eddy response.

Upper limb injury in rugby union football: results of a cohort study.

PubMed

Usman, Juliana; McIntosh, Andrew Stuart

2013-04-01

There have been few in-depth studies of upper limb injury epidemiology in rugby union football, despite reports that they accounted for between 14% and 28% of all rugby injuries. To report on upper limb injury incidence, injury severity and to identify the risk factors associated with upper limb injuries, for example, level of play, season (years) and playing position. Prospective cohort study across five rugby seasons from 2004 to 2008. Formal rugby competitions-suburban, provincial and international. 1475 adult male rugby players in Colts, Grade and Elite competitions. An upper limb injury resulting in a missed game and its characteristics. A total of 61 598 athletic exposures (AE) and 606 upper limb injuries were recorded. About 66% of the injuries were to the shoulder. The overall upper limb injury incidence rate (IIR) was 9.84 injuries/1000 AE (95% CI 9.06 to 10.62). Statistically significant associations were found between upper limb injuries and level of play; and between shoulder injuries and playing position (p<0.05). No association was found between upper limb and shoulder injuries and study year. The overall upper limb IIR decreased as the level of play increased; 10.74 upper limb injuries/1000 AE (95% CI 9.93 to 11.56) in Colts to 6.07 upper limb injuries/1000 AE (95% CI 5.46 to 6.69) in Elite. The upper limb IIR decreased as the level of play increased indicating that age, level of skill and playing experience may be risk factors for upper limb injury.

Upper aerodigestive tract burn: a case report of firework injury.

PubMed

Kerekhanjanarong, V; Supiyaphun, P; Saengpanich, S

2001-02-01

The case of a 46 year-old German man with upper aerodigestive burn by firework was reported. He presented with the symptoms and signs of upper airway obstruction. Tracheostomy was done and direct laryngoscopy with microscopic examination revealed swelling and denudation of the mucosa of the oral cavity and supraglottic area. Intravenous steroids and antibiotics were administrated for treatment. It is suggested that proper management needs an understanding of the mechanism and effect of the corrosive agent. Careful airway management resulted in a good outcome in this patient.

Assessing the value and pest management window provided by neonicotinoid seed treatments for management of soybean aphid (Aphis glycines Matsumura) in the Upper Midwestern United States.

PubMed

Krupke, Christian H; Alford, Adam M; Cullen, Eileen M; Hodgson, Erin W; Knodel, Janet J; McCornack, Brian; Potter, Bruce D; Spigler, Madeline I; Tilmon, Kelley; Welch, Kelton

2017-10-01

A 2-year, multi-state study was conducted to assess the benefits of using soybean seed treated with the neonicotinoid thiamethoxam to manage soybean aphid in the upper Midwestern USA and compare this approach with an integrated pest management (IPM) approach that included monitoring soybean aphids and treating with foliar-applied insecticide only when the economic threshold was reached. Concentrations of thiamethoxam in soybean foliage were also quantified throughout the growing season to estimate the pest management window afforded by insecticidal seed treatments. Both the IPM treatment and thiamethoxam-treated seed resulted in significant reductions in cumulative aphid days when soybean aphid populations reached threshold levels. However, only the IPM treatment resulted in significant yield increases. Analysis of soybean foliage from thiamethoxam-treated seeds indicated that tissue concentrations of thiamethoxam were statistically similar to plants grown from untreated seeds beginning at the V2 growth stage, indicating that the period of pest suppression for soybean aphid is likely to be relatively short. These data demonstrate that an IPM approach, combining scouting and foliar-applied insecticide where necessary, remains the best option for treatment of soybean aphids, both in terms of protecting the yield potential of the crop and of break-even probability for producers. Furthermore, we found that thiamethoxam concentrations in foliage are unlikely to effectively manage soybean aphids for most of the pests' activity period across the region. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

Job stress and mental well-being: similarities and differences among American, Japanese, and Indian managers.

PubMed

DeFrank, R S; Ivancevich, J M; Schweiger, D M

1988-01-01

The sources and mediators of occupational stress have been assessed frequently but rarely from a cross-cultural perspective. The present study examined responses to a number of stress, social support, job satisfaction, and personal characteristics measures and their relationships to mental well-being among samples of lower-, middle-, and upper-level managers in the United States, Japan, and India. These data suggested basic similarities between 178 U.S. and 306 Indian managers; the 222 Japanese managers tended to report more negative reactions than the other two groups. Variability among these groups was seen, however, in the relative weights given to the factors of the mental well-being measure and in the association of these factors with the various independent variables. Implications and shortcomings of these results are discussed, along with suggestions for future research priorities.

A survey of major east coast snowstorms, 1960-1983. Part 2. Summary of surface and upperlevel characteristics

NASA Technical Reports Server (NTRS)

Kocin, P. J.; Uccellini, L. W.

1985-01-01

Surface and upper-level characteristics of selected meteorological fields are summarized. Two major types of sea level development are described and applied to the cases at hand, with a few storm systems showing characteristics of both types. Aspects such as rapid sea level deepening, coastal frontogenesis, cold air damming, low level jet formation, the development of an S-shaped isotherm pattern, diffluence downwind of a negatively tilted upper level trough axis, upper level confluence and an increase of geopotential heights at the base of the upper level trough characterized the pre-cyclogenetic and cyclogenetic periods of many of the storm systems. Large variability was also observed, especially with regard to the spatial dimensions of the surface and upper level systems, as well as variations in trough/ridge amplification and the evolution of upper level jet streak systems. The influence of transverse circulations associated with a confluent jet streak entrance region and the diffluent exit region of a jet streak/trough system on the production of snowfall is also discussed.

Does the advantage of the upper part of words occur at the lexical level?

PubMed

Perea, Manuel; Comesaña, Montserrat; Soares, Ana P

2012-11-01

Several recent studies have shown that the upper part of words is more important than the lower part in visual word recognition. Here, we examine whether or not this advantage arises at the lexical or at the letter (letter feature) level. To examine this issue, we conducted two lexical decision experiments in which words/pseudowords were preceded by a very brief (50-ms) presentation of their upper or lower parts (e.g., ). If the advantage for the upper part of words arises at the letter (letter feature) level, the effect should occur for both words and pseudowords. Results revealed an advantage for the upper part of words, but not for pseudowords. This suggests that the advantage for the upper part of words occurs at the lexical level, rather than at the letter (or letter feature) level.

Perceptions of Emergency Medicine Residency and Hand Surgery Fellowship Program Directors in the Appropriate Disposition of Upper Extremity Emergencies.

PubMed

Drolet, Brian C; Lifchez, Scott D; Jacoby, Sidney M; Varone, Andrew; Regan, Linda A; Baren, Jill M; Akelman, Edward; Osterman, A Lee; Levin, L Scott

2015-12-01

To survey emergency medicine (EM) residency and hand surgery fellowship program directors (PDs) to identify consensus in their perceptions of appropriate emergency care of upper extremity emergencies. We created a framework to group common upper extremity emergency diagnoses and surveyed PDs to evaluate the training background--EM, general orthopedic or plastic surgery, or hand fellowship--most appropriate to provide acute, point-of-care management for each of these diagnostic groupings. Responses were pooled and consensus was established with greater than 75% agreement between groups. We received 79 responses from hand fellowship PDs (90% response rate) and 151 responses from EM PDs (49% response rate). We identified consensus for the training background that PDs in both specialties felt was appropriate to care for 17 of 21 diagnostic groupings in the framework. There was a high level of consensus between EM and hand surgery PDs regarding diagnoses that acutely require training in hand surgery versus those that can be managed by an EM physician. Our diagnostic framework may help reduce unnecessary hand surgery consultation and may help to identify patients who do not require more specialized acute care and thus decrease unnecessary transfers. Economic and Decision Analyses IV. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Synthesis of Upper Verde River research and monitoring 1993-2008

Treesearch

Daniel G. Neary; Alvin L. Medina; John N. Rinne

2012-01-01

This volume is a state-of-knowledge synthesis of monitoring and research conducted on the Upper Verde River (UVR) of Arizona. It contains information on the history, hydrology, soils, geomorphology, vegetation, and fish fauna of the area that can help land managers and other scientists in successfully conducting ecosystem management and future monitoring and research...

Reference conditions for old-growth pine forests in the Upper West Gulf Coastal Plain

Treesearch

Don C. Bragg

2002-01-01

Ecosystem restoration has become an important component of forest management. especially on public lands. However, determination of manageable reference conditions has lagged behind the interest. This paper presents a case study from pine-dominated forests in the Upper West Gulf Coastal Plain (UWGCP), with special emphasis on southern Arkansas. Decades of forest...

The principles of management of congenital anomalies of the upper limb.

PubMed

Watson, S

2000-07-01

Management of congenital anomalies of the upper limb is reviewed with reference to classification and aetiology, incidence, diagnosis before birth, broad principles of treatment, timing of x rays and scans, functional aims, cosmetic appearance, counselling of parents, therapists, scars, skin grafts, growth, and timing of surgery. Notes on 11 congenital hand conditions are given.

A unified framework for managing provenance information in translational research

PubMed Central

2011-01-01

Background A critical aspect of the NIH Translational Research roadmap, which seeks to accelerate the delivery of "bench-side" discoveries to patient's "bedside," is the management of the provenance metadata that keeps track of the origin and history of data resources as they traverse the path from the bench to the bedside and back. A comprehensive provenance framework is essential for researchers to verify the quality of data, reproduce scientific results published in peer-reviewed literature, validate scientific process, and associate trust value with data and results. Traditional approaches to provenance management have focused on only partial sections of the translational research life cycle and they do not incorporate "domain semantics", which is essential to support domain-specific querying and analysis by scientists. Results We identify a common set of challenges in managing provenance information across the pre-publication and post-publication phases of data in the translational research lifecycle. We define the semantic provenance framework (SPF), underpinned by the Provenir upper-level provenance ontology, to address these challenges in the four stages of provenance metadata: (a) Provenance collection - during data generation (b) Provenance representation - to support interoperability, reasoning, and incorporate domain semantics (c) Provenance storage and propagation - to allow efficient storage and seamless propagation of provenance as the data is transferred across applications (d) Provenance query - to support queries with increasing complexity over large data size and also support knowledge discovery applications We apply the SPF to two exemplar translational research projects, namely the Semantic Problem Solving Environment for Trypanosoma cruzi (T.cruzi SPSE) and the Biomedical Knowledge Repository (BKR) project, to demonstrate its effectiveness. Conclusions The SPF provides a unified framework to effectively manage provenance of translational research data during pre and post-publication phases. This framework is underpinned by an upper-level provenance ontology called Provenir that is extended to create domain-specific provenance ontologies to facilitate provenance interoperability, seamless propagation of provenance, automated querying, and analysis. PMID:22126369

Sedimentation rates in the marshes of Sand Lake National Wildlife Refuge

USGS Publications Warehouse

Gleason, R.A.; Euliss, N.H.; Holmes, C.W.

2003-01-01

Impoundments located within river systems in the Northern Great Plains are vulnerable to sediment inputs because intensive agriculture in watersheds has increased soil erosion and sediments in rivers. At the request of the U.S. Fish and Wildlife Service (FWS), we evaluated the vertical accretion of sediment in the Mud Lake impoundment of Sand Lake National Wildlife Refuge (NWR), Brown County, South Dakota. The Mud Lake impoundment was created in 1936 by constructing a low-head dam across the James River. We collected sediment cores from the Mud Lake impoundment during August 2000 for determination of vertical accretion rates. Accretion rates were estimated using cesium-13 7 and lead-210 isotopic dating techniques to estimate sediment accretion over the past 100 years. Accretion rates were greatest near the dam (1.3 cm yr-1) with less accretion (0.2 cm yr-1) occurring in the upper reaches of Mud Lake. As expected, accretion was highest near the dam where water velocities and greater water depth facilitates sediment deposition. Higher rates of sedimentation (accretion> 2.0 cm year-1) occurred during the 1990s when river flows were especially high. Since 1959, sediment accretion has reduced maximum pool depth of Mud Lake near the dam by 55 cm. Assuming that sediment accretion rates remain the same in the future, we project Mud Lake will have a maximum pool depth of 77 and 51 cm by 2020 and 2040, respectively. Over this same time frame, water depths in the upper reaches of Mud Lake would be reduced to< 2 cm. Projected future loss of water depth will severely limit the ability of managers to manipulate pool levels in Mud Lake to cycle vegetation and create interspersion of cover and water to meet current wildlife habitat management objectives. As predicted for major dams constructed on rivers throughout the world, Mud Lake will have a finite life span. Our data suggests that the functional life span of Mud Lake since construction will be < 100 years. We anticipate that over the next 20 years, sediments entering Mud Lake will reduce water depths to the point that current wildlife management objectives cannot be achieved through customary water-level manipulations. Sedimentation impacts are not unique to the Sand Lake NWR. It is widely accepted that impoundments trap sediments and shallow impoundments, such as those managed by the FWS, are especially vulnerable. Given the ecological impacts associated with loss of water depths, we recommend that managers begin evaluating the long-term wildlife management goals for the refuge relative to associated costs and feasibility of options available to enhance and maximize the life span of existing impoundments, including upper watershed management.

The use of parenteral nutrition for the management of PKU patient undergoing chemotherapy for lymphoma: a case report.

PubMed

Salvarinova-Zivkovic, R; Hartnett, C; Sinclair, G; Dix, D; Horvath, G; Lillquist, Y; Stockler-Ipsiroglu, S

2012-04-01

The metabolic control of phenylalanine levels is a challenge during illness. We present the metabolic management of a 6 year old boy with classical PKU who was diagnosed with stage III intraabdominal Burkit's lymphoma and underwent surgical resection and chemotherapy. The metabolic control during chemotherapy was achieved by the use of parenteral custom made amino acid solution and pro-active adjustment of intake. From the 94 obtained plasma phenylalanine (Phe) levels, 18.4% were above our clinic's recommended upper limit (360 μmol/L, 6 mg/dL) while 52.7% of Phe levels were below the recommended lower limit (120 μmol/L, 2 mg/dL). Phe levels above recommended range were associated with low caloric/protein intake, while levels below recommended range reflected the difficulty in achieving the full prescribed Phe intake. We recommend early institution of custom made amino acid solution with maximum amino acid content and caloric intake to provide optimal phenylalanine control. Administration of phenylalanine via regular intravenous amino acid solution may assist in avoiding low Phe levels when prescribed intake is compromised due to vomiting and other disease related illnesses. Use of custom made, phenylalanine free amino acid solution proved beneficial in the management of blood phenylalanine levels in a PKU patient during chemotherapy for Burkitt lymphoma. Copyright © 2012 Elsevier Inc. All rights reserved.

Organizational Leaders’ and Staff Members’ Appraisals of Their Work Environment Within a Children’s Social Service System

PubMed Central

Patterson, David A.; Dulmus, Catherine; Maguin, Eugene; Keesler, John; Powell, Byron

2014-01-01

Several studies have demonstrated the effect of an organization’s culture and climate on the delivery of services to clients and the success of clinical outcomes. Workers’ perceptions are integral components of organizational social context, and in order to create a positive organizational culture and climate, managers and frontline staff need to have a shared understanding of the social context. The existing literature does not adequately address that discrepancies in perceptions of culture and climate between frontline staff and managers impact the implementation of policies and services. The purpose of this study is to compare the workgroup-level culture and climate of a single, large child and family social services organization, based on the reported experiences of front-line workers and senior managers. The results showed that, as a group, senior managers rated the organization as having a culture that was much more proficient and much less rigid and a climate that was more engaged and more functional than the average frontline workgroup. The discrepancies between the perceptions of upper management and workgroup-level staff indicate the need for interventions that can improve communication and cohesiveness between these two groups. PMID:25101308

A dynamic traction splint for the management of extrinsic tendon tightness.

PubMed

Dovelle, S; Heeter, P K; Phillips, P D

1987-02-01

The dynamic traction splint designed by therapists at Walter Reed Army Medical Center is used for the management of extrinsic extensor tendon tightness commonly seen in brachial plexus injuries and traumatic soft tissue injuries of the upper extremity. The two components of the splint allow for simultaneous maximum flexion of the MCP and IP joints. This simple and economical splint provides an additional modality to any occupational therapy service involved in the management of upper extremity disorders.

Inventory and management of trespass recreation use at Upper Delaware and Scenic and Recreational River

USGS Publications Warehouse

Marion, J.L.; More, Thomas A.; Donnelly, Maureen P.; Graefe, Alan R.; Vaske, Jerry J.

1989-01-01

Recreational trespass on private lands within the Upper Delaware Scenic and Recreational River, located along the eastern border between Pennsylvania and New York, prompted this survey of recreational trespass sites. The National Park Service has been mandated to manage river recreational use within its boundaries but land ownership shall remain predominantly private. This survey was conducted to document the number and distribution of river recreation trespass sites and to recommend appropriate management actions to minimize trespass use.

Reproduction on cut-over swamplands in the Upper Peninsula of Michigan

Treesearch

Z.A. Zasada

1952-01-01

The 1 ¼ million acres of coniferous swamp forest in the Upper Peninsula of Michigan are important to industry, game management and water conservation. Because there was little knowledge on handling this type, foresters in 1950 began a program of research in swamp forest management. The first project was a survey of recent swamp cuttings. The survey shows that...

Forage yield and nutritive value of turf bermudagrasses managed to simulate a horse pasture management scheme in the U.S. Upper Transition Zone

USDA-ARS?s Scientific Manuscript database

Turf-type bermudagrasses [Cynodon dactylon (Pers.) L.] with improved cold tolerance could have potential use in horse pastures of the U.S. upper south for minimizing the damage to grass stands in these pastures from heavy trampling; however, the nutritive values of these bermudagrasses are not known...

The principles of management of congenital anomalies of the upper limb

PubMed Central

Watson, S.

2000-01-01

Management of congenital anomalies of the upper limb is reviewed with reference to classification and aetiology, incidence, diagnosis before birth, broad principles of treatment, timing of x rays and scans, functional aims, cosmetic appearance, counselling of parents, therapists, scars, skin grafts, growth, and timing of surgery. Notes on 11 congenital hand conditions are given.

 PMID:10868991

Upper-Tropospheric Synoptic-Scale Waves. Part II: Maintenance and Excitation of Quasi Modes.

NASA Astrophysics Data System (ADS)

Rivest, Chantal; Farrell, Brian F.

1992-11-01

In a preceding paper a simple dynamical model for the maintenance of upper-tropospheric waves was proposed: the upper-level Eady normal modes. In this paper it is shown that these modes have counterparts in basic states with positive tropospheric gradients of potential vorticity, and that these counterparts can be maintained and excited on time scales consistent with observations.In the presence of infinitesimal positive tropospheric gradients of potential vorticity, the upper-level normal-mode solutions no longer exist. That the normal-mode solution disappears when gradients are infinitesimal represents an apparent singularity and challenges the interpretation of upper-level synoptic-scale waves as related to the upper-level Eady normal modes. What happens to the upper-level modal solution in the presence of tropospheric gradients of potential vorticity is examined in a series of initial-value experiments. Our results show that they become slowly decaying quasi modes. Mathematically the quasi modes consist of a superposition of singular modes sharply peaked in the phase speed domain, and their decay proceeds as the modes interfere with one another. We repeat these experiments in basic states with a smooth tropopause in the presence of tropospheric and stratospheric gradients, and similar results are obtained.Following a previous study by Farrell, a class of near-optimal initial conditions for the excitation of upper-level waves is identified. The initial conditions consist of upper-tropospheric disturbances that lean against the shear. They strongly excite upper-level waves not only in the absence of tropospheric potential vorticity gradients, but also in their presence. This result is important mathematically since it suggests that quasi modes are as likely to emerge from favorably configured initial disturbances as true normal modes, although the excitation is followed by a slow decay.

Women and the Workplace: The Glass Ceiling. Hearing before the Subcommittee on Employment and Productivity of the Committee on Labor and Human Resources, United States Senate, One Hundred Second Congress, First Session (October 23, 1991).

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Committee on Labor and Human Resources.

These proceedings are from a hearing that addressed the so-called "glass ceiling"--the dearth of women in mid- and upper-management level positions in corporations and other organizations. Statements of the following persons are included: Senator Paul Simon; Elsie Vartanian, Director of the Women's Bureau; Senator Robert Dole; Lynn…

An Analysis of Factors Related to Retirement Intentions of Upper Level Civil Service Employees in the Air Force.

DTIC Science & Technology

1986-09-01

workforce that is incapable of performing organizational objectives (Humple and Lyons , 1983; Tucker, 1985). . Research into retirement within the federal...organization (Donnelly, Gibson, Ivancevich ; 1984). The present study focuses on civilian middle managers, GM13 to GMI5, within technical career fields...Masson, Demestree, and Lyon ; 1979). The second study performed a factorial analysis on data from 457 respondents between the ages of 25 to 64 that worked

Comparison of laparoscopic stone surgery and percutaneous nephrolithotomy in the management of large upper urinary stones: a meta-analysis.

PubMed

Zhao, Chenming; Yang, Huan; Tang, Kun; Xia, Ding; Xu, Hua; Chen, Zhiqiang; Ye, Zhangqun

2016-11-01

For the treatment of large upper urinary stones percutaneous nephrolithotomy (PCNL) is generally considered the first choice, and Laparoscopic Stone Surgery (LSS) is an alternative. We aim to compare the efficiency and safety of PCNL with LSS, as far as the management of large upper urinary stones is concerned. A systematic search from Pubmed, Web of Science, Wiley Online Library and Elsevier was performed up to August 1, 2015 for the relevant published studies. After data extraction and quality assessment, meta-analysis was performed using the RevMan 5.3 software. 15 eligible trials evaluating LSS vs. PCNL were identified including 6 prospective and 9 retrospective studies with 473 patients undergoing LSS and 523 patients undergoing PCNL. Although LSS led to longer operative time (p = 0.01) and higher open conversion rate (p = 0.02), patients might benefit from significantly fewer overall complications (p = 0.03), especially lower bleeding rate (p = 0.02), smaller drop in hemoglobin level (p < 0.001), less need of blood transfusion (p = 0.01). The stone free rate was also higher for LSS compared with PCNL (p < 0.001) with less secondary/complementary procedure (p = 0.006). There was no significant difference in other demographic parameters between the two groups. Our data suggests that LSS turns out to be a safe and feasible alternative to PCNL for large upper urinary stones with less bleeding and higher stone free rate. Because of the inherent limitations of the included studies, further large sample prospective, multi-centric studies and randomized control trials should be undertaken to confirm our findings.

How State-Funded Home Care Programs Respond to Changes in Medicare Home Health Care: Resource Allocation Decisions on the Front Line

PubMed Central

Corazzini, Kirsten

2003-01-01

Objective To examine how case managers in a state-funded home care program allocate home care services in response to information about a client's Medicare home health care status, with particular attention to the influence of work environment. Data Sources/Study Setting Primary data collected on 355 case managers and 26 agency directors employed in June 1999 by 26 of the 27 regional agencies administering the Massachusetts Home Care Program for low-income elders. Study Design Data were collected in a cross-sectional survey study design. A case manager survey included measures of work environment, demographics, and factorial survey vignette clients (N=2,054), for which case managers assessed service eligibility levels. An agency director survey included measures of management practices. Data Collection/Extraction Methods Hierarchical linear models estimated the effects of work environment on the relationship between client receipt of Medicare home health care and care plan levels while controlling for case-mix differences in agencies' clients. Principal Findings Case managers did not supplement extant Medicare home health services, but did allocate more generous service plans to clients who have had Medicare home health care services recently terminated. This finding persisted when controlling for case mix and did not vary by work environment. Work environment affected overall care plan levels. Conclusions Study findings indicate systematic patterns of frontline resource allocation shaping the relationships among community-based long-term care payment sources. Further, results illustrate how nonuniform implementation of upper-level initiatives may be partially attributed to work environment characteristics. PMID:14596390

[Analysis of development, safety and efficacy of percutaneous nephrolithotomy for management of upper urinary tract calculi in pediatric patients].

PubMed

Yu, L P; Xu, T

2017-08-18

To evaluate the development, safety and efficacy of percutaneous nephrolithotomy(PNL) for management of upper urinary tract calculi in pediatric patients. In the study, 77 pediatric patients undergoing 87 PNLs through mini or standard tract for upper urinary tract calculi between January 2005 and December 2016 in Peking University People's hospital were reviewed, including 69 renal calculi, 6 upper ureteral calculi, 12 renal and upper ureteral calculi, 35 single calculi, 43 multiple calculi and 9 staghorn calculi. The development and efficacy of PNL in pediatric patients were studied by analyzing the characteristics and clinical indexes, and by reviewing the associated literature. The Clavien classification system was used to evaluate the complications after PNL. A total of 87 PNLs were performed in 77 pediatric patients. Eighty-one upper urinary tract calculi were managed through a single tract(93.1%), 5 pediatric patients were managed through 2 tracts(5.7%), and 1 pediatric patient was managed through 3 tracts(1.2%). The mean operating time was (77.0±29.8) min. The stone-free rate after one session was 100% for single calculi and 71.2% for multiple or staghorn calculi, 5(5.8%) children underwent auxiliary procedure to remove the residual calculi and the final stone-free rate of PNL was 88.5%. One of the main complications of pediatric PNL was fever. Sixteen (18.4%) had moderate fever(38-39 °C), 5 (5.7%) had high fever (39-40 °C) and there were no severe complications of infection, such as sepsis or septic shock. The mean hemoglobin loss was (10.3±16.1) g/L and the serum creatinine rise was (7.0±13.3) μmol/L. One(1.2%) pediatric patient suffered ureteroscopic lithotripsy because of the obstruction by the residual stone in ureter. No injury of organs or retroperitoneal urinary extravasation occurred. General assessment of the complications showed Clavien grade I complications in 14 (16.1%) pediatric patients, grade II in 7(8.0%) children and grade III in 1(1.2%) children. There was no grade IV or V complications. The overall complication rate was 25.3%. PNL for management of upper urinary tract calculi in pediatric patients is effective. Complications after PNL, as assessed with Clavien classification system, are mild and PNL in pediatric patients is safe.

FDG-PET/CT Limited to the Thorax and Upper Abdomen for Staging and Management of Lung Cancer.

PubMed

Arens, Anne I J; Postema, Jan W A; Schreurs, Wendy M J; Lafeber, Albert; Hendrickx, Baudewijn W; Oyen, Wim J G; Vogel, Wouter V

2016-01-01

This study evaluates the diagnostic accuracy of [F-18]-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) of the chest/upper abdomen compared to the generally performed scan from head to upper thighs, for staging and management of (suspected) lung cancer in patients with no history of malignancy or complaints outside the thorax. FDG-PET/CT scans of 1059 patients with suspected or recently proven lung cancer, with no history of malignancy or complaints outside the thorax, were analysed in a retrospective multi-centre trial. Suspect FDG-avid lesions in the chest and upper abdomen, the head and neck area above the shoulder line and in the abdomen and pelvis below the caudal tip of the liver were noted. The impact of lesions detected in the head and neck area and abdomen and pelvis on additional diagnostic procedures, staging and treatment decisions was evaluated. The head and neck area revealed additional suspect lesions in 7.2%, and the abdomen and pelvis in 15.8% of patients. Imaging of the head and neck area and the abdomen and pelvic area showed additional lesions in 19.5%, inducing additional diagnostic procedures in 7.8%. This resulted in discovery of additional lesions considered malignant in 10.7%, changing patient management for lung cancer in 1.2%. In (suspected) lung cancer, PET/CT limited to the chest and upper abdomen resulted in correct staging in 98.7% of patients, which led to the identical management as full field of view PET in 98.8% of patients. High value of FDG-PET/CT for staging and correct patient management is already achieved with chest and upper abdomen. Findings in head and neck area and abdomen and pelvis generally induce investigations with limited or no impact on staging and treatment of NSCLC, and can be interpreted accordingly.

A queuing-theory-based interval-fuzzy robust two-stage programming model for environmental management under uncertainty

NASA Astrophysics Data System (ADS)

Sun, Y.; Li, Y. P.; Huang, G. H.

2012-06-01

In this study, a queuing-theory-based interval-fuzzy robust two-stage programming (QB-IRTP) model is developed through introducing queuing theory into an interval-fuzzy robust two-stage (IRTP) optimization framework. The developed QB-IRTP model can not only address highly uncertain information for the lower and upper bounds of interval parameters but also be used for analysing a variety of policy scenarios that are associated with different levels of economic penalties when the promised targets are violated. Moreover, it can reflect uncertainties in queuing theory problems. The developed method has been applied to a case of long-term municipal solid waste (MSW) management planning. Interval solutions associated with different waste-generation rates, different waiting costs and different arriving rates have been obtained. They can be used for generating decision alternatives and thus help managers to identify desired MSW management policies under various economic objectives and system reliability constraints.

Using the Assessment Model for Developing Learning Managements in Enrichment Science Classrooms of Upper Secondary Educational Students' Outcomes in Thailand

ERIC Educational Resources Information Center

Athan, Athit; Srisa-ard, Boonchom; Suikraduang, Arun

2015-01-01

The aim of this work is to develop and investigate the model for assessing learning management on the enrichment science classrooms in the upper secondary education of the Development and Promotion of Science and Technology Talents Project in Thailand. Using the research methodologies with the four phases: to investigate the background of the…

Rural household chicken management and challenges in the Upper River Region of the Gambia.

PubMed

Olaniyan, Olawale Festus; Camara, Samba

2018-06-23

Systematic assessment and documentation of extensive livestock production systems are necessary to design or review breeding programs, extension services, and policies. This study therefore examined management practices and challenges concerning village chicken production in the Upper River Region of the Gambia. The data gathered with 45-variable semi-structured questionnaires were analyzed based on the household head's education status and gender. Illiteracy level was high, and only 38% indicated that they attended certain schools. There was a significant relationship (p < 0.05) and phi coefficient of 0.35 between household heads' education status and record keeping. None of the examined management practices had a statistically significant relationship (p > 0.05) with household heads' gender. Children (10-14 years) were mostly responsible for providing care to the chickens. Foundation and replacement stocks were mainly acquired through purchase (78%). Many households (74%) indicated supplementary feeding of their flocks but only 34% provided separate houses apart from the household dwellings. Newcastle (68%) was the most common disease. Sick birds were recognized by restlessness (34%) and diarrhea (28%). External parasites were mainly controlled through local practices (52%) while the most common way to dispose dead birds was to throw them away (88%). Up to 90% indicated no formal training on disease management and access to extension agents was also low (20%). Control of chicken movement was occasionally done to protect birds from predators (60%) and then, to avoid contagious diseases (38%). Individual farmers and their associations need to be supported by stakeholders to access relevant information and uptake improved management techniques.

Incentivizing advanced mathematics study at upper secondary level: the case of bonus points in Ireland

NASA Astrophysics Data System (ADS)

Treacy, Páraic Thomas

2018-04-01

Secondary level mathematics education in Ireland has recently experienced a period of significant change with the introduction of new curricula and the addition of an incentive to study upper secondary mathematics at the most advanced level (Higher Level). This incentive, typically referred to as 'bonus points', appears to have aided a significant increase in the number of students studying upper secondary mathematics at Higher Level. However, thematic analysis of interviews with experienced upper secondary mathematics examiners and exploration of mathematics diagnostic test data outlined in this paper suggest that the difficulty of the Higher Level upper secondary mathematics final examination in Ireland has reduced since the introduction of the bonus points initiative. The sharp increase in students attempting this examination coupled with a policy of maintaining a consistent proportion of students achieving passing grades was identified as a key reason for this possible reduction in standards.

A Game Changer: Electrifying Remote Communities by Using Isolated Microgrids

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

Lu, Xiaonan; Wang, Jianhui

Microgrids, as self-contained entities, are of increasing interest in modern electric grids. Microgrids provide a sustainable solution to aggregate distributed energy resources (DERs) [e.g., photovoltaics (PVs), wind turbines], energy storage, and loads in a localized manner, especially in distribution systems. As a controllable unit, a microgrid can manage and balance the source and load power inside it to ensure stable and reliable operation. Moreover, through coordination with upper-level control systems, it can be dispatched and respond to the control commands issued by the central controller in the distribution system-in other words, a system that is effectively a distribution management systemmore » (DMS).« less

Groundwater simulation and management models for the upper Klamath Basin, Oregon and California

USGS Publications Warehouse

Gannett, Marshall W.; Wagner, Brian J.; Lite, Kenneth E.

2012-01-01

The upper Klamath Basin encompasses about 8,000 square miles, extending from the Cascade Range east to the Basin and Range geologic province in south-central Oregon and northern California. The geography of the basin is dominated by forested volcanic uplands separated by broad interior basins. Most of the interior basins once held broad shallow lakes and extensive wetlands, but most of these areas have been drained or otherwise modified and are now cultivated. Major parts of the interior basins are managed as wildlife refuges, primarily for migratory waterfowl. The permeable volcanic bedrock of the upper Klamath Basin hosts a substantial regional groundwater system that provides much of the flow to major streams and lakes that, in turn, provide water for wildlife habitat and are the principal source of irrigation water for the basin's agricultural economy. Increased allocation of surface water for endangered species in the past decade has resulted in increased groundwater pumping and growing interest in the use of groundwater for irrigation. The potential effects of increased groundwater pumping on groundwater levels and discharge to springs and streams has caused concern among groundwater users, wildlife and Tribal interests, and State and Federal resource managers. To provide information on the potential impacts of increased groundwater development and to aid in the development of a groundwater management strategy, the U.S. Geological Survey, in collaboration with the Oregon Water Resources Department and the Bureau of Reclamation, has developed a groundwater model that can simulate the response of the hydrologic system to these new stresses. The groundwater model was developed using the U.S. Geological Survey MODFLOW finite-difference modeling code and calibrated using inverse methods to transient conditions from 1989 through 2004 with quarterly stress periods. Groundwater recharge and agricultural and municipal pumping are specified for each stress period. All major streams and most major tributaries for which a substantial part of the flow comes from groundwater discharge are included in the model. Groundwater discharge to agricultural drains, evapotranspiration from aquifers in areas of shallow groundwater, and groundwater flow to and from adjacent basins also are simulated in key areas. The model has the capability to calculate the effects of pumping and other external stresses on groundwater levels, discharge to streams, and other boundary fluxes, such as discharge to drains. Historical data indicate that the groundwater system in the upper Klamath Basin fluctuates in response to decadal climate cycles, with groundwater levels and spring flows rising and declining in response to wet and dry periods. Data also show that groundwater levels fluctuate seasonally and interannually in response to groundwater pumping. The most prominent response is to the marked increase in groundwater pumping starting in 2001. The calibrated model is able to simulate observed decadal-scale climate-driven fluctuations in the groundwater system as well as observed shorter-term pumping-related fluctuations. Example model simulations show that the timing and location of the effects of groundwater pumping vary markedly depending on the pumping location. Pumping from wells close (within a few miles) to groundwater discharge features, such as springs, drains, and certain streams, can affect those features within weeks or months of the onset of pumping, and the impacts can be essentially fully manifested in several years. Simulations indicate that seasonal variations in pumping rates are buffered by the groundwater system, and peak impacts are closer to mean annual pumping rates than to instantaneous rates. Thus, pumping effects are, to a large degree, spread out over the entire year. When pumping locations are distant (more than several miles) from discharge features, the effects take many years or decades to fully impact those features, and much of the pumped water comes from groundwater storage over a broad geographic area even after two decades. Moreover, because the effects are spread out over a broad area, the impacts to individual features are much smaller than in the case of nearby pumping. Simulations show that the discharge features most affected by pumping in the area of the Bureau of Reclamation's Klamath Irrigation Project are agricultural drains, and impacts to other surface-water features are small in comparison. A groundwater management model was developed that uses techniques of constrained optimization along with the groundwater flow model to identify the optimal strategy to meet water user needs while not violating defined constraints on impacts to groundwater levels and streamflows. The coupled groundwater simulation-optimization models were formulated to help identify strategies to meet water demand in the upper Klamath Basin. The models maximize groundwater pumping while simultaneously keeping the detrimental impacts of pumping on groundwater levels and groundwater discharge within prescribed limits. Total groundwater withdrawals were calculated under alternative constraints for drawdown, reductions in groundwater discharge to surface water, and water demand to understand the potential benefits and limitations for groundwater development in the upper Klamath Basin. The simulation-optimization model for the upper Klamath Basin provides an improved understanding of how the groundwater and surface-water system responds to sustained groundwater pumping within the Bureau of Reclamation's Klamath Project. Optimization model results demonstrate that a certain amount of supplemental groundwater pumping can occur without exceeding defined limits on drawdown and stream capture. The results of the different applications of the model demonstrate the importance of identifying constraint limits in order to better define the amount and distribution of groundwater withdrawal that is sustainable.

Integrating Wind Profiling Radars and Radiosonde Observations with Model Point Data to Develop a Decision Support Tool to Assess Upper-level Winds For Space Launch

NASA Technical Reports Server (NTRS)

Bauman, William H., III; Flinn, Clay

2012-01-01

Launch directors need to know upper-level wind forecasts. We developed an Excel-based GUI to display upper-level winds: (1) Rawinsonde at CCAFS, (2) Wind profilers at KSC, (3) Model point data at CCAFS.

Airway Management During Upper GI Endoscopic Procedures: State of the Art Review.

PubMed

Goudra, Basavana; Singh, Preet Mohinder

2017-01-01

With the growing popularity of propofol mediated deep sedation for upper gastrointestinal (GI) endoscopic procedures, challenges are being felt and appreciated. Research suggests that management of the airway is anything but routine in this setting. Although many studies and meta-analyses have demonstrated the safety of propofol sedation administered by registered nurses under the supervision of gastroenterologists (likely related to the lighter degrees of sedation than those provided by anesthesia providers and is under medicolegal controversy in the United States), there is no agreement on the optimum airway management for procedures such as endoscopic retrograde cholangiopancreatography. Failure to rescue an airway at an appropriate time has led to disastrous consequences. Inability to evaluate and appreciate the risk factors for aspiration can ruin the day for both the patient and the health care providers. This review apprises the reader of various aspects of airway management relevant to the practice of sedation during upper GI endoscopy. New devices and modification of existing devices are discussed in detail. Recognizing the fact that appropriate monitoring is important for timely recognition and management of potential airway disasters, these issues are explored thoroughly.

Upper Cervical Epidural Abscess in Clinical Practice: Diagnosis and Management

PubMed Central

Al-Hourani, Khalid; Al-Aref, Rami; Mesfin, Addisu

2015-01-01

Study Design Narrative review. Objective Upper cervical epidural abscess (UCEA) is a rare surgical emergency. Despite increasing incidence, uncertainty remains as to how it should initially be managed. Risk factors for UCEA include immunocompromised hosts, diabetes mellitus, and intravenous drug use. Our objective is to provide a comprehensive overview of the literature including the history, clinical manifestations, diagnosis, and management of UCEA. Methods Using PubMed, studies published prior to 2015 were analyzed. We used the keywords “Upper cervical epidural abscess,” “C1 osteomyelitis,” “C2 osteomyelitis,” “C1 epidural abscess,” “C2 epidural abscess.” We excluded cases with tuberculosis. Results The review addresses epidemiology, etiology, imaging, microbiology, and diagnosis of this condition. We also address the nonoperative and operative management options and the relative indications for each as reviewed in the literature. Conclusion A high index of suspicion is required to diagnose this rare condition with magnetic resonance imaging being the imaging modality of choice. There has been a shift toward surgical management of this condition in recent times, with favorable outcomes. PMID:27190742

Synoptic climatology of the long-distance dispersal of white pine blister rust I. Development of an upper level synoptic classification

Treesearch

K. L. Frank; L. S. Kalkstein; B. W. Geils; H. W. Thistle

2008-01-01

This study developed a methodology to temporally classify large scale, upper level atmospheric conditions over North America, utilizing a newly-developed upper level synoptic classification (ULSC). Four meteorological variables: geopotential height, specific humidity, and u- and v-wind components, at the 500 hPa level over North America were obtained from the NCEP/NCAR...

Increased Waterborne blaNDM-1 Resistance Gene Abundances Associated with Seasonal Human Pilgrimages to the Upper Ganges River

PubMed Central

2014-01-01

Antibiotic resistance (AR) is often rooted in inappropriate antibiotic use, but poor water quality and inadequate sanitation exacerbate the problem, especially in emerging countries. An example is increasing multi-AR due to mobile carbapenemases, such as NDM-1 protein (coded by blaNDM-1 genes), which can produce extreme drug-resistant phenotypes. In 2010, NDM-1 positive isolates and blaNDM-1 genes were detected in surface waters across Delhi and have since been detected across the urban world. However, little is known about blaNDM-1 levels in more pristine locations, such as the headwaters of the Upper Ganges River. This area is of particular interest because it receives massive numbers of visitors during seasonal pilgrimages in May/June, including visitors from urban India. Here we quantified blaNDM-1 abundances, other AR genes (ARG), and coliform bacteria in sediments and water column samples from seven sites in the Rishikesh-Haridwar region of the Upper Ganges and five sites on the Yamuna River in Delhi to contrast blaNDM-1 levels and water quality conditions between season and region. Water quality in the Yamuna was very poor (e.g., anoxia at all sites), and blaNDM-1 abundances were high across sites in water (5.4 ± 0.4 log(blaNDM-1·mL–1); 95% confidence interval) and sediment (6.3 ± 0.7 log(blaNDM-1·mg–1)) samples from both seasons. In contrast, water column blaNDM-1 abundances were very low across all sites in the Upper Ganges in February (2.1 ± 0.6 log(blaNDM-1·mL–1)), and water quality was good (e.g., near saturation oxygen). However, per capita blaNDM-1 levels were 20 times greater in June in the Ganges water column relative to February, and blaNDM-1 levels significantly correlated with fecal coliform levels (r = 0.61; p = 0.007). Given that waste management infrastructure is limited in Rishikesh-Haridwar, data imply blaNDM-1 levels are higher in visitor’s wastes than local residents, which results in seasonally higher blaNDM-1 levels in the river. Pilgrimage areas without adequate waste treatment are possible “hot spots” for AR transmission, and waste treatment must be improved to reduce broader AR dissemination via exposed returning visitors. PMID:24521347

Two-Stage Technique Used to Manage Severe Upper Airway Obstruction and Avoid Surgical Tracheostomy: A Case Report.

PubMed

Onwochei, Desire N; El-Boghdadly, Kariem; Ahmad, Imran

2018-03-01

Severe upper airway obstruction is commonly managed with surgical tracheostomy under local anesthesia. We present a 49-year-old woman with postradiotherapy laryngeal fixation and transglottic stenosis for dilation of a pharyngeal stricture who refused elective tracheostomy. A 2-stage technique was used, which involved an awake fiberoptic intubation, followed by the transtracheal insertion of a Cricath needle and ventilation using an ejector-based Ventrain device. We discuss management aspects of this clinical scenario and the principles by which the Ventrain works.

Fort Peck Dam/Fort Peck Lake Master Plan with Integrated Programmatic Environmental Assessment, Missouri River, Montana: Update of Design Memorandum MFP-105D

DTIC Science & Technology

2008-08-01

wilderness areas, and a self-guided auto tour. BUREAU OF LAND MANAGEMENT The l49-mile Upper Missouri National Wild and Scenic River flows between Fort...and CMR. This segment is classified as scenic. The National Park Service (NPS) is the overseeing agency for the National Wild and Scenic Rivers...System. Under NPS oversight, the Bureau of Land Management (BLM) is the managing agency for the Upper Missouri National Wild and Scenic River. Within

Stakeholder views on flood risk management in Hungary's Upper Tisza Basin.

PubMed

Vari, Anna; Linnerooth-Bayer, Joanne; Ferencz, Zoltan

2003-06-01

With escalating costs of flood mitigation and relief, a challenge for the Hungarian government is to develop a flood mitigation and insurance/relief system that is viewed as efficient and fair by the many stakeholders involved. To aid policymakers in this task, this article reports on a recent study to elicit stakeholder views on flood risk management in the Upper Tisza Basin, including views on appropriate means of reducing losses and for transferring the residual losses from the direct victims to taxpayers or an insurance pool. This study is part of a project to develop an integrated approach to flood risk management coordinated by the International Institute of Applied Systems Analysis (IIASA) in collaboration with Swedish and Hungarian researchers. The discussion begins by describing the background of flood risk management problems in the Upper Tisza Basin. The results of interviews carried out with selected key stakeholders and the results of a public survey eliciting views on flood risk management are reported. The final section draws conclusions on incorporating stakeholder views into a flood risk management model, which will be used to illustrate policy paths at an upcoming stakeholder workshop. The conclusions are also of direct interest to Hungarian policymakers.

Management of the aging upper eyelid in the asian patient.

PubMed

Karam, Amir M; Lam, Samuel M

2010-08-01

Successful management of the aging upper eyelid region in the Asian patient requires a unique skill set and clinical experience. The surgeon must exhibit a thorough understanding of the unique anatomy of the Asian eyelid and its variations and of the cultural expectations of the patient and must possess a unique set of surgical skills such as de novo creation of the supratarsal crease as well as complementary procedures such as fat transfer used for volume augmentation of the periorbital region. The modern approach outlined here summarizes the key elements necessary to restore the youthful appearance of the upper eyelid region in a natural and ethnically consistent fashion.

Upper cervical and upper thoracic thrust manipulation versus nonthrust mobilization in patients with mechanical neck pain: a multicenter randomized clinical trial.

PubMed

Dunning, James R; Cleland, Joshua A; Waldrop, Mark A; Arnot, Cathy F; Young, Ian A; Turner, Michael; Sigurdsson, Gisli

2012-01-01

Randomized clinical trial. To compare the short-term effects of upper cervical and upper thoracic high-velocity low-amplitude (HVLA) thrust manipulation to nonthrust mobilization in patients with neck pain. Although upper cervical and upper thoracic HVLA thrust manipulation and nonthrust mobilization are common interventions for the management of neck pain, no studies have directly compared the effects of both upper cervical and upper thoracic HVLA thrust manipulation to nonthrust mobilization in patients with neck pain. Patients completed the Neck Disability Index, the numeric pain rating scale, the flexion-rotation test for measurement of C1-2 passive rotation range of motion, and the craniocervical flexion test for measurement of deep cervical flexor motor performance. Following the baseline evaluation, patients were randomized to receive either HVLA thrust manipulation or nonthrust mobilization to the upper cervical (C1-2) and upper thoracic (T1-2) spines. Patients were reexamined 48-hours after the initial examination and again completed the outcome measures. The effects of treatment on disability, pain, C1-2 passive rotation range of motion, and motor performance of the deep cervical flexors were examined with a 2-by-2 mixed-model analysis of variance (ANOVA). One hundred seven patients satisfied the eligibility criteria, agreed to participate, and were randomized into the HVLA thrust manipulation (n = 56) and nonthrust mobilization (n = 51) groups. The 2-by-2 ANOVA demonstrated that patients with mechanical neck pain who received the combination of upper cervical and upper thoracic HVLA thrust manipulation experienced significantly (P<.001) greater reductions in disability (50.5%) and pain (58.5%) than those of the nonthrust mobilization group (12.8% and 12.6%, respectively) following treatment. In addition, the HVLA thrust manipulation group had significantly (P<.001) greater improvement in both passive C1-2 rotation range of motion and motor performance of the deep cervical flexor muscles as compared to the group that received nonthrust mobilization. The number needed to treat to avoid an unsuccessful outcome was 1.8 and 2.3 at 48-hour follow-up, using the global rating of change and Neck Disability Index cut scores, respectively. The combination of upper cervical and upper thoracic HVLA thrust manipulation is appreciably more effective in the short term than nonthrust mobilization in patients with mechanical neck pain. Therapy, level 1b.

Overuse injuries of the upper extremity in the competitive athlete: magnetic resonance imaging findings associated with repetitive trauma.

PubMed

Banks, Kevin P; Ly, Justin Q; Beall, Douglas P; Grayson, David E; Bancroft, Laura W; Tall, Michael A

2005-01-01

Overuse injuries are a very common cause of pain in athletes, accounting for a significant loss of training time and missed competitions. Magnetic resonance imaging (MRI) is playing an increasing role in facilitating the expeditious and safe return of these individuals to their preinjury level of physical performance by allowing accurate diagnosis. Sports physicians are increasingly relying on the exquisite anatomic detail afforded by this technique to formulate diagnoses that assist with the optimal management of these athletic injuries. Some upper extremity overuse entities are well recognized; two examples are medial epicondylitis, classically appearing in baseball pitchers, and lateral epicondylitis, in tennis players. Other less well-known injuries of the upper extremity, such as intersection syndrome in rowers and distal clavicular stress fractures in weightlifters, are frequent occurrences in certain circles of athletes. The following article is a pictorial review of the MRI findings of upper extremity overuse injuries encountered in the competitive athlete, with an emphasis on the sports scenarios in which they occur. We will depict mechanisms of injury and applicable anatomy and show characteristic imaging findings. A wide range of entities are addressed, including but not limited to overuse injuries occurring in baseball, swimming, gymnastics, weightlifting, bowling, and cycling.

Less common upper limb mononeuropathies.

PubMed

Williams, Faren H; Kumiga, Bryan

2013-05-01

This article will focus on the less commonly injured nerves of the upper extremity. These nerves may be involved when trauma results in fractures, dislocations, or swelling with resultant nerve compression. Tumors and ganglions can also compress nerves, causing pain and, over time, demyelination or axon degeneration with weakness. Other mechanisms for upper limb nerve injury include participation in high-level sports, that is, those that generate torque about the arm and shoulder, abnormal stresses about the joints and muscles, or muscle hypertrophy, which may result in nerve injury. The goals of this review are to discuss the clinical presentation and possible causes of upper extremity nerve entrapments and to formulate an electrodiagnostic plan for evaluation. Descriptions of the appropriate nerve conduction studies or needle electromyographic protocols are included for specific nerves. The purpose of the electrodiagnostic examination is to evaluate the degree of nerve injury, axon loss over time, and later, evidence for reinnervation to assist with prognostication. The latter has implications for management of the neuropathy, including the type of exercises and therapy that may be indicated to help maintain the stability and motion of the involved joint(s) and promote strengthening over time as the nerve regenerates. Copyright © 2013 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Management by the intensivist of gastrointestinal bleeding in adults and children

PubMed Central

2012-01-01

Intensivists are regularly confronted with the question of gastrointestinal bleeding. To date, the latest international recommendations regarding prevention and treatment for gastrointestinal bleeding lack a specific approach to the critically ill patients. We present recommendations for management by the intensivist of gastrointestinal bleeding in adults and children, developed with the GRADE system by an experts group of the French-Language Society of Intensive Care (Société de Réanimation de Langue Française (SRLF), with the participation of the French Language Group of Paediatric Intensive Care and Emergencies (GFRUP), the French Society of Emergency Medicine (SFMU), the French Society of Gastroenterology (SNFGE), and the French Society of Digestive Endoscopy (SFED). The recommendations cover five fields of application: management of gastrointestinal bleeding before endoscopic diagnosis, treatment of upper gastrointestinal bleeding unrelated to portal hypertension, treatment of upper gastrointestinal bleeding related to portal hypertension, management of presumed lower gastrointestinal bleeding, and prevention of upper gastrointestinal bleeding in intensive care. PMID:23140348

Sources of groundwater and characteristics of surface-water recharge at Bell, White, and Suwannee Springs, Florida, 2012–13

USGS Publications Warehouse

Stamm, John F.; McBride, W. Scott

2016-12-21

Discharge from springs in Florida is sourced from aquifers, such as the Upper Floridan aquifer, which is overlain by an upper confining unit that locally can have properties of an aquifer. Water levels in aquifers are affected by several factors, such as precipitation, recharge, and groundwater withdrawals, which in turn can affect discharge from springs. Therefore, identifying groundwater sources and recharge characteristics can be important in assessing how these factors might affect flows and water levels in springs and can be informative in broader applications such as groundwater modeling. Recharge characteristics include the residence time of water at the surface, apparent age of recharge, and recharge water temperature.The groundwater sources and recharge characteristics of three springs that discharge from the banks of the Suwannee River in northern Florida were assessed for this study: Bell Springs, White Springs, and Suwannee Springs. Sources of groundwater were also assessed for a 150-foot-deep well finished within the Upper Floridan aquifer, hereafter referred to as the UFA well. Water samples were collected for geochemical analyses in November 2012 and October 2013 from the three springs and the UFA well. Samples were analyzed for a suite of major ions, dissolved gases, and isotopes of sulfur, strontium, oxygen, and hydrogen. Daily means of water level and specific conductance at White Springs were continuously recorded from October 2012 through December 2013 by the Suwannee River Water Management District. Suwannee River stage at White Springs was computed on the basis of stage at a U.S. Geological Survey streamgage about 2.4 miles upstream. Water levels in two wells, located about 2.5 miles northwest and 13 miles southeast of White Springs, were also used in the analyses.Major ion concentrations were used to differentiate water from the springs and Upper Floridan aquifer into three groups: Bell Springs, UFA well, and White and Suwannee Springs. When considered together, evidence from water-level, specific conductance, major-ion concentration, and isotope data indicated that groundwater at Bell Springs and the UFA well was a mixture of surface water and groundwater from the upper confining unit, and that groundwater at White and Suwannee Springs was a mixture of surface water, groundwater from the upper confining unit, and groundwater from the Upper Floridan aquifer. Higher concentrations of magnesium in groundwater samples at the UFA well than in samples at Bell Springs might indicate less mixing with surface water at the UFA well than at Bell Springs. Characteristics of surface-water recharge, such as residence time at the surface, apparent age, and recharge water temperature, were estimated on the basis of isotopic ratios, and dissolved concentrations of gases such as argon, tritium, and sulfur hexafluoride. Oxygen and deuterium isotopic ratios were consistent with rapid recharge by rainwater for samples collected in 2012, and longer residence time at the surface (ponding) for samples collected in 2013. Apparent ages of groundwater samples, computed on the basis of tritium activity and sulfur hexafluoride concentration, indicated groundwater recharge occurred after the late 1980s; however, the estimated apparent ages likely represent the average of ages of multiple sources. Recharge since the 1980s is consistent with groundwater from shallow sources, such as the upper confining unit and Upper Floridan aquifer. Recharge water temperature computed for the three springs and UFA well averaged 20.1 degrees Celsius, which is similar to the mean annual air temperature of 20.6 degrees Celsius at a nearby weather station for 1960–2014.

Perfusion scintigraphy and patient selection for lung volume reduction surgery.

PubMed

Chandra, Divay; Lipson, David A; Hoffman, Eric A; Hansen-Flaschen, John; Sciurba, Frank C; Decamp, Malcolm M; Reilly, John J; Washko, George R

2010-10-01

It is unclear if lung perfusion can predict response to lung volume reduction surgery (LVRS). To study the role of perfusion scintigraphy in patient selection for LVRS. We performed an intention-to-treat analysis of 1,045 of 1,218 patients enrolled in the National Emphysema Treatment Trial who were non-high risk for LVRS and had complete perfusion scintigraphy results at baseline. The median follow-up was 6.0 years. Patients were classified as having upper or non-upper lobe-predominant emphysema on visual examination of the chest computed tomography and high or low exercise capacity on cardiopulmonary exercise testing at baseline. Low upper zone perfusion was defined as less than 20% of total lung perfusion distributed to the upper third of both lungs as measured on perfusion scintigraphy. Among 284 of 1,045 patients with upper lobe-predominant emphysema and low exercise capacity at baseline, the 202 with low upper zone perfusion had lower mortality with LVRS versus medical management (risk ratio [RR], 0.56; P = 0.008) unlike the remaining 82 with high perfusion where mortality was unchanged (RR, 0.97; P = 0.62). Similarly, among 404 of 1,045 patients with upper lobe-predominant emphysema and high exercise capacity, the 278 with low upper zone perfusion had lower mortality with LVRS (RR, 0.70; P = 0.02) unlike the remaining 126 with high perfusion (RR, 1.05; P = 1.00). Among the 357 patients with non-upper lobe-predominant emphysema (75 with low and 282 with high exercise capacity) there was no improvement in survival with LVRS and measurement of upper zone perfusion did not contribute new prognostic information. Compared with optimal medical management, LVRS reduces mortality in patients with upper lobe-predominant emphysema when there is low rather than high perfusion to the upper lung.

Integrated analysis of landscape management scenarios using state and transition models in the upper Grande Ronde River subbasin, Oregon, USA.

Treesearch

Miles A. Hemstrom; James Merzenich; Allison Reger; Barbara. Wales

2007-01-01

We modeled the integrated effects of natural disturbances and management activities for three disturbance scenarios on a 178 000-ha landscape in the upper Grande Ronde subbasin of northeast Oregon. The landscape included three forest environments (warm-dry, cool-moist, and cold) as well as a mixture of publicly and privately owned lands. Our models were state and...

Diagnosing and Managing IBD

MedlinePlus

... of your abdomen. Newer scanners have an open design to minimize claustrophobia. A CT of the abdomen ... CE) Upper tract Crohn’s disease EGD-Upper GI Series (UGIS) Perianal Crohn’s disease MRI-EUS PSC (primary ...

78 FR 7810 - Glen Canyon Dam Adaptive Management Work Group

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-04

.... Dated: January 29, 2013. Anamarie Gold, Deputy Regional Director, Upper Colorado Regional Office, Salt... Reclamation, Upper Colorado Regional Office, 125 South State Street, Room 6107, Salt Lake City, Utah, 84138...

Theoretical studies of solar-pumped lasers

NASA Technical Reports Server (NTRS)

Harries, W. L.

1983-01-01

Metallic vapor lasers of Na2 and Li2 are examined as solar energy converters. The absorbed photons cause transitions to vibrational-rotational levels in an upper electronic state. With broad band absorption the resultant levels can have quantum numbers considerably higher than the upper lasing level. The excited molecule then relaxes to the upper lasing level which is one of the lower vibrational levels in the upper electronic state. The relaxation occurs from collisions, provided the molecule is not quenched into the ground level electronic state. Lasing occurs with a transition to a vibrational level in the lower electronic state. Rough estimates of solar power efficiencies are 1 percent for Na2 and probably a similar figure for Li2. The nondissociative lasers from a family distinct from materials which dissociate to yield an excited atom.

Physics Identity Development: A Snapshot of the Stages of Development of Upper-Level Physics Students

ERIC Educational Resources Information Center

Irving, Paul W.; Sayre, Eleanor C.

2013-01-01

As part of a longitudinal study into identity development in upper-level physics students a phenomenographic research method is employed to assess the stages of identity development of a group of upper-level students. Three categories of description were discovered which indicate the three different stages of identity development for this group…

Research and Teaching: Integrating Lecture and Laboratory in Health Sciences Courses Improves Student Satisfaction and Performance

ERIC Educational Resources Information Center

Finn, Kevin; FitzPatrick, Kathleen; Yan, Zi

2017-01-01

Students often struggle in introductory health sciences courses; some students have difficulty in upper level classes. To address this, we converted three lecture/lab courses, traditional first-year Anatomy and Physiology (A&P I), upper level Biomechanics, and upper level Microbiology to an integrated studio model. We used the Student…

Principles of Tendon Reconstruction Following Complex Trauma of the Upper Limb

PubMed Central

Chattopadhyay, Arhana; McGoldrick, Rory; Umansky, Elise; Chang, James

2015-01-01

Reconstruction of tendons following complex trauma to the upper limb presents unique clinical and research challenges. In this article, the authors review the principles guiding preoperative assessment, surgical reconstruction, and postoperative rehabilitation and management of the upper extremity. Tissue engineering approaches to address tissue shortages for tendon reconstruction are also discussed. PMID:25685101

Status and risk of extinction for westslope cutthroat trout in the Upper River Basin, Montana

Treesearch

Bradley B. Shepard; Brian Sanborn; Linda Ulmer; Danny C. Lee

1997-01-01

Westslope cutthroat trout Oncorhynchus clarki lewisi now occupy less than 5% of the subspecies' historical range within the upper Missouri River drainage in Montana. We assessed the risk of extinction for 144 known populations inhabiting streams within federally managed lands in the upper Missouri River basin using a Bayesian...

Cross-Sector Collaboration in Upper Secondary School Vocational Education: Experiences from Two Industrial Towns in Sweden and Norway

ERIC Educational Resources Information Center

Rusten, Grete; Hermelin, Brita

2017-01-01

This study explores industry-education collaboration on vocational education and training (VET) in upper secondary schools in Sweden and Norway, with particular attention to the initiatives, organisation and operational management, and aspects of robustness and lock-in effects. The case studies include two upper secondary schools situated in…

Comparison between cervical disc arthroplasty and conservative treatment for patients with single level cervical radiculopathy at C5/6.

PubMed

He, Axiang; Xie, Dong; Qu, Bo; Cai, Xiaomin; Kong, Qin; Yang, Lili; Chen, Xiongsheng; Jia, Lianshun

2018-01-31

Cervical radiculopathy is a common disease that affects millions of people. Patients usually are managed by conservative therapy and surgical treatments. To compare the clinical outcomes between cervical disc arthroplasty (CDA) and conservative management for patients with single level cervical radiculopathy at C5/6. Seventy-two patients with cervical radiculopathy that only affect C5/6 joints were included and thirty-two of them received CDA surgery, and forty patients were treated with conservative management. All the patients were followed up around 4 years. Cervical curvature, cervical range of motion (CROM), horizontal displacement of cervical spine, and intervertebral gap were measured by radiological examination. All the patients have comparable disease severity based on pre-surgical radiological assessments. At the 4-year follow-up examination, patients with CDA surgery had less CROM at C5/6 level, while greater CROM at C4/5 level, than control group. Similarly, the horizontal displacement in CDA group decreased at C5/6 vertebrae, and increased at C4/5 level at the 4-year follow-up examination. The intervertebral gaps of patients in CDA group were larger than control group at one-year and last follow-up examination. CDA surgery stabilized C5/6 vertebrae and increased the CROM and horizontal displacement of upper adjacent C4/5 vertebrae. Copyright © 2018. Published by Elsevier Ltd.

Substance P expression in the gingival tissue after upper third molar extraction: effect of ketoprofen, a preliminary study.

PubMed

Abbate, G M; Mangano, A; Sacerdote, P; Amodeo, G; Moschetti, G; Levrini, L

2017-01-01

The aim of this study was to evaluate substance P (SP) levels and the effect of a non-steroidal anti-inflammatory drug (NSAID), ketoprofen, on SP in the pericoronal gingival tissue after extraction of upper third molars. A sample of 20 young non-smoking systemically healthy adults of both sexes, with a healthy upper third molar to extract for orthodontic purposes, was selected. After extraction, a sample of the gingival tissue of the pericoronal region was collected with a sterile scalpel, placed into test tubes and kept frozen at -20°C until the SP determination. SP levels were determined by using a commercially available enzyme immunoassay (ELISA) kit. The subjects were randomly divided into two groups: group 1 received a single dose of ketoprofen 30 minutes prior to the experimental procedure. The subjects of group 2 did not receive any kind of drug administration before extraction. The patients were asked to complete a diary on the postoperative pain. A relevant amount of SP was measured in all the gingival samples. No statistically significant difference could be detected in SP expression between the two groups. In group 1 pain appearance was significantly delayed (6.2±0.13 hours) in comparison with group 2 (3.95±0.2 hours). In this small selected group of subjects and limited study design, preventive administration of ketoprofen did not significantly affect the gingival levels of SP, the clinical recommendation emerging is that of NSAID administration postoperatively but before pain appearance in order to optimize the management of pain of the patient.

Upper Gastrointestinal Stent Insertion in Malignant and Benign Disorders

PubMed Central

Kang, Hyoun Woo

2015-01-01

Upper gastrointestinal (GI) stents are increasingly being used to manage upper GI obstructions. Initially developed for palliative treatment of esophageal cancer, upper GI stents now play an emerging role in benign strictures of the upper GI tract. Because recurrent obstruction and stent-related complications are common, new modifications of stents have been implemented. Self-expandable metal stents (SEMS) have replaced older plastic stents. In addition, newly designed SEMS have been developed to prevent complications. This review provides an overview of the various types, indications, methods, complications, and clinical outcomes of upper GI stents in a number of malignant and benign disorders dividing the esophagus and gastroduodenum. PMID:26064817

Upper Atmosphere Research Satellite (UARS): A program to study global ozone change

NASA Technical Reports Server (NTRS)

1991-01-01

A general overview of NASA's Upper Atmosphere Research Satellite (UARS) program is presented in a broad based informational publication. The UARS will be responsible for carrying out the first systematic, comprehensive study of the stratosphere and will furnish important new data on the mesosphere and thermosphere. The UARS mission objectives are to provide an increased understanding of energy input into the upper atmosphere; global photochemistry of the upper atmosphere; dynamics of the upper atmosphere; coupling among these processes; and coupling between the upper and lower atmosphere. These mission objectives are briefly described along with the UARS on-board instrumentation and related data management systems.

Endoscopic management and outcomes of pregnant women hospitalized for nonvariceal upper GI bleeding: a nationwide analysis.

PubMed

Nguyen, Geoffrey C; Dinani, Amreen M; Pivovarov, Kevin

2010-11-01

Upper GI endoscopy has an important diagnostic and therapeutic role in the management of nonvariceal upper GI bleeding (NVUGB). To characterize nationwide patterns of utilization of upper GI endoscopy in pregnant women with NVUGB and to assess health outcomes. Retrospective cohort study. Participating hospitals from the Nationwide Inpatient Sample, 1998-2007. Pregnant and age-matched nonpregnant women admitted for NVUGB. The study population was classified as pregnant women with NVUGB (n = 1210) and nonpregnant women with NVUGB (n = 6050). Rate of upper GI endoscopy, maternal mortality, fetal death/complications, and premature delivery. Pregnant women were less likely than nonpregnant women to undergo upper GI endoscopy (26% vs 69%; P < .0001) even after adjustment for comorbidities, transfusion requirement, and the presence of hypovolemic shock (adjusted odds ratio, 0.19; 95% confidence interval, 0.16-0.22). Among those who underwent endoscopy, pregnant women were less likely to undergo the procedure within 24 hours of admission (50% vs 57%; P = .02). Mortality was lower among pregnant women compared with nonpregnant women (0% vs 0.6%; P = .006). In comparing outcomes between those who did and did not undergo endoscopy, there was no difference in fetal loss (0.2% vs 0.6%), fetal distress/complications (2.7% vs 2.6%), or premature delivery (7.3% vs 6.4%). The study was based on administrative data. A conservative nonendoscopic approach is common in the management of pregnant women with NVUGB and is not associated with worse maternal or fetal outcomes. Upper GI endoscopy is, however, safe when judiciously implemented in the actively bleeding patient. Copyright © 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

Estimating Radiological Doses to Predators Foraging in a Low-Level Radioactive Waste Management Area

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

L.Soholt; G.Gonzales; P.Fresquez

2003-03-01

Since 1957, Los Alamos National Laboratory has operated Area G as its low-level, solid radioactive waste management and disposal area. Although the waste management area is developed, plants, small mammals, and avian and mammalian predators still occupy the less disturbed and revegetated portions of the land. For almost a decade, we have monitored the concentrations of selected radionuclides in soils, plants, and small mammals at Area G. The radionuclides tritium, plutonium-238, and plutonium-239 are regularly found at levels above regional background in all three media. Based on radionuclide concentrations in mice collected from 1994 to 1999, we calculated doses tomore » higher trophic levels (owl, hawk, kestrel, and coyote) that forage on the waste management area. These predators play important functions in the regional ecosystems and are an important part of local Native American traditional tales that identify the uniqueness of their culture. The estimated doses are compared to Department of Energy's interim limit of 0.1 rad/day for the protection of terrestrial wildlife. We used exposure parameters that were derived from the literature for each receptor, including Environmental Protection Agency's exposure factors handbook. Estimated doses to predators ranged from 9E-06 to 2E-04 rad/day, assuming that they forage entirely on the waste management area. These doses are greater than those calculated for predators foraging exclusively in reference areas, but are still well below the interim dose limit. We believe that these calculated doses represent upper-bound estimates of exposure for local predators because the larger predators forage over areas that are much greater than the 63-acre waste management area. Based on these results, we concluded that predators foraging on this area do not face a hazard from radiological exposure under current site conditions.« less

Opportunities for Reducing Nitrate Export from Drainage Systems through In-field Nitrogen Management, Cropping Practices, and Drainage Design and Management

NASA Astrophysics Data System (ADS)

Helmers, M.; Zhou, X.; Qi, Z.; Christianson, R.; Pederson, C.

2011-12-01

Subsurface drainage systems are widely used throughout the upper Midwest corn-belt. While the use of these drainage systems has greatly increased crop production, they have also increased nitrate-nitrogen export to downstream waterbodies. As a result, there is a need to evaluate and implement management practices that have potential to reduce nitrate-nitrogen loss. A twenty year study in Iowa has shown that major factors in nitrate-nitrogen loss are land use and hydrology. Studies from north-central Iowa have also indicated that nitrogen application rate and to a lesser degree timing of nitrogen application important factors for nitrate-nitrogen loss. A four-year (2007-2010) drainage management study in southeast Iowa indicates that shallow and controlled drainage systems have potential to decrease subsurface drainage and thereby reduce nitrate-N loss from drain water but the level of implementation of controlled drainage may be limited by topography. Cropping practices through cover crops or perennial biomass crops have also been documented to have potential to reduce downstream nitrate-nitrogen export but the level of implementation may be limited by management and economic considerations. To achieve reduction goals for protection of local and regional water quality will require a combination of these practices at the landscape scale.

Potentiometric surface of the intermediate aquifer system, west- central Florida, May 1987

USGS Publications Warehouse

Lewelling, B.R.

1988-01-01

The intermediate aquifer system within the Southwest Florida Water Management District underlies a 5,000 sq mi area of De Soto, Sarasota, Hardee, Manatee, and parts of Charlotte, Hillsborough, Highlands, and Polk Counties. The intermediate aquifer system occurs between the overlying surficial aquifer system and the underlying Floridan aquifer system, and consists of layers of sand, shell, clay, marl, limestone, and dolom of the Tamiami, Hawthorn, and Tampa Formations of late Tertiary age. The intermediate aquifer system contains one or more water-bearing units separated by discontinuous confining units. This aquifer system is the principal source of potable water in the southwestern part of the study area and is widely used as a source of water in other parts where wells are open to the intermediate aquifer system or to both the intermediate and Floridan aquifer systems. Yields of individual wells open to the intermediate aquifer system range from a few gallons to several hundred gallons per minute. The volume of water withdrawn from the intermediate aquifer system is considerably less than that withdrawn from the Floridan aquifer system in the study area. The surface was mapped by determining the altitude of water levels in a network of wells and is represented on maps by contours that connect points of equal altitude. The compos potentiometric surface of all water-bearing units within the intermediate aquifer system is shown. In areas where multiple aquifers exist, wells open to all aquifers were selected for water level measurements whenever possible. In the southwestern and lower coastal region of the study area, two aquifers and confining units are described for the intermediate aquifer system: the Tamiami-upper Hawthorn aquifer and the underlying lower Hawthorn-upper Tampa aquifer. The potentiometric surface of the Tamiami-upper Hawthorn aquifer is also shown. Water levels are from wells drilled and open exclusively to that aquifer. The exact boundary for the Tamiami-upper Hawthorn aquifer is undetermined because of limd geohydrologic data available from wells. (Lantz-PTT)

Management guidelines for enhancing Cerulean Warbler breeding habitat in Appalachian hardwood forests

USGS Publications Warehouse

Wood, Petra; Sheehan, James; Keyser, Patrick D.; Buehler, David A.; Larkin, Jeff; Rodewald, Amanda D.; Stoleson, Scott H.; Wigley, T. Bently; Mizel, Jeremy; Boves, Than J.; George, Greg; Bakermans, Marja H.; Beachy, Tiffany A.; Evans, Andrea; McDermott, Molly E.; Newell, Felicity L.; Perkins, Kelly A.; White, Matt

2013-01-01

The Cerulean Warbler (Setophaga cerulea) is a migratory songbird that breeds in mature deciduous forests of eastern North America. Cerulean Warblers (hereafter, ceruleans) require heavily forested landscapes for nesting and, within Appalachian forests, primarily occur on ridge tops and steep, upper slopes. They are generally associated with oakdominated (Quercus spp.) stands that contain gaps in the forest canopy, that have large diameter trees (>16 inches diameter breast height (dbh)), and that have well-developed understory-and upper-canopy layers. Ceruleans primarily use the midand upper-canopy where they glean insects from the surface of leaves and conceal their open cup nests. Because they are severely declining across much of their range (Fig. 1), habitat management is a high priority. Management for this species can also improve conditions for a number of other wildlife species that depend on the same structure.

Role of Interventional Radiology in the Emergent Management of Acute Upper Gastrointestinal Bleeding

PubMed Central

Navuluri, Rakesh; Patel, Jay; Kang, Lisa

2012-01-01

Approximately 100,000 cases of upper gastrointestinal bleeding (UGIB) require inpatient admission annually in the United States. When medical management and endoscopic therapy are inadequate, endovascular intervention can be lifesaving. These emergent situations highlight the importance of immediate competence of the interventional radiologist in the preangiographic evaluation as well as the endovascular treatment of UGIB. We describe a case of UGIB managed with endovascular embolization and detail the angiographic techniques used. The case description is followed by a detailed discussion of the treatment approach to UGIB, with attention to both nonvariceal and variceal algorithms. PMID:23997408

Geographic distribution of genetic diversity in populations of Rio Grande Chub Gila pandora

USGS Publications Warehouse

Galindo, Rene; Wilson, Wade; Caldwell, Colleen A.

2016-01-01

In the southwestern United States (US), the Rio Grande chub (Gila pandora) is state-listed as a fish species of greatest conservation need and federally listed as sensitive due to habitat alterations and competition with non-native fishes. Characterizing genetic diversity, genetic population structure, and effective number of breeders will assist with conservation efforts by providing a baseline of genetic metrics. Genetic relatedness within and among G. pandora populations throughout New Mexico was characterized using 11 microsatellite loci among 15 populations in three drainage basins (Rio Grande, Pecos, Canadian). Observed heterozygosity (HO) ranged from 0.71–0.87 and was similar to expected heterozygosity (0.75–0.87). Rio Ojo Caliente (Rio Grande) had the highest allelic richness (AR = 15.09), while Upper Rio Bonito (Pecos) had the lowest allelic richness (AR = 6.75). Genetic differentiation existed among all populations with the lowest genetic variation occurring within the Pecos drainage. STRUCTURE analysis revealed seven genetic clusters. Populations of G. pandora within the upper Rio Grande drainage (Rio Ojo Caliente, Rio Vallecitos, Rio Pueblo de Taos) had high levels of admixture with Q-values ranging from 0.30–0.50. In contrast, populations within the Pecos drainage (Pecos River and Upper Rio Bonito) had low levels of admixture (Q = 0.94 and 0.87, respectively). Estimates of effective number of breeders (N b ) varied from 6.1 (Pecos: Upper Rio Bonito) to 109.7 (Rio Grande: Rio Peñasco) indicating that populations in the Pecos drainage are at risk of extirpation. In the event that management actions are deemed necessary to preserve or increase genetic diversity of G. pandora, consideration must be given as to which populations are selected for translocation.

Water-table and Potentiometric-surface altitudes in the Upper Glacial, Magothy, and Lloyd aquifers beneath Long Island, New York, April-May 2010

USGS Publications Warehouse

Monti, Jack; Como, Michael D.; Busciolano, Ronald J.

2013-01-01

The U.S. Geological Survey (USGS), in cooperation with State and local agencies, systematically collects groundwater data at varying measurement frequencies to monitor the hydrologic conditions on Long Island, New York. Each year during April and May, the USGS conducts a synoptic survey of water levels to define the spatial distribution of the water table and potentiometric surfaces within the three main water-bearing units underlying Long Island—the upper glacial, Magothy, and Lloyd aquifers (Smolensky and others, 1989)—and the hydraulically connected Jameco (Soren, 1971) and North Shore aquifers (Stumm, 2001). These data and the maps constructed from them are commonly used in studies of Long Island’s hydrology and are used by water managers and suppliers for aquifer management and planning purposes. Water-level measurements made in 503 monitoring wells, a network of observation and supply wells, and 16 streamgage locations across Long Island during April–May 2010 were used to prepare the maps in this report. Measurements were made by the wetted-tape method to the nearest hundredth of a foot. Water-table and potentiometric-surface altitudes in these aquifers were contoured by using these measurements. The water-table contours were interpreted by using water-level data collected from 16 streamgages, 349 observation wells, and 1 supply well screened in the upper glacial aquifer and (or) shallow Magothy aquifer; the Magothy aquifer’s potentiometric-surface contours were interpreted from measurements at 67 observation wells and 27 supply wells screened in the middle to deep Magothy aquifer and (or) the contiguous and hydraulically connected Jameco aquifer. The Lloyd aquifer’s potentiometric-surface contours were interpreted from measurements at 55 observation wells and 4 supply wells screened in the Lloyd aquifer or the contiguous and hydraulically connected North Shore aquifer. Many of the supply wells are in continuous operation and, therefore, were turned off for a minimum of 24 hours before measurements were made so that the water levels in the wells could recover to the level of the potentiometric head in the surrounding aquifer. Full recovery time at some of these supply wells can exceed 24 hours; therefore, water levels measured at these wells are assumed to be less accurate than those measured at observation wells, which are not pumped (Busciolano, 2002). In this report, all water-level altitudes are referenced to the National Geodetic Vertical Datum of 1929 (NGVD 29). Hydrographs are included on these maps for selected wells that are instrumented with recording equipment. These hydrographs are representative of the 2010 water year1 to show the changes that have occurred throughout that period. The synoptic survey water level measured at the well is included on each hydrograph.

Transcatheter arterial embolization for acute nonvariceal upper gastrointestinal bleeding: Indications, techniques and outcomes.

PubMed

Loffroy, R; Favelier, S; Pottecher, P; Estivalet, L; Genson, P Y; Gehin, S; Cercueil, J P; Krausé, D

2015-01-01

Over the past three decades, transcatheter arterial embolization has become the first-line therapy for the management of acute nonvariceal upper gastrointestinal bleeding that is refractory to endoscopic hemostasis. Advances in catheter-based techniques and newer embolic agents, as well as recognition of the effectiveness of minimally invasive treatment options, have expanded the role of interventional radiology in the treatment of bleeding for a variety of indications. Transcatheter arterial embolization is a fast, safe, and effective minimally invasive alternative to surgery, when endoscopic treatment fails to control acute bleeding from the upper gastrointestinal tract. This article describes the role of arterial embolization in the management of acute nonvariceal upper gastrointestinal bleeding and summarizes the literature evidence on the outcomes of endovascular therapy in such a setting. Copyright © 2015 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

Elongated uvula and diagnostic utility of spirometry in upper airway obstruction

PubMed Central

Paliwal, Rajiv; Patel, Satish; Patel, Purvesh; Soni, Hiren

2010-01-01

Elongated uvula is relatively an uncommon condition. Upper airway obstruction is often a missed complication of such a rare condition. Clinical presentations of upper airway obstruction often mimic asthma. Hence it is very easily mis-diagnosed as asthma. Spirometry offers a very simple test to diagnose upper airway obstruction very early and easily. Once diagnosed, the management of elongated uvula, almost exclusively, is surgical excision leading to total cure. Here is a case report of such a rare condition. PMID:20539769

Effectiveness of cervical epidural injections in the management of chronic neck and upper extremity pain.

PubMed

Diwan, Sudhir; Manchikanti, Laxmaiah; Benyamin, Ramsin M; Bryce, David A; Geffert, Stephanie; Hameed, Haroon; Sharma, Manohar Lal; Abdi, Salahadin; Falco, Frank J E

2012-01-01

Chronic persistent neck pain with or without upper extremity pain is common in the general adult population with prevalence of 48% for women and 38% for men, with persistent complaints in 22% of women and 16% of men. Multiple modalities of treatments are exploding in managing chronic neck pain along with increasing prevalence. However, there is a paucity of evidence for all modalities of treatments in managing chronic neck pain. Cervical epidural injections for managing chronic neck pain are one of the commonly performed interventions in the United States. However, the literature supporting cervical epidural steroids in managing chronic pain problems has been scant. A systematic review of cervical interlaminar epidural injections for cervical disc herniation, cervical axial discogenic pain, cervical central stenosis, and cervical postsurgery syndrome. To evaluate the effect of cervical interlaminar epidural injections in managing various types of chronic neck and upper extremity pain emanating as a result of cervical spine pathology. The available literature on cervical interlaminar epidural injections in managing chronic neck and upper extremity pain were reviewed. The quality assessment and clinical relevance criteria utilized were the Cochrane Musculoskeletal Review Group criteria as utilized for interventional techniques for randomized trials and the criteria developed by the Newcastle-Ottawa Scale criteria for observational studies. The level of evidence was classified as good, fair, and limited based on the quality of evidence developed by the U.S. Preventive Services Task Force (USPSTF). Data sources included relevant literature identified through searches of PubMed and EMBASE from 1966 to December 2011, and manual searches of the bibliographies of known primary and review articles. The primary outcome measure was pain relief (short-term relief = up to 6 months and long-term > 6 months). Secondary outcome measures were improvement in functional status, psychological status, return to work, and reduction in opioid intake. For this systematic review, 34 studies were identified. Of these, 24 studies were excluded and a total of 9 randomized trials, with 2 duplicate studies, met inclusion criteria for methodological quality assessment. For cervical disc herniation, the evidence is good for cervical epidural with local anesthetic and steroids; whereas, it was fair with local anesthetic only. For axial or discogenic pain, the evidence is fair for local anesthetic, with or without steroids. For spinal stenosis, the evidence is fair for local anesthetic, with or without steroids. For postsurgery syndrome, the evidence is fair for local anesthetic, with or without steroids. The limitations of this systematic review continue to be the paucity of literature. The evidence is good for radiculitis secondary to disc herniation with local anesthetics and steroids, fair with local anesthetic only; whereas, it is fair for local anesthetics with or without steroids, for axial or discogenic pain, pain of central spinal stenosis, and pain of post surgery syndrome.

Impact of integrated upper limb spasticity management including botulinum toxin A on patient-centred goal attainment: rationale and protocol for an international prospective, longitudinal cohort study (ULIS-III)

PubMed Central

Turner-Stokes, Lynne; Ashford, Stephen; Jacinto, Jorge; Maisonobe, Pascal; Balcaitiene, Jovita; Fheodoroff, Klemens

2016-01-01

Objectives Describe the rationale and protocol for the Upper Limb International Spasticity (ULIS)-III study, which aims to evaluate the impact of integrated spasticity management, involving multiple botulinum toxin A (BoNT-A) injection cycles and concomitant therapies, on patient-centred goal attainment. Outline novel outcome assessment methods for ULIS-III and report initial evaluation data from goal setting in early stages of the study. Design Large international longitudinal cohort study of integrated upper limb spasticity management, including BoNT-A. Participants and setting ULIS-III is a 2-year study expected to enrol >1000 participants at 58 study centres across 14 countries. Interventions The study design is non-interventional and intended to reflect real-life clinical practice. It will describe injection practices and additional treatment strategies, and record clinical decision-making in a serial approach to long-term spasticity management. Outcome measures ULIS-III will use a goal-directed approach to selection of targeted standardised measures to capture the diversity of presentation, goals and outcomes. ULIS-III will implement the Upper Limb Spasticity Index, a battery of assessments including a structured approach to goal attainment scaling (Goal Attainment Scaling—Evaluation of Outcomes for Upper Limb Spasticity tool), alongside a limited set of standardised measures, chosen according to patients' selected goal areas. Concomitant therapy inputs, patient satisfaction with engagement in goal setting, health economic end points and health-related quality of life data will also be captured. Results of initial evaluation of goal quality Recruitment started in January 2015. By June 2015, 58 sites had been identified and initial data collected for 79 patients across 13 sites in 3 countries. Goal setting data were quality-checked and centres rated on the basis of function-related and Specific, Measurable, Achievable, Realistic, Timed (SMART) characteristics of goal statements. Overall, 11/13 centres achieved the highest rating (A++). Conclusions ULIS-III will provide valuable information regarding treatment of and outcomes from real-life upper limb spasticity management worldwide. Trial registration number NCT02454803; Pre-results. PMID:27315835

Definitive airway management of patients presenting with a pre-hospital inserted King LT(S)-D laryngeal tube airway: a historical cohort study.

PubMed

Subramanian, Arun; Garcia-Marcinkiewicz, Annery G; Brown, Daniel R; Brown, Michael J; Diedrich, Daniel A

2016-03-01

The King LT(S)-D laryngeal tube (King LT) has gained popularity as a bridge airway for pre-hospital airway management. In this study, we retrospectively reviewed the use of the King LT and its associated airway outcomes at a single Level 1 trauma centre. The data on all adult patients presenting to the Mayo Clinic in Rochester, Minnesota with a King LT in situ from July 1, 2007 to October 10, 2012 were retrospectively evaluated. Data collected and descriptively analyzed included patient demographics, comorbidities, etiology of respiratory failure, airway complications, subsequent definitive airway management technique, duration of mechanical ventilation, and status at discharge. Forty-eight adult patients met inclusion criteria. The most common etiology for respiratory failure requiring an artificial airway was cardiac arrest [28 (58%) patients] or trauma [9 (19%) patients]. Four of the nine trauma patients had facial trauma. Surgical tracheostomy was the definitive airway management technique in 14 (29%) patients. An airway exchange catheter, direct laryngoscopy, and video laryngoscopy were used in 11 (23%), ten (21%), and ten (21%) cases, respectively. Seven (78%) of the trauma patients underwent surgical tracheostomy compared with seven (18%) of the medical patients. Adverse events associated with King LT use occurred in 13 (27%) patients, with upper airway edema (i.e., tongue engorgement and glottic edema) being most common (19%). In this study of patients presenting to a hospital with a King LT, the majority of airway exchanges required an advanced airway management technique beyond direct laryngoscopy. Upper airway edema was the most common adverse observation associated with King LT use.

Health care managers' views on and approaches to implementing models for improving care processes.

PubMed

Andreasson, Jörgen; Eriksson, Andrea; Dellve, Lotta

2016-03-01

To develop a deeper understanding of health-care managers' views on and approaches to the implementation of models for improving care processes. In health care, there are difficulties in implementing models for improving care processes that have been decided on by upper management. Leadership approaches to this implementation can affect the outcome. In-depth interviews with first- and second-line managers in Swedish hospitals were conducted and analysed using grounded theory. 'Coaching for participation' emerged as a central theme for managers in handling top-down initiated process development. The vertical approach in this coaching addresses how managers attempt to sustain unit integrity through adapting and translating orders from top management. The horizontal approach in the coaching refers to managers' strategies for motivating and engaging their employees in implementation work. Implementation models for improving care processes require a coaching leadership built on close manager-employee interaction, mindfulness regarding the pace of change at the unit level, managers with the competence to share responsibility with their teams and engaged employees with the competence to share responsibility for improving the care processes, and organisational structures that support process-oriented work. Implications for nursing management are the importance of giving nurse managers knowledge of change management. © 2015 John Wiley & Sons Ltd.

Clinico-Radiological Diagnosis of Isolated Congenital Esophageal Stenosis in a Preterm Neonate

PubMed Central

Sham, Minakshi

2013-01-01

A 2-day-old preterm female neonate weighing 1.6 kg and having excessive frothing from mouth was investigated for suspected esophageal atresia and tracheoesophageal fistula. X-ray findings of an unusually low-ending upper pouch (up to T8 level) and the absence of gas in abdomen lead to suspicion of an unusual variety of esophageal atresia. Hence unlike the usual management of pure esophageal atresia, in terms of esophagostomy and gastrostomy in neonatal period, right thoracotomy was performed allowing successful primary anastomosis. A high index of suspicion on the basis of radiological picture led to early diagnosis of a rare anomaly like congenital esophageal stenosis and successful management of this low birth weight baby. PMID:25755945

Scaling up food production in the Upper Mississippi river basin: modeling impacts on water quality and nutrient cycling

NASA Astrophysics Data System (ADS)

Bowen, E. E.; Martin, P. A.; Schuble, T. J.; Yan, E.; Demissie, Y.

2010-12-01

Agricultural production imposes significant environmental stress on the landscape, both in the intensity and extent of agricultural activities. Among the most significant impacts, agriculture dominates the natural reactive nitrogen cycle, with excess reactive nitrogen leading to the degraded quality of inland and coastal waters. In the U.S., policymakers and stakeholders nationwide continue to debate strategies for decreasing environmental degradation from agricultural lands. Such strategies aim to optimize the balance among competing demands for food, fuel and ecosystem services. One such strategy increasingly discussed in the national debate is that of localizing food production around urban areas, developing what some have recently called “foodsheds”. However, the environmental impacts of localizing food production around population centers are not well-understood given the hard-to-generalize variety seen in management practices currently employed among local farms marketing food crops directly to consumers. As a first, landscape level study of potential impacts from scaling up this type of agriculture, we use the USDA Soil and Water Assessment Tool (SWAT) model to quantify environmental impacts from developing foodsheds for all population centers in the Upper Mississippi river basin. Specifically, we focus on nutrient cycling and water quality impacts determining direct greenhouse gas emissions and changes to nutrient runoff from increased food production in this watershed. We investigate a variety of scenarios in which food production is scaled up to the regional level using different types of farm management practices, ranging from conventional production of fruits and vegetables, to production of these products from small-scale, diversified systems integrating conservation easements. In addition to impacts on nutrient cycling and water quality, we also characterize relative levels of productivity in conjunction with overall demand for food associated with population centers to address one aspect of socio-economic concern.

Numerical simulations of a transverse indirect circulation and low-level jet in the exit region of an upper-level jet

NASA Technical Reports Server (NTRS)

Brill, K. F.; Uccellini, L. W.; Burkhart, R. P.; Warner, T. T.; Anthes, R. A.

1985-01-01

A numerical study was performed of a severe weather event (tornado) which occurred on May 10, 1973 in the Ohio region. The situation was modeled with a primitive equation mesoscale dynamic formulation. Account was taken of precipitation, the planetary boundary layer parameters as bulk quantities, the vertical pressure gradient, and lateral boundary conditions based on radiosonde data. Two 12-hr simulations, adiabatic and nondivergent, respectively, were analyzed for relationships between upper and lower level jets. In the adiabatic formulation, a transverse circulation with a low level jet formed at the exit region of the upper level jet. The nondivergent situation led to similar, but weaker, phenomena. Both forms suggest that indirect circulation in the exit zone of an upper level jet is strongly influenced by the initial structure of the jet.

Physician decision-making in the management of work related upper extremity injuries.

PubMed

Szekeres, Mike; Macdermid, Joy C; Katchky, Adam; Grewal, Ruby

2018-05-22

Physicians working in a tertiary care injured worker clinic are faced with clinical decision-making that must balance the needs of patients and society in managing complex clinical problems that are complicated by the work-workplace context. The purpose of this study is to describe and characterize the decision-making process of upper extremity specialized surgeons when managing injured workers within a specialized worker's compensation clinic. Surgeons were interviewed in a semi-structured manner. Following each interview, the surgeon was also observed in a clinic visit during a new patient assessment, allowing observation of the interactional patterns between surgeon and patient, and comparison of the process described in the interview to what actually occurred during clinic visits. The primary central theme emerging from the surgeon interviews and the clinical observation was the focus on the importance of comprehensive assessment to make the first critical decision: an accurate diagnosis. Two subthemes were also found. The first of these involved the decision whether to proceed to management strategies or to continue with further investigation if the correct diagnosis is uncertain. Once the central theme of diagnosis was achieved, a second subtheme was highlighted; selecting appropriate management options, given the complexities of managing the injured worker, the workplace, and the compensation board. This study illustrates that upper extremity surgeons rely on their training and experience with upper extremity conditions to follow a sequential but iterative decision-making process to provide a more definitive diagnosis and treatment plan for workers with injuries that are often complex. The surgeons are challenged by the context which takes them out of their familiar zone of typical clinical practice to deal with the interactions between the injury, worker, work, workplace and insurer.

[Primary upper urinary tract tumors and subsequent location in the bladder].

PubMed

Azémar, M-D; Audouin, M; Revaux, A; Misraï, V; Comperat, E; Bitker, M-O; Chartier-Kastler, E; Richard, F; Cussenot, O; Rouprêt, M

2009-10-01

The urothelium is the epithelium that lines the upper and lower urinary tract. Over 95% of urothelial carcinomas are derived from urothelium. They can be located in the lower tract (bladder, urethra) or upper tract (pyelocaliceal cavities, ureter). Urothelial carcinomas are the fourth most common tumours after prostate (or breast) cancer, lung cancer and colorectal cancer. On one hand, bladder tumours account for 90-95% of urothelial carcinomas. It is the most common malignancy of the urinary tract and the second most common malignancy of the urogenital tract after prostate cancer. It accounts for 5-10% of all cancers diagnosed each year in Europe. On the other hand, upper urinary tract urothelial cell carcinomas (UUT-UCC) are scarce and account for only 5-10% of urothelial carcinomas. Recurrence in the bladder after primary UUT-UCC occurs in 15-50% of UUT-UCC. Differences in treatment modalities of the primary UUT-UCC do not play a key role in the subsequent appearance of a bladder recurrence. However, others factors have been described such as stage and location in the upper tract of the primary tumour or upper tract tumour multifocality. Previous history of bladder tumour is also associated with the risk that another tumour arises in the bladder subsequently. However, it becomes difficult to distinguish between natural history of bladder tumour and evolution of UUT-UCC in these cases. In most cases, bladder cancer occurs in the first two years after UUT-UCC management. Surveillance protocol is based on cystoscopy and on urinary cytology during at least every three months for two years. Current surveillance regimen have a low level of evidence considering the paucity of UUT-UCC.

Hemobilia: An Uncommon But Notable Cause of Upper Gastrointestinal Bleeding.

PubMed

Cathcart, Scott; Birk, John W; Tadros, Michael; Schuster, Micheal

2017-10-01

A literature review to improve practitioners' knowledge and performance concerning the epidemiology, diagnosis, and management of hemobilia. A search of Pubmed, Google Scholar, and Medline was conducted using the keyword hemobilia and relevant articles were reviewed and analyzed. The findings pertaining to hemobilia etiology, investigation, and management techniques were considered and organized by clinicians practiced in hemobilia. The majority of current hemobilia cases have an iatrogenic cause from either bile duct or liver manipulation. Blunt trauma is also a significant cause of hemobilia. The classic triad presentation of right upper quadrant pain, jaundice, and upper gastrointestinal bleeding is rarely seen. Computed tomography and magnetic resonance imaging are the preferred diagnostic modalities, and the preferred therapeutic management includes interventional radiology and endoscopic retrograde cholangiopancreatography. Surgery is rarely a therapeutic option. With advances in computed tomography and magnetic resonance imaging technology, diagnosis with these less invasive investigations are the favored option. However, traditional catheter angiography is still the gold standard. The management of significant hemobilia is still centered on arterial embolization, but arterial and biliary stents have become accepted alternative therapies.

Recent advances in endovascular techniques for management of acute nonvariceal upper gastrointestinal bleeding

PubMed Central

Loffroy, Romaric F; Abualsaud, Basem A; Lin, Ming D; Rao, Pramod P

2011-01-01

Over the past two decades, transcatheter arterial embolization has become the first-line therapy for the management of upper gastrointestinal bleeding that is refractory to endoscopic hemostasis. Advances in catheter-based techniques and newer embolic agents, as well as recognition of the effectiveness of minimally invasive treatment options, have expanded the role of interventional radiology in the management of hemorrhage for a variety of indications, such as peptic ulcer bleeding, malignant disease, hemorrhagic Dieulafoy lesions and iatrogenic or trauma bleeding. Transcatheter interventions include the following: selective embolization of the feeding artery, sandwich coil occlusion of the gastroduodenal artery, blind or empiric embolization of the supposed bleeding vessel based on endoscopic findings and coil pseudoaneurysm or aneurysm embolization by three-dimensional sac packing with preservation of the parent artery. Transcatheter embolization is a fast, safe and effective, minimally invasive alternative to surgery when endoscopic treatment fails to control bleeding from the upper gastrointestinal tract. This article reviews the various transcatheter endovascular techniques and devices that are used in a variety of clinical scenarios for the management of hemorrhagic gastrointestinal emergencies. PMID:21860697

Model Based Definition

NASA Technical Reports Server (NTRS)

Rowe, Sidney E.

2010-01-01

In September 2007, the Engineering Directorate at the Marshall Space Flight Center (MSFC) created the Design System Focus Team (DSFT). MSFC was responsible for the in-house design and development of the Ares 1 Upper Stage and the Engineering Directorate was preparing to deploy a new electronic Configuration Management and Data Management System with the Design Data Management System (DDMS) based upon a Commercial Off The Shelf (COTS) Product Data Management (PDM) System. The DSFT was to establish standardized CAD practices and a new data life cycle for design data. Of special interest here, the design teams were to implement Model Based Definition (MBD) in support of the Upper Stage manufacturing contract. It is noted that this MBD does use partially dimensioned drawings for auxiliary information to the model. The design data lifecycle implemented several new release states to be used prior to formal release that allowed the models to move through a flow of progressive maturity. The DSFT identified some 17 Lessons Learned as outcomes of the standards development, pathfinder deployments and initial application to the Upper Stage design completion. Some of the high value examples are reviewed.

Managed nutrient reduction impacts on nutrient concentrations, water clarity, primary production, and hypoxia in a north temperate estuary

NASA Astrophysics Data System (ADS)

Oviatt, Candace; Smith, Leslie; Krumholz, Jason; Coupland, Catherine; Stoffel, Heather; Keller, Aimee; McManus, M. Conor; Reed, Laura

2017-12-01

Except for the Providence River and side embayments like Greenwich Bay, Narragansett Bay can no longer be considered eutrophic. In summer 2012 managed nitrogen treatment in Narragansett Bay achieved a goal of reducing effluent dissolved inorganic nitrogen inputs by over 50%. Narragansett Bay represents a small northeast US estuary that had been heavily loaded with sewage effluent nutrients since the late 1800s. The input reduction was reflected in standing stock nutrients resulting in a statistically significant 60% reduction in concentration. In the Providence River estuary, total nitrogen decreased from 100 μm to about 40 μm, for example. We tested four environmental changes that might be associated with the nitrogen reduction. System apparent production was significantly decreased by 31% and 45% in the upper and mid Bay. Nutrient reductions resulted in statistically improved water clarity in the mid and upper Bay and in a 34% reduction in summer hypoxia. Nitrogen reduction also reduced the winter spring diatom bloom; winter chlorophyll levels after nutrient reduction have been significantly lower than before the reduction. The impact on the Bay will continue to evolve over the next few years and be a natural experiment for other temperate estuaries that will be experiencing nitrogen reduction. To provide perspective we review factors effecting hypoxia in other estuaries with managed nutrient reduction and conclude that, as in Narragansett Bay, physical factors can be as important as nutrients. On a positive note managed nutrient reduction has mitigated further deterioration in most estuaries.

Surveillance and management of urologic complications after spinal cord injury.

PubMed

Kreydin, Evgeniy; Welk, Blayne; Chung, Doreen; Clemens, Quentin; Yang, Claire; Danforth, Teresa; Gousse, Angelo; Kielb, Stephanie; Kraus, Stephen; Mangera, Altaf; Reid, Sheilagh; Szell, Nicole; Cruz, Francisco; Chartier-Kastler, Emmanuel; Ginsberg, David A

2018-05-29

Neurogenic bladder due to spinal cord injury has significant consequences for patients' health and quality of life. Regular surveillance is required to assess the status of the upper and lower urinary lower urinary tracts and prevent their deterioration. In this review, we examine surveillance techniques in neurogenic bladder, describe common complications of this disease, and address strategies for their management. This work represents the efforts of SIU-ICUD joint consultation on Urologic Management of the Spinal Cord injury. For this specific topic, a workgroup was formed and comprehensive literature search of English language manuscripts regarding neurogenic bladder management was performed using key words of neurogenic bladder. Articles were compiled, and recommendations in the chapter are based on group discussion and follow the Oxford Centre for Evidence-based Medicine system for Levels of Evidence (LOEs) and Grades of Recommendation (GORs). At a minimum, patients should undergo an annual history and physical examination, renal functional testing (e.g., serum creatinine), and upper tract imaging (e.g., renal ultrasonography). The existing evidence does not support the use of other modalities, such as cystoscopy or urodynamics, for routine surveillance. Urologic complications in neurogenic bladder patients are common and often more complex than in the general population. There is a shortage of high-quality evidence to support any particular neurogenic bladder surveillance protocol. However, there is consensus regarding certain aspects of regular genitourinary system evaluation in these patients. Proper surveillance allows the clinician to avoid or address common urological complications, and to guide, alter, or maintain appropriate therapeutic regimens for individual patients.

A contemporary review of management and prognostic factors of upper tract urothelial carcinoma.

PubMed

Leow, Jeffrey J; Orsola, Anna; Chang, Steven L; Bellmunt, Joaquim

2015-04-01

Upper tract urothelial carcinoma (UTUC) accounts for <5% of all urothelial cancers. Although the main treatment is radical nephroureterectomy (NU), oncologic outcomes are not comparable to lower tract urothelial cancers. Identifying prognostic factors can help guide management and potentially improve outcomes. This article systematically reviews current literature on prognostic factors and management options for UTUC. A comprehensive literature search was performed to identify all studies examining prognostic factors and management options for UTUC. The search included the Medline, Embase, Cochrane Central Register of Controlled Trials databases, and abstracts from the American Society of Clinical Oncology meetings up to November 2014. An updated systematic review was performed. Preoperative prognostic factors for UTUC patients include age, race, performance status, obesity, smoking status, elevated fibrinogen levels, hydronephrosis, tumor size, multi-focality, location, clinical grade and previous/synchronous bladder cancer. Postoperative variables include tumor stage/grade, multifocality, nodal involvement, lympho-vascular invasion, initial ureteral location, necrosis, sessile architecture, variant histologies and presence of tissue ALDH1 and SOX2. Curative treatment of choice is NU, with lymphadenectomy conferring survival benefits. Minimally invasive surgery has equivalent oncologic and better peri-operative outcomes compared to open surgery. Conservative therapy includes adjuvant BCG and intravesical mitomycin C. Two randomized trials investigating postoperative instillation of mitomycin C suggest bladder recurrence benefits. Adjuvant chemo-radiotherapy may be useful for patients with advanced T3/4 and/or N+ disease. Gold-standard treatment for UTUC remains NU, increasingly performed using minimally invasive surgery. Nomograms including pre- and post-operative variables can aid prognostication and guide further therapy. Copyright © 2015 Elsevier Ltd. All rights reserved.

Legislation Amendment Impact on Coastal Management Pattern: An Edge of Chaos towards Punctuated Equilibrium

NASA Astrophysics Data System (ADS)

Rahmawati, Dian

2017-07-01

Management of coastal areas and small islands in Indonesia refers to a set of coordination consists of planning, utilizing, monitoring, and controlling coastal resources that are carried out by every level of the government and many related sectors. An alteration has occurred in National Act about Local Government, Act No. 23/2014, which has the implications in the coastal management territorial zone. The issues started by the shifting of the seaward delineation authorities, it is stated that from 0 - 12 Nautical Miles (nmi) are under provincial government which previously 0 - 4 nmi were under city government, and 4 - 12 nmi were under provincial government. That said, there are no territorial management that is handled by the city/local government, including permit regulation. In hierarchy, provincial government are in upper level than city government. Chaos are happening especially in the context of authorities’ management level, but to reach the main purpose of the National Act there should be an equilibrium point to normalize the situation and get the stakeholders understand the principles and keep engaged in the new form of management. This article aims to assess the impact of the National Act alteration to the sustainability of coastal management. A case study to simplify the model is in the East Java province. Theoretical framework to assess the alteration impact were related to Integrated Coastal Zone Management principles and regulatory review of the coastal zones. The analytical methods used in this article is descriptive comparative to observe the alteration in the pattern of coastal zone management variables. The comparative study was then mapped in a flow diagram to be compared on different management situation. As a result, significant changes were revealed in the pattern of the coastal management factors: (i) Authorities delineation; (ii) Planning documents; (iii) Permit system; (iv) Control; and (iii) Program Accreditation.

Education Pays Off! On Transition to Work for 25 Year Olds in Norway with Upper Secondary Education or Lower as Their Highest Educational Level

ERIC Educational Resources Information Center

Markussen, Eifred

2017-01-01

In this article we examine the relationship between educational level and position in the labour market at age 25 for those who have completed upper secondary education or lower as their highest educational level. Whilst completion of upper secondary education is widely regarded as being important, we find that early and lasting work experience…

Bed-level adjustments in the Arno River, central Italy

NASA Astrophysics Data System (ADS)

Rinaldi, Massimo; Simon, Andrew

1998-02-01

Two distinct phases of bed-level adjustment over the last 150 years are identified for the principal alluvial reaches of the Arno River (Upper Valdarno and Lower Valdarno). The planimetric configuration of the river in these reaches is the result of a series of hydraulic works (canalization, rectification, artificial cut-offs, etc.) carried out particularly between the 18th and the 19th centuries. Subsequently, a series of interventions at basin level (construction of weirs, variations in land use), intense instream gravel-mining after World War II, and the construction of two dams on the Arno River, caused widespread degradation of the streambed. Since about 1900, total lowering of the channel bed is typically between 2 and 4 m in the Upper Valdarno Reach and between 5 and 8 m in some areas of the Lower Valdarno Reach. Bed-level adjustments with time are analyzed for a large number of cross-sections and described by an exponential-decay function. This analysis identified the existence of two main phases of lowering: the first, triggered at the end of the past century; the second, triggered in the interval 1945-1960 and characterized by more intense degradation of the streambed. The first phase derived from changes in land-use and land-management practices. The second phase is the result of the superimposition of two factors: intense instream mining of gravel, and the construction of the Levane and La Penna dams.

Influence of the Tibetan Plateau snow cover on East Asian winter upper-level jet streams at daily time scale

NASA Astrophysics Data System (ADS)

Guo, W.; Li, W.; Qiu, B.; Xue, Y.

2017-12-01

The Tibetan Plateau (TP) acts as an elevated cooling source in the middle troposphere at wintertime. We here present evidence that the intraseasonal variability of the TP snow cover (TPSC) controls part of the East Asian upper-level jet stream. This study found that there is significant positive lag correlation between the East Asian (EA) upper-level westerly jet and the TPSC in winter. When the TPSC increases/decreases, the EA upper-level westerly jet enhances/weakens in the following 8 days. We performed numerical experiments to prove that the lag correlation is causal relationship by using a regional climate model. Due to the high albedo of the snow cover, the increased/decreased snow cover increases/decreases the albedo and affects the surface energy balance over the TP. The energy absorbed by the surface is reduced/increased due to increased/decreased shortwave reflects to the atmosphere. There is anomalous cooling/heating effect over the TP. Such effect leads to anomalous geopotential height (GHT) field that propagates eastward with the zonal wind to the east. The anomalous GHT reaches key region of EA upper-level westerly jet at about 6 days. The adaptive modulation of GHT gradients affects wind fields (through geostrophic balance). As a result, the EA upper-level westerly jet is enhanced (weakened). Through the above process, the TPSC eventually influences the EA upper-level westerly jet. This report reveals that the intraseasonal variability of TPSC can server as an indicator of East Asia Atmospheric circulation on short-to-medium range.

Optimization based on benefit of regional energy suppliers of distributed generation in active distribution network

NASA Astrophysics Data System (ADS)

Huo, Xianxu; Li, Guodong; Jiang, Ling; Wang, Xudong

2017-08-01

With the development of electricity market, distributed generation (DG) technology and related policies, regional energy suppliers are encouraged to build DG. Under this background, the concept of active distribution network (ADN) is put forward. In this paper, a bi-level model of intermittent DG considering benefit of regional energy suppliers is proposed. The objective of the upper level is the maximization of benefit of regional energy suppliers. On this basis, the lower level is optimized for each scene. The uncertainties of DG output and load of users, as well as four active management measures, which include demand-side management, curtailing the output power of DG, regulating reactive power compensation capacity and regulating the on-load tap changer, are considered. Harmony search algorithm and particle swarm optimization are combined as a hybrid strategy to solve the model. This model and strategy are tested with IEEE-33 node system, and results of case study indicate that the model and strategy successfully increase the capacity of DG and benefit of regional energy suppliers.

Perfusion Scintigraphy and Patient Selection for Lung Volume Reduction Surgery

PubMed Central

Chandra, Divay; Lipson, David A.; Hoffman, Eric A.; Hansen-Flaschen, John; Sciurba, Frank C.; DeCamp, Malcolm M.; Reilly, John J.; Washko, George R.

2010-01-01

Rationale: It is unclear if lung perfusion can predict response to lung volume reduction surgery (LVRS). Objectives: To study the role of perfusion scintigraphy in patient selection for LVRS. Methods: We performed an intention-to-treat analysis of 1,045 of 1,218 patients enrolled in the National Emphysema Treatment Trial who were non–high risk for LVRS and had complete perfusion scintigraphy results at baseline. The median follow-up was 6.0 years. Patients were classified as having upper or non–upper lobe–predominant emphysema on visual examination of the chest computed tomography and high or low exercise capacity on cardiopulmonary exercise testing at baseline. Low upper zone perfusion was defined as less than 20% of total lung perfusion distributed to the upper third of both lungs as measured on perfusion scintigraphy. Measurements and Main Results: Among 284 of 1,045 patients with upper lobe–predominant emphysema and low exercise capacity at baseline, the 202 with low upper zone perfusion had lower mortality with LVRS versus medical management (risk ratio [RR], 0.56; P = 0.008) unlike the remaining 82 with high perfusion where mortality was unchanged (RR, 0.97; P = 0.62). Similarly, among 404 of 1,045 patients with upper lobe–predominant emphysema and high exercise capacity, the 278 with low upper zone perfusion had lower mortality with LVRS (RR, 0.70; P = 0.02) unlike the remaining 126 with high perfusion (RR, 1.05; P = 1.00). Among the 357 patients with non–upper lobe–predominant emphysema (75 with low and 282 with high exercise capacity) there was no improvement in survival with LVRS and measurement of upper zone perfusion did not contribute new prognostic information. Conclusions: Compared with optimal medical management, LVRS reduces mortality in patients with upper lobe–predominant emphysema when there is low rather than high perfusion to the upper lung. PMID:20538961

Upper-Level Waves of Synoptic Scale at Midlatitudes

NASA Astrophysics Data System (ADS)

Rivest, Chantal

1990-01-01

Upper-level waves of synoptic scale are important dynamical entities at midlatitudes. They often induce surface cyclogenesis (cf. Peterssen and Smebye, 1971), and their life duration is typically longer than time scales for disruption by the ambient shear (Sanders, 1988). The objectives of the present thesis are to explain the maintenance and genesis of upper-level synoptic-scale waves in the midlatitude flow. We develop an analytical model of waves on generalized Eady basic states that have uniform tropospheric and stratospheric potential vorticity, but allow for the decay of density with height. The Eady basic state represents the limiting case of infinite stratospheric stability and constant density. We find that the Eady normal mode characteristics hold in the presence of realistic tropopause and stratosphere. In particular, the basic states studied support at the synoptic scale upper-level normal modes. These modes provide simple models for the dynamics of upper-level synoptic-scale waves, as waves supported by the large latitudinal gradients of potential vorticity at the tropopause. In the presence of infinitesimal positive tropospheric gradients of potential vorticity, the upper-level normal mode solutions no longer exist, as was demonstrated in Green (1960). Disappearance of the normal mode solution when a parameter changes slightly represents a dilemma that we seek to understand. We examine what happens to the upper-level normal modes in the presence of tropospheric gradients of potential vorticity in a series of initial -value experiments. Our results show that the normal modes become slowly decaying quasi-modes. Mathematically the quasi-modes consist of a superposition of singular modes sharply peaked in the phase speed domain, and their decay proceeds as the modes interfere with one another. We repeat these experiments in basic states with a smooth tropopause in the presence of tropospheric and stratospheric gradients, and similar results are obtained. Basic states with positive tropospheric and stratospheric gradients of potential vorticity are found to support upper-level synoptic-scale waves for time scales consistent with observations. Following Farrell (1989), we then identify a class of near optimal initial conditions for the excitation of upper-level waves. The initial conditions consist of upper -tropospheric disturbances that lean against the shear. They strongly excite upper-level waves not only in the absence of tropospheric potential vorticity gradients, but also in their presence. This result demonstrates that quasi -modes are as likely to emerge from favorably configured initial conditions as real normal modes, although their excitation is followed by a slow decay. (Copies available exclusively from MIT Libraries, Rm. 14-0551, Cambridge, MA 02139-4307. Ph. 617-253-5668; Fax 617-253-1690.).

Splenic cyst and its management in a 21-month-old boy: a rare complication of invasive meningococcal disease.

PubMed

Pratt, Jeremy John; Connell, Tom G; Bekhit, Elhamy; Crawford, Nigel W

2018-05-04

Splenic complications of invasive meningococcal disease (IMD) are well recognised, though cyst formation is rare, particularly in paediatric populations. The best approach to their management is not yet established. This case outlines the management of a splenic cyst in a 21-month-old boy following severe IMD. The case took place in the context of an acute emergence of serogroup W prompting significant media attention and subsequent change in vaccination practice at a jurisdictional level in Australia. The patient was critically unwell early in the illness, then later a collection in the left upper quadrant was detected, shown on ultrasound to be a 11.6×7.7 cm splenic cyst. In this case, the cyst was managed by ultrasound-guided drainage tube insertion. The residual collection was small and stable on subsequent imaging. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Coastal ground water at risk - Saltwater contamination at Brunswick, Georgia and Hilton Head Island, South Carolina

USGS Publications Warehouse

Krause, Richard E.; Clarke, John S.

2001-01-01

IntroductionSaltwater contamination is restricting the development of ground-water supply in coastal Georgia and adjacent parts of South Carolina and Florida. The principal source of water in the coastal area is the Upper Floridan aquifer—an extremely permeable and high-yielding aquifer—which was first developed in the late 1800s. Pumping from the aquifer has resulted in substantial ground-water-level decline and subsequent saltwater intrusion of the aquifer from underlying strata containing highly saline water at Brunswick, Georgia, and with encroachment of sea-water into the aquifer at the northern end of Hilton Head Island, South Carolina. The saltwater contamination at these locations has constrained further development of the Upper Floridan aquifer in the coastal area and has created competing demands for the limited supply of freshwater. The Georgia Department of Natural Resources, Georgia Environmental Protection Division (GaEPD) has restricted permitted withdrawal of water from the Upper Floridan aquifer in parts of the coastal area (including the Savannah and Brunswick areas) to 1997 rates, and also has restricted additional permitted pumpage in all 24 coastal area counties to 36 million gallons per day above 1997 rates. These actions have prompted interest in alternative management of the aquifer and in the development of supplemental sources of water supply including those from the shallower surficial and upper and lower Brunswick aquifers and from the deeper Lower Floridan aquifer.

The Arm is Not the Leg: Pathophysiology, Diagnosis, and Management of Upper Extremity Deep Vein Thrombosis.

PubMed

Noyes, Adam M; Dickey, John

2017-05-01

Upper extremity deep venous thrombosis (UEDVT) involves thrombosis of the deep veins of the arm as they enter the thorax. They are increasing in frequency, largely due to the rising use of central venous catheters and implantable cardiac devices, and represent more than 10% of all DVT cases, Upper extremity deep venous thrombosis has been historically misunderstood when compared to lower extremity deep vein thrombosis (LEDVT). Their associated disease states may carry devastating complications, with mortality rates often higher than that of LEDVT. Thus, education on recognition, classification and management is critical to avoid long-term sequelae and mortality from UEDVT. [Full article available at http://rimed.org/rimedicaljournal-2017-05.asp].

Upper Elementary Teachers' Self-Efficacy and Spelling Instruction: A Qualitative Study

ERIC Educational Resources Information Center

Fernandes, Brian E.

2017-01-01

A great deal of research has been conducted regarding spelling instruction at the early childhood and lower elementary levels, but not at the upper elementary level. This qualitative study explored the perceptions and experiences of upper elementary teachers to gain a better understanding of how they instruct spelling and their related…

Impact of a joint labor-management ergonomics program on upper extremity musculoskeletal symptoms among garment workers.

PubMed

Herbert, R; Dropkin, J; Warren, N; Sivin, D; Doucette, J; Kellogg, L; Bardin, J; Kass, D; Zoloth, S

2001-10-01

This study evaluated the effect of an ergonomics intervention program on the prevalence and intensity of symptoms of upper extremity work-related musculoskeletal disorders among 36 garment workers performing an operation called spooling. Adjustable chairs were introduced and workers were trained in their use. Symptom surveys were administered prior to and 6 months after introduction of adjustable chairs. Quantitative pre- and post-intervention measurement of joint position was performed utilizing videotapes among a subgroup of nineteen. Eighty nine percent of the cohort reported pain in either the neck or at least one upper extremity anatomic site prior to the adjustable chair intervention. Among subjects reporting pain at baseline, there were significantly decreased pain levels in 10 of 11 anatomic sites after the intervention. Among all subjects, the proportion reporting pain decreased for each anatomic site following the intervention, with statistically significant decreases in 3 sites. However, there were only modest declines in awkward posture among the videotaped subgroup. This study suggests that introduction of an ergonomics program focused on education and introduction of an adjustable chair may diminish musculoskeletal symptomatology in apparel manufacturing workers.

Lower limb injuries caused by improvised explosive devices: proposed 'Bastion classification' and prospective validation.

PubMed

Jacobs, N; Rourke, K; Rutherford, J; Hicks, A; Smith, S R C; Templeton, P; Adams, S A; Jansen, J O

2014-09-01

Complex lower limb injury caused by improvised explosive devices (IEDs) has become the signature wounding pattern of the conflict in Afghanistan. Current classifications neither describe this injury pattern well, nor correlate with management. There is need for a new classification, to aid communication between clinicians, and help evaluate interventions and outcomes. We propose such a classification, and present the results of an initial prospective evaluation. The classification was developed by a panel of military surgeons whilst deployed to Camp Bastion, Afghanistan. Injuries were divided into five classes, by anatomic level. Segmental injuries were recognised as a distinct entity. Associated injuries to the intraperitoneal abdomen, genitalia and perineum, pelvic ring, and upper limbs, which impact on clinical management and resources, were also accounted for. Between 1 November 2010 and 20 February 2011, 179 IED-related lower limb injuries in 103 consecutive casualties were classified, and their subsequent vascular and musculoskeletal treatment recorded. 69% of the injuries were traumatic amputations, and the remainder segmental injuries. 49% of casualties suffered bilateral lower limb amputation. The most common injury was class 3 (involving proximal lower leg or thigh, permitting effective above-knee tourniquet application, 49%), but more proximal patterns (class 4 or 5, preventing effective tourniquet application) accounted for 18% of injuries. Eleven casualties had associated intraperitoneal abdominal injuries, 41 suffered genital or perineal injuries, 9 had pelvic ring fractures, and 66 had upper limb injuries. The classification was easy to apply and correlated with management. The 'Bastion classification' is a pragmatic yet clinically relevant injury categorisation, which describes current injury patterns well, and should facilitate communication between clinicians, and the evaluation of interventions and outcomes. The validation cohort confirms that the injury burden from IEDs in the Helmand Province of Afghanistan remains high, with most casualties sustaining amputation through or above the knee. The rates of associated injury to the abdomen, perineum, pelvis and upper limbs are high. These findings have important implications for the training of military surgeons, staffing and resourcing of medical treatment facilities, to ensure an adequate skill mix to manage these complex and challenging injuries. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

Life threatening angioedema in a patient on ACE inhibitor (ACEI) confined to the upper airway

PubMed Central

Tharayil, Abdulgafoor Muslim; Chanda, Arshad Hussain; Shiekh, Hakim Ahmad; Elkhatib, Mohamed Saad; Nayeemuddin, Mohammed; Alshamandy, Abdelhafiz Ali Ahmed

2014-01-01

Introduction: ACE inhibitors accounts for 8% of all cases of angioneurotic edema and the overall incidence is 0.1 to 0.7% of patients on ACE inhibitors. It is a leading cause (20-40%) of emergency room visits in the US with angioedema. We report a case of angioedema caused by ACE inhibitors confined to the upper airway after four years on treatment with Lisinopril which persisted for three weeks and required endotracheal intubation and subsequent tracheostomy due to delayed resolution. This case is one of the rare cases presented as upper airway edema which persisted for a long time. Presentation: A 60-year-old Sudanese male patient with osteoarthritis in both knees underwent bilateral total knee replacement under single-shot epidural anesthesia. He had significant past medical history of type II diabetes, bipolar affective disorder and hypertension managed with Lisinopril for the past four years. Postoperatively after 10 hours the patient desaturated and developed airway obstruction requiring intubation. Laryngoscopy revealed an edematous tongue and upper airway and vocal cords were not visualized. In view of this clinical picture a provisional diagnosis of angioedema secondary to Lisinopril was made and it was discontinued. CT scan of the neck and soft tissues revealed severe airway edema with snugly fitting endotracheal tube with no peritubal air. A repeat CT neck on the tenth postoperative day showed no signs of resolution and an elective tracheostomy was performed on the eleventh postoperative day. C1 inhibitor protein and C4 levels were assayed to exclude hereditary angioedema and were found to be within normal range. Decannulation of tracheostomy was done after airway edema resolved on the twenty-fourth postoperative day as confirmed by CT scan. Subsequently he was transferred to the ward and discharged home. Conclusion: ACEI induced angioedema is a well-recognized condition. Early diagnosis based on a high index of suspicion, immediate withdrawal of the offending drug followed by supportive therapy is the cornerstone of management. PMID:25745598

Upper-limb sensory impairments after stroke: Self-reported experiences of daily life and rehabilitation.

PubMed

Carlsson, Håkan; Gard, Gunvor; Brogårdh, Christina

2018-01-10

To describe stroke survivors' experiences of sensory impairment in the upper limb, the influence of such impairment on daily life, coping strategies used, and sensory training for the affected hand. A qualitative study with a content analysis approach. Fifteen post-stroke patients interviewed individually. Five categories emerged from the data: "Changed and varied perception of the sensation"; "Affected movement control"; "Problems using the hand in daily life"; "Various strategies to cope with upper limb disability"; and "Lack of sensory training". Numbness and tingling, changes in temperature sensitivity, and increased sensitivity to touch and pain were reported. Many subjects had difficulty adjusting their grip force and performing movements with precision. It was problematic and mentally fatiguing managing personal care and carrying out household and leisure activities. Practical adaptations, compensation with vision, increased concentration, and use of the less affected hand were strategies used to overcome difficulties. Despite their problems very few subjects had received any specific sensory training for the hand. Stroke survivors perceive that sensory impairment of the upper limb has a highly negative impact on daily life, but specific rehabilitation for the upper limb is lacking. These findings imply that the clinical management of upper limb sensory impairment after stroke requires more attention.

76 FR 56145 - Clearwater National Forest; ID; Upper Lochsa Land Exchange EIS

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-12

... for timber production. For the most part these lands currently meet State Best Management Practices... River drainage to provide more efficient and effective resource management. This purpose can be achieved... years, differing management practices on the private lands has influenced resource management decision...

77 FR 13257 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-06

..., Office of Information and Regulatory Affairs, Office of Management and Budget (OMB), Washington, DC, OIRA... Resource Management Plan (USFS 1990) and Upper McKenzie River Management Plan (``UMRMP,'' USFS 1992), (2...) inform management practices to protect and enhance the outstandingly remarkable values identified for the...

Impact of the operation of cascade reservoirs in upper Yangtze River on hydrological variability of the mainstream

NASA Astrophysics Data System (ADS)

Changjiang, Xu; Dongdong, Zhang

2018-06-01

As the impacts by climate changes and human activities are intensified, variability may occur in river's annual runoff as well as flood and low water characteristics. In order to understand the characteristics of variability in hydrological series, diagnosis and identification must be conducted specific to the variability of hydrological series, i.e., whether there was variability and where the variability began to occur. In this paper, the mainstream of Yangtze River was taken as the object of study. A model was established to simulate the impounding and operation of upstream cascade reservoirs so as to obtain the runoff of downstream hydrological control stations after the regulation by upstream reservoirs in different level years. The Range of Variability Approach was utilized to analyze the impact of the operation of upstream reservoirs on the variability of downstream. The results indicated that the overall hydrologic alterations of Yichang hydrological station in 2010 level year, 2015 level year and the forward level year were 68.4, 72.5 and 74.3 % respectively, belonging to high alteration in all three level years. The runoff series of mainstream hydrological stations presented variability in different degrees, where the runoff series of the four hydrological stations including Xiangjiaba, Gaochang and Wulong belonged to high alteration in the three level years; and the runoff series of Beibei hydrological station in 2010 level year belonged to medium alteration, and high alteration in 2015 level year and the forward level year. The study on the impact of the operation of cascade reservoirs in Upper Yangtze River on hydrological variability of the mainstream had important practical significance on the sustainable utilization of water resources, disaster prevention and mitigation, safe and efficient operation and management of water conservancy projects and stable development of the economic society.

Radiative Heating of the ISCCP Upper Level Cloud Regimes and its Impact on the Large-scale Tropical Circulation

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

Li, Wei; Schumacher, Courtney; McFarlane, Sally A.

2013-01-31

Radiative heating profiles of the International Satellite Cloud Climatology Project (ISCCP) cloud regimes (or weather states) were estimated by matching ISCCP observations with radiative properties derived from cloud radar and lidar measurements from the Department of Energy (DOE) Atmospheric Radiation Measurement (ARM) sites at Manus, Papua New Guinea, and Darwin, Australia. Focus was placed on the ISCCP cloud regimes containing the majority of upper level clouds in the tropics, i.e., mesoscale convective systems (MCSs), deep cumulonimbus with cirrus, mixed shallow and deep convection, and thin cirrus. At upper levels, these regimes have average maximum cloud occurrences ranging from 30% tomore » 55% near 12 km with variations depending on the location and cloud regime. The resulting radiative heating profiles have maxima of approximately 1 K/day near 12 km, with equal heating contributions from the longwave and shortwave components. Upper level minima occur near 15 km, with the MCS regime showing the strongest cooling of 0.2 K/day and the thin cirrus showing no cooling. The gradient of upper level heating ranges from 0.2 to 0.4 K/(day∙km), with the most convectively active regimes (i.e., MCSs and deep cumulonimbus with cirrus) having the largest gradient. When the above heating profiles were applied to the 25-year ISCCP data set, the tropics-wide average profile has a radiative heating maximum of 0.45Kday-1 near 250 hPa. Column-integrated radiative heating of upper level cloud accounts for about 20% of the latent heating estimated by the Tropical Rainfall Measuring Mission (TRMM) Precipitation Radar (PR). The ISCCP radiative heating of tropical upper level cloud only slightly modifies the response of an idealized primitive equation model forced with the tropics-wide TRMM PR latent heating, which suggests that the impact of upper level cloud is more important to large-scale tropical circulation variations because of convective feedbacks rather than direct forcing by the cloud radiative heating profiles. However, the height of the radiative heating maxima and gradient of the heating profiles are important to determine the sign and patterns of the horizontal circulation anomaly driven by radiative heating at upper levels.« less

Understanding middle managers' influence in implementing patient safety culture.

PubMed

Gutberg, Jennifer; Berta, Whitney

2017-08-22

The past fifteen years have been marked by large-scale change efforts undertaken by healthcare organizations to improve patient safety and patient-centered care. Despite substantial investment of effort and resources, many of these large-scale or "radical change" initiatives, like those in other industries, have enjoyed limited success - with practice and behavioural changes neither fully adopted nor ultimately sustained - which has in large part been ascribed to inadequate implementation efforts. Culture change to "patient safety culture" (PSC) is among these radical change initiatives, where results to date have been mixed at best. This paper responds to calls for research that focus on explicating factors that affect efforts to implement radical change in healthcare contexts, and focuses on PSC as the radical change implementation. Specifically, this paper offers a novel conceptual model based on Organizational Learning Theory to explain the ability of middle managers in healthcare organizations to influence patient safety culture change. We propose that middle managers can capitalize on their unique position between upper and lower levels in the organization and engage in 'ambidextrous' learning that is critical to implementing and sustaining radical change. This organizational learning perspective offers an innovative way of framing the mid-level managers' role, through both explorative and exploitative activities, which further considers the necessary organizational context in which they operate.

Reaching consensus on the physiotherapeutic management of patients following upper abdominal surgery: a pragmatic approach to interpret equivocal evidence.

PubMed

Hanekom, Susan D; Brooks, Dina; Denehy, Linda; Fagevik-Olsén, Monika; Hardcastle, Timothy C; Manie, Shamila; Louw, Quinette

2012-02-06

Postoperative pulmonary complications remain the most significant cause of morbidity following open upper abdominal surgery despite advances in perioperative care. However, due to the poor quality primary research uncertainty surrounding the value of prophylactic physiotherapy intervention in the management of patients following abdominal surgery persists. The Delphi process has been proposed as a pragmatic methodology to guide clinical practice when evidence is equivocal. The objective was to develop a clinical management algorithm for the post operative management of abdominal surgery patients. Eleven draft algorithm statements extracted from the extant literature by the primary research team were verified and rated by scientist clinicians (n=5) in an electronic three round Delphi process. Algorithm statements which reached a priori defined consensus-semi-interquartile range (SIQR)<0.5-were collated into the algorithm. The five panelists allocated to the abdominal surgery Delphi panel were from Australia, Canada, Sweden, and South Africa. The 11 draft algorithm statements were edited and 5 additional statements were formulated. The panel reached consensus on the rating of all statements. Four statements were rated essential. An expert Delphi panel interpreted the equivocal evidence for the physiotherapeutic management of patients following upper abdominal surgery. Through a process of consensus a clinical management algorithm was formulated. This algorithm can now be used by clinicians to guide clinical practice in this population.

Assessing Upper-Level Winds on Day-of-Launch

NASA Technical Reports Server (NTRS)

Bauman, William H., III; Wheeler, Mark M.

2012-01-01

On the day-or-launch. the 45th Weather Squadron Launch Weather Officers (LWOS) monitor the upper-level winds for their launch customers to include NASA's Launch Services Program (LSP). During launch operations, the payload launch team sometimes asks the LWO if they expect the upper level winds to change during the countdown but the LWOs did not have the capability to quickly retrieve or display the upper-level observations and compare them to the numerical weather prediction model point forecasts. The LWOs requested the Applied Meteorology Unit (AMU) develop a capability in the form of a graphical user interface (GUI) that would allow them to plot upper-level wind speed and direction observations from the Kennedy Space Center Doppler Radar Wind Profilers and Cape Canaveral Air Force Station rawinsondes and then overlay model point forecast profiles on the observation profiles to assess the performance of these models and graphically display them to the launch team. The AMU developed an Excel-based capability for the LWOs to assess the model forecast upper-level winds and compare them to observations. They did so by creating a GUI in Excel that allows the LWOs to first initialize the models by comparing the O-hour model forecasts to the observations and then to display model forecasts in 3-hour intervals from the current time through 12 hours.

Preface: Bridging the gap between theory and practice on the upper Mississippi River

USGS Publications Warehouse

Lubinski, Kenneth S.

1995-01-01

In July 1994, the Upper Mississippi River (UMR) served as a nexus for coalescing scientific information and management issues related to worldwide floodplain river ecosystems. The objective of the conference ‘Sustaining the Ecological Integrity of Large Floodplain Rivers: Application of Ecological Knowledge to River Management’, was to provide presentations of current ideas from the scientific community. To translate the many lessons learned on other river systems to operational decisions on the UMR, a companion workshop for managers and the general public was held immediately after the conference.An immediate local need for such sharing has existed for several years, as the U.S. Corps of Engineers is currently planning commercial navigation activities that will influence the ecological integrity of the river over the next half century. Recently, other equally important management issues have surfaced, including managing the river as an element of the watershed, and assessing its ecological value as a system instead of a collection of parts (Upper Mississippi River Conservation Committee, 1993). Regional and state natural resource agencies are becoming more convinced that they need to address these issues within their own authorities, however spatially limited, rather than relying on the U.S. Corps of Engineers to manage the ecosystem as an adjunct to its purpose of navigation support.

Implementing reduced-risk integrated pest management in fresh-market cabbage: influence of sampling parameters, and validation of binomial sequential sampling plans for the cabbage looper (Lepidoptera Noctuidae).

PubMed

Burkness, Eric C; Hutchison, W D

2009-10-01

Populations of cabbage looper, Trichoplusiani (Lepidoptera: Noctuidae), were sampled in experimental plots and commercial fields of cabbage (Brasicca spp.) in Minnesota during 1998-1999 as part of a larger effort to implement an integrated pest management program. Using a resampling approach and the Wald's sequential probability ratio test, sampling plans with different sampling parameters were evaluated using independent presence/absence and enumerative data. Evaluations and comparisons of the different sampling plans were made based on the operating characteristic and average sample number functions generated for each plan and through the use of a decision probability matrix. Values for upper and lower decision boundaries, sequential error rates (alpha, beta), and tally threshold were modified to determine parameter influence on the operating characteristic and average sample number functions. The following parameters resulted in the most desirable operating characteristic and average sample number functions; action threshold of 0.1 proportion of plants infested, tally threshold of 1, alpha = beta = 0.1, upper boundary of 0.15, lower boundary of 0.05, and resampling with replacement. We found that sampling parameters can be modified and evaluated using resampling software to achieve desirable operating characteristic and average sample number functions. Moreover, management of T. ni by using binomial sequential sampling should provide a good balance between cost and reliability by minimizing sample size and maintaining a high level of correct decisions (>95%) to treat or not treat.

Submersed Aquatic Vegetation Modeling Output Online

USGS Publications Warehouse

Yin, Yao; Rogala, Jim; Sullivan, John; Rohweder, Jason J.

2005-01-01

Introduction The ability to predict the distribution of submersed aquatic vegetation in the Upper Mississippi River on the basis of physical or chemical variables is useful to resource managers. Wildlife managers have a keen interest in advanced estimates of food quantity such as American wildcelery (Vallisneria americana) population status to give out more informed advisories to hunters before the fall hunting season. Predictions for distribution of submerged aquatic vegetation beds can potentially increase hunter observance of voluntary avoidance zones where foraging birds are left alone to feed undisturbed. In years when submersed aquatic vegetation is predicted to be scarce in important wildlife habitats, managers can get the message out to hunters well before the hunting season (Jim Nissen, Upper Mississippi River National Wildlife and Fish Refuge, La Crosse District Manager, La Crosse, Wisconsin, personal communication). We developed a statistical model to predict the probability of occurrence of submersed aquatic vegetation in Pool 8 of the Upper Mississippi River on the basis of a few hydrological, physical, and geomorphic variables. Our model takes into consideration flow velocity, wind fetch, bathymetry, growing-season daily water level, and light extinction coefficient in the river (fig. 1) and calculates the probability of submersed aquatic vegetation existence in Pool 8 in individual 5- x 5-m grid cells. The model was calibrated using the data collected in 1998 (516 sites), 1999 (595 sites), and 2000 (649 sites) using a stratified random sampling protocol (Yin and others, 2000b). To validate the model, we chose the data from the Long Term Resource Monitoring Program (LTRMP) transect sampling in backwater areas (Rogers and Owens 1995; Yin and others, 2000a) and ran the model for each 5- x 5-m grid cell in every growing season from 1991 to 2001. We tallied all the cells and came up with an annual average percent frequency of submersed aquatic vegetation occurrence and compared the results with actual LTRMP survey data (fig. 2). Both a paired Student's test (P = 0.4620) and a Wilcoxon's two-sample test (P = 0.4738) did not contradict our null hypothesis that the model prediction and the sampling data are statistically the same. We have not found an effective statistical test to compare model-predicted spatial pattern with aerial photography geographic information, but we are satisfied with the model's outcome on the basis of visual inspection (fig. 3). A unique feature about this model is that a prediction can be made by the end of June each year; therefore, providing wildlife managers an assessment of current year vegetation growth condition 3 to 4 months ahead of the arrival of migrating waterfowl that feed on submersed aquatic vegetation. We are working with the LTRMP partnership to create a mechanism so that model predictions (fig. 4) can be updated annually and the results posted on the LTRMP Web site. Our model underestimated the prevalence of vegetation from 2001 to 2004. We speculate that the summer water level reduction conducted in 2001 and 2002 triggered vegetation responses that are outside the model's domain. Future enhancement of the model will incorporate the summer water level drawdown effects as well as the effects of growth conditions in previous years.

Wildlife Management Overview: A Primer on the Essentials of Managing for Wildlife.

ERIC Educational Resources Information Center

Clearing: Nature and Learning in the Pacific Northwest, 1984

1984-01-01

Provides an introduction to wildlife management. Topics (suitable for upper elementary and secondary students) include habitat, carrying capacity, birth and death rate, population growth and decline, predator control, refuges, stocking, habitat management, hunting and trapping, and others. A list of instructional resource materials and sample…

76 FR 14801 - Establishment of Class E Airspace; Colebrook, NH

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-18

... Standard Instrument Approach Procedure (SIAP) serving the Upper Connecticut Valley Hospital Heliport. This action enhances the safety and airspace management of Instrument Flight Rules (IFR) operations within the... approach procedures developed for Upper Connecticut Valley Hospital Heliport. This action is necessary for...

Hemospray for treatment of acute bleeding due to upper gastrointestinal tumours.

PubMed

Arena, Monica; Masci, Enzo; Eusebi, Leonardo Henry; Iabichino, Giuseppe; Mangiavillano, Benedetto; Viaggi, Paolo; Morandi, Elisabetta; Fanti, Lorella; Granata, Antonino; Traina, Mario; Testoni, Pier Alberto; Opocher, Enrico; Luigiano, Carmelo

2017-05-01

Hemospray is a new endoscopic haemostatic powder that can be used in the management of upper gastrointestinal bleedings. To assess the efficacy and safety of Hemospray as monotherapy for the treatment of acute upper gastrointestinal bleeding due to cancer. The endoscopy databases of 3 Italian Endoscopic Units were reviewed retrospectively and 15 patients (8 males; mean age 74 years) were included in this study. Immediate haemostasis was achieved in 93% of cases. Among the successful cases, 3 re-bled, one case treated with Hemospray and injection had a good outcome, while 2 cases died both re-treated with Hemospray, injection and thermal therapy. No complications related to Hemospray occurred. Finally, 80% of patients had a good clinical outcome at 30days and 50% at six months. Hemospray may be considered an effective and safe method for the endoscopic management of acute neoplastic upper gastrointestinal bleedings. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Laparoscopic nephroureterectomy: making management of upper-tract transitional-cell carcinoma entirely minimally invasive.

PubMed

Keeley, F X; Tolley, D A

1998-04-01

Endoscopic treatment of upper-tract transitional-cell carcinoma (TCC) is well established. Nevertheless, many patients still required major ablative surgery. We have applied our experience with laparoscopic nephrectomy to the performance of laparoscopic nephroureterectomy in order to make the management of upper-tract TCC entirely minimally invasive. Since 1993, we have performed 22 laparoscopic nephroureterectomies for upper-tract TCC. Initially, we excluded patients with tumors below the pelvic brim, but we now offer a trial of laparoscopy to all patients. We describe the evolution of our technique, which involves resecting the ureteral orifice prior to laparoscopic dissection of the kidney and ureter. We have had to convert three cases to open surgery, one each for bleeding, failure to progress, and unappreciated tumor extent. Operative times averaged 156 minutes, which compares well with contemporary times for open nephroureterectomy. Complication rates, transfusion requirements, and length of stay, although higher than those of laparoscopic nephrectomy, were all reduced in comparison with open nephroureterectomy.

Measures of upper limb function for people with neck pain: a systematic review of measurement and practical properties (protocol).

PubMed

Alreni, Ahmad Salah Eldin; Harrop, Deborah; Gumber, Anil; McLean, Sionnadh

2015-04-07

Upper limb disability is a common musculoskeletal condition frequently associated with neck pain. Recent literature has reported the need to utilise validated upper limb outcome measures in the assessment and management of patients with neck pain. However, there is a lack of clear guidance about the suitability of available measures, which may impede utilisation. This review will identify all available measures of upper limb function developed for use in neck pain patients and evaluate their measurement and practical properties in order to identify those measures that are most appropriate for use in clinical practice and research. This review will be performed in two phases. Phase one will identify all measures used to assess upper limb function for patients with neck pain. Phase two will identify all available studies of the measurement and practical properties of identified instrument. The COnsensus-based Standards for selection of health Measurement INstrument (COSMIN) will be used to evaluate the methodological quality of the included studies. To ensure methodological rigour, the findings of this review will be reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guideline. Optimal management of patients with neck pain should incorporate upper limb rehabilitation. The findings of this study will assist clinicians who seek to utilise suitable and accurate measures to assess upper limb function for a patient with neck pain. In addition, the findings of this study may suggest new research directions to support the development of upper limb outcome measures for patients with neck pain. PROSPERO CRD42015016624.

Site, gender and age variation in normal skin colour on the back and the forearm: tristimulus colorimeter measurements.

PubMed

Fullerton, A; Serup, J

1997-02-01

To study whether anatomical location and age and gender of subjects had any influence on the objective skin colour measurements. Baseline colour in prone position was measured with the Minolta ChromaMeter® in the upper, middle and lower level of the upper back and on the forearm of 168 volunteers. These two sites are commonly used in skin testing. Higher basal a* and lower basal L* levels were found on the upper scapular region compared to the lower scapular region and the subscapular region. The basal b* level showed no variation relative to site. The basal a* and the basal b* levels were lower on the forearm compared to the upper back while the basal L* level was higher. Females above 65 years showed a less coloured skin with lower values as compared to those of younger age. Females were found to have a generally lower basal a* level than males both on the upper back and forearm skin. These relatively major differences and sources of variation have to be considered when planning irritancy studies where colour differences between erythema and normal skin is used.

[Management of patients under 18years of age by adult intensive care unit professionals: Level of training, workload, and specific challenges].

PubMed

Brossier, D; Villedieu, F; Letouzé, N; Pinto Da Costa, N; Jokic, M

2017-03-01

In routine practice, intensive care physicians rarely have to manage children under 18years of age, particularly those under 15. This study's objectives were to assess the quality of training in pediatrics of adult intensive care teams, to document the workload generated by care of pediatric patients, and to identify the difficulties encountered in managing minors as patients. A survey was administered in Lower Normandy from 4 April 2012 to 1 September 2012. Physicians, residents, nurses, and nurses' aides practicing in one of the nine intensive care units of Lower Normandy were asked to complete an electronic or paper format questionnaire. This questionnaire assessed their level of pediatric training, the workload management of pediatric patients entailed, and the challenges posed by these patients. One hundred and nine questionnaires were returned (by 26 attending physicians, 18 residents, 38 nurses, and 27 nurses' aides). Eighty-three of the respondents (76%) had no experience in a pediatric unit of any kind. Forty-two percent thought that the pediatric age range lies between 3months and 15years of age. However, more than 50% of respondents would like the upper limit to be 16years or even older. Ninety-three respondents (85%) estimated having some exposure to pediatric patients in their routine practice, but this activity remained quite low. Seventy-three (67%) reported difficulties with the management of these young patients. This survey provides current information regarding the level of training of adult intensive care unit professionals and their concerns about managing patients under 18years of age, both in terms of workload and specific challenges. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Upper limb function in persons with long term paraplegia and implications for independence: Part II.

PubMed

Pentland, W E; Twomey, L T

1994-04-01

Research has shown that wheelchair use in long term paraplegia is associated with upper limb pain and degeneration that interferes with the independent performance of activities of daily living. This paper proposes a model to explain the development of upper limb problems in persons with long term paraplegia, and one that will guide in the prevention and management of this type of long term complication.

Presence and absence of bats across habitat scales in the Upper Coastal Plain of South Carolina.

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

Ford, W.Mark; Menzel, Jennifer M.; Menzel, Michael A.: Edwards, John W.

Abstract During 2001, we used active acoustical sampling (Anabat II) to survey foraging habitat relationships of bats on the Savannah River Site (SRS) in the upper Coastal Plain of South Carolina. Using an a priori information-theoretic approach, we conducted logistic regression analysis to examine presence of individual bat species relative to a suite of microhabitat, stand, and landscape-level features such as forest structural metrics, forest type, proximity to riparian zones and Carolina bay wetlands, insect abundance, and weather. There was considerable empirical support to suggest that the majority of the activity of bats across most of the 6 species occurredmore » at smaller, stand-level habitat scales that combine measures of habitat clutter (e.g., declining forest canopy cover and basal area), proximity to riparian zones, and insect abundance. Accordingly, we hypothesized that most foraging habitat relationships were more local than landscape across this relatively large area for generalist species of bats. The southeastern myotis (Myotis austroriparius) was the partial exception, as its presence was linked to proximity of Carolina bays (best approximating model) and bottomland hardwood communities (other models with empirical support). Efforts at SRS to promote open longleaf pine (Pinus palustris) and loblolly pine (P. taeda) savanna conditions and to actively restore degraded Carolina bay wetlands will be beneficial to bats. Accordingly, our results should provide managers better insight for crafting guidelines for bat habitat conservation that could be linked to widely accepted land management and environmental restoration practices for the region.« less

Effect of Upper Limb Deformities on Gross Motor and Upper Limb Functions in Children with Spastic Cerebral Palsy

ERIC Educational Resources Information Center

Park, Eun Sook; Sim, Eun Geol; Rha, Dong-wook

2011-01-01

The aims of this study were to investigate the nature and extent of upper limb deformities via the use of various classifications, and to analyze the relationship between upper limb deformities and gross motor or upper limb functionality levels. Upper extremity data were collected from 234 children with spastic cerebral palsy (CP) who were…

Patient with giant upper limb melanoma presenting to a UK plastic surgery unit: differentials and experience of management.

PubMed

Honeyman, Calum Sinclair; Wilson, Paul

2016-02-02

A 57-year-old woman was referred to our regional sarcoma unit following a 2-year history of a progressively enlarging mass on her right forearm. At 14 × 7 × 12 cm, this mass turned out to be one of the largest upper limb cutaneous malignant melanomas ever described, and, to the best of our knowledge, the first documented in the UK. Remarkably, despite having a T4 malignant tumour with a Breslow thickness of 70 mm, this patient is still alive over 4 years later with no locoregional or distant metastatic spread. We present our experience in the management of this giant malignant melanoma of the upper limb and consider important differentials. 2016 BMJ Publishing Group Ltd.

Antiplatelet agents and/or anticoagulants are not associated with worse outcome following nonvariceal upper gastrointestinal bleeding.

PubMed

Teles-Sampaio, Elvira; Maia, Luís; Salgueiro, Paulo; Marcos-Pinto, Ricardo; Dinis-Ribeiro, Mário; Pedroto, Isabel

2016-11-01

Nonvariceal upper gastrointestinal bleeding emerges as a major complication of using antiplatelet agents and/or anticoagulants and represents a clinical challenge in patients undergoing these therapies. To characterize patients with nonvariceal upper gastrointestinal bleeding related to antithrombotics and their management, and to determine clinical predictors of adverse outcomes. Retrospective cohort of adults who underwent upper gastrointestinal endoscopy after nonvariceal upper gastrointestinal bleeding from 2010 to 2012. The outcomes were compared between patients exposed and not exposed to antithrombotics. Five hundred and forty-eight patients with nonvariceal upper gastrointestinal bleeding (67% men; mean age 66.5 ± 16.4 years) were included, of which 43% received antithrombotics. Most patients had comorbidities. Peptic ulcer was the main diagnosis and endoscopic therapy was performed in 46% of cases. The 30-day mortality rate was 7.7% (n = 42), and 36% were bleeding-related. The recurrence rate was 9% and 14% of patients with initial endoscopic treatment needed endoscopic retreatment. There were no significant differences between the exposed and non-exposed groups in most outcomes. Co-morbidities, hemodynamic instability, high Rockall score, low hemoglobin (7.76 ± 2.72 g/dL) and higher international normalized ratio (1.63 ± 1.13) were associated significantly with mortality in a univariate analysis. Adverse outcomes were not associated with antithrombotic use. The management of nonvariceal upper gastrointestinal bleeding constitutes a challenge to clinical performance optimization and clinical cooperation.

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

Brown, Nicholas, E-mail: nibrown@cantab.net; Olayos, Elizabeth; Elmer, Sandra

Management of intractable haematuria and obstructive urosepsis from upper tract urothelial carcinoma can be problematic in patients not suitable for surgery, chemotherapy or radiotherapy. Interventional radiology techniques provide alternative approaches in this setting, such as complete kidney embolization to cease urine output, percutaneous nephrostomy, antegrade injection of sclerotherapy agents and sterilisation of the upper collecting system. Related approaches have been successfully employed to sclerose renal cysts, lymphoceles, chyluria and intractable lower tract haemorrhage. No reports of percutaneous, antegrade sclerotherapy in the upper urinary tract have previously been published. We present a case of recurrent haematuria and obstructive urosepsis caused bymore » invasive upper tract urothelial carcinoma in a non-operative patient, which was treated with renal embolisation and percutaneous upper tract urothelial sclerotherapy.« less

Metals in fish from the Upper Benue River and lakes Geriyo and Njuwa in northeastern Nigeria

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

Eromosele, C.O.; Eromosele, I.C.; Muktar, S.L.M.

Lakes Geriyo and Njuwa occupy natural depressions near the upper Benue River in northeastern Nigeria. The lakes are flooded by the river during the rainy season spanning the months of May to September. Fishing activities on the lakes and river provide fish for consumption by the local communities. Industrial activity around the upper Benue River and the lakes is low and there is no information on other activities with the potential for polluting the Benue River as it flows from neighboring Cameroon. However, an unconfirmed report indicated high levels of lead in the upper Benue River, generally speculated as arisingmore » from biogeometrical factors. Trace elements, some of which are toxic, may accumulate in edible marine organisms to levels which may be deleterious to human health. For the upper Benue River and its associate lakes, Geriyo and Njuwa, there is yet no report of a systematic study to assess the levels of metals in fish found in these waters. This paper presents the results of a study on metal levels in fish collected from Lakes Geriyo and Njuwa and upper Benue River in northeastern Nigeria. 7 refs., 1 fig., 2 tabs.« less

Initializing a Mesoscale Boundary-Layer Model with Radiosonde Observations

NASA Astrophysics Data System (ADS)

Berri, Guillermo J.; Bertossa, Germán

2018-01-01

A mesoscale boundary-layer model is used to simulate low-level regional wind fields over the La Plata River of South America, a region characterized by a strong daily cycle of land-river surface-temperature contrast and low-level circulations of sea-land breeze type. The initial and boundary conditions are defined from a limited number of local observations and the upper boundary condition is taken from the only radiosonde observations available in the region. The study considers 14 different upper boundary conditions defined from the radiosonde data at standard levels, significant levels, level of the inversion base and interpolated levels at fixed heights, all of them within the first 1500 m. The period of analysis is 1994-2008 during which eight daily observations from 13 weather stations of the region are used to validate the 24-h surface-wind forecast. The model errors are defined as the root-mean-square of relative error in wind-direction frequency distribution and mean wind speed per wind sector. Wind-direction errors are greater than wind-speed errors and show significant dispersion among the different upper boundary conditions, not present in wind speed, revealing a sensitivity to the initialization method. The wind-direction errors show a well-defined daily cycle, not evident in wind speed, with the minimum at noon and the maximum at dusk, but no systematic deterioration with time. The errors grow with the height of the upper boundary condition level, in particular wind direction, and double the errors obtained when the upper boundary condition is defined from the lower levels. The conclusion is that defining the model upper boundary condition from radiosonde data closer to the ground minimizes the low-level wind-field errors throughout the region.

Wetland Management Reduces Sediment and Nutrient Loading to the Upper Mississippi River

EPA Science Inventory

Restored riparian wetlands in the Upper Mississippi River basin have the potential to remove sediment and nutrients from tributaries before they flow into the Mississippi River. For 3 yr we calculated retention efficiencies of a marsh complex, which consisted of a restored marsh...

Performance of new thresholds of the Glasgow Blatchford score in managing patients with upper gastrointestinal bleeding.

PubMed

Laursen, Stig B; Dalton, Harry R; Murray, Iain A; Michell, Nick; Johnston, Matt R; Schultz, Michael; Hansen, Jane M; Schaffalitzky de Muckadell, Ove B; Blatchford, Oliver; Stanley, Adrian J

2015-01-01

Upper gastrointestinal hemorrhage (UGIH) is a common cause of hospital admission. The Glasgow Blatchford score (GBS) is an accurate determinant of patients' risk for hospital-based intervention or death. Patients with a GBS of 0 are at low risk for poor outcome and could be managed as outpatients. Some investigators therefore have proposed extending the definition of low-risk patients by using a higher GBS cut-off value, possibly with an age adjustment. We compared 3 thresholds of the GBS and 2 age-adjusted modifications to identify the optimal cut-off value or modification. We performed an observational study of 2305 consecutive patients presenting with UGIH at 4 centers (Scotland, England, Denmark, and New Zealand). The performance of each threshold and modification was evaluated based on sensitivity and specificity analyses, the proportion of low-risk patients identified, and outcomes of patients classified as low risk. There were differences in age (P = .0001), need for intervention (P < .0001), mortality (P < .015), and GBS (P = .0001) among sites. All systems identified low-risk patients with high levels of sensitivity (>97%). The GBS at cut-off values of ≤1 and ≤2, and both modifications, identified low-risk patients with higher levels of specificity (40%-49%) than the GBS with a cut-off value of 0 (22% specificity; P < .001). The GBS at a cut-off value of ≤2 had the highest specificity, but 3% of patients classified as low-risk patients had adverse outcomes. All GBS cut-off values, and score modifications, had low levels of specificity when tested in New Zealand (2.5%-11%). A GBS cut-off value of ≤1 and both GBS modifications identify almost twice as many low-risk patients with UGIH as a GBS at a cut-off value of 0. Implementing a protocol for outpatient management, based on one of these scores, could reduce hospital admissions by 15% to 20%. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

Upper-Level Undergraduate Chemistry Students' Goals for Their Laboratory Coursework

ERIC Educational Resources Information Center

DeKorver, Brittland K.; Towns, Marcy H.

2016-01-01

Efforts to reform undergraduate chemistry laboratory coursework typically focus on the curricula of introductory-level courses, while upper-level courses are bypassed. This study used video-stimulated recall to interview 17 junior- and senior- level chemistry majors after they carried out an experiment as part of a laboratory course. It is assumed…

22. VIEW ACROSS UPPER LEVEL OF EAST BUILDING TOWARDS THE ...

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

22. VIEW ACROSS UPPER LEVEL OF EAST BUILDING TOWARDS THE SOUTH (RIVER) SHOWING ROOF TRUSSES, PLANK AND PATTERN STORAGE, HINGED ACCESS HATCH TO STREET LEVEL SHOP CAN BE SEEN OPENED IN FOREGROUND. - Lowell's Boat Shop, 459 Main Street, Amesbury, Essex County, MA

CRANE WINCH MECHANISM, UPPER LEVEL OF HYDROELECTRIC POWER HOUSE ...

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

CRANE WINCH MECHANISM, UPPER LEVEL OF HYDROELECTRIC POWER HOUSE - St. Lucie Canal, Lock No. 1, Hydroelectric Power House, St. Lucie, Cross State Canal, Okeechobee Intracoastal Waterway, Stuart, Martin County, FL

ELECTRICAL SWITCHBOARD IN UPPER LEVEL OF HYDROELECTRIC POWER HOUSE ...

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

ELECTRICAL SWITCHBOARD IN UPPER LEVEL OF HYDROELECTRIC POWER HOUSE - St. Lucie Canal, Lock No. 1, Hydroelectric Power House, St. Lucie, Cross State Canal, Okeechobee Intracoastal Waterway, Stuart, Martin County, FL

Brachial plexus injury management through upper extremity amputation with immediate postoperative prostheses.

PubMed

Malone, J M; Leal, J M; Underwood, J; Childers, S J

1982-02-01

Management of patients with brachial plexus injuries requires a team approach so that all aspects of their care are addressed simultaneously. This report examines elective amputation and prosthetic rehabilitation in a patient with brachial plexus avulsion of the left arm. The best possibility for good prosthetic rehabilitation is the early application of prosthetic devices with intensive occupational therapy. Using this type of approach, we have achieved significant improvement in amputation rehabilitation of upper extremity amputees treated with immediate postoperative conventional electric and myoelectric prostheses.

An infrastructure for data-intensive seismology using ADMIRE: laying the bricks for a new data highway

NASA Astrophysics Data System (ADS)

Trani, L.; Spinuso, A.; Galea, M.; Atkinson, M.; Van Eck, T.; Vilotte, J.

2011-12-01

The data bonanza generated by today's digital revolution is forcing scientists to rethink their methodologies and working practices. Traditional approaches to knowledge discovery are pushed to their limit and struggle to keep apace with the data flows produced by modern systems. This work shows how the ADMIRE data-intensive architecture supports seismologists by enabling them to focus on their scientific goals and questions, abstracting away the underlying technology platform that enacts their data integration and analysis tasks. ADMIRE accomplishes this partly by recognizing 3 different types of experts that require clearly defined interfaces between their interaction: the domain expert who is the application specialist, the data-analysis expert who is a specialist in extracting information from data, and the data-intensive engineer who develops the infrastructure for data-intensive computation. In order to provide a context in which each category of expert may flourish, ADMIRE uses a 3-level architecture: the upper - tool - level supports the work of both domain and data-analysis experts, housing an extensive and evolving set of portals, tools and development environments; the lower - enactment - level houses a large and dynamic community of providers delivering data and data-intensive enactment environments as an evolving infrastructure that supports all of the work underway in the upper layer. Most data-intensive engineers work here; the crucial innovation lies in the middle level, a gateway that is a tightly defined and stable interface through which the two diverse and dynamic upper and lower layers communicate. This is a minimal and simple protocol and language (DISPEL), ultimately to be controlled by standards, so that the upper and lower communities may invest, secure in the knowledge that changes in this interface will be carefully managed. We implemented a well-established procedure for processing seismic ambient noise on the prototype architecture. The primary goal was to evaluate its capabilities for large-scale integration and analysis of distributed data. A secondary goal was to gauge its potential and the added value that it might bring to the seismological community. Though still in its infant state, the architecture met the demands of our use case and promises to cater for our future requirements. We shall continue to develop its capabilities as part of an EU funded project VERCE - Virtual Earthquake and Seismology Research Community for Europe. VERCE aims to significantly advance our understanding of the Earth in order to aid society in its management of natural resources and hazards. Its strategy is to enable seismologists to fully exploit the under-utilized wealth of seismic data, and key to this is a data-intensive computation framework adapted to the scale and diversity of the community. This is a first step in building a data-intensive highway for geoscientists, smoothing their travel from the primary sources of data to new insights and rapid delivery of actionable information.

41. VIEW NORTH OF UPPER LEVEL OF CRUSHER ADDITION. DINGS ...

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

41. VIEW NORTH OF UPPER LEVEL OF CRUSHER ADDITION. DINGS MAGNETIC PULLEY AT CENTER. ALSO SHOWS 100-TON CRUSHED UNOXIDIZED ORE BIN (RIGHT), PULLEY FORM 18 INCH BELT CONVEYOR CRUSHED OXIDIZED ORE BIN FEED AND STEPHENSADAMSON 25 TON/HR BUCKET ELEVATOR (UPPER CENTER). THE UPPER PORTION OF THE SAMPLING ELEVATOR IS ABOVE THE MAGNETIC PULLEY (CENTER LEFT) WITH THE ROUTE OF THE 16 INCH BELT CONVEYOR FINES FEED TO CRUSHED OXIDIZED ORE BIN TO ITS LEFT. - Bald Mountain Gold Mill, Nevada Gulch at head of False Bottom Creek, Lead, Lawrence County, SD

U.S. academic medical centers under the managed health care environment.

PubMed

Guo, K

1999-06-01

This research investigates the impact of managed health care on academic medical centers in the United States. Academic medical centers hold a unique position in the U.S. health care system through their missions of conducting cutting-edge biomedical research, pursuing clinical and technological innovations, providing state-of-the-art medical care and producing highly qualified health professionals. However, policies to control costs through the use of managed care and limiting resources are detrimental to academic medical centers and impede the advancement of medical science. To survive the threats of managed care in the health care environment, academic medical centers must rely on their upper level managers to derive successful strategies. The methods used in this study include qualitative approaches in the form of key informants and case studies. In addition, a survey questionnaire was sent to 108 CEOs in all the academic medical centers in the U.S. The findings revealed that managers who perform the liaison, monitor, entrepreneur and resource allocator roles are crucial to ensure the survival of academic medical centers, so that academic medical centers can continue their missions to serve the general public and promote their well-being.

6. Vacuum purification room and upper level offices Bureau ...

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

6. Vacuum purification room and upper level offices - Bureau of Mines Boulder City Experimental Station, Titanium Research Building, Date Street north of U.S. Highway 93, Boulder City, Clark County, NV

12. DETAIL OF PAINTED SIGNS AND UPPER LEVEL WINDOWS ON ...

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

12. DETAIL OF PAINTED SIGNS AND UPPER LEVEL WINDOWS ON SOUTH SIDE. VIEW TO NORTHWEST. - Commercial & Industrial Buildings, Dubuque Seed Company Warehouse, 169-171 Iowa Street, Dubuque, Dubuque County, IA

VIEW NORTHEAST, Interior of Power Station, upper level showing windows ...

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

VIEW NORTHEAST, Interior of Power Station, upper level showing windows on east and north elevations - Bay City Traction & Electric Company, Power Station, 301 Washington Street, Bay City, Bay County, MI

VIEW SOUTHEAST, Interior of Power Station, upper level showing windows ...

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

VIEW SOUTHEAST, Interior of Power Station, upper level showing windows on east and south elevations - Bay City Traction & Electric Company, Power Station, 301 Washington Street, Bay City, Bay County, MI

Integrating Wind Profiling Radars and Radiosonde Observations with Model Point Data to Develop a Decision Support Tool to Assess Upper-Level Winds for Space Launch

NASA Technical Reports Server (NTRS)

Bauman, William H., III; Flinn, Clay

2013-01-01

On the day of launch, the 45th Weather Squadron (45 WS) Launch Weather Officers (LWOs) monitor the upper-level winds for their launch customers. During launch operations, the payload/launch team sometimes asks the LWOs if they expect the upper-level winds to change during the countdown. The LWOs used numerical weather prediction model point forecasts to provide the information, but did not have the capability to quickly retrieve or adequately display the upper-level observations and compare them directly in the same display to the model point forecasts to help them determine which model performed the best. The LWOs requested the Applied Meteorology Unit (AMU) develop a graphical user interface (GUI) that will plot upper-level wind speed and direction observations from the Cape Canaveral Air Force Station (CCAFS) Automated Meteorological Profiling System (AMPS) rawinsondes with point forecast wind profiles from the National Centers for Environmental Prediction (NCEP) North American Mesoscale (NAM), Rapid Refresh (RAP) and Global Forecast System (GFS) models to assess the performance of these models. The AMU suggested adding observations from the NASA 50 MHz wind profiler and one of the US Air Force 915 MHz wind profilers, both located near the Kennedy Space Center (KSC) Shuttle Landing Facility, to supplement the AMPS observations with more frequent upper-level profiles. Figure 1 shows a map of KSC/CCAFS with the locations of the observation sites and the model point forecasts.

APPLYING THE ECOSYSTEM SERVICES CONCEPT FOR ENVIRONMENTAL MANAGEMENT IN THE UPPER SAN PEDRO BASIN, ARIZONA

EPA Science Inventory

The Upper San Pedro River flows intermittently north from Sonora, Mexico into southeastern Arizona and is one of the last few large unimpounded rivers in the American Southwest. The remaining perennial reaches support a desert riparian ecosystem that is a rare remnant of what ...

Congenital bilateral upper eyelid eversion: report of a case.

PubMed

Cingü, Abdullah Kürşat; Sahin, Alparslan; Yüksel, Harun; Ozkök, Ahmet; Arı, Seyhmus; Caça, Ihsan

2014-01-01

Congenital bilateral upper eyelid eversion is a rare condition and the definite cause is not known. It is often seen in Black babies or babies with Down's syndrome. With early diagnosis and appropriate treatment, the condition can be managed without surgery. We report a case of congenital upper eyelid eversion in an otherwise healthy Caucasian neonate, born by normal vaginal delivery. The case responded well to conservative treatment, including eyelid repositioning, lubricants, antibiotic ointment, and eyelid patching.

A comparison of upper limb amputees and patients with upper limb injuries using the Disability of the Arm, Shoulder and Hand (DASH).

PubMed

Davidson, Judith

To use the Disability of the Arm Shoulder and Hand (DASH) scale to measure the disability of patients with upper limb amputation(s) and to compare these to other upper limb injuries. All 274 patients over the age of 18 years presenting to Prince Henry Hospital in Sydney over a 4-year time frame were given the DASH assessment tool and asked to complete it under supervision of the Occupational Therapist. Patients with brachial plexus injuries, Complex Regional Pain Syndrome and bilateral upper limb amputations demonstrated significantly higher levels of disability to patients with unilateral upper limb amputations. Partial hand amputees reported a higher level of disability than major unilateral upper limb amputees. For the 48 patients who completed pre- and post-treatment assessments, there was a significant improvement in their health status. Further research is required to understand the factors that affect a patient's perceptions of their disability. Perhaps the definitive nature of an amputation and the immediate involvement of highly skilled health professionals serve to assist patients to accept their injury and therefore minimizes the level of disability.

Ageing midface: The impact of surgeon's experience on the consistency in the assessment and proposed management.

PubMed

Hazrati, Ali; Izadpanah, Ali; Zadeh, Teanoosh; Gosman, Amanda; Chao, James J; Dobke, Marek K

2011-02-01

An individual's face undergoes numerous changes throughout life. Since mid-face aesthetic units are key areas for rejuvenation procedures, their comprehensive assessment is essential for the development of any aesthetic management plan. Despite the availability of many evaluation criteria for treatment of mid-face ageing, there are discrepancies existing in both assessment and management approaches. The goal of this study was to determine if there are any identifiable profiles of clinical judgements and approaches related to the level of surgeon's experience. Forty seven standardised non-digital and not altered natural size photographic images of patients' faces (front and profile) were presented to eight senior board certified plastic surgeons, eight junior non-board certified plastic surgeons and eight plastic surgery residents from an independent program. Surveyed physicians were 'blinded' from each other and asked to assess five different major features characterising ageing mid-face. An interclass correlation data analysis was performed and the Cronbach coefficient alpha values were computed for each category. Responses obtained from senior plastic surgeons were consistently characterised by higher Cronbach coefficient alpha values indicating higher concordance. The highest agreement levels were obtained for the assessment of rhytids and jowls across all groups and the lowest agreement levels were obtained for the assessment and recommendation of upper lip management. This study illustrated that discrepancies in clinical assessments and surgical management exist among surgeons involved in the aesthetic surgery of the mid-face ageing. It appears that the level of surgeon's experience significantly impacts the inter-rater reliability and consensus in assessment and treatment of mid-face ageing. The most senior plastic surgeons' assessment and recommendations had the highest level of concordance while the junior non-board certified plastic surgeons and the residents group produced variations with less consistency. Copyright © 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Female healthcare managers and the glass ceiling. The obstacles and opportunities for women in management.

PubMed

Wiggins, C

1991-01-01

Despite the large number of women in the healthcare field, healthcare management resembles other industries in its severe lack of women in upper-management positions and in the "glass ceiling" that contributes to this dearth. Although not enough has been specifically written on women healthcare managers, the author reviews what is available, along with some of the general management literature.

[Localization of upper airway stricture by CT scan in patients with obstructive sleep apnea syndrome during drug-induced sleeping].

PubMed

Hu, Ji-bo; Hu, Hong-jie; Hou, Tie-ning; Gao, Hang-xiang; He, Jian

2010-03-01

To evaluate the feasibility of multi-slice spiral CT scan to localize upper airway stricture in patients with obstructive sleep apnea syndrome (OSAS) during drug-induced sleeping. One hundred and fourteen patients diagnosed as OSAS by polysomnography were included in the study. Multi-slice spiral CT scan covering upper airway was performed at the end of inspiration and clear upper airway images were obtained in waking. After injecting 5 mg of midazolam intravenously slowly in 109 patients, CT scan was performed at apnea and clear upper airway images were obtained in sleeping. Cross-section area and minimal diameter of airway were measured and the parameters were compared under those two states. Upper airway was displayed intuitionisticly by using post-processing techniques. One hundred and nine patients with OSAS finished the examination with a success rate of 100 %. Airway obstruction at retropalatal level was observed in 62 patients, among whom 26 were associated with airway obstruction at retroglossal level, 27 with narrower airway at retroglossal level in sleeping compared with that in waking, and 9 with no significant change of the airway at retroglossal level after sleeping. Narrower airway at retropalatal level in sleeping compared with that in waking was observed in 40 patients, among whom 20 were associated with narrower airway at retroglossal level in sleeping compared with that in waking, 10 with complete airway obstruction at retroglossal level in sleeping, and 7 with no significant change of the airway at both retropalatal and retroglossal levels before and after sleeping. Minimal mean cross-section area of airway at retropalatal level was (72.60 +/-45.15)mm(2) in waking and (8.26 +/-18.16)mm(2) in sleeping; and minimal mean cross-section area of airway at retroglossal level was (133.21 +/-120.36)mm(2)in waking and (16.73 +/-30.21)mm(2) in sleeping (P <0.01). Minimal mean diameter of airway at retropalatal level was (6.91 +/-2.23) mm in waking and (1.18 +/-2.14) mm in sleeping; and minimal mean diameter of airway at retroglossal level was (8.68 +/-4.32) mm in waking and (1.68 +/-2.22) mm in sleeping (P <0.01). Multi-slice spiral CT with post-processing techniques can display the shape of the upper airway in patients with OSAS in sleeping, and can localize the upper airway stricture and assess its range accurately.

The effect of arm weight support on upper limb muscle synergies during reaching movements

PubMed Central

2014-01-01

Background Compensating for the effect of gravity by providing arm-weight support (WS) is a technique often utilized in the rehabilitation of patients with neurological conditions such as stroke to facilitate the performance of arm movements during therapy. Although it has been shown that, in healthy subjects as well as in stroke survivors, the use of arm WS during the performance of reaching movements leads to a general reduction, as expected, in the level of activation of upper limb muscles, the effects of different levels of WS on the characteristics of the kinematics of motion and of the activity of upper limb muscles have not been thoroughly investigated before. Methods In this study, we systematically assessed the characteristics of the kinematics of motion and of the activity of 14 upper limb muscles in a group of 9 healthy subjects who performed 3-D arm reaching movements while provided with different levels of arm WS. We studied the hand trajectory and the trunk, shoulder, and elbow joint angular displacement trajectories for different levels of arm WS. Besides, we analyzed the amplitude of the surface electromyographic (EMG) data collected from upper limb muscles and investigated patterns of coordination via the analysis of muscle synergies. Results The characteristics of the kinematics of motion varied across WS conditions but did not show distinct trends with the level of arm WS. The level of activation of upper limb muscles generally decreased, as expected, with the increase in arm WS. The same eight muscle synergies were identified in all WS conditions. Their level of activation depended on the provided level of arm WS. Conclusions The analysis of muscle synergies allowed us to identify a modular organization underlying the generation of arm reaching movements that appears to be invariant to the level of arm WS. The results of this study provide a normative dataset for the assessment of the effects of the level of arm WS on muscle synergies in stroke survivors and other patients who could benefit from upper limb rehabilitation with arm WS. PMID:24594139

A one-year economic evaluation of six alternative strategies in the management of uninvestigated upper gastrointestinal symptoms in Canadian primary care.

PubMed

Barkun, Alan N; Crott, Ralph; Fallone, Carlo A; Kennedy, Wendy A; Lachaine, Jean; Levinton, Carey; Armstrong, David; Chiba, Naoki; Thomson, Alan; Veldhuyzen van Zanten, Sander; Sinclair, Paul; Escobedo, Sergio; Chakraborty, Bijan; Smyth, Sandra; White, Robert; Kalra, Helen; Nevin, Krista

2010-08-01

The cost-effectiveness of initial strategies in managing Canadian patients with uninvestigated upper gastrointestinalsymptoms remains controversial. To assess the cost-effectiveness of six management approaches to uninvestigated upper gastrointestinal symptoms in the Canadian setting. The present study analyzed data from four randomized trials assessing homogeneous and complementary populations of Canadian patients with uninvestigated upper gastrointestinal symptoms with comparable outcomes. Symptom-free months, qualityadjusted life-years (QALYs) and direct costs in Canadian dollars of two management approaches based on the Canadian Dyspepsia Working Group (CanDys) Clinical Management Tool, and four additional strategies (two empirical antisecretory agents, and two prompt endoscopy) were examined and compared. Prevalence data, probabilities, utilities and costs were included in a Markov model, while sensitivity analysis used Monte Carlo simulations. Incremental cost-effectiveness ratios and cost-effectiveness acceptability curves were determined. Empirical omeprazole cost $226 per QALY ($49 per symptom-free month) per patient. CanDys omeprazole and endoscopy approaches were more effective than empirical omeprazole, but more costly. Alternatives using H2-receptor antagonists were less effective than those using a proton pump inhibitor. No significant differences were found for most incremental cost-effectiveness ratios. As willingness to pay (WTP) thresholds rose from $226 to $24,000 per QALY, empirical antisecretory approaches were less likely to be the most costeffective choice, with CanDys omeprazole progressively becoming a more likely option. For WTP values ranging from $24,000 to $70,000 per QALY, the most clinically relevant range, CanDys omeprazole was the most cost-effective strategy (32% to 46% of the time), with prompt endoscopy-proton pump inhibitor favoured at higher WTP values. Although no strategy was the indisputable cost effective option, CanDys omeprazole may be the strategy of choiceover a clinically relevant range of WTP assumptions in the initial management of Canadian patients with uninvestigated dyspepsia.

Groundwater conditions and studies in the Augusta–Richmond County area, Georgia, 2008–2009

USGS Publications Warehouse

Gonthier, Gerard; Lawrence, Stephen J.; Peck, Michael F.; Holloway, O. Gary

2011-01-01

Groundwater studies and monitoring efforts conducted during 2008–2009, as part of the U.S. Geological Survey (USGS) Cooperative Water Program with the City of Augusta in Richmond County, Georgia, provided data for the effective management of local water resources. During 2008–2009 the USGS completed: (1) installation of three monitoring wells and the collection of lithologic and geophysical logging data to determine the extent of hydrogeologic units, (2) collection of continuous groundwater-level data from wells near Well Fields 2 and 3, (3) collection of synoptic groundwater-level measurements and construction of potentiometric-surface maps in Richmond County to establish flow gradients and groundwater-flow directions in the Dublin and Midville aquifer systems, (4) completion of a 24-hour aquifer test to determine hydraulic characteristics of the lower Dublin aquifer, and upper and lower Midville aquifers in Well Field 2, and (5) collection of groundwater samples from selected wells in Well Field 2 for laboratory analysis of volatile organic compounds and groundwater tracers to assess groundwater quality and estimate the time of groundwater recharge. Potentiometric-surface maps of the Dublin and Midville aquifer systems for 2008–2009 indicate that the general groundwater flow direction within Richmond County is eastward toward the Savannah River, with the exception of the area around Well Field 2, where pumping interrupts the eastward flow of water toward the Savannah River and causes flow lines to bend toward the center of pumping. Results from a 24-hour aquifer test conducted in 2009 within the upper and lower Midville aquifers at Well Field 2 indicated a transmissivity and storativity for the upper and lower Midville aquifers, combined, of 4,000 feet-squared per day and 2x10-4, respectively. The upper and lower Midville aquifers and the middle lower Midville confining unit, which is 85-feet thick in this area, yielded horizontal hydraulic conductivity and specific storage values of about 45 feet per day and 2x10-6 ft-1, respectively. Results from the 24-hour aquifer test also indicate a low horizontal hydraulic conductivity for the lower Dublin aquifer of less than 1 foot per day. Of the 35 volatile organic compounds (VOCs) analyzed in 23 groundwater samples during 2008–2009, only six were detected above laboratory reporting limits in samples from eight wells. No concentration in groundwater samples collected during 2008–2009 exceeded drinking water standards. Trichloroethene had the maximum VOC concentration (1.9 micrograms per liter) collected from a water sample during 2008–2009. Water-quality sampling of several wells near Well Field 2 indicate that, while in operation, the northernmost production well might have diverted groundwater, containing low levels of trichloroethene from at least two other production wells. Analysis of sulfur hexafluoride data indicate the average year of recharge ranges between 1981 and 1984 for water samples from five wells open to the upper and lower Midville aquifers, and 1991 for a water sample from one shallow well open to the lower Dublin aquifer. All of these ages suggest a short flow path and nearby source of contamination. The actual source of low levels of VOCs at Well Field 2 remains unknown. Three newly installed monitoring wells indicate that hydrogeologic units beneath Well Fields 2 and 3 are composed of sand and clay layers. Hydrogeologic units, encountered at Well Field 2, in order of increasing depth are the lower Dublin confining unit, lower Dublin aquifer, upper Midville confining unit, upper Midville aquifer, lower Midville confining unit, and lower Midville aquifer. West of Well Field 3, hydrogeologic units, in order of increasing depth are the Upper Three Runs aquifer, Gordon confining unit, Gordon aquifer, lower Dublin confining unit, lower Dublin aquifer, upper Midville confining unit, upper Midville aquifer, lower Midville confining unit, and lower Midville aquifer.

Management of Subclinical Hypothyroidism in Pregnancy: A Comment from the Italian Society of Endocrinology and the Italian Thyroid Association to the 2017 American Thyroid Association Guidelines-"The Italian Way".

PubMed

Rotondi, Mario; Chiovato, Luca; Pacini, Furio; Bartalena, Luigi; Vitti, Paolo

2018-05-01

The 2017 American Thyroid Association guidelines for the diagnosis and management of thyroid disease during pregnancy and the postpartum were published six years after the previous ones. They provide comprehensive clinical recommendations for the whole spectrum of thyroid diseases, as well as for optimal iodine intake during pregnancy, postpartum, and lactation. The present position statement mainly regards the recommended flow chart for therapeutic decision making in pregnant women being diagnosed with subclinical hypothyroidism. Here, we comment on the major biochemical and clinical situations and the corresponding therapeutic recommendations. In particular, we welcome the critical revision of the thyrotropin (TSH) reference range in pregnancy, and we agree that there is no need to treat thyroid peroxidase antibody-negative women with a serum TSH ranging from 2.5 μIU/mL to the upper limit of the reference range. This recommendation will hopefully reduce the huge proportion of healthy pregnant women in whom, according to the previous guidelines, levothyroxine therapy had to be initiated. On the other hand, we are concerned with the recommendation to only "consider treatment" in thyroid peroxidase antibody-negative pregnant women with a serum TSH ranging from the upper limit of the reference range to 10.0 μIU/mL. This is because thyroid antibodies may be falsely negative during gestation, and serum negative chronic autoimmune thyroiditis is a well-known clinical entity even outside pregnancy. Based on these and other arguments, we recommend treatment with levothyroxine in pregnant women with TSH levels ranging between the upper limit of the reference range and 10.0 μIU/mL independently from their thyroid antibody status.

Incentivizing Advanced Mathematics Study at Upper Secondary Level: The Case of Bonus Points in Ireland

ERIC Educational Resources Information Center

Treacy, Páraic Thomas

2018-01-01

Secondary level mathematics education in Ireland has recently experienced a period of significant change with the introduction of new curricula and the addition of an incentive to study upper secondary mathematics at the most advanced level (Higher Level). This incentive, typically referred to as 'bonus points', appears to have aided a significant…

The Legacy Ecosystem Management Framework: From Theory to Application in the Detention Pond Case Study

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

Coty, J; Stevenson, M; Vogt, K A

The Detention Pond is a constructed and lined storm water treatment basin at Lawrence Livermore National Laboratory that serves multiple stakeholder objectives and programmatic goals. This paper examines the process and outcome involved in the development of a new management plan for the Detention Pond. The plan was created using a new ecosystem management tool, the Legacy Framework. This stakeholder-driven conceptual framework provides an interdisciplinary methodology for determining ecosystem health, appropriate management strategies, and sensitive indicators. The conceptual framework, the Detention Ponds project, and the use of the framework in the context of the project, are described and evaluated, andmore » evaluative criteria for this and other ecosystem management frameworks are offered. The project benefited in several ways from use of the Legacy Framework, although refinements to the framework are suggested. The stakeholder process created a context and environment in which team members became receptive to using an ecosystem management approach to evaluate and support management alternatives previously not considered. This allowed for the unanimous agreement to pursue support from upper management and organizational funding to implement a progressive management strategy. The greatly improved stakeholder relations resulted in upper management support for the project.« less

Old groundwater in parts of the upper Patapsco aquifer, Atlantic Coastal Plain, Maryland, USA: Evidence from radiocarbon, chlorine-36 and helium-4

USGS Publications Warehouse

Plummer, Niel; Eggleston, John R.; Raffensperger, Jeff P.; Hunt, Andrew G.; Casile, Gerolamo C.; Andreasen, D.C.

2012-01-01

Apparent groundwater ages along two flow paths in the upper Patapsco aquifer of the Maryland Atlantic Coastal Plain, USA, were estimated using 14C, 36Cl and 4He data. Most of the ages range from modern to about 500 ka, with one sample at 117 km downgradient from the recharge area dated by radiogenic 4He accumulation at more than one Ma. Last glacial maximum (LGM) water was located about 20 km downgradient on the northern flow path, where the radiocarbon age was 21.5 ka, paleorecharge temperatures were 0.5–1.5  °C (a maximum cooling of about 12 °C relative to the modern mean annual temperature of 13 °C), and Cl–, Cl/Br, and stable isotopes of water were minimum. Low recharge temperatures (typically 5–7 °C) indicate that recharge occurred predominantly during glacial periods when coastal heads were lowest due to low sea-level stand. Flow velocities averaged about 1.0 m a–1 in upgradient parts of the upper Patapsco aquifer and decreased from 0.13 to 0.04 m a–1 at 40 and 80 km further downgradient, respectively. This study demonstrates that most water in the upper Patapsco aquifer is non-renewable on human timescales under natural gradients, thus highlighting the importance of effective water-supply management to prolong the resource.

Confusing or Ambiguous Upper Gut Symptoms

MedlinePlus

... esophageal sphincter. This is called gastroesophageal reflux – the fundamental abnormality underlying GERD. Unlike vomiting, the regurgitated material ... Belching Bloating and Distension Chronic Pain Medications Self-management Other Management Techniques 8-step Approach to Chronic ...

Upper Colorado River Basin Climate Effects Network

USGS Publications Warehouse

Belnap, Jayne; Campbell, Donald; Kershner, Jeff

2011-01-01

The Upper Colorado River Basin (UCRB) Climate Effects Network (CEN) is a science team established to provide information to assist land managers in future decision making processes by providing a better understanding of how future climate change, land use, invasive species, altered fire cycles, human systems, and the interactions among these factors will affect ecosystems and the services they provide to human communities. The goals of this group are to (1) identify science needs and provide tools to assist land managers in addressing these needs, (2) provide a Web site where users can access information pertinent to this region, and (3) provide managers technical assistance when needed. Answers to the team's working science questions are intended to address how interactions among climate change, land use, and management practices may affect key aspects of water availability, ecosystem changes, and societal needs within the UCRB.

2. EXTERIOR, SOUTH FRONT, UPPER LEVELS SHOWING ROOF CORNICE AND ...

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

2. EXTERIOR, SOUTH FRONT, UPPER LEVELS SHOWING ROOF CORNICE AND BAY WINDOW UNIT WITH PRESSED TIN SPANDREL - West Lexington Street, Number 314 (Commercial Building), 314 West Lexington Street, Baltimore, Independent City, MD

22. DETAILCATWALKS OF THE UPPER LEVEL OF BUILDING 36 AT ...

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

22. DETAIL--CATWALKS OF THE UPPER LEVEL OF BUILDING 36 AT THE INTERSECTION OF THE EAST AND NORTH WINGS. - Navy Yard, Ordnance Building, Intersection of Paulding & Kennon Streets, Washington, District of Columbia, DC

KSC-04PD-1048

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. -- David Sutherland (left), manager, Pad A Operations (with United Space Alliance), accompanies STS- 114 crew members on a tour of the pad. In the center is Mission Specialist Soichi Noguchi, who represents the Japanese Aerospace and Exploration Agency; at right is Mission Commander Eileen Collins. Beyond the pad is the aqua blue Atlantic Ocean, glimpsed between the railing on an upper level of the Fixed Service Structure on Launch Pad 39A. The STS-114 mission is Logistics Flight 1, which is scheduled to deliver supplies and equipment plus the external stowage platform to the International Space Station.

Design, Simulation, and Preliminary Testing of a 20 Ampere Energy Management System

DTIC Science & Technology

2015-06-01

Vre f 0.5 V 0.58 V Vil 0.8 V 1.1 V Vih 1.9 V 2.25 V An important feature of this power module is the smart shutdown feature [15]. A simpli- fied...protection is removed when the pin voltage reaches the high-logic level Vih [15]. Values for Rshunt , RSD, and CSD had to be selected to implement this over...0.58 V Vil 0.8 V Vih 2.25 V Table 3.3. Truth table for H-bridge IGBTs, from [16]. Logic Input Output Shutdown Pin Lower IGBT Upper IGBT Lower IGBT

Ground-water conditions in Georgia, 1997

USGS Publications Warehouse

Cressler, A.M.

1998-01-01

Ground-water conditions in Georgia during 1997 and for the period of record were evaluated using data from ground-water-level and ground-water-quality monitoring networks. Data for 1997 included in this report are from continuous water-level records from 71 wells and chloride analyses from 14 wells. In 1997, annual mean ground-water levels in Georgia ranged from 6.2 feet (ft) lower to 5.6 ft higher than in 1996. Of the 71 wells summarized in this report, 23 wells had annual mean water levels that were higher, 35 wells had annual mean water levels that were lower, and 11 wells had annual mean water levels that were about the same in 1997 as during 1996. Data for two wells are incomplete because data collection was discontinued at one well, and the equipment was vandalized at one well. Record-low daily mean water levels were recorded in six wells tapping the Upper Floridan aquifer, one well tapping the Caliborne aquifer, two wells tapping the Clayton aquifer, and three wells tapping Cretaceous aquifers. These record lows were from 0.2 to 5.6 ft lower than previous record lows. Chloride concentration in water from the Upper Floridan aquifer in most of coastal Georgia was within drinking-water standards established by the Georgia Department of Natural Resources and the U.S. Environmental Protection Agency. In the Savannah area, chloride concentration has not changed appreciably with time. However, chloride concentration in water from some wells that tap the Floridan aquifer system in the Brunswick area exceeds the drinking-water standard. Ground-water-level and ground-water-quality data are essential for water assessment and management. Ground-water-level fluctuations and trends can be used to estimate changes in aquifer storage resulting from the effects of ground-water withdrawal and recharge from precipitation. These data can be used to address water-management needs and to evaluate the effects of management and conservation programs. As part of the ground-water investigations conducted by the U.S. Geological Survey (USGS), in cooperation with the State of Georgia and city and county governments, a Statewide water-level- measurement program was started in 1938. Initially, this program consisted of an observation-well network in the coastal area of Georgia to monitor variations in ground- water storage and quality. Additional wells were later included in areas where data could be used to predict potential water-resource problems. During 1997, periodic water-level measurements were made in 67 wells, and continuous water-level measurements were obtained from 151 wells. Continuous water-level records were obtained using analog (pen and chart) recorders, digital recorders that record the water level at 30-minute or 60-minute intervals, and electronic data recorders that record the water level at 60-minute intervals. For wells having incomplete water-level record, water levels during periods of missing record may have been higher or lower than recorded water levels. Water samples collected from 23 wells during April and November 1997 were analyzed to determine chloride concentration in the Savannah and Brunswick areas.

Asia-Pacific working group consensus on non-variceal upper gastrointestinal bleeding: an update 2018.

PubMed

Sung, Joseph Jy; Chiu, Philip Cy; Chan, Francis K L; Lau, James Yw; Goh, Khean-Lee; Ho, Lawrence Hy; Jung, Hwoon-Young; Sollano, Jose D; Gotoda, Takuji; Reddy, Nageshwar; Singh, Rajvinder; Sugano, Kentaro; Wu, Kai-Chun; Wu, Chun-Yin; Bjorkman, David J; Jensen, Dennis M; Kuipers, Ernst J; Lanas, Angel

2018-04-24

Non-variceal upper gastrointestinal bleeding remains an important emergency condition, leading to significant morbidity and mortality. As endoscopic therapy is the 'gold standard' of management, treatment of these patients can be considered in three stages: pre-endoscopic treatment, endoscopic haemostasis and post-endoscopic management. Since publication of the Asia-Pacific consensus on non-variceal upper gastrointestinal bleeding (NVUGIB) 7 years ago, there have been significant advancements in the clinical management of patients in all three stages. These include pre-endoscopy risk stratification scores, blood and platelet transfusion, use of proton pump inhibitors; during endoscopy new haemostasis techniques (haemostatic powder spray and over-the-scope clips); and post-endoscopy management by second-look endoscopy and medication strategies. Emerging techniques, including capsule endoscopy and Doppler endoscopic probe in assessing adequacy of endoscopic therapy, and the pre-emptive use of angiographic embolisation, are attracting new attention. An emerging problem is the increasing use of dual antiplatelet agents and direct oral anticoagulants in patients with cardiac and cerebrovascular diseases. Guidelines on the discontinuation and then resumption of these agents in patients presenting with NVUGIB are very much needed. The Asia-Pacific Working Group examined recent evidence and recommends practical management guidelines in this updated consensus statement. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Dental implants placement in paranoid squizofrenic patient with obsessive-compulsive disorder: A case report

PubMed Central

Castellanos-Cosano, Lizett; Corcuera-Flores, José-Ramón; Mesa-Cabrera, María; Cabrera-Domínguez, José; Torres-Lagares, Daniel; Machuca-Portillo, Guillermo

2017-01-01

Background Paranoid schizophrenia is a mental illness that involves no observable anatomical alteration. Main characteristic affects the personality of the individual, as well as areas of his own psychology. Case Report A 33-year-old man with paranoid schizophrenia and obsessive-compulsive disorder in treatment with Haloperidol, Oxcarbazepine, Olanzapine and Seroquel is presented. Dental exploration showed widespread decay mostly cervical with numerous root fragments, agenesis of lateral incisors, impacted wisdom teeth, missing teeth and malocclusion. Treatment plan included restoration of teeth decay, extractions of root fragments and implant-supported prostheses in bilateral upper lateral incisors for aesthetics reason. A previous consultation with a psychiatric specialist was performed and no contraindication were observed. A preliminary radiological examination was performed previous dental treatment and implant placement. Due to patient refusal to replace dental abscenses with implants, inform consent was signed up from his parents. After local anesthesia, first implant was placed at upper right lateral positions (Straumann Bone Level Ø 3.3 mm, length 10 mm). Two weeks later a second implant was placed at upper left lateral position (Straumann Bone Level Ø 3.3 mm, length 12 mm). The patient showed no postoperative complications. After implant placement, the patient attended scheduled review appointments. The prosthesis was placed after a 3-month period of osseointegration. Conclusions Implant placement can be considered a suitable option for people with mental disorders. A previous consultation with psychiatric specialists for conducting a good patient management is necessaire. Key words:Paranoid schizophrenia, obsessive-compulsive disorder, dental implants. PMID:29302292

Assessment of multiple management systems in the Upper Midwest

USDA-ARS?s Scientific Manuscript database

Reduced tillage, multi-crop rotations and use of organic fertilizers are characteristically expected to improve soil quality. As measures of soil quality, microbial and soluble C and N were evaluated in an nine-year assessment of management practices alternative to a conventionally managed two-year ...

12 CFR 614.4155 - Interest rates.

Code of Federal Regulations, 2011 CFR

2011-01-01

... pursuant to an interest rate plan within which management may establish rates. Any interest rate plan shall... management may adjust rates, and provide the upper and lower limits on management authority. Any interest... its review and approval of the institution's operational and strategic business plan. [62 FR 66818...

12 CFR 614.4155 - Interest rates.

Code of Federal Regulations, 2010 CFR

2010-01-01

... pursuant to an interest rate plan within which management may establish rates. Any interest rate plan shall... management may adjust rates, and provide the upper and lower limits on management authority. Any interest... its review and approval of the institution's operational and strategic business plan. [62 FR 66818...

Roy's safety-first portfolio principle in financial risk management of disastrous events.

PubMed

Chiu, Mei Choi; Wong, Hoi Ying; Li, Duan

2012-11-01

Roy pioneers the concept and practice of risk management of disastrous events via his safety-first principle for portfolio selection. More specifically, his safety-first principle advocates an optimal portfolio strategy generated from minimizing the disaster probability, while subject to the budget constraint and the mean constraint that the expected final wealth is not less than a preselected disaster level. This article studies the dynamic safety-first principle in continuous time and its application in asset and liability management. We reveal that the distortion resulting from dropping the mean constraint, as a common practice to approximate the original Roy's setting, either leads to a trivial case or changes the problem nature completely to a target-reaching problem, which produces a highly leveraged trading strategy. Recognizing the ill-posed nature of the corresponding Lagrangian method when retaining the mean constraint, we invoke a wisdom observed from a limited funding-level regulation of pension funds and modify the original safety-first formulation accordingly by imposing an upper bound on the funding level. This model revision enables us to solve completely the safety-first asset-liability problem by a martingale approach and to derive an optimal policy that follows faithfully the spirit of the safety-first principle and demonstrates a prominent nature of fighting for the best and preventing disaster from happening. © 2012 Society for Risk Analysis.

Rigid fixation of facial fractures in children.

PubMed

Koltai, P J; Rabkin, D; Hoehn, J

1995-01-01

This article presents a retrospective analysis of a selective use of rigid fixation among 62 children with facial fractures, treated at a Level I trauma center over a 5-year period (1986-1991). There were 21 mandible fractures, 11 orbital fractures, 11 zygomaticomalar complex fractures, 7 nasal fractures, 5 maxillary fractures, 3 pan-facial fractures, 2 nasal-orbital-ethmoidal complex fractures, and 2 frontal sinus fractures. Only 18 children had rigid fixation of their injuries. Complications of Le Fort upper facial fractures repaired with rigid fixation involved perioperative sinusitis; one case required oral antibiotics, the other ethmoidectomy and maxillary antrostomy. One child with a Le Fort fracture had delayed exposure of a zygomaticomalar buttress plate, which required surgical removal. Permanent enophthalmos occurred in two children with Le Fort fractures. The authors conclude that traditional conservative management is appropriate in most cases. However, in children aged 13 and older with mandible fractures and children with complex mid- and upper facial fractures, a judicious use of rigid fixation has advantages over the traditional techniques.

Annual Tropical Cyclone Report, 1983.

DTIC Science & Technology

1983-01-01

impact on Ellen. In addition to were based primarily on the presence of interferring with Ellen’s outflow at upper- upper-level banding features...upper-level flow impacting Thelma is reflected in the rapidity with which the The first warning on Thelma, as a system sheared while moving...8217 %,d 4 "." ,"." .".-*. .*’,.--" * . . ." .’% .. .J *. " . . . . . . .. . . . . .• . ’ .".• -* ". FOREWORD The Annual Tropical Cyclone Report

DETAIL INTERIOR VIEW OF ELECTRIC GENERATOR ON UPPER LEVEL ON ...

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

DETAIL INTERIOR VIEW OF ELECTRIC GENERATOR ON UPPER LEVEL ON HYDROELECTRIC POWER HOUSE - St. Lucie Canal, Lock No. 1, Hydroelectric Power House, St. Lucie, Cross State Canal, Okeechobee Intracoastal Waterway, Stuart, Martin County, FL

20. VIEW SOUTHEAST OF UPPER LEVEL (LUMBER STORAGE) IN EAST ...

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

20. VIEW SOUTHEAST OF UPPER LEVEL (LUMBER STORAGE) IN EAST BUILDING SHOWING BUILDING FRAMEWORK, IRON HANGING RODS, AND CEDAR PLANKS BEING SEASONED FOR BOAT CONSTRUCTION. - Lowell's Boat Shop, 459 Main Street, Amesbury, Essex County, MA

Temporal Variability of Upper-level Winds at the Eastern Range, Western Range and Wallops Flight Facility

NASA Technical Reports Server (NTRS)

Decker, Ryan K.; Barbre, Robert E., Jr.

2014-01-01

Space launch vehicles incorporate upper-level wind profiles to determine wind effects on the vehicle and for a commit to launch decision. These assessments incorporate wind profiles measured hours prior to launch and may not represent the actual wind the vehicle will fly through. Uncertainty in the upper-level winds over the time period between the assessment and launch can be mitigated by a statistical analysis of wind change over time periods of interest using historical data from the launch range. Five sets of temporal wind pairs at various times (.75, 1.5, 2, 3 and 4-hrs) at the Eastern Range, Western Range and Wallops Flight Facility were developed for use in upper-level wind assessments. Database development procedures as well as statistical analysis of temporal wind variability at each launch range will be presented.

Effectiveness of audiovisual distraction in behavior modification during dental caries assessment and sealant placement in children with autism spectrum disorder.

PubMed

Fakhruddin, Kausar Sadia; El Batawi, Hisham Yehia

2017-01-01

The aim of this study was to evaluate the effectiveness of audiovisual (AV) distraction in behavior modification during dental caries assessment and sealant placement in children with autism spectrum disorder. This study was conducted on 28 children diagnosed with autism spectrum disorder, aged 6.5-9.8 years. Children underwent one introductory (desensitization) appointment and three treatment sessions. During the introductory session, children had the procedures explained to them, they watched a movie projected on a screen while oral screening and assessment of cooperation level were carried out. In treatment session I, oral examination, charting, and dental x-rays were undertaken, whereas the children watched movies with or without video eyewear. During treatment sessions II/III, dental prophylaxis was carried out on upper and lower jaws in addition to the application of dental sealants on the right upper and lower and the left upper and lower permanent molars, respectively, while the children were distracted by cartoon movies using video eyewear. Changes in pulse oximeter and heart rate were recorded every 5 min. Independent samples t -test was used to assess the significance of changes in pulse and O 2 saturation levels during each visit. International Caries Detection and Assessment System-code 2 was found to be the most prevalent ( n = 58; 52%). A significant difference ( P < 0.02) was observed in mean heart rate during dental screening of the upper and lower jaws with and without video eyewear. A decrease was observed in the mean heart rate during subsequent treatment sessions. Initial desensitization appointment and "tell-show-do" approach, followed by short and positive treatment sessions, assisted in gaining cooperation and improving behavior in the subjects. Video eyewear distraction proved an effective tool in managing children with autism spectrum disorder during noninvasive preventive dental procedures.

Effectiveness of audiovisual distraction in behavior modification during dental caries assessment and sealant placement in children with autism spectrum disorder

PubMed Central

Fakhruddin, Kausar Sadia; El Batawi, Hisham Yehia

2017-01-01

Background: The aim of this study was to evaluate the effectiveness of audiovisual (AV) distraction in behavior modification during dental caries assessment and sealant placement in children with autism spectrum disorder. Materials and Methods: This study was conducted on 28 children diagnosed with autism spectrum disorder, aged 6.5−9.8 years. Children underwent one introductory (desensitization) appointment and three treatment sessions. During the introductory session, children had the procedures explained to them, they watched a movie projected on a screen while oral screening and assessment of cooperation level were carried out. In treatment session I, oral examination, charting, and dental x-rays were undertaken, whereas the children watched movies with or without video eyewear. During treatment sessions II/III, dental prophylaxis was carried out on upper and lower jaws in addition to the application of dental sealants on the right upper and lower and the left upper and lower permanent molars, respectively, while the children were distracted by cartoon movies using video eyewear. Changes in pulse oximeter and heart rate were recorded every 5 min. Independent samples t-test was used to assess the significance of changes in pulse and O2 saturation levels during each visit. Results: International Caries Detection and Assessment System-code 2 was found to be the most prevalent (n = 58; 52%). A significant difference (P < 0.02) was observed in mean heart rate during dental screening of the upper and lower jaws with and without video eyewear. A decrease was observed in the mean heart rate during subsequent treatment sessions. Conclusion: Initial desensitization appointment and “tell-show-do” approach, followed by short and positive treatment sessions, assisted in gaining cooperation and improving behavior in the subjects. Video eyewear distraction proved an effective tool in managing children with autism spectrum disorder during noninvasive preventive dental procedures. PMID:28702058

17. Interior of upper level (Turf Club level) of south ...

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

17. Interior of upper level (Turf Club level) of south and west additions to the Clubhouse. Camera pointed W. Stairs in foreground lead to the 'Gallery' room. Stairs in background lead to the 'Callahan' room. 'Broderick' room (not shown) is entered from south side of 'Gallery' room. (July 1993) - Longacres, Clubhouse & Additions, 1621 Southwest Sixteenth Street, Renton, King County, WA

The quality of our Nation's waters: water quality in the Upper Floridan aquifer and overlying surficial aquifers, southeastern United States, 1993-2010

USGS Publications Warehouse

Berndt, Marian P.; Katz, Brian G.; Kingsbury, James A.; Crandall, Christy A.

2015-01-01

About 10 million people rely on groundwater from the Upper Floridan and surficial aquifers for drinking water. The Upper Floridan aquifer also is of primary importance to the region as a source of water for irrigation and as a source of crystal clear water that discharges to springs and streams providing recreational and tourist destinations and unique aquatic habitats. The reliance of the region on the Upper Floridan aquifer for drinking water and for the tourism and agricultural economies highlights the importance of long-term management to sustain the availability and quality of these resources.

Pathogen Transport and Fate Modeling in the Upper Salem River Watershed using SWAT Model

EPA Science Inventory

SWAT (Soil and Water Assessment Tool) is a dynamic watershed model that is applied to simulate the impact of land management practices on water quality over a continuous period. The Upper Salem River, located in Salem County New Jersey, is listed by the New Jersey Department of ...

THE BENEFITS OF WETLANDS: THE UPPER HALFWAY CREEK PROJECT

EPA Science Inventory

Researchers from the U.S. EPA are working in collaboration with U.S. Geological Survey and the U.S. Fish and Wildlife Services on this project. Upper Halfway Creek marsh is a constructed wetland managed by the U.S. Fish and Wildlife Service. This project will assist the U.S. EP...

Principals' Leadership in Mexican Upper High Schools: The Paradoxes between Rules and Practices

ERIC Educational Resources Information Center

Santizo Rodall, Claudia A.; Ortega Salazar, Sylvia B.

2018-01-01

This article discusses the type of organization and leadership that underlies a competency-based management rule established in Mexico (2008) applicable to principals in public upper high schools. This rule, identified as the 449 Agreement, describes competencies and communicates expected behavior. Implementation, however, is mediated by the…

RELATION OF LANDSCAPE-SCALE ENVIRONMENTAL CHARACTERISTICS TO FISH ASSEMBLAGES IN THE UPPER FRENCH BROAD RIVER BASIN, NORTH CAROLINA

EPA Science Inventory

Fish assemblages at 16 sites in the upper French Broad river basin in North Carolina were related to environmental characteristics at the landscape scale, the scale at which management activities and decisions are most likely to occur. Indirect gradient analysis and subsequent re...

Pathogen Transport and Fate Modeling in the Upper Salem River Watershed Using SWAT Model

EPA Science Inventory

SWAT (Soil and Water Assessment Tool) is a dynamic watershed model that is applied to simulate the impact of land management practices on water quality over a continuous period. The Upper Salem River, located in Salem County New Jersey, is listed by the New Jersey Department of ...

Collaborative environmental planning in river management: An application of multicriteria decision analysis in the White River Watershed in Vermont

USGS Publications Warehouse

Hermans, C.; Erickson, J.; Noordewier, T.; Sheldon, A.; Kline, M.

2007-01-01

Multicriteria decision analysis (MCDA) provides a well-established family of decision tools to aid stakeholder groups in arriving at collective decisions. MCDA can also function as a framework for the social learning process, serving as an educational aid in decision problems characterized by a high level of public participation. In this paper, the framework and results of a structured decision process using the outranking MCDA methodology preference ranking organization method of enrichment evaluation (PROMETHEE) are presented. PROMETHEE is used to frame multi-stakeholder discussions of river management alternatives for the Upper White River of Central Vermont, in the northeastern United States. Stakeholders met over 10 months to create a shared vision of an ideal river and its services to communities, develop a list of criteria by which to evaluate river management alternatives, and elicit preferences to rank and compare individual and group preferences. The MCDA procedure helped to frame a group process that made stakeholder preferences explicit and substantive discussions about long-term river management possible. ?? 2006 Elsevier Ltd. All rights reserved.

Collaborative environmental planning in river management: an application of multicriteria decision analysis in the White River Watershed in Vermont.

PubMed

Hermans, Caroline; Erickson, Jon; Noordewier, Tom; Sheldon, Amy; Kline, Mike

2007-09-01

Multicriteria decision analysis (MCDA) provides a well-established family of decision tools to aid stakeholder groups in arriving at collective decisions. MCDA can also function as a framework for the social learning process, serving as an educational aid in decision problems characterized by a high level of public participation. In this paper, the framework and results of a structured decision process using the outranking MCDA methodology preference ranking organization method of enrichment evaluation (PROMETHEE) are presented. PROMETHEE is used to frame multi-stakeholder discussions of river management alternatives for the Upper White River of Central Vermont, in the northeastern United States. Stakeholders met over 10 months to create a shared vision of an ideal river and its services to communities, develop a list of criteria by which to evaluate river management alternatives, and elicit preferences to rank and compare individual and group preferences. The MCDA procedure helped to frame a group process that made stakeholder preferences explicit and substantive discussions about long-term river management possible.

EMBA Integration: From Rhetoric to Practice

ERIC Educational Resources Information Center

Scott, Charles; Derrick, Frederick; Hoadley, Ellen

2012-01-01

For the modern business world, business education needs to molt from the cocoon of discipline silos to the integrated business education model to train the next generation of managers. Upper management problems are rarely silo specific. Managers do things right, but leaders do the right things; and executive programs exist to build business…

Mapping spatial and temporal variation of stream water temperature in the upper Esopus Creek watershed

NASA Astrophysics Data System (ADS)

Chien, H.; McGlinn, L.

2017-12-01

The upper Esopus Creek and its tributary streams located in the Catskill Mountain region of New York State provide habitats for cold-adapted aquatic species. However, ongoing global warming may change the stream water temperature within a watershed and disturb the persistence of coldwater habitats. Characterizing thermal regimes within the upper Esopus Creek watershed is important to provide information of thermally suitable habitats for aquatic species. The objectives of this study are to measure stream water temperature and map thermal variability among tributaries to the Esopus Creek and within Esopus Creek. These objectives will be achieved by measuring stream water temperature for at least two years. More than 100 water temperature data loggers have been placed in the upper Esopus Creek and their tributaries to collect 30-minute interval water temperatures. With the measured water temperature, we will use spatial interpolation in ArcGIS to create weekly and monthly water temperature surface maps to evaluate the thermal variation over time and space within the upper Esopus Creek watershed. We will characterize responsiveness of water temperature in tributary streams to air temperature as well. This information of spatial and temporal variation of stream water temperature will assist stream managers with prioritizing management practices that maintain or enhance connectivity of thermally suitable habitats in high priority areas.

Hydrogeology and quality of ground water in Orange County, Florida

USGS Publications Warehouse

Adamski, James C.; German, Edward R.

2004-01-01

Ground water is the main source of water supply in central Florida and is critical for aquatic habitats and human consumption. To provide a better understanding for the conservation, development, and management of the water resources of Orange County, Florida, a study of the hydrogeologic framework, water budget, and ground-water quality characteristics was conducted from 1998 through 2002. The study also included extensive analyses of the surface-water resources, published as a separate report. An increase in population from about 264,000 in 1960 to 896,000 in 2000 and subsequent urban growth throughout this region has been accompanied by a substantial increase in water use. Total ground-water use in Orange County increased from about 82 million gallons per day in 1965 to about 287 million gallons per day in 2000. The hydrogeology of Orange County consists of three major hydrogeologic units: the surficial aquifer system, the intermediate confining unit, and the Floridan aquifer system. Data were compiled from 634 sites to construct hydrogeologic maps and sections of Orange County. Water-level elevations measured in 23 wells tapping the surficial aquifer system ranged from about 10.6 feet in eastern Orange County to 123.8 feet above NGVD 29 in northwestern Orange County from March 2000 through September 2001. Water levels also were measured in 14 wells tapping the Upper Floridan aquifer. Water levels fluctuate over time from seasonal and annual variations in rainfall; however, water levels in a number of wells tapping the Upper Floridan aquifer have declined over time. Withdrawal of ground water from the aquifers by pumping probably is causing the declines because the average annual precipitation rate has not changed substantially in central Florida since the 1930s, although yearly rates can vary. A generalized water budget was computed for Orange County from 1991 to 2000. Average rates for the 10-year period for the following budget components were computed based on reported measurements or estimates: precipitation was 53 inches per year (in/yr), runoff was 11 in/yr, spring discharge was 2 in/yr, and net lateral subsurface outflow and exported water was 1 in/yr. Evapotranspiration was 39 in/yr, which was calculated as the residual of the water-budget analysis, assuming changes in storage were negligible. Water-quality samples were collected from April 1999 through May 2001 from a total of 26 wells tapping the surficial aquifer system, 1 well tapping the intermediate confining unit, 24 wells tapping the Upper Floridan aquifer, 2 springs issuing from the Upper Floridan aquifer, and 8 wells tapping the Lower Floridan aquifer. These data were supplemented with existing water-quality data collected by the U.S. Geological Survey and St. Johns River Water Management District. Concentrations of total dissolved solids, sulfate, and chloride in samples from the surficial aquifer system generally were low. Concentrations of nitrate were higher in samples from the surficial aquifer system than in samples from the Upper Floridan or Lower Floridan aquifers, probably as a result of agricultural and residential land use. Water type throughout most of the Upper Floridan and Lower Floridan aquifers was calcium or calcium-magnesium bicarbonate, probably as a result of dissolution of the carbonate rocks. Water type in both the surficial and Floridan aquifer systems in eastern Orange County is sodium chloride. Concentrations of total dissolved solids, sulfate, and chloride in the aquifers increase toward eastern Orange County. Data from 16 of 24 wells in eastern Orange County with long-term water-quality records indicated distinct increases in concentrations of chloride over time. The increases probably are related to withdrawal of ground water at the Cocoa well field, causing an upwelling of deeper, more saline water. The most commonly detected trace elements were aluminum, barium, boron, iron, manganese, and strontium. In addition, arse

Use of paired management action grids for ease in depicting differences between users' and managers' perceptions of problems

Treesearch

R. J. Steele; James E. Fletcher

1992-01-01

This research was to determine whether differences exist between users and managers concerning perceptions of actual and perceived problems in parks and primarily to present a method of graphically depicting the differing perceptions of problems which exist between users and park managers which can be easily employed by area managers and related to the public, upper...

Sharing the floodplain: Mediated modeling for environmental management

USGS Publications Warehouse

Metcalf, S.S.; Wheeler, E.; BenDor, T.K.; Lubinski, S.J.; Hannon, B.M.

2010-01-01

Complex ecosystems, such as the Upper Mississippi River (UMR), present major management challenges. Such systems often provide a range of ecosystem services that are differentially valued by stakeholders representing distinct interests (e.g., agriculture, conservation, navigation) or institutions (e.g., federal and state agencies). When no single entity has the knowledge or authority to resolve conflicts over shared resource use, stakeholders may struggle to jointly understand the scope of the problem and to reach reasonable compromises. This paper explores mediated modeling as a group consensus building process for understanding relationships between ecological, economic and cultural well-being in the UMR floodplain. We describe a workshop structure used to engage UMR stakeholders that may be extended to resource use conflicts in other complex ecosystems. We provide recommendations for improving on these participatory methods in structuring future efforts. In conclusion, we suggest that tools which facilitate collaborative learning, such as mediated modeling, need to be incorporated at an institutional level as a vital element of integrated ecosystem management. ?? 2008 Elsevier Ltd.

[Health and the market].

PubMed

Vecchio, C

2000-09-01

The main problem facing the health systems in all western countries is the curbing of their rising costs. This fact represents a serious risk for the stability of any health system. Free-trade solutions, founded on market-driven systems, do not seem to be capable of preserving the peculiarity of all the national European health systems, characterized by universalism and public management, together with efficacy and effectiveness. The market spurs the demand but does not reduce the costs. Its main social danger is that it may give rise to a two-level health system: the first, of good quality but more expensive, managed by private companies and possible only for the upper and middle classes; the second, of poor quality but naturally less expensive, managed by the Public Health Service for the lower classes. Solidarity, responsibility, and equity are three civil virtues that must be deeply rooted in all European National Health Services (particularly the Italian National Health Service) so that their historical capacity of guaranteeing a sure and effective protection against disease can be consolidated.

Crew interface specification development study for in-flight maintenance and stowage functions

NASA Technical Reports Server (NTRS)

Carl, J. G.

1971-01-01

The need and potential solutions for an orderly systems engineering approach to the definition, management and documentation requirements for in-flight maintenance, assembly, servicing, and stowage process activities of the flight crews of future spacecraft were investigated. These processes were analyzed and described using a new technique (mass/function flow diagramming), developed during the study, to give visibility to crew functions and supporting requirements, including data products. This technique is usable by NASA for specification baselines and can assist the designer in identifying both upper and lower level requirements associated with these processes. These diagrams provide increased visibility into the relationships between functions and related equipments being utilized and managed and can serve as a common communicating vehicle between the designer, program management, and the operational planner. The information and data product requirements to support the above processes were identified along with optimum formats and contents of these products. The resulting data product concepts are presented to support these in-flight maintenance and stowage processes.

Influence of Land Cover Heterogeneity, Land-Use Change and Management on the Regional Carbon Cycle in the Upper Midwest USA as Evaluated by High-Density Observations and a Dynamic Ecosystem Model

NASA Astrophysics Data System (ADS)

Desai, A. R.; Bolstad, P. V.; Moorcroft, P. R.; Davis, K. J.

2005-12-01

The interplay between land use change, forest management and land cover variability complicates the ability to characterize regional scale (10-1000 km) exchange of carbon dioxide between the land surface and atmosphere in heterogeneous landscapes. An attempt was made to observe and model these factors and their influence on the regional carbon cycle across the upper Midwest USA. A high density of eddy-covariance carbon flux, micrometeorology, carbon dioxide mixing ratio, stand-scale biometry and canopy component flux observations have been occurring in this area as part of the Chequamegon Ecosystem-Atmosphere Study. Observations limited to sampling only dominant stands and coarse-resolution biogeochemical models limited to biome-scale parameterization neither accurately capture the variability of carbon fluxes measured by the network of eddy covariance towers nor match the regional-scale carbon flux inferred from very tall tower eddy covariance measurements and multi-site upscaling. Analysis of plot level biometric data, U.S. Forest Service Forest Inventory Analysis data and high-resolution land cover data around the tall tower revealed significant variations in vegetation type, stand age, canopy stocking and structure. Wetlands, clearcuts and recent natural disturbances occur in characteristic small non-uniformly distributed patches that aggregate to form more than 30% of the landscape. The Ecosystem Demography model, a dynamic ecosystem model that incorporates vegetation heterogeneity, canopy structure, stand age, disturbance, land use change and forest management, was parameterized with regional biometric data and meteorology, historical records of land management and high-resolution satellite land cover maps. The model will be used to examine the significance of past land use change, natural disturbance history and current forest management in explaining landscape structure and regional carbon fluxes observed in the region today.

4. Upper level of marine museum looking southwest at enclosed ...

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

4. Upper level of marine museum looking southwest at enclosed exterior wall of area office building - Duluth Ship Canal, Marine Museum-Area Office, North end of Minnesota Point at Canal Park, Duluth, St. Louis County, MN

FAST CHOPPER BUILDING, TRA665, INTERIOR. UPPER LEVEL. CONCRETE WALLS. INL ...

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

FAST CHOPPER BUILDING, TRA-665, INTERIOR. UPPER LEVEL. CONCRETE WALLS. INL NEGATIVE NO. HD42-2. Mike Crane, Photographer, 3/2004 - Idaho National Engineering Laboratory, Test Reactor Area, Materials & Engineering Test Reactors, Scoville, Butte County, ID

Lactobacillus gasseri in the Upper Small Intestine Impacts an ACSL3-Dependent Fatty Acid-Sensing Pathway Regulating Whole-Body Glucose Homeostasis.

PubMed

Bauer, Paige V; Duca, Frank A; Waise, T M Zaved; Dranse, Helen J; Rasmussen, Brittany A; Puri, Akshita; Rasti, Mozhgan; O'Brien, Catherine A; Lam, Tony K T

2018-03-06

Long-chain acyl-CoA synthetase (ACSL)-dependent upper small intestinal lipid metabolism activates pre-absorptive pathways to regulate metabolic homeostasis, but whether changes in the upper small intestinal microbiota alter specific fatty acid-dependent pathways to impact glucose homeostasis remains unknown. We here first find that upper small intestinal infusion of Intralipid, oleic acid, or linoleic acid pre-absorptively increases glucose tolerance and lowers glucose production in rodents. High-fat feeding impairs pre-absorptive fatty acid sensing and reduces upper small intestinal Lactobacillus gasseri levels and ACSL3 expression. Transplantation of healthy upper small intestinal microbiota to high-fat-fed rodents restores L. gasseri levels and fatty acid sensing via increased ACSL3 expression, while L. gasseri probiotic administration to non-transplanted high-fat-fed rodents is sufficient to restore upper small intestinal ACSL3 expression and fatty acid sensing. In summary, we unveil a glucoregulatory role of upper small intestinal L. gasseri that impacts an ACSL3-dependent glucoregulatory fatty acid-sensing pathway. Copyright © 2018 Elsevier Inc. All rights reserved.

Challenges in merging fisheries research and management: The Upper Mississippi River experience

USGS Publications Warehouse

Garvey, J.; Ickes, B.; Zigler, S.

2010-01-01

The Upper Mississippi River System (UMRS) is a geographically diverse basin extending 10?? north temperate latitude that has produced fishes for humans for millennia. During European colonization through the present, the UMRS has been modified to meet multiple demands such as navigation and flood control. Invasive species, notably the common carp, have dominated fisheries in both positive and negative ways. Through time, environmental decline plus reduced economic incentives have degraded opportunities for fishery production. A renewed focus on fisheries in the UMRS may be dawning. Commercial harvest and corresponding economic value of native and non-native species along the river corridor fluctuates but appears to be increasing. Recreational use will depend on access and societal perceptions of the river. Interactions (e. g., disease and invasive species transmission) among fish assemblages within the UMRS, the Great Lakes, and other lakes and rivers are rising. Data collection for fisheries has varied in intensity and contiguousness through time, although resources for research and management may be growing. As fisheries production likely relies on the interconnectivity of fish populations and associated ecosystem processes among river reaches (e. g., between the pooled and unpooled UMRS), species-level processes such as genetics, life-history interactions, and migratory behavior need to be placed in the context of broad ecosystem- and landscape-scale restoration. Formal communication among a diverse group of researchers, managers, and public stakeholders crossing geographic and disciplinary boundaries is necessary through peer-reviewed publications, moderated interactions, and the embrace of emerging information technologies. ?? Springer Science+Business Media B.V. 2010.

Upper Atmosphere Research Satellite (UARS) science data processing center implementation history

NASA Technical Reports Server (NTRS)

Herring, Ellen L.; Taylor, K. David

1990-01-01

NASA-Goddard is responsible for the development of a ground system for the Upper Atmosphere Research Satellite (UARS) observatory, whose launch is scheduled for 1991. This ground system encompasses a dedicated Central Data Handling Facility (CDHF); attention is presently given to the management of software systems design and implementation phases for CDHF by the UARS organization. Also noted are integration and testing activities performed following software deliveries to the CDHF. The UARS project has an obvious requirement for a powerful and flexible data base management system; an off-the-shelf commercial system has been incorporated.

Endourologic management of malignant ureteral obstruction: indications, results, and quality-of-life issues.

PubMed

Sountoulides, Petros; Pardalidis, Nikolaos; Sofikitis, Nikolaos

2010-01-01

Obstruction of the upper urinary tract is a problem commonly faced by practicing urologists. The constant evolution in endourology has effectively facilitated minimally invasive management of upper-tract obstruction. In a case in which malignancy is the cause of obstruction, however, the situation significantly changes. Questions arise regarding the need for relieving the obstruction, the means to accomplish this, and the benefits and drawbacks of each technique regarding both their efficacy and their impact on the patients well-being and the crucial issue of quality of life in the face of malignancy.

8. EAST ELEVATION OF SKIDOO MILL AND UPPER ORE BIN, ...

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

8. EAST ELEVATION OF SKIDOO MILL AND UPPER ORE BIN, LOOKING WEST FROM ACCESS ROAD. THE ROADWAY ON THIS LEVEL (CENTER) WAS USED FOR UNLOADING ORE BROUGHT ON BURROWS INTO THE ORE BIN AT THE TOP LEVEL OF THE MILL. THE ORE BIN IN THE UPPER LEFT WAS ADDED LATER WHEN ORE WAS BROUGHT TO THE MILL BY TRUCKS. - Skidoo Mine, Park Route 38 (Skidoo Road), Death Valley Junction, Inyo County, CA

Comparison the Serum STREM1 Levels Between Children with Upper and Lower UTI.

PubMed

Ehsanipour, Fahime; Noorbakhsh, Samileh; Zarabi, Vida; Movahedi, Zahra; Rahimzadeh, Nahid

2017-01-01

Pyelonephritis is the most common and important infection among Iranian pediatric population. Differentiation between upper and lower Urinary Tract Infection (UTI) is often difficult based on clinical data. Therefore, definite diagnosis is helpful for choosing appropriate antibiotic and decision for hospital admission. The main purpose of this study was todetermine the diagnostic value of serum STREM-1 level in children suspicious to UTI and differentiation of upper UTI and lower UTI. This prospective cross sectional study (2010-2011) was performed to evaluate and compare the serum level of STREM- 1 (pg. /ml) in 36 diagnosed UTI patients (24 upper and 12 lower UTI) with 25 normal children (without UTI) in Rasoul Akram hospital, Tehran, Iran. The mean age of studied children was 3.64 years; 24 male and 37 female. Urinary analysis and urine culture were performed for all UTI cases and only the positive cultured cases with the same microorganism were enrolled in the study. Distinguishing the upper from lower UTI was done on the basis of clinical manifestation and laboratory tests and confirmed by Imaging studies (ultra sonography /or DMSA scan). Blood sampling was taken from all children and centrifuged .The level of STREM-1 (pg /ml) in all sera was determined by Enzyme immunoassay technique (Human TREM-1 immunoassay Sandwich test, Quantikine, R&D systems, Minneapolis; USA). Cut-off levels for STREM-1 were illustrated by ROC curve. The p<0.05 was considered as significant for differences between groups. The mean of STREM -1level had significant difference between overall cases of UTI (427.72pg/ml) and controls (124.24 pg. /ml; P =0.000) ; with cutoff point 111.5 pg./ml ; it had 83.3% sensitivity; and 60 % specificity to distinguish UTI from control. Serum STREM -1 level had no significantly difference between the upper and lower UTI (500pg/ml vs. 283 pg. /ml, P value=0.1) with cutoff point 132 pg./ml it had 83.3% sensitivity ; and 60 % specificity to distinguish upper UTI from lower UTI. Our study demonstrates that even low amount of serum STREM-1 (111.5 pg./ml) has 83.3% sensitivity ; and 60 % specificity to distinguish the UTI from normal cases (P value =0.000) but higher level (132 pg./ml) was needed for definite diagnosis (83.3% sensitivity; 60 % specificity) of upper and lower UTI. It is concluded that serum STREM-1 level test is a valuable tool for early diagnosis of the normal cases with false positive urine culture, or in highly suspicious upper UTI cases with false negative urine culture. Indeed higher titer of this biomarker could be helpful for discriminating the upper from lower UTI. Therefore adding this new biologic marker (STREM-1) to previous ones (CRP, PCT) is suggested to prevent the unnecessary hospital admission and empiric antibiotic therapy. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

51. View of upper radar scanner switch in radar scanner ...

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

51. View of upper radar scanner switch in radar scanner building 105 from upper catwalk level showing emanating waveguides from upper switch (upper one-fourth of photograph) and emanating waveguides from lower radar scanner switch in vertical runs. - Clear Air Force Station, Ballistic Missile Early Warning System Site II, One mile west of mile marker 293.5 on Parks Highway, 5 miles southwest of Anderson, Anderson, Denali Borough, AK

Incentives for Optimal Multi-level Allocation of HIV Prevention Resources

PubMed Central

Malvankar, Monali M.; Zaric, Gregory S.

2013-01-01

HIV/AIDS prevention funds are often allocated at multiple levels of decision-making. Optimal allocation of HIV prevention funds maximizes the number of HIV infections averted. However, decision makers often allocate using simple heuristics such as proportional allocation. We evaluate the impact of using incentives to encourage optimal allocation in a two-level decision-making process. We model an incentive based decision-making process consisting of an upper-level decision maker allocating funds to a single lower-level decision maker who then distributes funds to local programs. We assume that the lower-level utility function is linear in the amount of the budget received from the upper-level, the fraction of funds reserved for proportional allocation, and the number of infections averted. We assume that the upper level objective is to maximize the number of infections averted. We illustrate with an example using data from California, U.S. PMID:23766551

Path-following in model predictive rollover prevention using front steering and braking

NASA Astrophysics Data System (ADS)

Ghazali, Mohammad; Durali, Mohammad; Salarieh, Hassan

2017-01-01

In this paper vehicle path-following in the presence of rollover risk is investigated. Vehicles with high centre of mass are prone to roll instability. Untripped rollover risk is increased in high centre of gravity vehicles and high-friction road condition. Researches introduce strategies to handle the short-duration rollover condition. In these researches, however, trajectory tracking is affected and not thoroughly investigated. This paper puts stress on tracking error from rollover prevention. A lower level model predictive front steering controller is adopted to deal with rollover and tracking error as a priority sequence. A brake control is included in lower level controller which directly obeys an upper level controller (ULC) command. The ULC manages vehicle speed regarding primarily tracking error. Simulation results show that the proposed control framework maintains roll stability while tracking error is confined to predefined error limit.

Concurrent Chemotherapy and Radiation Therapy for Inoperable Locally Advanced Non-Small-Cell Lung Cancer.

PubMed

Rosenzweig, Kenneth E; Gomez, Jorge E

2017-01-01

The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice. A 72-year-old man with a 40-pack-year tobacco history developed a cough and decreased exercise tolerance. A chest x-ray demonstrated a right-upper-lobe opacity. Chest computed tomography (CT) scan revealed a 2.5-cm mass in the right upper lobe with multiple mediastinal lymph node disease ( Fig 1 ). A positron emission tomography (PET) scan confirmed the lung lesion and the mediastinal lymphadenopathy without distant metastases. Brain magnetic resonance imaging results were negative. The biopsy specimen revealed adenocarcinoma with no actionable mutations present. Cervical mediastinoscopy was positive for carcinoma in level 2, 3, 4R, and 7 lymph nodes; level 4L was negative. The patient's stage was T1bN2M0, stage IIIA. His medical history was significant for hyperlipidemia and hypothyroidism. He had smoked one pack a day for 40 years and had quit 15 years earlier. Physical examination was unrevealing, and the patient had an Eastern Cooperative Oncology Group performance status of 0. Because of the extent of lung cancer in the mediastinum, the patient's cancer was deemed inoperable, and he was referred for consideration of concurrent chemotherapy and radiation.

The medial temporal lobe-conduit of parallel connectivity: a model for attention, memory, and perception.

PubMed

Mozaffari, Brian

2014-01-01

Based on the notion that the brain is equipped with a hierarchical organization, which embodies environmental contingencies across many time scales, this paper suggests that the medial temporal lobe (MTL)-located deep in the hierarchy-serves as a bridge connecting supra- to infra-MTL levels. Bridging the upper and lower regions of the hierarchy provides a parallel architecture that optimizes information flow between upper and lower regions to aid attention, encoding, and processing of quick complex visual phenomenon. Bypassing intermediate hierarchy levels, information conveyed through the MTL "bridge" allows upper levels to make educated predictions about the prevailing context and accordingly select lower representations to increase the efficiency of predictive coding throughout the hierarchy. This selection or activation/deactivation is associated with endogenous attention. In the event that these "bridge" predictions are inaccurate, this architecture enables the rapid encoding of novel contingencies. A review of hierarchical models in relation to memory is provided along with a new theory, Medial-temporal-lobe Conduit for Parallel Connectivity (MCPC). In this scheme, consolidation is considered as a secondary process, occurring after a MTL-bridged connection, which eventually allows upper and lower levels to access each other directly. With repeated reactivations, as contingencies become consolidated, less MTL activity is predicted. Finally, MTL bridging may aid processing transient but structured perceptual events, by allowing communication between upper and lower levels without calling on intermediate levels of representation.

38. DETAIL OF CYLINDER LEVELING SYSTEM SHOWING TYPICAL UPPER AND ...

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

38. DETAIL OF CYLINDER LEVELING SYSTEM SHOWING TYPICAL UPPER AND LOWER PULLEY BRACKET. F.C. TORKELSON DRAWING NUMBER 842-ARVFS-701-S-8. INEL INDEX CODE - Idaho National Engineering Laboratory, Advanced Reentry Vehicle Fusing System, Scoville, Butte County, ID

5. INTERIOR VIEW OF UPPER LEVEL ROOM OF THE CONTROL ...

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

5. INTERIOR VIEW OF UPPER LEVEL ROOM OF THE CONTROL HOUSE LOCATED ON THE SOUTH END OF BIG TUJUNGA DAM SHOWING THE CONTROL PANEL. - Big Tujunga Dam, Control House, 809 West Big Tujunga Road, Sunland, Los Angeles County, CA

The Mission Operations Planning Assistant

NASA Technical Reports Server (NTRS)

Schuetzle, James G.

1987-01-01

The Mission Operations Planning Assistant (MOPA) is a knowledge-based system developed to support the planning and scheduling of instrument activities on the Upper Atmospheric Research Satellite (UARS). The MOPA system represents and maintains instrument plans at two levels of abstraction in order to keep plans comprehensible to both UARS Principal Investigators and Command Management personnel. The hierarchical representation of plans also allows MOPA to automatically create detailed instrument activity plans from which spacecraft command loads may be generated. The MOPA system was developed on a Symbolics 3640 computer using the ZetaLisp and ART languages. MOPA's features include a textual and graphical interface for plan inspection and modification, recognition of instrument operational constraint violations during the planning process, and consistency maintenance between the different planning levels. This paper describes the current MOPA system.

The mission operations planning assistant

NASA Technical Reports Server (NTRS)

Schuetzle, James G.

1987-01-01

The Mission Operations Planning Assistant (MOPA) is a knowledge-based system developed to support the planning and scheduling of instrument activities on the Upper Atmospheric Research Satellite (UARS). The MOPA system represents and maintains instrument plans at two levels of abstraction in order to keep plans comprehensible to both UARS Prinicpal Investigators and Command Management personnel. The hierarchical representation of plans also allows MOPA to automatically create detailed instrument activity plans from which spacecraft command loads may be generated. The MOPA system was developed on a Symbolics 3640 computer using the ZETALISP and ART languages. MOPA's features include a textual and graphical interface for plan inspection and modification, recognition of instrument operational constraint violations during the planning process, and consistency maintenance between the different planning levels. This paper describes the current MOPA system.

Radionuclide Concentrations in Honey Bees from Area G at TA-54 during 1999

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

T. K. Haarmann; P. R. Fresquez

Honey bees were collected from two colonies located at Los Alamos National Laboratory's Area G, Technical Area 54, and from one control (background) colony located near Jemez Springs, NM. Samples were analyzed for various radionuclides. Area G sample results from both colonies were higher than the upper (95%) level background concentration for {sup 3}H. Sample results from one colony were higher than the upper (95%) level background concentration for total uranium, while sample results from the other colony were higher than the upper (95%) level background concentration for {sup 90}Sr.

Assessing the relationship between water quality parameters and changes in landuse patterns in the Upper Manyame River, Zimbabwe

NASA Astrophysics Data System (ADS)

Kibena, J.; Nhapi, I.; Gumindoga, W.

For the past 30 years, the increases in population pressure and external influences, such as economic growth, have accelerated the demand for land within the Upper Manyame River catchment in Zimbabwe which has caused substantial changes in landuse. The general objective of this research was to assess the impacts of landuse activities on the water quality of the Upper Manyame River which drains the rural and urbanised part of the catchment up to flow gauging station C21. Landcover data for the month of April in years of 1984, 1995, 2003 and 2011 were acquired from available Landsat TM and ETM images and were classified through the maximum likelihood digital image classification using the supervised classification approach. The status of water quality of the Upper Manyame River was also assessed through analyses of historical concentrations and pollution loads for TP, DO, COD, NH3-N, SS, Pb, NO3, BOD5, EC, PO4-P and TN at the Environmental Management Agency (EMA) gauging station CR21 sampling point for 1996, 2000/1 and 2008/9. Water quality of 15 monitoring sites comprising 25 water quality parameters were monitored monthly from January to June 2012. These locations were selected to reflect a wide array of landuse for both the dry and wet seasons. The results indicated that there was an increase in pollution load from 1995 to 2012; for TP from 130 kg/day to 376 kg/d, and for TN from 290 kg/day to 494 kg/d. This indicates high pollution levels which have severe impacts on downstream users and also severe sewage contamination. Significant deviations occurred in DO (0.1-6.8) mg/L, COD (11-569) mg/L, BOD5 (5-341) mg/L, PO4-P (0.01-4.45) mg/L, NH3-N (0.001-6.800) mg/L and EC (38-642) μS/cm. Hydrologic Response Unit and buffer analysis were used to determine the dominant landuse which contributes to a certain water quality. Results of digital image classification indicate that woodland/forest, grassland and bareland decreased between years 1984 to 2011 by 24.0%, 22.6% and 31.7% respectively. This was mainly due to expansion or increase of agriculture and urban areas by 24.4% and 41.6% respectively over the same time period. It was concluded that settlements and agricultural areas are the ones mainly affecting the water quality in Upper Manyame River with a Pearson's Correlation Coefficient of r = 0.97 for COD and r = 0.78 for TSS respectively. It was also observed that the water quality status of the Upper Manyame River and its tributaries is very poor and the level of pollution generally increases from upstream to downstream. The results obtained provided baseline information which may be used in the development of appropriate water quality management systems in the catchment. Thus the study recommended a combined programme of point source control and landuse modification.

Redefining treatment of gummy smile with Botox--a report of three cases.

PubMed

Singh, Harpreet; Srivastava, Dhirendra; Sharma, Poonam; Kapoor, Pranav; Roy, Pinaki

2014-01-01

Excessive contraction of upper lip elevator muscles is one of the many ascribed reasons of gummy smiles for which patients seek treatment. Myriad numbers of invasive surgical procedures have been employed for the improvement of the condition, but increased cost and involved risks act as major deterrent. Botulinum toxin type A (BTX-A) has been widely used in the management of several conditions associated with excessive muscular contraction and pain. This article aims to highlight the efficacy of BTX-A in treatment of gummy smiles. Three adult patients with gummy smiles due to hyperfunctional upper lip muscles were injected with BTX-A injections under electromyographic guidance. This minimally invasive treatment modality produced esthetically pleasing smiles in these patients, lasting up to 3-5 months. BTX-A injections at preselected hyperactive muscle sites provides novel and cosmetically viable alternative for management of gummy smiles caused by hypefunctional upper lip musculature.

Changes in upper gastrointestinal physiology with age.

PubMed

Newton, J L

2004-12-01

Diseases of the upper gastrointestinal tract such as peptic ulceration and gastric cancer become more common and more severe with advancing age. In the normal stomach and duodenum, there is a balance between mucosal protective mechanisms and endogenous (gastric acid and pepsin) and exogenous aggressive factors. The high incidence of gastrointestinal pathology seen in older age groups is not related to increase in the secretion of endogenous aggressive factors. Recent work suggests that gastrointestinal mucosal protective mechanisms are impaired with age. The roles in the gastrointestinal tract of molecules that have been implicated in mucosal repair, such as trefoil peptides and matrix components, are beginning to be elucidated and their study in older people is essential to ensure appropriate, efficient, cost-effective management of gastric pathology in the elderly. Strategies to improve the management of upper gastrointestinal diseases in older people will reduce mortality and improve quality of life.

CT measurement of glenoid erosion in arthritis.

PubMed

Mullaji, A B; Beddow, F H; Lamb, G H

1994-05-01

We studied serial CT scans of 45 arthritic shoulders (34 rheumatoid, 11 osteoarthritic) and 19 normal shoulders, making measurements at three levels on axial images. The maximum anteroposterior diameter of the glenoid was increased in rheumatoid glenoids at the upper and middle levels by 6 mm and in osteoarthritic glenoids at all levels by 5 to 8 mm as compared with normal. In rheumatoid cases, nearly half the available surface of the glenoid was of unsupported bone, mainly posteriorly at the upper and middle levels. In osteoarthritic glenoids, the best supported bone was anterior at the upper level and central at the middle and lower levels. The depth of the rheumatoid glenoid was reduced by a mean of 6 mm at the upper and middle levels and by 3 mm at the lower level. This inclined the surface of the glenoid superiorly. The depth at the middle level in osteoarthritis was reduced by a mean of 5 mm, suggesting central protrusion. Osteoarthritic glenoids were retroverted by a mean of 12.5 degrees, but of rheumatoid glenoids two-thirds were retroverted (mean 15.1 degrees) and one-third anteverted (mean 8.2 degrees). Our findings have important implications for the planning and placement of the glenoid component of total shoulder replacements; CT can provide useful information.

Hydrogeologic framework of the North Fork and surrounding areas, Long Island, New York

USGS Publications Warehouse

Schubert, Christopher E.; Bova, Richard G.; Misut, Paul E.

2004-01-01

Ground water on the North Fork of Long Island is the sole source of drinking water, but the supply is vulnerable to saltwater intrusion and upconing in response to heavy pumping. Information on the area's hydrogeologic framework is needed to analyze the effects of pumping and drought on ground-water levels and the position of the freshwater-saltwater interface. This will enable water-resource managers and water-supply purveyors to evaluate a wide range of water-supply scenarios to safely meet water-use demands. The extent and thickness of hydrogeologic units and position of the freshwater-saltwater interface were interpreted from previous work and from exploratory drilling during this study.The fresh ground-water reservoir on the North Fork consists of four principal freshwater flow systems (referred to as Long Island mainland, Cutchogue, Greenport, and Orient) within a sequence of unconsolidated Pleistocene and Late Cretaceous deposits. A thick glacial-lake-clay unit appears to truncate underlying deposits in three buried valleys beneath the northern shore of the North Fork. Similar glacial-lake deposits beneath eastern and east-central Long Island Sound previously were inferred to be younger than the surficial glacial deposits exposed along the northern shore of Long Island. Close similarities in thickness and upper-surface altitude between the glacial-lake-clay unit on the North Fork and the glacial-lake deposits in Long Island Sound indicate, however, that the two are correlated at least along the North Fork shore.The Matawan Group and Magothy Formation, undifferentiated, is the uppermost Cretaceous unit on the North Fork and constitutes the Magothy aquifer. The upper surface of this unit contains a series of prominent erosional features that can be traced beneath Long Island Sound and the North Fork. Northwest-trending buried ridges extend several miles offshore from areas southeast of Rocky Point and Horton Point. A promontory in the irregular, north-facing cuesta slope extends offshore from an area southwest of Mattituck Creek and James Creek. Buried valleys that trend generally southeastward beneath Long Island Sound extend onshore northeast of Hashamomuck Pond and east of Goldsmith Inlet.An undifferentiated Pleistocene confining layer, the lower confining unit, consists of apparently contiguous units of glacial-lake, marine, and nonmarine clay. This unit is more than 200 feet thick in buried valleys filled with glacial-lake clay along the northern shore, but elsewhere on the North Fork, it is generally less than 50 feet thick and presumably represents an erosional remnant of marine clay. Its upper surface is generally 75 feet or more below sea level where it overlies buried valleys, and is generally 100 feet or less below sea level in areas where marine clay has been identified.A younger unit of glacial-lake deposits, the upper confining unit, is a local confining layer and underlies a sequence of late Pleistocene moraine and outwash deposits. This unit is thickest (more than 45 feet thick) beneath two lowland areas--near Mattituck Creek and James Creek, and near Hashamomuck Pond--but pinches out close to the northern and southern shores and is locally absent in inland areas of the North Fork. Its upper-surface altitude generally rises to near sea level toward the southern shore.Freshwater in the Orient flow system is limited to the upper glacial aquifer above the top of the lower confining unit. The upper confining unit substantially impedes the downward flow of freshwater in inland parts of the Greenport flow system. Deep freshwater within the lower confining unit in the east-central part of the Cutchogue flow system probably is residual from an interval of lower sea level. The upper confining unit is absent or only a few feet thick in the west-central part of the Cutchogue flow system and does not substantially impede the downward flow of freshwater, but the lower confining unit probably impedes the downward flow of freshwater within a southeast-trending buried valley in this area.

Development of a Unified Hydrostratigraphic Framework for the Floridan Aquifer System in Central and Southern Florida

NASA Astrophysics Data System (ADS)

Reese, R. S.

2008-05-01

The mostly carbonate Floridan aquifer system (FAS) of central and southern Florida is a widely used resource with a complex hydrostratigraphic framework that is managed primarily in a subregional context according to water management jurisdictional boundaries. As use of the FAS increases, a consistent regional hydrostratigraphic framework is needed for effective management across these boundaries. Stratigraphic marker horizons within and near the top of FAS were delineated and mapped to develop a preliminary, correlative stratigraphic framework. This framework was used to identify and determine aquifers, subaquifers, and confining units and map their spatial distribution. These horizons are based on lithologic changes and geophysical log signatures identified in previous studies, and they were extended throughout the study area primarily by correlation of natural gamma-ray logs. The FAS consists of the Upper Floridan aquifer, middle confining unit, and Lower Floridan aquifer. A regional, productive zone is delineated and informally referred to as the Avon Park permeable zone. This zone is present over most of the study area and is characterized by thick units of dolostone with interbedded limestone and high fracture permeability. The zone has been identified in different regions in previous studies, either as the upper part of the Lower Floridan aquifer or as the lower part of the Upper Floridan aquifer. In this study it is generally considered to be within the middle confining unit. Transmissivity of the Avon Park permeable zone, a major source of water supply, generally ranges from less than 1x104 up to 1.6x106 ft2/day, and is greatest in central Florida where dolomite is developed as a major component of the zone. A large area of low transmissivity (less than 105 ft2/day) in southern Florida coincides with an area where limestone is the predominant lithology within the zone. Major uses of the FAS now include withdrawal for public and agricultural supply, including treatment with reverse osmosis, aquifer storage and recovery, and disposal of treated wastewater. Water-level and water-quality conflicts could arise between these competing uses, and delineating the extent and hydraulic connectivity of the Avon Park permeable zone within the FAS may help managers and others predict and minimize such conflicts.

Low levels of 25-hydroxyvitamin D are associated with the occurrence of concomitant upper limb fractures in older women who sustain a fall-related fracture of the hip.

PubMed

Di Monaco, Marco; Vallero, Fulvia; Castiglioni, Carlotta; Di Monaco, Roberto; Tappero, Rosa

2011-01-01

To investigate the association between serum levels of 25-hydroxyvitamin D and the occurrence of simultaneous fractures of the upper limb in older women who sustain a fall-related fracture of the hip. Cross-sectional study. We investigated 472 of 480 white women consecutively admitted to a rehabilitation hospital because of a fall-related hip fracture. Twenty-seven (5.7%) of the 472 women sustained a concomitant upper-limb fracture of either distal radius (20 women) or proximal humerus (seven women). We assessed serum levels of 25-hydroxyvitamin D 14.2 ± 4.1 (mean ± SD) days after surgical repair of the hip fracture in the 472 women by an immunoenzymatic assay. Twenty-five-hydroxyvitamin D levels were significantly lower in the 27 women with concomitant fractures of both hip and upper limb than in the remaining 445 hip-fracture women: mean ± SD values were 6.5 ± 5.0 ng/ml and 11.7 ± 10.4 ng/ml respectively in the two groups (mean difference between groups 5.2 ng/ml: 95% CI 1.2-9.2; p=0.011). Low levels of 25-hydroxyvitamin D were significantly associated with concomitant fractures of the upper limb (p=0.017), after adjustment for eight potential confounders including age, height, weight, hip-fracture type, cognitive impairment, neurologic impairment, previous hip fracture, and previous upper-limb fracture. Low levels of 25-hydroxyvitamin D were significantly associated with concomitant upper-limb fractures in our sample of older women with a fall-related fracture of the hip. Preventing vitamin D deficiency may lower the incidence of simultaneous fractures due to a singe fall in elderly women. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Subclinical hypothyroidism in childhood - current knowledge and open issues.

PubMed

Salerno, Mariacarolina; Capalbo, Donatella; Cerbone, Manuela; De Luca, Filippo

2016-12-01

Subclinical hypothyroidism is defined as serum levels of TSH above the upper limit of the reference range, in the presence of normal concentrations of total T 4 or free T 4 . This biochemical profile might be an indication of mild hypothyroidism, with a potential increased risk of metabolic abnormalities and cardiovascular disease recorded among adults. Whether subclinical hypothyroidism results in adverse health outcomes among children is a matter of debate and so management of this condition remains challenging. Mild forms of untreated subclinical hypothyroidism do not seem to be associated with impairments in growth, bone health or neurocognitive outcome. However, ongoing scientific investigations have highlighted the presence of subtle proatherogenic abnormalities among children with modest elevations in their TSH levels. Although current findings are insufficient to recommend levothyroxine treatment for all children with mild asymptomatic forms of subclinical hypothyroidism, they highlight the potential need for assessment of cardiovascular risk among children with this condition. Increased understanding of the early metabolic risk factors associated with subclinical hypothyroidism in childhood will help to improve the management of affected individuals.

Water inventory management in condenser pool of boiling water reactor

DOEpatents

Gluntz, Douglas M.

1996-01-01

An improved system for managing the water inventory in the condenser pool of a boiling water reactor has means for raising the level of the upper surface of the condenser pool water without adding water to the isolation pool. A tank filled with water is installed in a chamber of the condenser pool. The water-filled tank contains one or more holes or openings at its lowermost periphery and is connected via piping and a passive-type valve (e.g., squib valve) to a high-pressure gas-charged pneumatic tank of appropriate volume. The valve is normally closed, but can be opened at an appropriate time following a loss-of-coolant accident. When the valve opens, high-pressure gas inside the pneumatic tank is released to flow passively through the piping to pressurize the interior of the water-filled tank. In so doing, the initial water contents of the tank are expelled through the openings, causing the water level in the condenser pool to rise. This increases the volume of water available to be boiled off by heat conducted from the passive containment cooling heat exchangers. 4 figs.

Water inventory management in condenser pool of boiling water reactor

DOEpatents

Gluntz, D.M.

1996-03-12

An improved system for managing the water inventory in the condenser pool of a boiling water reactor has means for raising the level of the upper surface of the condenser pool water without adding water to the isolation pool. A tank filled with water is installed in a chamber of the condenser pool. The water-filled tank contains one or more holes or openings at its lowermost periphery and is connected via piping and a passive-type valve (e.g., squib valve) to a high-pressure gas-charged pneumatic tank of appropriate volume. The valve is normally closed, but can be opened at an appropriate time following a loss-of-coolant accident. When the valve opens, high-pressure gas inside the pneumatic tank is released to flow passively through the piping to pressurize the interior of the water-filled tank. In so doing, the initial water contents of the tank are expelled through the openings, causing the water level in the condenser pool to rise. This increases the volume of water available to be boiled off by heat conducted from the passive containment cooling heat exchangers. 4 figs.

Water level management and contaminant exposure to tree swallows nesting on the Upper Mississippi River

USGS Publications Warehouse

Custer, T.W.; Dummer, P.M.; Custer, Christine M.; Li, A.U.; Warburton, D.; Melancon, M.J.; Hoffman, D.J.; Matson, C.W.; Bickham, J.W.

2007-01-01

The U.S. Army Corps of Engineers conducted a water drawdown on Navigation Pool 8 of the Upper Mississippi River during the summers of 2001 and 2002 to increase aquatic vegetation production and thereby improve fish and wildlife habitat. Flooding of previously dried wetlands, however, may increase the rate of mercury methylation and make mercury more available to terrestrial vertebrates that feed in aquatic environments. Our objective was to determine if mercury, other elements, and organochlorine contaminants were more available to vertebrates following the 2001 drawdown. Tree swallow (Tachycineta bicolor) eggs and nestlings were collected at two sites on Pool 8 and a nearby Reference site in 2000 (pre-2001 drawdown), 2001 (pre-2001 drawdown) and 2002 (post-2001 drawdown) and tissues were analyzed for mercury, other elements, and organochlorine contaminants. Bioindicator measurements of genetic damage, oxidative stress, ethoxyresorufin-O-dealkylase activity, and the ratio of liver to nestling mass were also measured in nestlings at all sites and all years. Based on a multivariate analysis, the 2001 drawdown of Pool 8 did not influence element concentrations, organochlorine concentrations, or bioindicator response. Concentrations of inorganic and organochlorine contaminants in tree swallow eggs and nestlings were not at toxic levels. Hatching success did not differ among years and was comparable to the nationwide average.

Amputation rehabilitation and prosthetic restoration. From surgery to community reintegration.

PubMed

Esquenazi, Alberto

The purpose of this review is to summarize the literature related to the advances that have taken place in the management and rehabilitation care of limb amputation. Prostheses for the lower and upper limb amputee have changed greatly over the past several years, with advances in components, socket fabrication and fitting techniques, suspension systems and sources of power and electronic controls. Higher levels of limb amputation can now be fitted with functional prostheses, which allow more patients to achieve independent life styles. This is of particular importance for the multi-limb amputee. The rehabilitation of more traditional lower limb levels of amputation have also greatly benefited from the technological advances including energy storing feet, electronic control hydraulic knees, ankle rotators and shock absorbers to mention a few. For the upper limb amputee, myoelectric and proportional controlled terminal devices and elbow joints are now used routinely in some rehabilitation facilities. Experimental prosthetic fitting techniques and devices such as the use of osseo-implantation for suspension of the prosthesis, tension control hands or electromagnetic fluids for knee movement control will also be briefly discussed in this paper. It is possible to conclude from this review that many advances have occurred that have greatly impacted the functional outcomes of patients with limb amputation.

Fatty acid profile in vertical strata of elephant grass subjected to intermittent stocking.

PubMed

Dias, Kamila M; Schmitt, Daniel; Rodolfo, Giselle R; Deschamps, Francisco C; Camargo, Guilherme N; Pereira, Raphael S; Sbrissia, André F

2017-01-01

The milk and meat from animals with a pasture-based diet have higher proportions of CLA and C18:3 and lower omega-6:omega-3 ratios than products from animals with diets based on corn silage and concentrate. However, most of the published studies have evaluated fatty acid profiles in temperate climate grasses and the literature with tropical grasses is scarce. Thus, the aim of this study was to evaluate the morphological and fatty acid compositions in the vertical strata of elephant grass (Pennisetum purpureum Schum.) swards subjected to grazing heights (90 or 120 cm pre-grazing heights) and levels of defoliation (50% or 70% removal of the initial pre-grazing height). There were no interactions among pre-grazing height, the level of defoliation and grazing stratum. However, higher proportion of C18:3 (58% and 63%) was found in the 90-cm swards and in the half upper stratum. A higher proportion of C18:3 was associated with a higher leaf proportion and crude protein content. Thus, the upper stratum of sward or a grazing management scheme (e.g. first-last stocking) resulting in a higher proportion of leaves and crude protein both provide higher proportions of C18:3 to animals grazing in elephant grass swards.

A Rasch-validated version of the upper extremity functional index for interval-level measurement of upper extremity function.

PubMed

Hamilton, Clayon B; Chesworth, Bert M

2013-11-01

The original 20-item Upper Extremity Functional Index (UEFI) has not undergone Rasch validation. The purpose of this study was to determine whether Rasch analysis supports the UEFI as a measure of a single construct (ie, upper extremity function) and whether a Rasch-validated UEFI has adequate reproducibility for individual-level patient evaluation. This was a secondary analysis of data from a repeated-measures study designed to evaluate the measurement properties of the UEFI over a 3-week period. Patients (n=239) with musculoskeletal upper extremity disorders were recruited from 17 physical therapy clinics across 4 Canadian provinces. Rasch analysis of the UEFI measurement properties was performed. If the UEFI did not fit the Rasch model, misfitting patients were deleted, items with poor response structure were corrected, and misfitting items and redundant items were deleted. The impact of differential item functioning on the ability estimate of patients was investigated. A 15-item modified UEFI was derived to achieve fit to the Rasch model where the total score was supported as a measure of upper extremity function only. The resultant UEFI-15 interval-level scale (0-100, worst to best state) demonstrated excellent internal consistency (person separation index=0.94) and test-retest reliability (intraclass correlation coefficient [2,1]=.95). The minimal detectable change at the 90% confidence interval was 8.1. Patients who were ambidextrous or bilaterally affected were excluded to allow for the analysis of differential item functioning due to limb involvement and arm dominance. Rasch analysis did not support the validity of the 20-item UEFI. However, the UEFI-15 was a valid and reliable interval-level measure of a single dimension: upper extremity function. Rasch analysis supports using the UEFI-15 in physical therapist practice to quantify upper extremity function in patients with musculoskeletal disorders of the upper extremity.

A Rasch-Validated Version of the Upper Extremity Functional Index for Interval-Level Measurement of Upper Extremity Function

PubMed Central

Chesworth, Bert M.

2013-01-01

Background The original 20-item Upper Extremity Functional Index (UEFI) has not undergone Rasch validation. Objective The purpose of this study was to determine whether Rasch analysis supports the UEFI as a measure of a single construct (ie, upper extremity function) and whether a Rasch-validated UEFI has adequate reproducibility for individual-level patient evaluation. Design This was a secondary analysis of data from a repeated-measures study designed to evaluate the measurement properties of the UEFI over a 3-week period. Methods Patients (n=239) with musculoskeletal upper extremity disorders were recruited from 17 physical therapy clinics across 4 Canadian provinces. Rasch analysis of the UEFI measurement properties was performed. If the UEFI did not fit the Rasch model, misfitting patients were deleted, items with poor response structure were corrected, and misfitting items and redundant items were deleted. The impact of differential item functioning on the ability estimate of patients was investigated. Results A 15-item modified UEFI was derived to achieve fit to the Rasch model where the total score was supported as a measure of upper extremity function only. The resultant UEFI-15 interval-level scale (0–100, worst to best state) demonstrated excellent internal consistency (person separation index=0.94) and test-retest reliability (intraclass correlation coefficient [2,1]=.95). The minimal detectable change at the 90% confidence interval was 8.1. Limitations Patients who were ambidextrous or bilaterally affected were excluded to allow for the analysis of differential item functioning due to limb involvement and arm dominance. Conclusion Rasch analysis did not support the validity of the 20-item UEFI. However, the UEFI-15 was a valid and reliable interval-level measure of a single dimension: upper extremity function. Rasch analysis supports using the UEFI-15 in physical therapist practice to quantify upper extremity function in patients with musculoskeletal disorders of the upper extremity. PMID:23813086

A New Orthodontic Appliance with a Mini Screw for Upper Molar Distalization

PubMed Central

2016-01-01

The aim of this study is to present a new upper molar distalization appliance called Cise distalizer designed as intraoral device supported with orthodontic mini screw for upper permanent molar distalization. The new appliance consists of eight main components. In order to understand the optimum force level, the appliance under static loading is tested by using strain gage measurement techniques. Results show that one of the open coils produces approximately 300 gr distalization force. Cise distalizer can provide totally 600 gr distalization force. This range of force level is enough for distalization of upper first and second molar teeth. PMID:27528796

Acute inflammatory edema of the uvula (uvulitis) as a cause of respiratory distress: a case report.

PubMed

Hawke, M; Kwok, P

1987-06-01

Acute inflammatory edema of the uvula (uvulitis) is a relatively rare cause of upper airway distress or obstruction. The authors present a case report of a 37-year-old man who developed an acute cellulitis and edema of the uvula with upper airway distress, which was managed by an emergency uvulectomy.

A ROBUST DESIGN FOR THE ASSESSMENT OF A GREAT RIVER, ENVIRONMENTAL MONITORING, AND ASSESSMENT PROGRAM - UPPER MISSOURI RIVER (EMAP-UMR)

EPA Science Inventory

Great Rivers and reservoirs are complex, trans-border resources that are difficult and expensive to assess, monitor and manage. EMAP-UMR is a five-year effort to develop the methodology for Great River assessments, using the Upper Missouri as a test case. A major early achievemen...

78 FR 15658 - Airworthiness Directives; The Boeing Company Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-12

... Commercial Airplanes, Attention: Data & Services Management, P. O. Box 3707, MC 2H-65, Seattle, WA 98124-2207... upper skin and rear spar upper chord between LBL 70.50 and RBL 70.50 at STA 870. The crack sizes ranged... We reviewed Boeing Special Attention Service Bulletin 727-57-0187, dated March 8, 2012. For...

Dynamic upper airway changes during sleep in patients with obstructive sleep apnea syndrome.

PubMed

Chuang, Li-Pang; Chen, Ning-Hung; Li, Hsueh-Yu; Lin, Shih-Wei; Chou, Yu-Ting; Wang, Chao-Jan; Liao, Yu-Fang; Tsai, Ying-Huang

2009-12-01

The narrowing pattern of the upper airway in obstructive sleep apnea patients may be different in sleep as compared with awake. Three different types of obstruction were observed in these subjects during drug-induced sleep. The different obstruction pattern during drug-induced sleep suggests that different strategies should be selected in upper airway management. To identify the sites of narrowing and evaluate dynamic upper airway movement in patients with obstructive sleep apnea syndrome (OSAS) while awake and asleep. This study included 10 patients treated for OSAS between August 2003 and June 2004. Overnight polysomnography was performed on all patients. Parameters including gender, age, neck circumference, and body mass index were recorded. Ultra-fast MRI during awake and drug-induced sleep was arranged to evaluate the dynamic motion of the upper airway. The narrowing pattern of the upper airway during awake differed from the narrowing pattern during drug-induced sleep in 3 of 10 subjects. Three different types, palatal obstruction, combined upper and lower pharyngeal obstruction, and circumferential obstruction of the upper airway, were observed in these patients during drug-induced sleep.

Water supply, demand, and quality indicators for assessing the spatial distribution of water resource vulnerability in the Columbia River Basin

USGS Publications Warehouse

Chang, Heejun; Jung, Il-Won; Strecker, Angela L.; Wise, Daniel; Lafrenz, Martin; Shandas, Vivek; ,; Yeakley, Alan; Pan, Yangdong; Johnson, Gunnar; Psaris, Mike

2013-01-01

We investigated water resource vulnerability in the US portion of the Columbia River basin (CRB) using multiple indicators representing water supply, water demand, and water quality. Based on the US county scale, spatial analysis was conducted using various biophysical and socio-economic indicators that control water vulnerability. Water supply vulnerability and water demand vulnerability exhibited a similar spatial clustering of hotspots in areas where agricultural lands and variability of precipitation were high but dam storage capacity was low. The hotspots of water quality vulnerability were clustered around the main stem of the Columbia River where major population and agricultural centres are located. This multiple equal weight indicator approach confirmed that different drivers were associated with different vulnerability maps in the sub-basins of the CRB. Water quality variables are more important than water supply and water demand variables in the Willamette River basin, whereas water supply and demand variables are more important than water quality variables in the Upper Snake and Upper Columbia River basins. This result suggests that current water resources management and practices drive much of the vulnerability within the study area. The analysis suggests the need for increased coordination of water management across multiple levels of water governance to reduce water resource vulnerability in the CRB and a potentially different weighting scheme that explicitly takes into account the input of various water stakeholders.

20. Readiness Crew Building interior, upper level corridor. This corridor ...

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

20. Readiness Crew Building interior, upper level corridor. This corridor runs from northwest to southeast. Photograph taken at the northwest end looking southeast. Lyon - Whiteman Air Force Base, Bomber Alert Facility S-6, 1300 Alert Road, Knob Noster, Johnson County, MO

Students' Educational Use of Facebook Groups

ERIC Educational Resources Information Center

Dalsgaard, Christian

2016-01-01

The aim of the article is to explore educational use of student-managed Facebook groups in upper secondary education (in Denmark). Much research on educational potentials of Facebook has studied groups managed by teachers. However, there is a lack of in-depth research on Facebook groups managed by students and without participation from teachers.…

Management of Acute Upper Gastrointestinal Disease While at Sea.

PubMed

Carr, Matthew J; Oxner, Christopher; Elster, Eric A; Ritter, Eric M; Vicente, Diego

2018-02-06

Management of complex acute surgical pathology in austere environments necessitates rapid evaluation and resource appropriate management to avoid time-associated morbidity and potentially mortality. Obstructive upper gastrointestinal (UGI) pathologies can be particularly challenging and associated with significant morbidity. Herein, we present six patients with UGI obstructions encountered over the course of an 8-mo deployment onboard a US Navy Aircraft Carrier. Each patient presented to our medical department with signs and symptoms of obstructive UGI pathology including one gastric volvulus requiring operative management at sea, one with a new diagnosis of achalasia requiring transportation and continental United States outpatient evaluation, and four patients with food impaction requiring urgent endoscopic management. Although UGI pathology is seldom encountered at sea, definitive surgical interventions, including prompt evaluation and management of these acute pathologies, can be performed in an austere environment. We wish to call attention to these potential encounters in order that underway deployed medical units and supporting resources ashore are prepared and equipped to intervene on acute UGI obstructive pathology. © Association of Military Surgeons of the United States 2018. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Simulation of streamflow and the effects of brush management on water yields in the upper Guadalupe River watershed, south-central Texas, 1995-2010

USGS Publications Warehouse

Bumgarner, Johnathan R.; Thompson, Florence E.

2012-01-01

The U.S. Geological Survey, in cooperation with the Texas State Soil and Water Conservation Board and the Upper Guadalupe River Authority, developed and calibrated a Soil and Water Assessment Tool watershed model of the upper Guadalupe River watershed in south-central Texas to simulate streamflow and the effects of brush management on water yields in the watershed and to Canyon Lake for 1995-2010. Model simulations were done to quantify the possible change in water yield of individual subbasins in the upper Guadalupe River watershed as a result of the replacement of ashe juniper (Juniperus ashei) with grasslands. The simulation results will serve as a tool for resource managers to guide their brush-management efforts. Model hydrology was calibrated with streamflow data collected at the U.S. Geological Survey streamflow-gaging station 08167500 Guadalupe River near Spring Branch, Tex., for 1995-2010. Simulated monthly streamflow showed very good agreement with measured monthly streamflow: a percent bias of -5, a coefficient of determination of 0.91, and a Nash-Sutcliffe coefficient of model efficiency of 0.85. Modified land-cover input datasets were generated for the model in order to simulate the replacement of ashe juniper with grasslands in 23 brush-management subbasins in the watershed. Each of the 23 simulations showed an increase in simulated water yields in the targeted subbasins and to Canyon Lake. The simulated increases in average annual water yields in the subbasins ranged from 6,370 to 119,000 gallons per acre of ashe juniper replaced with grasslands with an average of 38,900 gallons. The simulated increases in average annual water yields to Canyon Lake from upstream subbasins ranged from 6,640 to 72,700 gallons per acre of ashe juniper replaced with grasslands with an average of 34,700 gallons.

Inflammatory Mediator Profiling of n-butanol Exposed Upper Airways in Individuals with Multiple Chemical Sensitivity.

PubMed

Dantoft, Thomas Meinertz; Skovbjerg, Sine; Andersson, Linus; Claeson, Anna-Sara; Lind, Nina; Nordin, Steven; Brix, Susanne

2015-01-01

Multiple Chemical Sensitivity (MCS) is a chronic condition characterized by reports of recurrent symptoms in response to low level exposure to various chemical substances. Recent findings suggests that dysregulation of the immune system may play a role in MCS pathophysiology. The aim of this study was to examine baseline and low dose n-butanol-induced upper airway inflammatory response profiles in MCS subjects versus healthy controls. Eighteen participants with MCS and 18 age- and sex-matched healthy controls were enrolled in the study. Epithelial lining fluid was collected from the nasal cavity at three time points: baseline, within 15 minutes after being exposed to 3.7 ppm n-butanol in an exposure chamber and four hours after exposure termination. A total of 19 cytokines and chemokines were quantified. Furthermore, at baseline and during the exposure session, participants rated the perceived intensity, valence and levels of symptoms and autonomic recordings were obtained. The physiological and psychophysical measurements during the n-butanol exposure session verified a specific response in MCS individuals only. However, MCS subjects and healthy controls displayed similar upper airway inflammatory mediator profiles (P>0.05) at baseline. Likewise, direct comparison of mediator levels in the MCS group and controls after n-butanol exposure revealed no significant group differences. We demonstrate no abnormal upper airway inflammatory mediator levels in MCS subjects before or after a symptom-eliciting exposure to low dose n-butanol, implying that upper airways of MCS subjects are functionally intact at the level of cytokine and chemokine production and secretory capacity. This suggests that previous findings of increased cytokine plasma levels in MCS are unlikely to be caused by systemic priming via excessive upper airway inflammatory processes.

Ageostrophic winds and vertical motion fields accompanying upper level jet streak propagation during the Red River Valley tornado outbreak

NASA Technical Reports Server (NTRS)

Moore, J. T.; Squires, M. F.

1982-01-01

Preliminary results are shown relating the ageostrophic wind field, through the terms of a semigeostrophic wind equation (assuming adiabatic conditions and the geostrophic momentum approximation) to both air parcel trajectories and their vertical motion fields computed from the parcels' displacement on isentropic surfaces, with respect to pressure. The analysis of results considers both upper-level (324 K) ageostrophic fields and low-level (304 K) fields. Preliminary results tend to support Uccellini and Johnson's (1979) hypothesis concerning upper-level-jet/low-level-jet (ULJ/LLJ) coupling in the exit region of the ULJ. Future plans are described briefly for research intended to clarify the mechanism behind ULJ streak propagation, LLJ development and their relationship to the initiation of severe convection.

Transfusion strategy for acute upper gastrointestinal bleeding.

PubMed

Handel, James; Lang, Eddy

2015-09-01

Clinical question Does a hemoglobin transfusion threshold of 70 g/L yield better patient outcomes than a threshold of 90 g/L in patients with acute upper gastrointestinal bleeding? Article chosen Villanueva C, Colomo A, Bosch A, et al. Transfusion strategies for acute upper gastrointestinal bleeding. N Engl J Med 2013;368(1):11-21. Study objectives The authors of this study measured mortality, from any cause, within the first 45 days, in patients with acute upper gastrointestinal bleeding, who were managed with a hemoglobin threshold for red cell transfusion of either 70 g/L or 90 g/L. The secondary outcome measures included rate of further bleeding and rate of adverse events.

Evaluating Local and Regional Sources of Trace Element Contamination in a Rural Sub Estuary of the Upper Chesapeake Bay

NASA Astrophysics Data System (ADS)

Krahforst, C.; Hartman, S.; Sherman, L.; Kehm, K.

2014-12-01

The distribution of trace elements (V, Cr, Co, Ni, Cu, Zn, As, Ag, Cd, Sn, Ba, W, Pb and U) along with Al and Fe and other sediment characteristics in surface sediment and sediment cores from the Chester River - a sub estuary of the Chesapeake Bay located in a predominantly agricultural watershed of Maryland's upper Eastern Shore, USA - have been determined in order to add to the understanding of contaminant transport and fate and inform management strategies designed to maintain or improve the ecological condition of estuaries. These analyses coupled with the comparison of elemental analysis of 210Pb - dated sediment cores, main stem water quality surveys, and a review of recent EPA National Coastal Condition Assessment sediment data from Chesapeake Bay provide added information about the roles of local and region scale processes on ecosystem condition. The high amount of suspended sediment in the Chester River (5-20 mg L-1) is an important factor controlling water quality conditions of the Chester River and a prime focus for environmental management of this system. Sources of suspended matter include local runoff, atmospheric deposition, local resuspension, and exchange with the Chesapeake Bay. In principle, each of these sources could be distinguished on the basis of chemical composition of surface sediment. Preliminary results from multivariate analytic models indicate that many of the elements investigated display significant covariance with Al (and other predominantly crustal signatures) which may indicate limited exogenic sources of contamination for sediments of this watershed. For example total Pb concentrations are mostly below the NOAA's low toxic effects level and lower than the median value of NCCA data for the upper Chesapeake suggesting that sediments have significant sources from within the watershed. Further, significant higher concentrations of Sn and Cu coincide with sediment collected in or near marinas and point to localized anthropogenic sources for these elements. Elemental enrichment values relative to Al of Chester River sediments are significantly lower than observations in sediments from Chesapeake Bay overall and may indicate that local watershed management strategies may be effective for improving water and habitat quality of the Chester River.

Groundwater levels for selected wells in Upper Kittitas County, Washington

USGS Publications Warehouse

Fasser, E.T.; Julich, R.J.

2011-01-01

Groundwater levels for selected wells in Upper Kittitas County, Washington, are presented on an interactive, web-based map to document the spatial distribution of groundwater levels in the study area measured during spring 2011. Groundwater-level data and well information were collected by the U.S. Geological Survey using standard techniques and are stored in the U.S. Geological Survey National Water Information System, Groundwater Site-Inventory database.

Analysis and preliminary design of Kunming land use and planning management information system

NASA Astrophysics Data System (ADS)

Li, Li; Chen, Zhenjie

2007-06-01

This article analyzes Kunming land use planning and management information system from the system building objectives and system building requirements aspects, nails down the system's users, functional requirements and construction requirements. On these bases, the three-tier system architecture based on C/S and B/S is defined: the user interface layer, the business logic layer and the data services layer. According to requirements for the construction of land use planning and management information database derived from standards of the Ministry of Land and Resources and the construction program of the Golden Land Project, this paper divides system databases into planning document database, planning implementation database, working map database and system maintenance database. In the design of the system interface, this paper uses various methods and data formats for data transmission and sharing between upper and lower levels. According to the system analysis results, main modules of the system are designed as follows: planning data management, the planning and annual plan preparation and control function, day-to-day planning management, planning revision management, decision-making support, thematic inquiry statistics, planning public participation and so on; besides that, the system realization technologies are discussed from the system operation mode, development platform and other aspects.

DIGITAL Q METER

DOEpatents

Briscoe, W.L.

1962-02-13

A digital Q meter is described for measuring the Q of mechanical or electrical devices. The meter comprises in combination a transducer coupled to an input amplifier, and an upper and lower level discriminator coupled to the amplifier and having their outputs coupled to an anticoincidence gate. The output of the gate is connected to a scaler. The lower level discriminator is adjusted to a threshold level of 36.8 percent of the operating threshold level of the upper level discriminator. (AEC)

Interior, north end, upper level, looking south towards door to ...

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

Interior, north end, upper level, looking south towards door to one of the building's refrigeration rooms. Photograph taken just south of CO-172-AQ-4. - Fitzsimons General Hospital, Ice Plant, Southwest Corner of East I Avenue & North Thirteenth Street, Aurora, Adams County, CO

Interior, north end, upper level, looking west. This photograph taken ...

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

Interior, north end, upper level, looking west. This photograph taken inside the refrigeration room whose door is in the background of CO-172-AQ-5. - Fitzsimons General Hospital, Ice Plant, Southwest Corner of East I Avenue & North Thirteenth Street, Aurora, Adams County, CO

Skylab

NASA Image and Video Library

1972-01-01

This photograph, with callouts, depicts the experiment area of the forward compartment at the upper level of the Orbital Workshop. The upper level consisted of a large work area and housed water storage tanks, a food freezer, storage vaults for film, scientific airlocks, mobility and stability experiment equipment, and other experimental equipment.

Service Learning in Domestic and International Settings

ERIC Educational Resources Information Center

Miller, Kari Knutson; Gonzalez, Amber M.

2009-01-01

This paper examines pre-service teacher outcomes associated with service learning in domestic and international settings. One group of upper-division undergraduate level pre service teachers participated in supervised experiences in domestic settings. A second group of upper-division undergraduate level pre-service teachers participated in…

The analysis and kinetic energy balance of an upper-level wind maximum during intense convection

NASA Technical Reports Server (NTRS)

Fuelberg, H. E.; Jedlovec, G. J.

1982-01-01

The purpose of this paper is to analyze the formation and maintenance of the upper-level wind maximum which formed between 1800 and 2100 GMT, April 10, 1979, during the AVE-SESAME I period, when intense storms and tornadoes were experienced (the Red River Valley tornado outbreak). Radiosonde stations participating in AVE-SESAME I are plotted (centered on Oklahoma). National Meteorological Center radar summaries near the times of maximum convective activity are mapped, and height and isotach plots are given, where the formation of an upper-level wind maximum over Oklahoma is the most significant feature at 300 mb. The energy balance of the storm region is seen to change dramatically as the wind maximum forms. During much of its lifetime, the upper-level wind maximum is maintained by ageostrophic flow that produces cross-contour generation of kinetic energy and by the upward transport of midtropospheric energy. Two possible mechanisms for the ageostrophic flow are considered.

The Influence of Wheelchair Propulsion Hand Pattern on Upper Extremity Muscle Power and Stress

PubMed Central

Slowik, Jonathan S.; Requejo, Philip S.; Mulroy, Sara J.; Neptune, Richard R.

2016-01-01

The hand pattern (i.e., full-cycle hand path) used during manual wheelchair propulsion is frequently classified as one of four distinct hand pattern types: arc, single loop, double loop and semicircular. Current clinical guidelines recommend the use of the semicircular pattern, which is based on advantageous levels of broad biomechanical metrics implicitly related to the demand placed on the upper extremity (e.g., lower cadence). However, an understanding of the influence of hand pattern on specific measures of upper extremity muscle demand (e.g., muscle power and stress) is needed to help make such recommendations, but these quantities are difficult and impractical to measure experimentally. The purpose of this study was to use musculoskeletal modeling and forward dynamics simulations to investigate the influence of the hand pattern used on specific measures of upper extremity muscle demand. The simulation results suggest that the double loop and semicircular patterns produce the most favorable levels of overall muscle stress and total muscle power. The double loop pattern had the lowest full-cycle and recovery-phase upper extremity demand but required high levels of muscle power during the relatively short contact phase. The semicircular pattern had the second-lowest full-cycle levels of overall muscle stress and total muscle power, and demand was more evenly distributed between the contact and recovery phases. These results suggest that in order to decrease upper extremity demand, manual wheelchair users should use either the double loop or semicircular pattern when propelling their wheelchairs at a self-selected speed on level ground. PMID:27062591

Groundwater quality and occurrence and distribution of selected constituents in the Aquia and Upper Patapsco aquifers, Naval Air Station Patuxent River, St. Mary's County, Maryland, July 2008

USGS Publications Warehouse

Dieter, Cheryl A.; Campo, Kimberly W.; Baker, Anna C.

2012-01-01

The Naval Air Station Patuxent River in southern Maryland has continued to expand in the first decade of the 21st century, contributing to rapid population growth in the surrounding area. The increase in population has caused State and County water managers and others to be concerned about the impact of population growth on the quantity and quality of groundwater supplies. The U.S. Geological Survey has been investigating the groundwater resources of the air station since 1998. As part of that ongoing investigation, groundwater was sampled in 2008 in six wells in the Aquia aquifer and two wells in the Upper Patapsco aquifer in the vicinity of Naval Air Station Patuxent River and Webster Outlying Field. Groundwater samples were analyzed for basic chemistry (field parameters, major ions, and nutrients) as well as several water-quality issues of concern including the occurrence of arsenic and tungsten, and saltwater intrusion. The results of the 2008 groundwater-quality sampling indicate that the overall quality of groundwater in the Aquia aquifer has not changed since 1943; data are too limited to determine if groundwater quality has changed in the Upper Patapsco aquifer. At one well in the Aquia aquifer, the arsenic concentration exceeded the U.S. Environmental Protection Agency standard for drinking water. Arsenic was not detected in samples from the Upper Patapsco aquifer. Tungsten concentrations were detected at low concentrations near the laboratory reporting level in all eight samples. There was no evidence of saltwater intrusion in any of the wells.

A generalized public goods game with coupling of individual ability and project benefit

NASA Astrophysics Data System (ADS)

Zhong, Li-Xin; Xu, Wen-Juan; He, Yun-Xin; Zhong, Chen-Yang; Chen, Rong-Da; Qiu, Tian; Shi, Yong-Dong; Ren, Fei

2017-08-01

Facing a heavy task, any single person can only make a limited contribution and team cooperation is needed. As one enjoys the benefit of the public goods, the potential benefits of the project are not always maximized and may be partly wasted. By incorporating individual ability and project benefit into the original public goods game, we study the coupling effect of the four parameters, the upper limit of individual contribution, the upper limit of individual benefit, the needed project cost and the upper limit of project benefit on the evolution of cooperation. Coevolving with the individual-level group size preferences, an increase in the upper limit of individual benefit promotes cooperation while an increase in the upper limit of individual contribution inhibits cooperation. The coupling of the upper limit of individual contribution and the needed project cost determines the critical point of the upper limit of project benefit, where the equilibrium frequency of cooperators reaches its highest level. Above the critical point, an increase in the upper limit of project benefit inhibits cooperation. The evolution of cooperation is closely related to the preferred group-size distribution. A functional relation between the frequency of cooperators and the dominant group size is found.

Groundwater levels, trends, and relations to pumping in the Bureau of Reclamation Klamath Project, Oregon and California

USGS Publications Warehouse

Gannett, Marshall W.; Breen, Katherine H.

2015-07-28

The use of groundwater to supplement surface-water supplies for the Bureau of Reclamation Klamath Project in the upper Klamath Basin of Oregon and California markedly increased between 2000 and 2014. Pre-2001 groundwater pumping in the area where most of this increase occurred is estimated to have been about 28,600 acre-feet per year. Subsequent supplemental pumping rates have been as high as 128,740 acre-feet per year. During this period of increased pumping, groundwater levels in and around the Bureau of Reclamation Klamath Project have declined by about 20-25 feet. Water-level declines are largely due to the increased supplemental pumping, but other factors include increased pumping adjacent to the Klamath Project and drying climate conditions. This report summarizes the distribution and magnitude of supplemental groundwater pumping and groundwater-level declines, and characterizes the relation between the stress and response in subareas of the Klamath Project to aid decision makers in developing groundwater-management strategies.

Simulation of groundwater storage changes in the eastern Pasco Basin, Washington

USGS Publications Warehouse

Heywood, Charles E.; Kahle, Sue C.; Olsen, Theresa D.; Patterson, James D.; Burns, Erick

2016-03-29

The Miocene Columbia River Basalt Group and younger sedimentary deposits of lacustrine, fluvial, eolian, and cataclysmic-flood origins compose the aquifer system of the Pasco Basin in eastern Washington. Irrigation return flow and canal leakage from the Columbia Basin Project have caused groundwater levels to rise substantially in some areas, contributing to landslides along the Columbia River. Water resource managers are considering extraction of additional stored groundwater to supply increasing demand and possibly mitigate problems caused by the increased water levels. To help address these concerns, the transient groundwater model of the Pasco Basin documented in this report was developed to quantify the changes in groundwater flow and storage. The MODFLOW model uses a 1-kilometer finite-difference grid and is constrained by logs and water levels from 846 wells in the study area. Eight model layers represent five sedimentary hydrogeologic units and underlying basalt formations. Head‑dependent flux boundaries represent the Columbia and Snake Rivers to the west and south, respectively, underflow to and (or) from adjacent areas to the northeast, and discharge to agricultural drains, springs, and groundwater withdrawal wells. Specified flux boundaries represent recharge from infiltrated precipitation and anthropogenic sources, including irrigation return flow and leakage from water-distribution canals. The model was calibrated with the parameter‑estimation code PEST++ to groundwater levels measured from 1907 through 2013 and measured discharge to springs and estimated discharge to agricultural drains. Increased recharge since pre-development resulted in a 6.8 million acre-feet increase in storage in the 508-14 administrative area of the Pasco Basin. Four groundwater-management scenarios simulate the 7-year drawdown resulting from withdrawals in different locations. Withdrawals of 2 million gallons per day (Mgal/d) from a hypothetical well field in the upper Ringold Formation along the Columbia River could generate 30–70 feet of drawdown, which may reduce landslide susceptibility along the White Bluffs. Drawdowns resulting from a 1 Mgal/d withdrawal from wells screened in either Pasco gravels, upper Ringold Formation, or both Ringold Formation and underlying basalt are simulated in the other three scenarios, and differ because of the contrasting hydraulic conductivities within the screened intervals.

Endoscopic management of foreign bodies in the upper gastrointestinal tract: An analysis of 846 cases in China

PubMed Central

Yuan, Fangfang; Tang, Xiaowei; Gong, Wei; Su, Lei; Zhang, Yali

2018-01-01

Foreign body ingestion is a relatively common occurrence, which may lead to morbidity and mortality. The aim of the present study was to report the experience of management of upper gastrointestinal foreign bodies by endoscopy in a large center. All patients who presented at the Department of Gastroenterology at Nanfang Hospital (Guangzhou, China) with complaints regarding upper gastrointestinal (GI) foreign body ingestion from December 1987 to December 2013. Hospital medical charts and endoscopic records were examined to evaluate etiology, treatment, and outcomes for these patients. A total of 846 patients were enrolled in the present study, from which foreign bodies were detected in 737 (87.1%) patients via X-ray or endoscopy. The objects most frequently ingested were bones (n=395, 53.6%). The detected foreign bodies were predominantly located in the cervical esophagus (n=325, 44.1%). Endoscopic foreign body extraction was successful in 92.5% of cases, whereas surgery was required in 6 patients. The most frequently used endoscopic accessory devices were retrieval forceps (n=480, 65.1%). The complication rate was 6.9%, including mucosal laceration (n=10) and others, all of which were managed conservatively. Associated GI diseases were reported in 74 (10.0%) patients, including postesophagectomy (n=34) and others. In conclusion, the endoscopic procedure was safe and effective for the removal of foreign bodies from the upper gastrointestinal tract, with a high success rate and low complication rate. PMID:29434711

Workplace management of upper limb disorders: a systematic review.

PubMed

Dick, F D; Graveling, R A; Munro, W; Walker-Bone, K

2011-01-01

Upper limb pain is common among working-aged adults and a frequent cause of absenteeism. To systematically review the evidence for workplace interventions in four common upper limb disorders. Systematic review of English articles using Medline, Embase, Cinahl, AMED, Physiotherapy Evidence Database PEDro (carpal tunnel syndrome and non-specific arm pain only) and Cochrane Library. Study inclusion criteria were randomized controlled trials, cohort studies or systematic reviews employing any workplace intervention for workers with carpal tunnel syndrome, non-specific arm pain, extensor tenosynovitis or lateral epicondylitis. Papers were selected by a single reviewer and appraised by two reviewers independently using methods based on Scottish Intercollegiate Guidelines Network (SIGN) methodology. 1532 abstracts were identified, 28 papers critically appraised and four papers met the minimum quality standard (SIGN grading + or ++) for inclusion. There was limited evidence that computer keyboards with altered force displacement characteristics or altered geometry were effective in reducing carpal tunnel syndrome symptoms. There was limited, but high quality, evidence that multi-disciplinary rehabilitation for non-specific musculoskeletal arm pain was beneficial for those workers absent from work for at least four weeks. In adults with tenosynovitis there was limited evidence that modified computer keyboards were effective in reducing symptoms. There was a lack of high quality evidence to inform workplace management of lateral epicondylitis. Further research is needed focusing on occupational management of upper limb disorders. Where evidence exists, workplace outcomes (e.g. successful return to pre-morbid employment; lost working days) are rarely addressed.

Guidelines for the diagnosis and treatment of acute non-variceal upper gastrointestinal bleeding (2015, Nanchang, China).

PubMed

Bai, Yu; Li, Zhao Shen

2016-02-01

Acute non-variceal upper gastrointestinal bleeding (ANVUGIB) is one of the most common medical emergencies in China and worldwide. In 2009, we published the "Guidelines for the diagnosis and treatment of acute non-variceal upper gastrointestinal bleeding" for the patients in China; however, during the past years numerous studies on the diagnosis and treatment of ANVUGIB have been conducted, and the management of ANVUGIB needs to be updated. The guidelines were updated after the databases including PubMed, Embase and CNKI were searched to retrieve the clinical trials on the management of ANVUGIB. The clinical trials were evaluated for high-quality evidence, and the advances in definitions, diagnosis, etiology, severity evaluation, treatment and prognosis of ANVUGIB were carefully reviewed, the recommendations were then proposed. After several rounds of discussions and revisions among the national experts of digestive endoscopy, gastroenterology, radiology and intensive care, the 2015 version of "Guidelines for the diagnosis and treatment of acute non-variceal upper gastrointestinal bleeding" was successfully developed by the Chinese Journal of Internal Medicine, National Medical Journal of China, Chinese Journal of Digestion and Chinese Journal of Digestive Endoscopy. It shall be noted that although much progress has been made, the clinical management of ANVUGIB still needs further improvement and refinement, and high-quality randomized trials are required in the future. © 2016 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

[Clinical, ureteroscopic and photodynamic diagnosis of urothelial carcinomas of the upper tract: state-of-the art review for the yearly scientific report of the French National Association of Urology].

PubMed

Nison, L; Bozzini, G; Rouprêt, M; Traxer, O; Colin, P

2014-11-01

To propose a state-of-the art of current knowledge about clinical, ureteroscopic and photodynamic for the diagnosis of the upper urinary tract cancer (UTUC). A systematic review of the literature search was performed from the database Medline (NLM, Pubmed), focused on the following keywords: urothelial carcinomas; upper urinary tract; ureter; renal pelvis; diagnosis; fluorescence; ureteroscopy; photodynamic technique; biopsy; cytology. Gross hematuria and flank pain are the two main clinical symptoms revealing a UTUC in daily clinical practice. Urinary cystoscopy and cystoscopy are mandatory to rule out a concomittant synchronous bladder tumour. Flexible ureteroscopy has revolutionized the management of UTUC by allowing a full exploration of upper urinary tract, an endoscopi vizualization of the tumour and assessment of grade with biopsies. A flexible ureteroscopy is mandatory in diagnostic evaluation of UTUC as soon as a conservative management is being considered. New investigation technologies such as fluorescence, narrow band imaging and optical coherence tomography (± combined with ultra sound), are promising for a near future. It has to be understood that the diagnostic work-up of a UTUC has to be exhaustive and particularly the search of another urothelial carcinoma within the urinary tract. Flexible ureterosocopy has revolutionized the diagnosis and management of UTUC and belongs fully to its initial evaluation. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

The Oncology of Discrimination and the Disparate Impact Therapy: Title VII and Upper Level Professional and Managerial Jobs.

ERIC Educational Resources Information Center

Sanders, Wayne

An examination was made of the evidentiary problems that exist in using a disparate impact theory to challenge the subjective criteria many organizations use to hire, promote, or dismiss upper-level professional and managerial employees. Although subjective criteria occur at all levels of employment, they are especially prevalent when dealing with…

KSC-2014-2302

NASA Image and Video Library

2014-04-25

CAPE CANAVERAL, Fla. – Construction workers have installed the framing and some of the inner walls inside Firing Room 4 in the Launch Control Center at NASA's Kennedy Space Center in Florida. Three rows of upper level management consoles remain. The Ground Systems Development and Operations Program is overseeing efforts to create a new firing room based on a multi-user concept. The design of Firing Room 4 will incorporate five control room areas that are flexible to meet current and future NASA and commercial user requirements. The equipment and most of the consoles from Firing Room 4 were moved to Firing Room 2 for possible future reuse. Photo credit: NASA/Dimitri Gerondidakis

KSC-2014-2304

NASA Image and Video Library

2014-04-25

CAPE CANAVERAL, Fla. – Construction workers have installed the framing and some of the inner walls inside Firing Room 4 in the Launch Control Center at NASA's Kennedy Space Center in Florida. Three rows of upper level management consoles remain. The Ground Systems Development and Operations Program is overseeing efforts to create a new firing room based on a multi-user concept. The design of Firing Room 4 will incorporate five control room areas that are flexible to meet current and future NASA and commercial user requirements. The equipment and most of the consoles from Firing Room 4 were moved to Firing Room 2 for possible future reuse. Photo credit: NASA/Dimitri Gerondidakis

KSC-2014-2303

NASA Image and Video Library

2014-04-25

CAPE CANAVERAL, Fla. – Construction workers have installed the framing and some of the inner walls inside Firing Room 4 in the Launch Control Center at NASA's Kennedy Space Center in Florida. Three rows of upper level management consoles remain. The Ground Systems Development and Operations Program is overseeing efforts to create a new firing room based on a multi-user concept. The design of Firing Room 4 will incorporate five control room areas that are flexible to meet current and future NASA and commercial user requirements. The equipment and most of the consoles from Firing Room 4 were moved to Firing Room 2 for possible future reuse. Photo credit: NASA/Dimitri Gerondidakis

Management of Upper Gastrointestinal Bleeding in Children: Variceal and Nonvariceal.

PubMed

Lirio, Richard A

2016-01-01

Upper gastrointestinal (UGI) bleeding is generally defined as bleeding proximal to the ligament of Treitz, which leads to hematemesis. There are several causes of UGI bleeding necessitating a detailed history to rule out comorbid conditions, medications, and possible exposures. In addition, the severity, timing, duration, and volume of the bleeding are important details to note for management purposes. Despite the source of the bleeding, acid suppression with a proton-pump inhibitor has been shown to be effective in minimizing rebleeding. Endoscopy remains the interventional modality of choice for both nonvariceal and variceal bleeds because it can be diagnostic and therapeutic. Copyright © 2016 Elsevier Inc. All rights reserved.

Ballistic trauma: lessons learned from iraq and afghanistan.

PubMed

Shin, Emily H; Sabino, Jennifer M; Nanos, George P; Valerio, Ian L

2015-02-01

Management of upper extremity injuries secondary to ballistic and blast trauma can lead to challenging problems for the reconstructive surgeon. Given the recent conflicts in Iraq and Afghanistan, advancements in combat-casualty care, combined with a high-volume experience in the treatment of ballistic injuries, has led to continued advancements in the treatment of the severely injured upper extremity. There are several lessons learned that are translatable to civilian trauma centers and future conflicts. In this article, the authors provide an overview of the physics of ballistic injuries and principles in the management of such injuries through experience gained from military involvement in Iraq and Afghanistan.

Ballistic Trauma: Lessons Learned from Iraq and Afghanistan

PubMed Central

Shin, Emily H.; Sabino, Jennifer M.; Nanos, George P.; Valerio, Ian L.

2015-01-01

Management of upper extremity injuries secondary to ballistic and blast trauma can lead to challenging problems for the reconstructive surgeon. Given the recent conflicts in Iraq and Afghanistan, advancements in combat-casualty care, combined with a high-volume experience in the treatment of ballistic injuries, has led to continued advancements in the treatment of the severely injured upper extremity. There are several lessons learned that are translatable to civilian trauma centers and future conflicts. In this article, the authors provide an overview of the physics of ballistic injuries and principles in the management of such injuries through experience gained from military involvement in Iraq and Afghanistan. PMID:25685099

The Monteggia fracture: series of 20 cases

PubMed Central

Chagou, Aniss; Rhanim, Abdelkarim; Berrada, Mohammed Saleh

2014-01-01

The Monteggia fracture is one of the pitfalls of conventional diagnosis of upper limb trauma. Through a retrospective study of 20 cases diagnosed at the Department of Orthopaedic Surgery and Traumatology, University Hospital Center, Ibn Sina, Mohamed V University, Rabat, Morocco, between 2010 and 2014, we have tried to do an update on the management of Monteggia fractures either at of paraclinical exams or the surgical management. We support the idea that the dislocation of the radial head should be sought systematically to any isolated fracture of the ulna, for not to miss fracture Monteggia authentic. Rehabilitation of the upper limb must be done as soon as possible. PMID:25667713

Cascade reservoir flood control operation based on risk grading and warning in the Upper Yellow River

NASA Astrophysics Data System (ADS)

Xuejiao, M.; Chang, J.; Wang, Y.

2017-12-01

Flood risk reduction with non-engineering measures has become the main idea for flood management. It is more effective for flood risk management to take various non-engineering measures. In this paper, a flood control operation model for cascade reservoirs in the Upper Yellow River was proposed to lower the flood risk of the water system with multi-reservoir by combining the reservoir flood control operation (RFCO) and flood early warning together. Specifically, a discharge control chart was employed to build the joint RFCO simulation model for cascade reservoirs in the Upper Yellow River. And entropy-weighted fuzzy comprehensive evaluation method was adopted to establish a multi-factorial risk assessment model for flood warning grade. Furthermore, after determining the implementing mode of countermeasures with future inflow, an intelligent optimization algorithm was used to solve the optimization model for applicable water release scheme. In addition, another model without any countermeasure was set to be a comparative experiment. The results show that the model developed in this paper can further decrease the flood risk of water system with cascade reservoirs. It provides a new approach to flood risk management by coupling flood control operation and flood early warning of cascade reservoirs.

Activities of the National Water-Quality Assessment Program in the upper Snake River Basin, Idaho and western Wyoming, 1991-2001

USGS Publications Warehouse

Low, Walton H.

1997-01-01

In 1991, the U.S. Geological Survey (USGS) began a full-scale National Water-Quality Assessment (NAWQA) Program. The long-term goals of the NAWQA Program are to describe the status and trends in the water quality of a large part of the Nation's rivers and aquifers and to improve understanding of the primary natural and human factors that affect water-quality conditions. In meeting these goals, the program will produce water-quality, ecological, and geographic information that will be useful to policy makers and managers at the national, State, and local levels. A major component of the program is study-unit investigations, upon which national-level assessment activities are based. The program's 60 study-unit investigations are associated with principal river basins and aquifer systems throughout the Nation. Study units encompass areas from 1,200 to more than 65,000 mi2 (square miles) and incorporate about 60 to 70 percent of the Nation's water use and population served by public water supply. In 1991, the upper Snake River Basin was among the first 20 NAWQA study units selected for implementation. From 1991 to 1995, a high-intensity data-collection phase of the upper Snake River Basin study unit (fig. 1) was implemented and completed. Components of this phase are described in a report by Gilliom and others (1995). In 1997, a low-intensity phase of data collection began, and work continued on data analysis, report writing, and data documentation and archiving activities that began in 1996. Principal data-collection activities during the low-intensity phase will include monitoring of surface-water and ground-water quality, assessment of aquatic biological conditions, and continued compilation of environmental setting information.

Hemostatic powder TC-325 in the management of upper and lower gastrointestinal bleeding: a two-year experience at a single institution.

PubMed

Chen, Yen-I; Barkun, Alan; Nolan, Sabrina

2015-02-01

TC-325 is a novel endoscopic hemostatic powder. Our aim was to describe a single-center experience with the use of TC-325 in the upper and lower gastrointestinal tract, while for the first time attempting to determine how long the powder remains on a lesion. The charts of consecutive patients receiving TC-325 therapy between July 2011 and July 2013 were reviewed retrospectively. Primary endpoints included immediate hemostasis and early rebleeding (≤ 72 hours). Overall, 60 patients received 67 treatments with TC-325: 21 for nonmalignant nonvariceal upper gastrointestinal bleeding, 19 for malignant upper gastrointestinal bleeding, 11 for lower gastrointestinal bleeding, and 16 for intra-procedural bleeding. Immediate hemostasis was achieved in 66 cases (98.5 %), with 6 cases (9.5 %) of early rebleeding. No serious adverse events were noted. No TC-325 powder was identified in the 11 patients who underwent second-look endoscopy, performed within 24 hours in 4 patients. TC-325 appears safe and effective for managing bleeding in the upper and lower gastrointestinal tract with a variety of causes. The time during which the powder remains in the gastrointestinal tract is short, with complete elimination from the gastrointestinal tract as early as within 24 hours after use. © Georg Thieme Verlag KG Stuttgart · New York.

Bleeding after expandable nitinol stent placement in patients with esophageal and upper gastrointestinal obstruction: incidence, management, and predictors.

PubMed

Oh, Se Jin; Song, Ho-Young; Nam, Deok Ho; Ko, Heung Kyu; Park, Jung-Hoon; Na, Han Kyu; Lee, Jong Jin; Kang, Min Kyoung

2014-11-01

Placement of self-expandable nitinol stents is useful for the treatment of esophageal and upper gastrointestinal (GI) obstruction. However, complications such as stent migration, tumor overgrowth, and bleeding occur. Although stent migration and tumor overgrowth are well documented in previous studies, the occurrence of bleeding has not been fully evaluated. To evaluate the incidence, management strategies, and predictors of bleeding after placement of self-expandable nitinol stents in patients with esophageal and upper GI obstruction. We retrospectively reviewed the medical records and results of computed tomography and endoscopy of 1485 consecutive patients with esophageal and upper GI obstructions who underwent fluoroscopically guided stent placement. Bleeding occurred in 25 of 1485 (1.7%) patients 0 to 348 days after stent placement. Early stent-related bleeding occurred in 10 patients (40%) and angiographic embolization was used for 5/10. Late bleeding occurred in 15 patients (60%) and endoscopic hemostasis was used for 7/15. Twenty-two of 25 (88%) patients with bleeding had received prior radiotherapy and/or chemotherapy. Bleeding is a rare complication after placement of expandable nitinol stents in patients with esophageal and upper GI obstruction, but patients with early bleeding may require embolization for control. Care must be exercised on placing stents in patients who have received prior radiotherapy or chemotherapy. © The Foundation Acta Radiologica 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Foraminiferal, lithic, and isotopic changes across four major unconformities at Deep Sea Drilling Project Site 548, Goban Spur: Chapter 14 in Initial reports of the Deep Sea Drilling Project

USGS Publications Warehouse

Poag, C. Wylie; Reynolds, Leslie A.; Mazzullo, James M.; Keigwin, Loyd D.

1985-01-01

Sediment samples taken at close intervals across four major unconformities (middle Miocene/upper Miocene, lower Oligocene/upper Oligocene, lower Eocene/upper Eocene, lower Paleocene/upper Paleocene) at DSDP-IPOD Site 548, Goban Spur, reveal that coeval biostratigraphic gaps, sediment discontinuities, and seismic unconformities coincide with postulated low stands of sea level. Foraminiferal, lithic, and isotopic analyses demonstrate that environments began to shift prior to periods of marine erosion, and that sedimentation resumed in the form of turbidites derived from nearby upper-slope sources. The unconformities appear to have developed where a water-mass boundary intersected the continental slope, rhythmically crossing the drill site in concert with sea-level rise and fall.

The medial temporal lobe—conduit of parallel connectivity: a model for attention, memory, and perception

PubMed Central

Mozaffari, Brian

2014-01-01

Based on the notion that the brain is equipped with a hierarchical organization, which embodies environmental contingencies across many time scales, this paper suggests that the medial temporal lobe (MTL)—located deep in the hierarchy—serves as a bridge connecting supra- to infra—MTL levels. Bridging the upper and lower regions of the hierarchy provides a parallel architecture that optimizes information flow between upper and lower regions to aid attention, encoding, and processing of quick complex visual phenomenon. Bypassing intermediate hierarchy levels, information conveyed through the MTL “bridge” allows upper levels to make educated predictions about the prevailing context and accordingly select lower representations to increase the efficiency of predictive coding throughout the hierarchy. This selection or activation/deactivation is associated with endogenous attention. In the event that these “bridge” predictions are inaccurate, this architecture enables the rapid encoding of novel contingencies. A review of hierarchical models in relation to memory is provided along with a new theory, Medial-temporal-lobe Conduit for Parallel Connectivity (MCPC). In this scheme, consolidation is considered as a secondary process, occurring after a MTL-bridged connection, which eventually allows upper and lower levels to access each other directly. With repeated reactivations, as contingencies become consolidated, less MTL activity is predicted. Finally, MTL bridging may aid processing transient but structured perceptual events, by allowing communication between upper and lower levels without calling on intermediate levels of representation. PMID:25426036

24. Pump Room interiordewatering pump motor on upper level. Note ...

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

24. Pump Room interior-dewatering pump motor on upper level. Note the removable roof hatch (steel frame) directly above motor. Dewatering pumps motor control center at left - Hunters Point Naval Shipyard, Drydock No. 4, East terminus of Palou Avenue, San Francisco, San Francisco County, CA

41. Upper level, electronic racks, left to rightprogrammer group, status ...

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

41. Upper level, electronic racks, left to right--programmer group, status command message processing group, UHF radio, impss rack security - Ellsworth Air Force Base, Delta Flight, Launch Facility, On County Road T512, south of Exit 116 off I-90, Interior, Jackson County, SD

43. Upper level, left to rightground missile guidance system liquid ...

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

43. Upper level, left to right--ground missile guidance system liquid cooling equipment, guidance and control coupler rack, programmer group - Ellsworth Air Force Base, Delta Flight, Launch Facility, On County Road T512, south of Exit 116 off I-90, Interior, Jackson County, SD

Skylab

NASA Image and Video Library

1972-01-01

This image, with callouts, depicts the storage area of the forward compartment at the upper level of the Orbital Workshop (OWS). The upper level consisted of a large work area and housed water storage tanks, a food freezer, storage vaults for film, scientific airlocks, mobility and stability experiment equipment, and other experimental equipment.

The U.S. Geological Survey Amphibian Research and Monitoring Initiative-2011 Annual Update

USGS Publications Warehouse

Adams, M.J.; Muths, E.; Grant, E.H.C.; Miller, David A.; Waddle, J.H.; Ball, L.C.

2012-01-01

Welcome to the inaugural issue of ARMI's Annual Update. This update provides highlights and significant milestones of this innovative program. ARMI is uniquely qualified to provide research and monitoring results that are scalable from local to national levels, and are useful to resource managers. ARMI has produced nearly 400 peer-reviewed publications, including 18 in 2011. Some of those publications are highlighted in this fact sheet. ARMI also has a new Website (armi.usgs.gov). You can now use it to explore an up-to-date list of ARMI products, to find summaries of research topics, to search for ARMI activities in your area, and to obtain amphibian photographs. ARMI's annual meeting was organized by Walt Sadinski, Upper Midwest Environmental Science Center, and held in St Louis, Missouri. We met with local scientists and managers in herpetology and were given a tour of the herpetology collection at the St. Louis Zoo.

Statistical analysis of the water-quality monitoring program, Upper Klamath Lake, Oregon, and optimization of the program for 2013 and beyond

USGS Publications Warehouse

Eldridge, Sara L. Caldwell; Wherry, Susan A.; Wood, Tamara M.

2014-01-01

Upper Klamath Lake in south-central Oregon has become increasingly eutrophic over the past century and now experiences seasonal cyanobacteria-dominated and potentially toxic phytoplankton blooms. Growth and decline of these blooms create poor water-quality conditions that can be detrimental to fish, including two resident endangered sucker species. Upper Klamath Lake is the primary water supply to agricultural areas within the upper Klamath Basin. Water from the lake is also used to generate power and to enhance and sustain downstream flows in the Klamath River. Water quality in Upper Klamath Lake has been monitored by the Klamath Tribes since the early 1990s and by the U.S. Geological Survey (USGS) since 2002. Management agencies and other stakeholders have determined that a re-evaluation of the goals for water-quality monitoring is warranted to assess whether current data-collection activities will continue to adequately provide data for researchers to address questions of interest and to facilitate future natural resource management decisions. The purpose of this study was to (1) compile an updated list of the goals and objectives for long-term water-quality monitoring in Upper Klamath Lake with input from upper Klamath Basin stakeholders, (2) assess the current water-quality monitoring programs in Upper Klamath Lake to determine whether existing data-collection strategies can fulfill the updated goals and objectives for monitoring, and (3) identify potential modifications to future monitoring plans in accordance with the updated monitoring objectives and improve stakeholder cooperation and data-collection efficiency. Data collected by the Klamath Tribes and the USGS were evaluated to determine whether consistent long-term trends in water-quality variables can be described by the dataset and whether the number and distribution of currently monitored sites captures the full range of environmental conditions and the multi-scale variability of water-quality parameters in the lake. Also, current monitoring strategies were scrutinized for unnecessary redundancy within the overall network.

The Public Discourse about Land Use and Water Quality: Themes in Newspapers in the Upper Mississippi River Basin

ERIC Educational Resources Information Center

Schmid, Andrea N.; Thompson, Jan R.; Bengston, David N.

2007-01-01

Effective educational and management programs to improve water quality will require an improved understanding of public perceptions of the relationship between land use and water quality. We analyzed a large database of newspaper articles in the Upper Mississippi River Basin to assess the public discourse about water quality and land use, and…

Potentiometric surface and water-level difference maps of selected confined aquifers in Southern Maryland and Maryland’s Eastern Shore, 1975-2015

USGS Publications Warehouse

Curtin, Stephen E.; Staley, Andrew W.; Andreasen, David C.

2016-01-01

Key Results This report presents potentiometric-surface maps of the Aquia and Magothy aquifers and the Upper Patapsco, Lower Patapsco, and Patuxent aquifer systems using water levels measured during September 2015. Water-level difference maps are also presented for these aquifers. The water-level differences in the Aquia aquifer are shown using groundwater-level data from 1982 and 2015, while the water-level differences are shown for the Magothy aquifer using data from 1975 and 2015. Water-level difference maps for both the Upper Patapsco and Lower Patapsco aquifer systems are shown using data from 1990 and 2015. The water-level differences in the Patuxent aquifer system are shown using groundwater-level data from 2007 and 2015. The potentiometric surface maps show water levels ranging from 53 feet above sea level to 164 feet below sea level in the Aquia aquifer, from 86 feet above sea level to 106 feet below sea level in the Magothy aquifer, from 115 feet above sea level to 115 feet below sea level in the Upper Patapsco aquifer system, from 106 feet above sea level to 194 feet below sea level in the Lower Patapsco aquifer system, and from 165 feet above sea level to 171 feet below sea level in the Patuxent aquifer system. Water levels have declined by as much as 116 feet in the Aquia aquifer since 1982, 99 feet in the Magothy aquifer since 1975, 66 and 83 feet in the Upper Patapsco and Lower Patapsco aquifer systems, respectively, since 1990, and 80 feet in the Patuxent aquifer system since 2007.

Meteorological risks are drivers of environmental innovation in agro-ecosystem management

NASA Astrophysics Data System (ADS)

Gobin, Anne; Van de Vijver, Hans; Vanwindekens, Frédéric; de Frutos Cachorro, Julia; Verspecht, Ann; Planchon, Viviane; Buyse, Jeroen

2017-04-01

Agricultural crop production is to a great extent determined by weather conditions. The research hypothesis is that meteorological risks act as drivers of environmental innovation in agro-ecosystem management. The methodology comprised five major parts: the hazard, its impact on different agro-ecosystems, vulnerability, risk management and risk communication. Generalized Extreme Value (GEV) theory was used to model annual maxima of meteorological variables based on a location-, scale- and shape-parameter that determine the center of the distribution, the deviation of the location-parameter and the upper tail decay, respectively. Spatial interpolation of GEV-derived return levels resulted in spatial temperature extremes, precipitation deficits and wet periods. The temporal overlap between extreme weather conditions and sensitive periods in the agro-ecosystem was realised using a bio-physically based modelling framework that couples phenology, a soil water balance and crop growth. 20-year return values for drought and waterlogging during different crop stages were related to arable yields. The method helped quantify agricultural production risks and rate both weather and crop-based agricultural insurance. The spatial extent of vulnerability is developed on different layers of geo-information to include meteorology, soil-landscapes, crop cover and management. Vulnerability of agroecosystems was mapped based on rules set by experts' knowledge and implemented by Fuzzy Inference System modelling and Geographical Information System tools. The approach was applied for cropland vulnerability to heavy rain and grassland vulnerability to drought. The level of vulnerability and resilience of an agro-ecosystem was also determined by risk management which differed across sectors and farm types. A calibrated agro-economic model demonstrated a marked influence of climate adapted land allocation and crop management on individual utility. The "chain of risk" approach allowed for investigating the hypothesis that meteorological risks act as drivers for agricultural innovation. Risk types were quantified in terms of probability and distribution, and further distinguished according to production type. Examples of strategies and options were provided at field, farm and policy level using different modelling methods.

Does the Level of Cervical Disc Herniation Surgery Affect Performance-based Outcomes in National Football League Athletes?

PubMed

Mai, Harry T; Burgmeier, Robert J; Mitchell, Sean M; Hecht, Andrew C; Maroon, Joseph C; Nuber, Gordon W; Hsu, Wellington K

2016-12-01

Retrospective cohort study. The aim of this study was to determine whether the level of a cervical disc herniation (CDH) procedure will uniquely impact performance-based outcomes in elite athletes of the National Football League (NFL). Comparative assessments of postsurgical outcomes in NFL athletes with CDH at different levels are unknown. Further, the surgical decision-making for these types of injuries in professional football athletes remains controversial. NFL players with a CDH injury at a definitive cervical level were identified through a review of publicly available archives. Injuries were divided into upper- (C2-C4) and lower-level (C4-T1) CDH. The impact on player outcomes was determined by comparing return to play statistics and calculating a "Performance Score" for each player on the basis of pertinent statistical data, both before and after surgery. A total of 40 NFL athletes met inclusion criteria. In the upper-level group, 10 of 15 (66.6%) players successfully returned to play an average of 44.6 games over 2.6 years. The lower-level cohort had 18 of 25 (72%) players return to play with an average of 44.1 games over 3.1 years. There was no significant difference in the rate of return to play (P = 0.71). Postsurgical performance scores of the upper and lower-level groups were 1.47 vs. 0.69 respectively, with no significant difference between these groups (P = 0.06). Adjacent segment disease requiring reoperation occurred in 10% of anterior cervical discectomy and fusion patients. In 50% of foraminotomy patients, a subsequent fusion was required. A uniquely high percentage of upper-level disc herniations develop in NFL athletes, and although CDH injuries present career threatening implications, an upper-level CDH does not preclude a player from successfully returning to play at a competitive level. In fact, these athletes showed comparable postsurgical performance to those athletes who underwent CDH procedures at lower cervical levels. 4.

A Decision-Making Model For Managing or Regenerating Southern Upland Hardwoods

Treesearch

K. Kyle Cunningham; Andrew W. Ezell; Keith L. Belli; John D. Hodges

2004-01-01

A decision-making model for managing or regenerating southern upland hardwoods is being created for three physiographic provinces including the Cumberland Plateau, Western Highland Rim, and Upper Coastal Plain. The model performs a stand evaluation, from a silvicultural standpoint, and declares a stand as being either manageable or in need of regeneration. Model...

Effects of Management on the Composition and Structure of Northern Hardwood Forests in Upper Michigan

Treesearch

Thomas R. Crow; David S. Buckley; Elizabeth A. Nauertz; John C. Zasada

2002-01-01

To improve our understanding of how management affects the composition and structure of northern hardwood forests, we compared managed with unmanaged sugar maple (Acer saccharum Marsh.) dominated forests. Unmanaged old-growth and unmanaged second-growth forests provided baselines for comparing the effects of even-aged and uneven-aged forest...

Feasibility of ultrasound-guided sacroiliac joint injection considering sonoanatomic landmarks at two different levels in cadavers and patients.

PubMed

Klauser, Andrea; De Zordo, Tobias; Feuchtner, Gudrun; Sögner, Peter; Schirmer, Michael; Gruber, Johann; Sepp, Norbert; Moriggl, Bernhard

2008-11-15

Sacroiliitis is often caused by rheumatic diseases, and besides other therapeutic options, treatment consists of intraarticular injection of corticosteroids. The purpose of this study was to assess the feasibility of ultrasound (US)-guided sacroiliac joint (SI joint) injection at 2 different puncture levels in cadavers and patients when defined sonoanatomic landmarks were considered. After defining sonoanatomic landmarks, US-guided needle insertion was performed in 10 human cadavers (20 SI joints) at 2 different puncture sites. Upper level was defined at the level of the posterior sacral foramen 1 and lower level at the level of the posterior sacral foramen 2. In 10 patients with unilateral sacroiliitis, injection at the most feasible level was attempted. Computed tomography confirmed correct intraarticular needle placement in cadavers by showing the tip of the needle in the joint and intraarticular diffusion of contrast media in 16 (80%) of 20 SI joints (upper level 7 [70%] of 10; lower level 9 [90%] of 10). In all 4 cases in which needle insertion failed, intraarticular SI joint injection at the other level was successful. In patients, 100% of US-guided injections were successful (8 lower level, 2 upper level), with a mean pain relief of 8.6 after 3 months. US guidance of needle insertion into SI joints was feasible at both levels when defined sonoanatomic landmarks were used. If SI joint alterations do not allow for direct visualization of the dorsal joint space of the lower level, which is easier to access, the upper level might offer an appropriate alternative.

Ground-water conditions in Georgia, 1999

USGS Publications Warehouse

Cressler, Alan M.

2000-01-01

Ground-water conditions in Georgia during 1999 and for the period of record were evaluated using data from U.S. Geological Survey ground-water-level and ground-water-quality monitoring networks. Data for 1999 included in this report are from continuous water-level records from 130 wells and chloride analyses from 14 wells. Data from one well is incomplete because data collection was discontinued. Chloride concentration in water from the Upper Floridan aquifer in most of coastal Georgia was within drinking-water standards established by the Georgia Department of Natural Resources and the U.S. Environmental Protection Agency. In the Savannah area, chloride concentration has not changed appreciably with time. However, chloride concentration in water from some wells that tap the Floridan aquifer system in the Brunswick area exceeds the drinking-water standards. Ground-water-level and ground-water-quality data are essential for water assessment and management. Ground-water-level fluctuations and trends can be used to estimate changes in aquifer storage resulting from the effects of ground-water withdrawal and recharge from precipitation. These data can be used to address water-management needs and to evaluate the effects of management and conservation programs. As part of the ground-water investigations conducted by the U.S. Geological Survey (USGS), in cooperation with the State of Georgia and city and county governments, a Statewide water-level-measurement program was started in 1938. Initially, this program consisted of an observation-well network in the coastal area of Georgia to monitor variations in ground-water storage and quality. Additional wells were later included in areas where data could be used to aid in water resources development and management. During 1999, periodic water-level measurements were made in 46 wells, and continuous water-level measurements were obtained from 165 wells. Continuous water-level records were obtained using analog (pen and chart) recorders and electronic data recorders that record the water level at 60-minute intervals. For wells having incomplete water-level record, water levels during periods of missing record may have been higher or lower than recorded water levels. Water samples collected from 85 wells during May, June, July, August, September, October, November, and December 1999 were analyzed to determine chloride concentration in the Savannah and Brunswick areas.

Probability of Future Observations Exceeding One-Sided, Normal, Upper Tolerance Limits

DOE PAGES

Edwards, Timothy S.

2014-10-29

Normal tolerance limits are frequently used in dynamic environments specifications of aerospace systems as a method to account for aleatory variability in the environments. Upper tolerance limits, when used in this way, are computed from records of the environment and used to enforce conservatism in the specification by describing upper extreme values the environment may take in the future. Components and systems are designed to withstand these extreme loads to ensure they do not fail under normal use conditions. The degree of conservatism in the upper tolerance limits is controlled by specifying the coverage and confidence level (usually written inmore » “coverage/confidence” form). Moreover, in high-consequence systems it is common to specify tolerance limits at 95% or 99% coverage and confidence at the 50% or 90% level. Despite the ubiquity of upper tolerance limits in the aerospace community, analysts and decision-makers frequently misinterpret their meaning. The misinterpretation extends into the standards that govern much of the acceptance and qualification of commercial and government aerospace systems. As a result, the risk of a future observation of the environment exceeding the upper tolerance limit is sometimes significantly underestimated by decision makers. This note explains the meaning of upper tolerance limits and a related measure, the upper prediction limit. So, the objective of this work is to clarify the probability of exceeding these limits in flight so that decision-makers can better understand the risk associated with exceeding design and test levels during flight and balance the cost of design and development with that of mission failure.« less

Medicine use practices in management of symptoms of acute upper respiratory tract infections in children (≤12 years) in Kampala city, Uganda.

PubMed

Ocan, Moses; Aono, Mary; Bukirwa, Clare; Luyinda, Emmanuel; Ochwo, Cathy; Nsambu, Elastus; Namugonza, Stella; Makoba, Joseph; Kandaruku, Enock; Muyende, Hannington; Nakawunde, Aida

2017-09-21

Medicines are commonly accessed and used for management of illness in children without a prescription. This potentially increases the risk of unwanted treatment outcomes. We investigated medicine use practices in management of symptoms of acute upper respiratory tract infections among children (≤12 years) in households in Nakawa division, Kampala city. This was a cross-sectional study conducted among 390 randomly selected children. Data on use of medicines in children (≤12 years) during recent episode of acute upper respiratory tract infection was collected from their care takers using an interviewer administered questionnaire. A recall period of two weeks (14 days) was used in during data collection. The prevalence of giving children non-prescription antimicrobial medicines was 44.8% (38.3-52.2). The most common disease symptoms that the children reportedly had included flu, 84.9% (331/390), cough, 83.1% (324/390), and undefined fever, 69.7% (272/390). Medicines commonly given to children included, paracetamol 53.1% (207/390), Coartem 29.7% (116/390), cough linctus 20.8% (81/390), amoxicillin 18.9% (74/390), Co-trimoxazole 18.5% (72/390), and diphenhydramine 15.4% (60/390). The major sources of medicines given to the children was hospital/clinic, 57.26% (223/390). Most of the children, 81% were given more than one medicine at a time. The majority, 62.3% (243/390) of the care takers who gave the children medicine during the recent illness were not aware of any medicine (s) that should not be given to children. The predictors of non-prescription use of antimicrobial medicines in managing symptoms of acute upper respiratory tract infections in children included, medicines obtained from drug shop (PR: 1.45, CI: 1.14-1.85), medicines at home (PR: 1.8, CI: 0.83-1.198) and type of medicine (antimalarial) (PR: 2.8, CI: 1.17-6.68). Children are commonly given multiple medicines during episodes of acute upper respiratory tract infections with most antimicrobial agents accessed and used without a prescription in Kampala city, Uganda.

40. Upper level, electronic racks, left to rightstatus command message ...

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

40. Upper level, electronic racks, left to right--status command message processing group, UHF radio, impss rack security, power supply group rack - Ellsworth Air Force Base, Delta Flight, Launch Facility, On County Road T512, south of Exit 116 off I-90, Interior, Jackson County, SD

42. Upper level, electronic racks, left to rightguidance and control ...

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

42. Upper level, electronic racks, left to right--guidance and control coupler rack, programmer group, status command message processing group, UHF radio - Ellsworth Air Force Base, Delta Flight, Launch Facility, On County Road T512, south of Exit 116 off I-90, Interior, Jackson County, SD

Fostering Students' Preparation and Achievement in Upper Level Mathematics Courses

ERIC Educational Resources Information Center

Celik, Mehmet; Shaqlaih, Ali

2017-01-01

This study describes an intervention to address both motivation, student engagement and preparation in upper-level mathematics courses. The effect of the intervention regarding students' achievements is investigated via students' opinions and data analysis from students' assessments. The results of this study show the featured intervention…

Sample Size Limits for Estimating Upper Level Mediation Models Using Multilevel SEM

ERIC Educational Resources Information Center

Li, Xin; Beretvas, S. Natasha

2013-01-01

This simulation study investigated use of the multilevel structural equation model (MLSEM) for handling measurement error in both mediator and outcome variables ("M" and "Y") in an upper level multilevel mediation model. Mediation and outcome variable indicators were generated with measurement error. Parameter and standard…

Response of River Discharge to Changing Climate Over the Past Millennium in the Upper Mackenzie Basin: Implications for Water Resource Management

NASA Astrophysics Data System (ADS)

Wolfe, B. B.; Hall, R. I.; Edwards, T. W.; Jarvis, S. R.; Sinnatamby, R. N.; Yi, Y.; Johnston, J. W.

2009-05-01

Runoff generated from high elevations is the primary source of freshwater for western North America, yet this critical resource is managed on the basis of short instrumental records that encompass an insufficient range of climatic conditions. Like other streams that drain this part of the continent and flow across the northern Great Plains, where seasonal and extended intervals of water deficit are a natural element of the landscape, the Peace and Athabasca rivers provide water that is crucial for societal needs. Climate variability and rapidly increasing industrial development are, however, raising concerns over the future availability of water resources for continued economic growth in these watersheds and to maintain the integrity of aquatic ecosystems, including the Peace-Athabasca Delta (PAD). This is particularly acute for the Athabasca River because the Alberta oil sands industry remains dependent on its water for bitumen extraction. Here we report the effects of climate change over the past 1000 years on river discharge in the upper Mackenzie River system based on paleoenvironmental information from the PAD and Lake Athabasca. The delta landscape responds to hydroclimatic changes with marked variability, capturing systematic changes in ice-jam flood frequency and perched basin water balance. Lake Athabasca level appears to directly monitor overall water availability with the highest levels occurring in concert with maximum glacier extent during the Little Ice Age, and the lowest during the 11th century prior to medieval glacier expansion. Recent climate-driven hydrological change appears to be on a trajectory to even lower levels as high-elevation snow and glacier meltwater contributions both continue to decline. The temporal perspective offered by these paleohydrological reconstructions indicates that climatic changes over the past millennium have led to characteristic responses in the quantity and seasonality of streamflow generated from the hydrographic apex of North America. For water resource managers, a key feature that emerges from these results is that the hydrograph of the 21st century may be evolving towards conditions unprecedented over the past 1000 years, extending beyond the 11th century when reduced glacier meltwater contributions were partly compensated by abundant snowmelt runoff. Continuing reduction in both peak and total discharge clearly underscores the need for stringent allocation of freshwater resources in these watersheds.

More Precise Estimation of Lower-Level Interaction Effects in Multilevel Models.

PubMed

Loeys, Tom; Josephy, Haeike; Dewitte, Marieke

2018-01-01

In hierarchical data, the effect of a lower-level predictor on a lower-level outcome may often be confounded by an (un)measured upper-level factor. When such confounding is left unaddressed, the effect of the lower-level predictor is estimated with bias. Separating this effect into a within- and between-component removes such bias in a linear random intercept model under a specific set of assumptions for the confounder. When the effect of the lower-level predictor is additionally moderated by another lower-level predictor, an interaction between both lower-level predictors is included into the model. To address unmeasured upper-level confounding, this interaction term ought to be decomposed into a within- and between-component as well. This can be achieved by first multiplying both predictors and centering that product term next, or vice versa. We show that while both approaches, on average, yield the same estimates of the interaction effect in linear models, the former decomposition is much more precise and robust against misspecification of the effects of cross-level and upper-level terms, compared to the latter.

Water-quality and algal conditions in the Clackamas River basin, Oregon, and their relations to land and water management

USGS Publications Warehouse

Carpenter, Kurt D.

2003-01-01

In 1998, the U.S. Geological Survey sampled the Clackamas River, its major tributaries, and reservoirs to characterize basic water quality (nutrients, dissolved oxygen, pH, temperature, and conductance), water quantity (water sources within the basin), and algal conditions (biomass and species composition). Sampling locations reflected the dominant land uses in the basin (forest management, agriculture, and urban development) as well as the influence of hydroelectric projects, to examine how these human influences might be affecting water quality and algal conditions. Nuisance algal growths, with accompanying negative effects on water quality, were observed at several locations in the basin during this study. Algal biomass in the lower Clackamas River reached a maximum of 300 mg/m2 chlorophyll a, producing nuisance algal conditions, including fouled stream channels and daily fluctuations in pH and dissolved oxygen concentrations to levels that did not meet water-quality standards. Algal biomass was highest at sites immediately downstream from the hydroelectric project's reservoirs and/or powerhouses. Nuisance algal conditions also were observed in some of the tributaries, including the North Fork of the Clackamas River, Clear Creek, Rock Creek, and Sieben Creek. High amounts of drifting algae increased turbidity levels in the Clackamas River during June, which coincided with a general increase in the concentration of disinfection by-products found in treated Clackamas River water used for drinking, presumably due to the greater amounts of organic matter in the river. The highest nutrient concentrations were found in the four lowermost tributaries (Deep, Richardson, Rock, and Sieben Creeks), where most of the agriculture and urban development is concentrated. Of these, the greatest load of nutrients came from Deep Creek, which had both high nutrient concentrations and relatively high streamflow. Streams draining forestland in the upper basin (upper Clackamas River and Oak Grove Fork) had the highest concentrations of phosphorus (and lowest concentrations of nitrogen), and streams draining forestland in the middle basin (Clear Creek, Eagle Creek, and the North Fork of the Clackamas River) had relatively high concentrations of nitrogen (and low concentrations of phosphorus). In contrast, relatively low concentrations of both nitrogen and phosphorus were found at the two reference streams, reflecting their pristine condition. Relatively high phosphorus levels in the upper basin are probably due to the erosion of naturally occurring phosphorus deposits in this area. Likely sources of nitrogen (mostly nitrate) in the forested watersheds include nitrogen-fixing plants, atmospheric deposition, timber harvesting, and applications of urea fertilizers.

An Analysis of Labwork Tasks Used in Science Teaching at Upper Secondary School and University Levels in Several European Countries.

ERIC Educational Resources Information Center

Tiberghien, Andree; Veillard, Laurent; Le Marechal, Jean-Francois; Buty, Christian; Millar, Robin

2001-01-01

Describes the results of a study on the similarities and differences in laboratory tasks used in science education at upper secondary school and university level in the three main science subjects in seven European countries. Some differences are noted between the science subjects and educational levels, but the dominant impression of the analysis…

The assessment of midface distraction osteogenesis in treatment of upper airway obstruction.

PubMed

Xu, Haisong; Yu, Zheyan; Mu, Xiongzheng

2009-09-01

Le Fort III osteotomy with midface distraction osteogenesis (Le Fort III DO) can improve the midface form and change the upper airway space. Some surgeons believe that midface advancement can improve respiratory outcome dramatically, but others think it does not predictably result in the cure of obstructive sleep apnea (OSA). In this study, we evaluated the structural and functional changes of the upper airway before and after Le Fort III DO; we hope these studies can improve future protocols for midface advancement. A retrospective study of 11 patients with severe midface retrusion who underwent Le Fort III osteotomy with midface external distractor system was undertaken. These patients had an average of 5.4 months of follow-up. Three-dimensional volumetric assessment of the upper airway was used before and after surgery. We also evaluated the two-dimensional cross-sectional area of the upper airway to show the changes in different airway levels. Two patients with preoperative evidence of OSA were evaluated both preoperatively and postoperatively by overnight polysomnography. The midface was distracted for an average of 20.27 +/- 8.04 mm. Comparison between preoperative and postoperative three-dimensional computed tomographic data showed an average 64.30% increase in upper airway volume, an improvement of 9.13 +/- 6.94 mL (P < 0.05). The two-dimensional measurement also showed that the cross-sectional area at the posterior nasal spine and uvula airway level increased (P < 0.05), but the cross-sectional area at the epiglottis level and the separation of airway and esophagus level did not increase (P > 0.05). Two patients with preoperative evidence of OSA had both preoperative and postoperative sleeping studies that showed improvement. Le Fort III DO can significantly improve the upper airway space in the cases of syndromic craniosynostosis. The upper airway space above the uvula level was significantly enlarged after Le Fort III DO according to two-dimensional and three-dimensional image measurements, and according to the polysomnography, the OSA was alleviated. Le Fort III DO is a promising procedure in the treatment of severe midface retrusion with OSA in young patients.

Total arsenic concentrations in Chinese children's urine by different geographic locations, ages, and genders.

PubMed

Zhang, Xuan; Wang, Beibei; Cui, Xiaoyong; Lin, Chunye; Liu, Xitao; Ma, Jin

2018-06-01

Little is known about the variation of Chinese children's exposure to arsenic by geography, age, gender, and other potential factors. The main objective of this study was to investigate the total arsenic concentration in Chinese children's urine by geographic locations, ages, and genders. In total, 259 24-h urine samples were collected from 210 2- to 12-year-old children in China and analyzed for total arsenic and creatinine concentrations. The results showed that the upper limit (upper limit of the 90% confidence interval for the 97.5 fractile) was 27.51 µg/L or 55.88 µg/g creatinine for Chinese children. The total urinary arsenic levels were significantly different for children in Guangdong, Hubei, and Gansu provinces (P < 0.05), where the upper limits were 24.29, 58.70, and 44.29 µg/g creatinine, respectively. In addition, the total urinary arsenic levels were higher for 2- to 7-year-old children than for 7- to 12-year-old children (P < 0.05; the upper limits were 59.06 and 44.29 µg/g creatinine, respectively) and higher for rural children than for urban children (P < 0.05; the upper limits were 59.06 and 50.44 µg/g creatinine, respectively). The total urinary arsenic levels for boys were not significantly different from those for girls (P > 0.05), although the level for boys (the upper limit was 59.30 µg/g) was slightly higher than that for girls (the upper limit was 58.64 µg/g creatinine). Because the total urinary arsenic concentrations are significantly different for general populations of children in different locations and age groups, the reference level of total urinary arsenic might be dependent on the geographic site and the child's age.

Medical and Surgical Advancements in the Management of Cystic Fibrosis Chronic Rhinosinusitis

PubMed Central

Tipirneni, Kiranya E.; Woodworth, Bradford A.

2017-01-01

Purpose of review The purpose of this review is to provide otolaryngologists with the most up-to-date advancements in both the medical and surgical management of CF-related sinus disease. Recent findings Recent studies have supported more aggressive CRS management, often with a combination of both medical and surgical therapies. Comprehensive treatment strategies have been shown to reduce hospital admissions secondary to pulmonary exacerbations in addition to improving CRS symptoms. Still, current management strategies are lacking in both high-level evidence and standardized guidelines. Summary The unified airway model describes the bi-directional relationship between the upper and lower airways as a single functional unit and suggests that CRS may play a pivotal role in both the development and progression of lower airway disease. Current strategies for CF CRS focus primarily on amelioration of symptoms with antibiotics, nasal saline and/or topical medicated irrigations, and surgery. However, there are no definitive management guidelines and there remains a persistent need for additional studies. Nevertheless, otolaryngologists have a significant role in the overall management of CF, which requires a multi-disciplinary approach and a combination of both surgical and medical interventions for optimal outcomes of airway disease. Here we present a review of currently available literature and summarize medical and surgical therapies best suited for the management of CF-related sinus disease. PMID:28989817

Upper Respiratory Tract Diseases in Athletes in Different Sports Disciplines.

PubMed

Gałązka-Franta, Anna; Jura-Szołtys, Edyta; Smółka, Wojciech; Gawlik, Radosław

2016-12-01

Upper respiratory tract diseases in athletes are a very common medical problem. Training conditions in different sports disciplines increase the risk of upper respiratory disease. Epidemiological evidence suggests that heavy acute or chronic exercise is related to an increased incidence of upper respiratory tract infections in athletes. Regular physical exercise at high intensity may lead to transient immunosuppression due to high prevalence of allergic diseases in athletes. Regardless of the cause they can exclude athletes from the training program and significantly impair their performance. In the present work, the most common upper respiratory tract diseases in athletes taking into account the disciplines in which they most often occur were presented. The focus was laid on symptoms, diagnostic methods and pharmacotherapy. Moreover, preventive procedures which can help reduce the occurrence of upper respiratory tract disease in athletes were presented. Management according to anti-doping rules, criteria for return to training and competition as an important issues of athlete's health were discussed.

Predictive Management of Asian Carps in the Upper Mississippi River System

USGS Publications Warehouse

Vondracek, Bruce C.; Carlson, Andrew K.

2014-01-01

Prolific non-native organisms pose serious threats to ecosystems and economies worldwide. Nonnative bighead carp (Hypophthalmichthys nobilis) and silver carp (H. molitrix), collectively referred to as Asian carps, continue to colonize aquatic ecosystems throughout the central United States. These species are r-selected, exhibiting iteroparous spawning, rapid growth, broad environmental tolerance, high density, and long-distance movement. Hydrological, thermal, and physicochemical conditions are favorable for establishment beyond the current range, rendering containment and control imperative. Ecological approaches to confine Asian carp populations and prevent colonization characterize contemporary management in the United States. Foraging and reproduction of Asian carps govern habitat selection and movement, providing valuable insight for predictive control. Current management approaches are progressive and often anticipatory but deficient in human dimensions. We define predictive management of Asian carps as synthesis of ecology and human dimensions at regional and local scales to develop strategies for containment and control. We illustrate predictive management in the Upper Mississippi River System and suggest resource managers integrate predictive models, containment paradigms, and human dimensions to design effective, socially acceptable management strategies. Through continued research, university-agency collaboration, and public engagement, predictive management of Asian carps is an auspicious paradigm for preventing and alleviating consequences of colonization in the United States.

Level of Agreement Between Forearm and Upper Arm Blood Pressure Measurements in Patients With Large Arm Circumference.

PubMed

Watson, Sheri; Aguas, Marita; Colegrove, Pat; Foisy, Nancy; Jondahl, Bonnie; Anastas, Zoe

2017-02-01

The purpose of the study was to determine if forearm blood pressures (BPs) measured in three different locations agree with the recommended upper arm location for noninvasive BP measurement. A method-comparison design was used. In a convenience sample of postanesthesia care unit patients with large upper arm circumference, BP's were obtained in three different forearm locations (lower forearm, middle forearm, and upper forearm) and compared to upper arm BP using an automated BP measuring device. The level of agreement (bias ± precision) between each forearm location and the upper arm BP was calculated using standard formulas. Acceptable levels of agreement based on expert opinion were set a priori at bias and precision values of less than ±5 mm Hg (bias) and ±8 mm Hg (precision). Forty-eight postanesthesia patients participated in the study. Bias and precision values were found to exceed the acceptable level of agreement for all but one of the systolic and diastolic BP comparisons in the three forearm BP locations. Fifty-six percent of all patients studied had one or more BP difference of at least 10 mm Hg in each of the three forearm locations, with 10% having one or more differences of at least 20 mm Hg. The differences in forearm BP measurements observed in this study indicate that the clinical practice of using a forearm BP with a regular-sized BP cuff in place of a larger sized BP cuff placed on the upper arm in postanesthesia care unit patients with large arm circumferences is inappropriate. The BPs obtained at the forearm location are not equivalent to the BPs obtained at the upper arm location. Copyright © 2015 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

Sustainable exploitation and management of autogenic ecosystem engineers: application to oysters in Chesapeake Bay.

PubMed

Wilberg, Michael J; Wiedenmann, John R; Robinson, Jason M

2013-06-01

Autogenic ecosystem engineers are critically important parts of many marine and estuarine systems because of their substantial effect on ecosystem services. Oysters are of particular importance because of their capacity to modify coastal and estuarine habitats and the highly degraded status of their habitats worldwide. However, models to predict dynamics of ecosystem engineers have not previously included the effects of exploitation. We developed a linked population and habitat model for autogenic ecosystem engineers undergoing exploitation. We parameterized the model to represent eastern oyster (Crassostrea virginica) in upper Chesapeake Bay by selecting sets of parameter values that matched observed rates of change in abundance and habitat. We used the model to evaluate the effects of a range of management and restoration options including sustainability of historical fishing pressure, effectiveness of a newly enacted sanctuary program, and relative performance of two restoration approaches. In general, autogenic ecosystem engineers are expected to be substantially less resilient to fishing than an equivalent species that does not rely on itself for habitat. Historical fishing mortality rates in upper Chesapeake Bay for oysters were above the levels that would lead to extirpation. Reductions in fishing or closure of the fishery were projected to lead to long-term increases in abundance and habitat. For fisheries to become sustainable outside of sanctuaries, a substantial larval subsidy would be required from oysters within sanctuaries. Restoration efforts using high-relief reefs were predicted to allow recovery within a shorter period of time than low-relief reefs. Models such as ours, that allow for feedbacks between population and habitat dynamics, can be effective tools for guiding management and restoration of autogenic ecosystem engineers.

Influence of fatigue on upper limb muscle activity and performance in tennis.

PubMed

Rota, Samuel; Morel, Baptiste; Saboul, Damien; Rogowski, Isabelle; Hautier, Christophe

2014-02-01

The study examined the fatigue effect on tennis performance and upper limb muscle activity. Ten players were tested before and after a strenuous tennis exercise. Velocity and accuracy of serve and forehand drives, as well as corresponding surface electromyographic (EMG) activity of eight upper limb muscles were measured. EMG and force were also evaluated during isometric maximal voluntary contractions (IMVC). Significant decreases were observed after exercise in serve accuracy (-11.7%) and velocity (-4.5%), forehand accuracy (-25.6%) and consistency (-15.6%), as well as pectoralis major (PM) and flexor carpi radialis (FCR) IMVC strength (-13.0% and -8.2%, respectively). EMG amplitude decreased for PM and FCR in serve, forehand and IMVC, and for extensor carpi radialis in forehand. No modification was observed in EMG activation timing during strokes or in EMG frequency content during IMVC. Several hypotheses can be put forward to explain these results. First, muscle fatigue may induce a reduction in activation level of PM and forearm muscles, which could decrease performance. Second, conscious or subconscious strategies could lead to a redistribution of muscle activity to non-fatigued muscles in order to protect the organism and/or limit performance losses. Otherwise, the modifications of EMG activity could also illustrate the strategies adopted to manage the speed-accuracy trade-off in such a complex task. Copyright © 2013 Elsevier Ltd. All rights reserved.

The Anterior Interosseus Artery Perforator Flap: Anatomical Dissections and Clinical Study.

PubMed

Panse, Nikhil S; Joshi, Sheetal B; Sahasrabudhe, Parag B; Bahetee, B; Gurude, Pradnya; Chandanwale, Ajay

2017-05-01

Reconstruction of upper extremity deformities continues to be a challenge to the reconstructive surgeon. Various loco regional, distant and free flaps are available for reconstruction. However, each has its own set of advantages and disadvantages. Of the commonly performed local flaps, radial artery forearm flap, and the posterior interosseus artery flap stand out prominently. Recently, perforator propeller flaps have been used for resurfacing the upper extremity. The anterior interosseus artery perforator flap is an uncommonly used and described flap. This study was divided into anatomical study and clinical application in a IV level of evidence. In the anatomical study, five upper extremities were studied. Clinically, 12 patients underwent reconstruction using the anterior interosseus artery perforator flap. Flaps were performed by a single surgeon. A retrospective review of these cases from November 2008 to May 2014 is presented. The anterior interosseus artery perforator was identified in four out of five cadaver limbs. The septocutaneous perforator was in the fifth extensor compartment around 4 cm proximal to the wrist joint. Of the twelve flaps, there was complete necrosis in one flap, and partial necrosis in one flap. The patient with complete necrosis underwent skin grafting at a later date. The wound healed secondarily in case of partial flap necrosis. Anterior interosseus artery perforator flap must be considered as an important reconstructive option in the armamentarium of the plastic surgeon, while managing hand and wrist defects.

Upper pole access is safe and effective for pediatric percutaneous nephrolithotomy.

PubMed

Oner, Sedat; Karagozlu Akgul, Ahsen; Demirbas, Murat; Onen, Efe; Aydos, Murat; Erdogan, Abdullah

2018-04-01

Upper pole access in percutaneous nephrolithotomy (PCNL) provides a straight tract to the ureter, resulting in easier placement of a guidewire to the ureter, good exposure of the pelvis, calices, and upper ureter, and comfortable manipulations. However, despite these benefits, upper pole access is usually avoided because of the risk of chest complications in both pediatric and adult patients. We aimed to evaluate the safety and morbidity of single upper pole access in pediatric patients undergoing PCNL. We retrospectively reviewed patients aged ≤17 years with renal stones who underwent PCNL with a single access between August 2004 and February 2016. The patients were separated into two groups: the single upper pole access group (SUPAG) and the single other pole access group (SOPAG). We compared the SUPAG and SOPAG in terms of the demographic features of the patients, stone burden and location, operative data, and postoperative outcomes. Complications were classified according to the modified Clavien system. During the study period, 101 PCNL procedures were performed, 77 of which were managed with only one access. The median age of the 77 patients managed with a single access was 12 years (range 3-17 years). The number of cases in the SUPAG and SOPAG was 10 and 67, respectively. There were no statistically significant differences between the SUPAG and SOPAG in terms of age, sex, stone location, hydronephrosis status, stone area, side of kidney, and previous stone treatment or renal surgery. Furthermoret, there were no significant differences between the groups in terms of the operative parameters. Although the difference was insignificant, the median operation times in the SUPAG and SOPAG were 37 and 45 min, respectively. There was no chest complication or bleeding that required transfusion in the SUPAG. Two cases required transfusion, and one case was managed with a double pigtail catheter (double-J) placement because of prolonged extravasation in the SOPAG. The stone-free ratios were 100% and 82.1% in the SUPAG and SOPAG, respectively. Upper pole access provides similar outcomes to other (middle and lower) pole accesses, and may be performed without serious complications. These results indicate that this is a safe and effective approach of PCNL, and it presents a good alternative for removal of renal stones in pediatric patients. Copyright © 2018 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Measuring the space between vagina and rectum as it relates to rectocele

PubMed Central

Liu, Jin; Zhai, Li-Dong; Li, Yun-Sheng; Liu, Wan-Xiang; Wang, Rui-Hua

2009-01-01

AIM: To measure the normal space between the posterior wall of the vagina and the anterior wall of the respectively rectum using computed tomography (CT) and reveal its were relationship to rectocele. METHODS: A total of twenty female volunteers without rectocele were examined by CT scan. We performed a middle level continuous horizontal pelvic scan from the upper part to the lower part and collected the measurement data to analyze the results using t-test. RESULTS: Twenty volunteers were enrolled in the study. The space between the posterior wall of the vagina and the anterior wall of the rectum was measured at three levels (upper 1/3, middle, lower 1/3 level of vagina). The results showed that the space from the posterior wall of the vagina to the anterior wall of the rectum at the upper 1/3 level and the middle level was 3.896 ± 0.3617 mm and 4.6575 ± 0.3052 mm, respectively. When the two groups of data were compared, we found the space at the upper 1/3 level was shorter than at the middle level (P < 0.01). Moreover, at the lower 1/3 level the space measured was 10.058 ± 0.4534 mm. The results revealed that the space at the lower 1/3 level was longer than that at the middle level (P < 0.01). CONCLUSION: These measurement data may be helpful in assessing rectocele clinical diagnosis and functional outcomes of rectocele repair. PMID:19554660

Local extirpations and regional declines of endemic upper beach invertebrates in southern California

NASA Astrophysics Data System (ADS)

Hubbard, D. M.; Dugan, J. E.; Schooler, N. K.; Viola, S. M.

2014-10-01

Along the world's highly valued and populous coastlines, the upper intertidal zones of sandy beach ecosystems and the biodiversity that these zones support are increasingly threatened by impacts of human activities, coastal development, erosion, and climate change. The upper zones of beaches typically support invertebrates with restricted distributions and dispersal, making them particularly vulnerable to habitat loss and fragmentation. We hypothesized that disproportionate loss or degradation of these zones in the last century has resulted in declines of upper shore macroinvertebrates in southern California. We identified a suite of potentially vulnerable endemic upper beach invertebrates with direct development, low dispersal and late reproduction. Based on the availability of printed sources and museum specimens, we investigated historical changes in distribution and abundance of two intertidal isopod species (Tylos punctatus, Alloniscus perconvexus) in southern California. Populations of these isopods have been extirpated at numerous historically occupied sites: T. punctatus from 16 sites (57% decrease), and A. perconvexus from 14 sites (64% decrease). During the same period, we found evidence of only five colonization events. In addition, the northern range limit of the southern species, T. punctatus, moved south by 31 km (8% of range on California mainland) since 1971. Abundances of T. punctatus have declined on the mainland coast; only three recently sampled populations had abundances >7000 individuals m-1. For A. perconvexus populations, abundances >100 individuals m-1 now appear to be limited to the northern part of the study area. Our results show that numerous local extirpations of isopod populations have resulted in regional declines and in greatly reduced population connectivity in several major littoral cells of southern California. Two of the six major littoral cells (Santa Barbara and Zuma) in the area currently support 74% of the remaining isopod populations. These isopods persist primarily on relatively remote, ungroomed, unarmored beaches with restricted vehicle access and minimal management activity. These predominantly narrow, bluff-backed beaches also support species-rich upper beach assemblages, suggesting these isopods can be useful indicators of biodiversity. The high extirpation rates of isopod populations on the southern California mainland over the last century provide a compelling example of the vulnerability of upper beach invertebrates to coastal urbanization. Climate change and sea level rise will exert further pressures on upper beach zones and biota in southern California and globally. In the absence of rapid implementation of effective conservation strategies, our results suggest many upper intertidal invertebrate species are at risk.

Environmental glasnost: protecting a resource you do not own

Treesearch

Malcomb Ross, Jr.

1992-01-01

The Upper Delaware River management plan offers an alternative to outright purchase and subsequent management of natural recreation areas. Advantages include providing for appropriate growth, pooling agency manpower and funding, and making the private sector more responsive to finding solutions to resource issues.

Congenital Lobar Emphysema: An Approach of Anesthetic Management.

PubMed

Mourya, Meenakshi; Meena, Dharam Singh

2016-08-01

Congenital Lobar Emphysema (CLE) is a medical condition which is quiet rarely seen especially in neonates. The disease is characterized by over inflation of lungs which is produced due to inhibition of escape of inspired air from lungs. This condition usually occurs in infants due to partial obstruction of the bronchus and can be reversed with timely and planned anaesthetic management. Here in, we are presenting a case of an infant who was merely four months of age. CLE was affecting his left upper lobe since birth which was being treated as lobar pneumonia outside at some peripheral health center. The case presented to hospital with the symptoms acute respiratory distress and was taken up for urgent surgical management. Left upper lobectomy was performed which relived his symptoms. Case was discharged from hospital after 10 days of uneventful hospital stay. The case was challenging, as it involved careful and planned anaesthetic management of lung separation as well as prevention of hyperventilation of the un-involved lung.

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

Edwards, Timothy S.

Normal tolerance limits are frequently used in dynamic environments specifications of aerospace systems as a method to account for aleatory variability in the environments. Upper tolerance limits, when used in this way, are computed from records of the environment and used to enforce conservatism in the specification by describing upper extreme values the environment may take in the future. Components and systems are designed to withstand these extreme loads to ensure they do not fail under normal use conditions. The degree of conservatism in the upper tolerance limits is controlled by specifying the coverage and confidence level (usually written inmore » “coverage/confidence” form). Moreover, in high-consequence systems it is common to specify tolerance limits at 95% or 99% coverage and confidence at the 50% or 90% level. Despite the ubiquity of upper tolerance limits in the aerospace community, analysts and decision-makers frequently misinterpret their meaning. The misinterpretation extends into the standards that govern much of the acceptance and qualification of commercial and government aerospace systems. As a result, the risk of a future observation of the environment exceeding the upper tolerance limit is sometimes significantly underestimated by decision makers. This note explains the meaning of upper tolerance limits and a related measure, the upper prediction limit. So, the objective of this work is to clarify the probability of exceeding these limits in flight so that decision-makers can better understand the risk associated with exceeding design and test levels during flight and balance the cost of design and development with that of mission failure.« less

Diagnosis and management of upper gastrointestinal bleeding in children.

PubMed

Owensby, Susan; Taylor, Kellee; Wilkins, Thad

2015-01-01

Upper gastrointestinal bleeding is an uncommon but potentially serious, life-threatening condition in children. Rapid assessment, stabilization, and resuscitation should precede all diagnostic modalities in unstable children. The diagnostic approach includes history, examination, laboratory evaluation, endoscopic procedures, and imaging studies. The clinician needs to determine carefully whether any blood or possible blood reported by a child or adult represents true upper gastrointestinal bleeding because most children with true upper gastrointestinal bleeding require admission to a pediatric intensive care unit. After the diagnosis is established, the physician should start a proton pump inhibitor or histamine 2 receptor antagonist in children with upper gastrointestinal bleeding. Consideration should also be given to the initiation of vasoactive drugs in all children in whom variceal bleeding is suspected. An endoscopy should be performed once the child is hemodynamically stable. © Copyright 2015 by the American Board of Family Medicine.

Upper Rio Grande water operations model: A tool for enhanced system management

Treesearch

Gail Stockton; D. Michael Roark

1999-01-01

The Upper Rio Grande Water Operations Model (URGWOM) under development through a multi-agency effort has demonstrated capability to represent the physical river/reservoir system, to track and account for Rio Grande flows and imported San Juan flows, and to forecast flows at various points in the system. Testing of the Rio Chama portion of the water operations model was...

Fire in upper Midwestern oak forest ecosystems: an oak forest restoration and management handbook

Treesearch

Lee E. Frelich; Peter B. Reich; David W. Peterson

2015-01-01

We reviewed the literature to synthesize what is known about the use of fire to maintain and restore oak forests, woodlands, and savannas of the upper Midwestern United States, with emphasis on Minnesota, Wisconsin, and Michigan. Included are (1) known physical and ecological effects of fire on oaks from acorn through seedling, established sapling, and mature stages of...

Upper Extremity Injuries in Tennis Players: Diagnosis, Treatment, and Management

PubMed Central

Chung, Kevin C.; Lark, Meghan E.

2016-01-01

Synopsis Upper extremity tennis injuries are most commonly characterized as overuse injuries to the wrist, elbow and shoulder. The complex anatomy of these structures and their interaction with biomechanical properties of tennis strokes contributes to the diagnostic challenges. A thorough understanding of tennis kinetics, in combination with the current literature surrounding diagnostic and treatment methods, will improve clinical decision-making. PMID:27886833

Influencing the practice and outcome in acute upper gastrointestinal haemorrhage. Steering Committee of the National Audit of Acute Upper Gastrointestinal Haemorrhage.

PubMed

Rockall, T A; Logan, R F; Devlin, H B; Northfield, T C

1997-11-01

To assess changes in practice and outcome in acute upper gastrointestinal haemorrhage following the feedback of data, the reemphasis of national guidelines, and specific recommendations following an initial survey. A prospective, multicentre, audit cycle. Forty five hospitals from three health regions participated in two phases of the audit cycle. Phase I: 2332 patients with acute upper gastrointestinal haemorrhage; phase II: 1625 patients with upper gastrointestinal haemorrhage. Patients were evaluated with respect to management (with reference to the recommendations in the national guidelines), mortality, and length of hospital stay. Following the distribution of data from the first phase of the National Audit and the formulation of specific recommendations for improving practice, the proportion of hospitals with local guidelines or protocols for the management of upper gastrointestinal haemorrhage rose from 71% (32/45) to 91% (41/45); 12 of the 32 hospitals with guidelines during the first phase revised their guidelines following the initial survey. There was a small but significant increase in the proportion of all patients who underwent endoscopy (from 81% to 86%), the proportion who underwent endoscopy within 24 hours of admission (from 50% to 56%), and the use of central venous pressure monitoring in patients with organ failure requiring blood transfusion or those with profound shock (from 30% to 43%). There was, however, no change in the use of high dependency beds or joint medical/surgical management in high risk cases. There was no significant change in crude or risk standardised mortality (13.4% in the first phase and 14.4% in the second phase). Although many of the participating hospitals have made efforts to improve practice by producing or updating guidelines or protocols, there has been only a small demonstrable change in some areas of practice during the National Audit. The failure to detect any improvement in mortality may reflect this lack of change of practice, but may also reflect the fact that a large proportion of the deaths in this unselected study are not preventable; only a very large study could hope to demonstrate a significant change out of the context of a clinical trial.

Military Wife Adjustment, An Independent Dependent

DTIC Science & Technology

1981-01-01

managing family responsibilities alone (Mc:Cubbin, 1978; McCubbin, et al., 1980; Rienerth, 1978). Wives utLlized various coping strategies during the...stiff upper lip." The family becomes matricentric, and the military mother becomes domestic manager in complete charge of all familial ...Highway University of Maryland ZIi K Arlington VA 22202 College of Business and Management . . ,and Department of Psychology Dr. Lartry-:..Cummings

Using a Density-Management Diagram to Develop Thinning Schedules for Loblolly Pine Plantations

Treesearch

Thomas J. Dean; V. Clark Baldwin

1993-01-01

A method for developing thinning schedules using a density-management diagram is presented. A density-management diagram is a form of stocking chart based on patterns of natural stand development. The diagram allows rotation diameter and the upper and lower limits of growing stock to be easily transformed into before and after thinning densities. Site height lines on...

Species diversity of polyporoid and corticioid fungi in northern hardwood forests with differing management histories

Treesearch

Daniel L. Lindner; Harold H., Jr. Burdsall; Glen R. Stanosz

2006-01-01

Effects of forest management on fungal diversity were investigated by sampling fruit bodies of polyporoid and corticioid fungi in forest stands that have different management histories. Fruit bodies were sampled in 15 northern hardwood stands in northern Wisconsin and the upper peninsula of Michigan. Sampling was conducted in five old-growth stands, five uneven-age...

What are the key contextual factors when preparing for successful implementation of assistive living technology in primary elderly care? A case study from Norway.

PubMed

Gjestsen, Martha Therese; Wiig, Siri; Testad, Ingelin

2017-09-07

To identify contextual factors at different organisational levels to guide the implementation of an assistive living technology intervention in Norwegian primary home care. A single embedded case study design was carried out in an urban municipality in Western Norway to get an overview of key contextual factors from the municipality's perspective. The data collection was based on a triangulation of methods involving document analysis, semi-structured individual interviews and focus group interviews to get a broad insight when preparing for an intervention. Data were collected on three levels of the healthcare system: (1) national policy documents and regulations (macro), (2) five individual interviews with senior managers and municipal strategy documents (meso) and (3) two focus group interviews with nurses and nurse managers in direct patient care (micro). The Model for Understanding Success in Quality framework was used as a guide in the data analysis. The main contextual factors identified were external motivators and project sponsorship (macro level); leadership, workforce focus and maturity (meso level);and motivation to change and maturity (micro level). Strategies developed in policy documents affected upper management in the municipality, but healthcare personnel at the micro level were not so familiar with strategies and emphasis on assistive living technologies. Healthcare personnel in our study were motivated to use technological solutions, but lack of data infrastructure and resource availability hindered this. Aligning interests across multiple stakeholders remain a challenge when planning for an assistive living technology intervention in primary care. In the studied municipality, integration of technological solutions into healthcare services was more a vision than a reality because of a low level of organisational readiness. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Effect of parallel refraction on magnetospheric upper hybrid waves

NASA Technical Reports Server (NTRS)

Engel, J.; Kennel, C. F.

1984-01-01

Large amplitude (not less than 10 mV/m) electrostatic plasma waves near the upper hybrid (UH) frequency have been observed from 0 to 50 deg magnetic latitude (MLAT) during satellite plasma-pause crossings. A three-dimensional numerical ray-tracing calculation, based on an electron distribution measured during a GEOS 1 dayside intense upper-hybrid wave event, suggests how UH waves might achieve such large amplitudes away from the geomagnetic equator. Refractive effects largely control the wave amplification and, in particular, the unavoidable refraction due to parallel geomagnetic field gradients restricts growth to levels below those observed. However, a cold electron density gradient parallel to the field can lead to upper hybrid wave growth that can account for the observed emission levels.

LPT. Shield test facility assembly and test building (TAN646). East ...

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

LPT. Shield test facility assembly and test building (TAN-646). East facade of ebor helium wing addition. Camera facing west. Note asbestos-cement siding on stair enclosure and upper-level. Concrete siding at lower level. Metal stack. Monorail protrudes from upper level of south wall at left of view. INEEL negative no. HD-40-7-4 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

Multiweek Cell Culture Project for Use in Upper-Level Biology Laboratories

ERIC Educational Resources Information Center

Marion, Rebecca E.; Gardner, Grant E.; Parks, Lisa D.

2012-01-01

This article describes a laboratory protocol for a multiweek project piloted in a new upper-level biology laboratory (BIO 426) using cell culture techniques. Human embryonic kidney-293 cells were used, and several culture media and supplements were identified for students to design their own experiments. Treatments included amino acids, EGF,…

Women in Leadership in Higher Education: Leadership Styles and the "Glass Ceiling"

ERIC Educational Resources Information Center

Michael, Rebecka

2013-01-01

Women in upper-level leadership positions in higher education are underrepresented. This study examined the predominant leadership styles of women who have achieved upper-level leadership positions in higher education explored intentional changes in their leadership styles. Primarily, the study sought to determine if these leaders had similar…

Undergraduate Chemistry Students' Perceptions of and Misconceptions about Buffers and Buffer Problems

ERIC Educational Resources Information Center

Orgill, MaryKay; Sutherland, Aynsley

2008-01-01

Both upper- and lower-level chemistry students struggle with understanding the concept of buffers and with solving corresponding buffer problems. While it might be reasonable to expect general chemistry students to struggle with this abstract concept, it is surprising that upper-level students in analytical chemistry and biochemistry continue to…

Pedagogical Issues in Teaching Upper-Level Science Courses at a "Community University"

ERIC Educational Resources Information Center

Deutch, Charles E.; Jurutka, Peter W.; Marshall, Pamela A.

2008-01-01

The authors teach upper-level science courses in cell biology, genetics, and biochemistry at a public, four-year "community university" that serves a demographically diverse population of traditional and nontraditional students. In this article, they describe some of the issues they have found to be particularly significant at their "community…

Upper Secondary and Vocational Level Teachers at Social Software

ERIC Educational Resources Information Center

Valtonen, Teemu; Kontkanen, Sini; Dillon, Patrick; Kukkonen, Jari; Väisänen, Pertti

2014-01-01

This study focuses on upper secondary and vocational level teachers as users of social software i.e. what software they use during their leisure and work and for what purposes they use software in teaching. The study is theorised within a technological pedagogical content knowledge framework, the emphasis is especially on technological knowledge…

BUFR TABLE A

Science.gov Websites

Surface data - sea 2 Vertical soundings (other than satellite) 3 Vertical soundings (satellite) 4 Single level upper-air data (other than satellite) 5 Single level upper-air data (satellite) 6 Radar data 7 tables, complete replacement or update 12 Surface data (satellite) 13 Forecasts 14 Warnings 15-19

An Experiential Approach to an Upper Division Course in Intercultural Communication.

ERIC Educational Resources Information Center

Ostermeier, Terry H.

Rapidly changing demographics are forcing more and more Americans to interact with people who are different from themselves. Americans must become more sensitive to cultural diversity. One way to address this challenge at the university level is to offer courses in intercultural communication. At one university, an upper level course in…

Online Learning: Outcomes and Satisfaction among Underprepared Students in an Upper-Level Psychology Course

ERIC Educational Resources Information Center

McDonough, Colleen; Roberts, Ramona Palmerio; Hummel, Jessamy

2014-01-01

Online learning is on the rise, but research on outcomes and student satisfaction has produced conflicting results, and systematic, targeted research on underprepared college students is generally lacking. This study compared three sections (traditional, online, and 50% hybrid) of the same upper-level psychology course, taught with identical…