School Counseling Programs: Comparing GEAR UP Schools with Non-GEAR UP Schools

ERIC Educational Resources Information Center

Thorngren, Jill M.; Nelson, Mark D.; Baker, Larry J.

2004-01-01

A survey was conducted using qualitative means to assess school counseling programs in Montana. Schools that were demonstration schools in a federal initiative, Gaining Early Awareness and Readiness for Undergraduate Programs (GEAR UP) were compared to non-GEAR UP schools. Several differences between GEAR UP and non-GEAR UP schools are noted and…

Cone beam CT-based set-up strategies with and without rotational correction for stereotactic body radiation therapy in the liver.

PubMed

Bertholet, Jenny; Worm, Esben; Høyer, Morten; Poulsen, Per

2017-06-01

Accurate patient positioning is crucial in stereotactic body radiation therapy (SBRT) due to a high dose regimen. Cone-beam computed tomography (CBCT) is often used for patient positioning based on radio-opaque markers. We compared six CBCT-based set-up strategies with or without rotational correction. Twenty-nine patients with three implanted markers received 3-6 fraction liver SBRT. The markers were delineated on the mid-ventilation phase of a 4D-planning-CT. One pretreatment CBCT was acquired per fraction. Set-up strategy 1 used only translational correction based on manual marker match between the CBCT and planning CT. Set-up strategy 2 used automatic 6 degrees-of-freedom registration of the vertebrae closest to the target. The 3D marker trajectories were also extracted from the projections and the mean position of each marker was calculated and used for set-up strategies 3-6. Translational correction only was used for strategy 3. Translational and rotational corrections were used for strategies 4-6 with the rotation being either vertebrae based (strategy 4), or marker based and constrained to ±3° (strategy 5) or unconstrained (strategy 6). The resulting set-up error was calculated as the 3D root-mean-square set-up error of the three markers. The set-up error of the spinal cord was calculated for all strategies. The bony anatomy set-up (2) had the largest set-up error (5.8 mm). The marker-based set-up with unconstrained rotations (6) had the smallest set-up error (0.8 mm) but the largest spinal cord set-up error (12.1 mm). The marker-based set-up with translational correction only (3) or with bony anatomy rotational correction (4) had equivalent set-up error (1.3 mm) but rotational correction reduced the spinal cord set-up error from 4.1 mm to 3.5 mm. Marker-based set-up was substantially better than bony-anatomy set-up. Rotational correction may improve the set-up, but further investigations are required to determine the optimal correction strategy.

Warm-up and performance in competitive swimming.

PubMed

Neiva, Henrique P; Marques, Mário C; Barbosa, Tiago M; Izquierdo, Mikel; Marinho, Daniel A

2014-03-01

Warm-up before physical activity is commonly accepted to be fundamental, and any priming practices are usually thought to optimize performance. However, specifically in swimming, studies on the effects of warm-up are scarce, which may be due to the swimming pool environment, which has a high temperature and humidity, and to the complexity of warm-up procedures. The purpose of this study is to review and summarize the different studies on how warming up affects swimming performance, and to develop recommendations for improving the efficiency of warm-up before competition. Most of the main proposed effects of warm-up, such as elevated core and muscular temperatures, increased blood flow and oxygen delivery to muscle cells and higher efficiency of muscle contractions, support the hypothesis that warm-up enhances performance. However, while many researchers have reported improvements in performance after warm-up, others have found no benefits to warm-up. This lack of consensus emphasizes the need to evaluate the real effects of warm-up and optimize its design. Little is known about the effectiveness of warm-up in competitive swimming, and the variety of warm-up methods and swimming events studied makes it difficult to compare the published conclusions about the role of warm-up in swimming. Recent findings have shown that warm-up has a positive effect on the swimmer's performance, especially for distances greater than 200 m. We recommend that swimmers warm-up for a relatively moderate distance (between 1,000 and 1,500 m) with a proper intensity (a brief approach to race pace velocity) and recovery time sufficient to prevent the early onset of fatigue and to allow the restoration of energy reserves (8-20 min).

Socioeconomic differences in health check-ups and medically certified sickness absence: a 10-year follow-up among middle-aged municipal employees in Finland.

PubMed

Piha, Kustaa; Sumanen, Hilla; Lahelma, Eero; Rahkonen, Ossi

2017-04-01

There is contradictory evidence on the association between health check-ups and future morbidity. Among the general population, those with high socioeconomic position participate more often in health check-ups. The main aims of this study were to analyse if attendance to health check-ups are socioeconomically patterned and affect sickness absence over a 10-year follow-up. This register-based follow-up study included municipal employees of the City of Helsinki. 13 037 employees were invited to age-based health check-up during 2000-2002, with a 62% attendance rate. Education, occupational class and individual income were used to measure socioeconomic position. Medically certified sickness absence of 4 days or more was measured and controlled for at the baseline and used as an outcome over follow-up. The mean follow-up time was 7.5 years. Poisson regression was used. Men and employees with lower socioeconomic position participated more actively in health check-ups. Among women, non-attendance to health check-up predicted higher sickness absence during follow-up (relative risk =1.26, 95% CI 1.17 to 1.37) in the fully adjusted model. Health check-ups were not effective in reducing socioeconomic differences in sickness absence. Age-based health check-ups reduced subsequent sickness absence and should be promoted. Attendance to health check-ups should be as high as possible. Contextual factors need to be taken into account when applying the results in interventions in other settings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Effect of active warm-up duration on morning short-term maximal performance during Ramadan.

PubMed

Baklouti, Hana; Chtourou, Hamdi; Aloui, Asma; Chaouachi, Anis; Souissi, Nizar

2015-01-01

Purpose To examine the effect of active warm-up duration on short-term maximal performance assessed during Ramadan in the morning. Methods Twelve healthy active men performed four Wingate tests for measurement of peak power and mean power before and during Ramadan at 09:00 a.m. The tests were performed on separate days, after either a 5-min or a 15-min warm-up. The warm-up consisted in pedaling at 50% of the power output obtained at the last stage of a submaximal multistage cycling test. Oral temperature was measured at rest and after warming-up. Furthermore, ratings of perceived exertion were obtained immediately after the Wingate test. Results Oral temperature was higher after the 15-min warm-up than the 5-min warm-up throughout the study. Moreover, peak power and mean power were higher after the 15-min warm-up than the 5-min warm-up before Ramadan. However, during Ramadan, there was no significant difference between the two warm-up durations. In addition, ratings of perceived exertion were higher after the 15-min warm-up than the 5-min warm-up only during Ramadan. Conclusions There is no need to prolong the warm-up period before short-term maximal exercise performed during Ramadan in the morning.

Effect of active warm-up duration on morning short-term maximal performance during Ramadan.

PubMed

Baklouti, Hana; Chtourou, Hamdi; Aloui, Asma; Chaouachi, Anis; Souissi, Nizar

2015-01-01

To examine the effect of active warm-up duration on short-term maximal performance assessed during Ramadan in the morning. Twelve healthy active men performed four Wingate tests for measurement of peak power and mean power before and during Ramadan at 09:00 a.m. The tests were performed on separate days, after either a 5-min or a 15-min warm-up. The warm-up consisted in pedaling at 50% of the power output obtained at the last stage of a submaximal multistage cycling test. Oral temperature was measured at rest and after warming-up. Furthermore, ratings of perceived exertion were obtained immediately after the Wingate test. Oral temperature was higher after the 15-min warm-up than the 5-min warm-up throughout the study. Moreover, peak power and mean power were higher after the 15-min warm-up than the 5-min warm-up before Ramadan. However, during Ramadan, there was no significant difference between the two warm-up durations. In addition, ratings of perceived exertion were higher after the 15-min warm-up than the 5-min warm-up only during Ramadan. There is no need to prolong the warm-up period before short-term maximal exercise performed during Ramadan in the morning.

Effect of active warm-up duration on morning short-term maximal performance during Ramadan

PubMed Central

Baklouti, Hana; Chtourou, Hamdi; Aloui, Asma; Chaouachi, Anis; Souissi, Nizar

2015-01-01

Purpose To examine the effect of active warm-up duration on short-term maximal performance assessed during Ramadan in the morning. Methods Twelve healthy active men performed four Wingate tests for measurement of peak power and mean power before and during Ramadan at 09:00 a.m. The tests were performed on separate days, after either a 5-min or a 15-min warm-up. The warm-up consisted in pedaling at 50% of the power output obtained at the last stage of a submaximal multistage cycling test. Oral temperature was measured at rest and after warming-up. Furthermore, ratings of perceived exertion were obtained immediately after the Wingate test. Results Oral temperature was higher after the 15-min warm-up than the 5-min warm-up throughout the study. Moreover, peak power and mean power were higher after the 15-min warm-up than the 5-min warm-up before Ramadan. However, during Ramadan, there was no significant difference between the two warm-up durations. In addition, ratings of perceived exertion were higher after the 15-min warm-up than the 5-min warm-up only during Ramadan. Conclusions There is no need to prolong the warm-up period before short-term maximal exercise performed during Ramadan in the morning. PMID:25676856

78 FR 32533 - Proposed Collection of Information: Direct Deposit, Go Direct, and Direct Express Sign-Up Forms

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-30

... Deposit, Go Direct, and Direct Express Sign-Up Forms AGENCY: Bureau of the Fiscal Service, Fiscal Service... ``Direct Deposit Sign-Up Form'', Form 1200 ``Go Direct Sign-Up Form for Direct Deposit of Federal Benefit... information described below: Title: Direct Deposit Sign-Up Form, and Go Direct Sign-Up Form, and Direct...

Follow-up Cost Study. TEX-SIS FOLLOW-UP SC5.

ERIC Educational Resources Information Center

Baugh, Ronald C.

This report presents data on the costs of follow-up studies, based on 29 separate follow-up studies conducted by eight public community/junior colleges in Texas. The purpose of this study, conducted by Navarro College as a subcontractor of Project FOLLOW-UP, was to provide data and information regarding the cost of follow-up studies that would be…

Built-up Land Expansion in Urban China

NASA Astrophysics Data System (ADS)

Chen, Yi; Chen, Zhigang; Huang, Xianjin

2017-04-01

Since the implementation of the reform and opening-up, rapid expansion of built-up land has caused a rapid reduction of arable land. The Ministry of Land and Resources of the People' s Republic of China has strengthened the management of built-up land through the basic arable land protection and the quota allocation of built-up land to control the urban sprawl. In addition, the general land use planning and the annual land use plan have been used to further ensure the effectiveness of land use management and control. However, the trend of built-up land expansion has not been effectively restrained. The built-up land expansion increased from 31.92 × 106 hm2 in 2005 to 38.89 × 106 hm2 in 2012. The rapid expansion of built-up land has been the major feature of land use changes in China and has led to built-up land vacancy and inefficient land use. This paper used a Data Envelopment Analysis (DEA) model to analyze the changes in built-up land efficiency in 336 cities in China from 2005 to 2012 during the implementation of National General Land Use Plan (2006-2020) (NGLUP). The results showed that the built-up land input-output efficiency of most cities declined, and more than half of the cities had excessive inputs of built-up land. Even in the most developed region of China, the built-up land efficiency was relatively low. The paper argues that the NGLUP failed to control the expansion of built-up land and to promote intensive land use. The allocation of built-up land designated by the Plan was not reasonable, and economic development has greatly relied on land inputs, which need to be improved. The paper finally suggests that the built-up land indices should be appropriately directed toward economically underdeveloped regions in central and western China, and the establishment of a withdrawal mechanism for inefficient land would better promote the efficient allocation of built-up land.

Effect of External Loading on Force and Power Production During Plyometric Push-ups.

PubMed

Hinshaw, Taylour J; Stephenson, Mitchell L; Sha, Zhanxin; Dai, Boyi

2018-04-01

Hinshaw, TJ, Stephenson, ML, Sha, Z, and Dai, B. Effect of external loading on force and power production during plyometric push-ups. J Strength Cond Res 32(4): 1099-1108, 2018-One common exercise to train upper-body strength and power is the push-up. Training at the loads that would produce the greatest power is an effective way to increase peak power. The purpose of the current study was to quantify the changes in peak force, peak power, and peak velocity among a modified plyometric push-up and plyometric push-ups with or without external loading in physically active young adults. Eighteen male and 17 female participants completed 4 push-ups: (a) modified plyometric push-up on the knees, (b) plyometric push-up without external loading, (c) plyometric push-up with an external load of 5% of body weight, and (d) plyometric push-up with an external load of 10% of body weight. Two force platforms were set up to collect vertical ground reaction forces at the hands and feet. The modified plyometric push-up demonstrated the lowest force, power, and velocity (5.4≥ Cohen's dz ≥1.2). Peak force and force at peak velocity increased (3.8≥ Cohen's dz ≥0.3) and peak velocity and velocity at peak power decreased (1.4≥ Cohen's dz ≥0.8) for the push-up without external loading compared with the 2 push-ups with external loading. No significant differences were observed for peak power among the push-ups with or without external loading (0.4≥ Cohen's dz ≥0.1). Although peak power is similar with or without external loading, push-ups without external loading may be more beneficial for a quick movement, and push-ups with external loading may be more beneficial for a greater force production.

Effects of Short or Long Warm-up on Intermediate Running Performance.

PubMed

van den Tillaar, Roland; Vatten, Tormod; von Heimburg, Erna

2017-01-01

van den Tillaar, R, Vatten, T, and von Heimburg, E. Effects of short or long warm-up on intermediate running performance. J Strength Cond Res 31(1): 37-44, 2017-The aim of the study was to compare the effects of a long warm-up (general + specific) and a short warm-up (specific) on intermediate running performance (3-minute run). Thirteen experienced endurance-trained athletes (age 23.2 ± 2.3 years, body mass 79.8 ± 8.2 kg, body height 1.82 ± 0.05 m) conducted 2 types of warm-ups in a crossover design with 1 week in between: a long warm-up (10 minutes, 80% maximal heart rate, and 8 × 60 m sprint with increasing intensity and 1 minute rest in between) and a short warm-up (8 × 60 m sprint with increasing intensity and 1 minute rest in between). Each warm-up was followed by a 3-minute running test on a nonmotorized treadmill. Total running distance, running velocity at each 30 seconds, heart rate, blood lactate concentration, oxygen uptake, and rate of perceived exertion were measured. No significant differences in running performance variables and physiological parameters were found between the 2 warm-up protocols, except for the rate of perceived exertion and heart rate, which were higher after the long warm-up and after the 3-minute running test compared with the short warm-up. It was concluded that a short warm-up is as effective as a long warm-up for intermediate performance. Therefore, athletes can choose for themselves if they want to include a general part in their warm-up routines, even though it would not enhance their running performance more compared with only using a short, specific warm-up. However, to increase efficiency of time for training or competition, these short, specific warm-ups should be performed instead of long warm-ups.

Start-up control system and vessel for LMFBR

DOEpatents

Durrant, Oliver W.; Kakarala, Chandrasekhara R.; Mandel, Sheldon W.

1987-01-01

A reflux condensing start-up system includes a steam generator, a start-up vessel connected parallel to the steam generator, a main steam line connecting steam outlets of the steam generator and start-up vessel to a steam turbine, a condenser connected to an outlet of the turbine and a feedwater return line connected between the condenser and inlets of the steam generator and start-up vessel. The start-up vessel has one or more heaters at the bottom thereof for heating feedwater which is supplied over a start-up line to the start-up vessel. Steam is thus generated to pressurize the steam generator before the steam generator is supplied with a heat transfer medium, for example liquid sodium, in the case of a liquid metal fast breeder reactor. The start-up vessel includes upper and lower bulbs with a smaller diameter mid-section to act as water and steam reservoirs. The start-up vessel can thus be used not only in a start-up operation but as a mixing tank, a water storage tank and a level control at low loads for controlling feedwater flow.

Start-up control system and vessel for LMFBR

DOEpatents

Durrant, Oliver W.; Kakarala, Chandrasekhara R.; Mandel, Sheldon W.

1987-01-01

A reflux condensing start-up system comprises a steam generator, a start-up vessel connected parallel to the steam generator, a main steam line connecting steam outlets of the steam generator and start-up vessel to a steam turbine, a condenser connected to an outlet of the turbine and a feedwater return line connected between the condenser and inlets of the steam generator and start-up vessel. The start-up vessel has one or more heaters at the bottom thereof for heating feedwater which is supplied over a start-up line to the start-up vessel. Steam is thus generated to pressurize the steam generator before the steam generator is supplied with a heat transfer medium, for example liquid sodium, in the case of a liquid metal fast breeder reactor. The start-up vessel includes upper and lower bulbs with a smaller diameter mid-section to act as water and steam reservoirs. The start-up vessel can thus be used not only in a start-up operation but as a mixing tank, a water storage tank and a level control at low loads for controlling feedwater flow.

Network Control Center User Planning System (NCC UPS)

NASA Astrophysics Data System (ADS)

Dealy, Brian

1991-09-01

NCC UPS is presented in the form of the viewgraphs. The following subject areas are covered: UPS overview; NCC UPS role; major NCC UPS functional requirements; interactive user access levels; UPS interfaces; interactive user subsystem; interface navigation; scheduling screen hierarchy; interactive scheduling input panels; autogenerated schedule request panel; schedule data tabular display panel; schedule data graphic display panel; graphic scheduling aid design; and schedule data graphic display.

Network Control Center User Planning System (NCC UPS)

NASA Technical Reports Server (NTRS)

Dealy, Brian

1991-01-01

NCC UPS is presented in the form of the viewgraphs. The following subject areas are covered: UPS overview; NCC UPS role; major NCC UPS functional requirements; interactive user access levels; UPS interfaces; interactive user subsystem; interface navigation; scheduling screen hierarchy; interactive scheduling input panels; autogenerated schedule request panel; schedule data tabular display panel; schedule data graphic display panel; graphic scheduling aid design; and schedule data graphic display.

Estimation of the 24-h urinary protein excretion based on the estimated urinary creatinine output.

PubMed

Ubukata, Masamitsu; Takei, Takashi; Nitta, Kosaku

2016-06-01

The urinary protein/creatinine ratio [Up/Ucr (g/gCr)] has been used in the clinical management of patients with chronic kidney disease (CKD). However, a discrepancy is often noted between the Up/Ucr and 24-h urinary protein excretion [24hUp (g/day)] in patients with extremes of muscle mass. We examined devised a method for precise estimation of the 24-h urinary protein excretion (E-24hUp) based on estimation of 24-h urinary creatinine output (E-24hCr). Three parameters, spot Up/Ucr, 24hUP and E-24hUp (=Up/Ucr × E-24hCr), were determined in 116 adult patients with CKD. The correlations among the groups were analyzed. There was a significant correlation between the Up/Ucr and 24hUp (p < 0.001). We divided the patients into three groups according to the 24hUp; the low urinary protein group (<1.0 g/day), the intermediate urinary protein group (1.0-3.5 g/day), and the high urinary protein group (>3.5 g/day). There was a significant correlation between the Up/Ucr and 24hUp in the low (p = 0.04) and high urinary protein (p = 0.01) groups, whereas the correlation coefficient was lower in the intermediate urinary protein (p = 0.07) group. Thus, we found a significant correlation between 24hUp and E-24hUp in the study population overall (p < 0.001), in the low (p = 0.01), in the intermediate (p < 0.001), and in the high urinary protein group (p < 0.001). We conclude that a poor correlation exists between the Up/Ucr and 24hUp in patients with intermediate urinary protein excretion levels. The recommended parameter for monitoring proteinuria in such patients may be the E-24hUp, which is calculated using the E-24hCr.

Effect of Passive, Active and Combined Warm up on Lower Limb Muscle Performance and Dynamic Stability in Recreational Sports Players.

PubMed

Gogte, Kedar; Srivastav, Prateek; Miyaru, Ganesh Balthillaya

2017-03-01

Warm up is an activity that is done before a sports activity. The warm up can be done actively and passively. The preferred mode is active warm up in athletes. There are inconclusive effects of passive warm up compared with an active warm up on short term muscle performance. The cumulative effect of passive and active warm up on muscle performance and dynamic stability is not known. To find out the effects of passive, active and combined warm up on lower limb muscle performance and dynamic stability in recreational sports players. A randomized crossover study was done on 19 recreational lower limb dominant sports players. Three different warm ups were included in the study passive, active and combined. Active warm up included series of activities like cycling, leg press, jump squats, squat jumps while passive warm up included application of moist heat for a period of 20 minutes on lower limb muscles. Combined warm up included both passive and active warm up. Six different sequences were made from these three warm ups. Subjects were screened and allotted into different groups based on the six warm up sequences after sequence randomization with 48 hours wash out period. After every warm up session Vertical Jump Test (VJT) and Star Excursion Balance Test (SEBT) was performed and results were recorded. Study duration was one year and six months. There was no difference noticed in both the outcome measures. Mean and SD values for passive, active and combined warm up are 47.62±9.64, 48.50±10.16 and 48.87±10.70 respectively in Vertical Jump Test (VJT) and 85.43±8.61, 85.17±8.60 and 85.17±8.38 respectively for SEBT. The p-value for mean difference between passive-active, active-combined, combined-passive are 0.67, 1.00, 0.51 respectively, for VJT and 1.00, 1.00, 1.00 respectively for SEBT. All warm ups are equally effective in short term sports performance.

Effect of Passive, Active and Combined Warm up on Lower Limb Muscle Performance and Dynamic Stability in Recreational Sports Players

PubMed Central

Gogte, Kedar; Miyaru, Ganesh Balthillaya

2017-01-01

Introduction Warm up is an activity that is done before a sports activity. The warm up can be done actively and passively. The preferred mode is active warm up in athletes. There are inconclusive effects of passive warm up compared with an active warm up on short term muscle performance. The cumulative effect of passive and active warm up on muscle performance and dynamic stability is not known. Aim To find out the effects of passive, active and combined warm up on lower limb muscle performance and dynamic stability in recreational sports players. Materials and Methods A randomized crossover study was done on 19 recreational lower limb dominant sports players. Three different warm ups were included in the study passive, active and combined. Active warm up included series of activities like cycling, leg press, jump squats, squat jumps while passive warm up included application of moist heat for a period of 20 minutes on lower limb muscles. Combined warm up included both passive and active warm up. Six different sequences were made from these three warm ups. Subjects were screened and allotted into different groups based on the six warm up sequences after sequence randomization with 48 hours wash out period. After every warm up session Vertical Jump Test (VJT) and Star Excursion Balance Test (SEBT) was performed and results were recorded. Study duration was one year and six months. Results There was no difference noticed in both the outcome measures. Mean and SD values for passive, active and combined warm up are 47.62±9.64, 48.50±10.16 and 48.87±10.70 respectively in Vertical Jump Test (VJT) and 85.43±8.61, 85.17±8.60 and 85.17±8.38 respectively for SEBT. The p-value for mean difference between passive-active, active-combined, combined-passive are 0.67, 1.00, 0.51 respectively, for VJT and 1.00, 1.00, 1.00 respectively for SEBT. Conclusion All warm ups are equally effective in short term sports performance. PMID:28511496

Aging and Outcome in Patients With Peripheral Artery Disease and Critical Limb Ischemia.

PubMed

Skonetzki, Saskia; Lüders, Florian; Engelbertz, Christiane; Malyar, Nasser M; Freisinger, Eva; Meyborg, Matthias; Reinecke, Holger

2016-10-01

Aging of the population is one of the major challenges facing public health systems. The impact of aging on acute and long-term outcome of patients with peripheral artery disease (PAD) and critical limb ischemia (CLI) is currently not sufficiently clarified. This analysis consists of comprehensive, anonymized data obtained from the largest public health insurance in Germany. A total of 41,740 PAD patients with an index hospitalization between January 1, 2009, and December 31, 2011, and a follow-up time up to 4 years were included (40-49 years: n = 1179; 50-59 years: n = 5415; 60-69 years: n = 10,565; 70-79 years: n = 13,313; 80-89 years: n = 9714; and 90-100 years: n = 1554). Advanced age was associated with female gender (men-women ratio up to 1:3.3), less smoking, less frequent obesity, more often chronic heart failure (up to 9-fold), chronic kidney disease (up to 4-fold), fewer angiographies (up to 0.8-fold), fewer endovascular (up to 0.5-fold) and surgical revascularizations (up to 0.9-fold), higher rates of amputation (up to 2.5-fold), acute renal failure (up to 3.7-fold), in-hospital mortality (up to 12-fold), myocardial infarction (up to 2.8-fold), ischemic stroke (up to 1.5-fold), infection (up to 1.4-fold), and sepsis (up to 1.8-fold) (each P < .001). During follow-up, advanced age was a highly significant independent predictor of long-term mortality, myocardial infarction, and stroke (each P < .001). Lengths of hospital stay (up to 1.3-fold longer) and reimbursement costs (up to 1.1-fold higher) were clearly associated with advanced age (each P < .001). This study demonstrates the impact of aging on morbidity, in-hospital treatment, complications, and acute and long-term outcome of PAD patients. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

"Hooking up" among college students: demographic and psychosocial correlates.

PubMed

Owen, Jesse J; Rhoades, Galena K; Stanley, Scott M; Fincham, Frank D

2010-06-01

This study investigated 832 college students' experiences with hooking up, a term that refers to a range of physically intimate behavior (e.g., passionate kissing, oral sex, and intercourse) that occurs outside of a committed relationship. Specifically, we examined how five demographic variables (sex, ethnicity, parental income, parental divorce, and religiosity) and six psychosocial factors (e.g., attachment styles, alcohol use, psychological well-being, attitudes about hooking up, and perceptions of the family environment) related to whether individuals had hooked up in the past year. Results showed that similar proportions of men and women had hooked up but students of color were less likely to hook up than Caucasian students. More alcohol use, more favorable attitudes toward hooking up, and higher parental income were associated with a higher likelihood of having hooked up at least once in the past year. Positive, ambivalent, and negative emotional reactions to the hooking up experience(s) were also examined. Women were less likely to report that hooking up was a positive emotional experience than men. Young adults who reported negative and ambivalent emotional reactions to hooking up also reported lower psychological well-being and less favorable attitudes toward hooking up as compared to students who reported a positive hooking up experience. Based on these findings, suggestions for psychoeducational programming are offered. Additionally, directions for future research are provided.

Warm Up to a Good Sound

ERIC Educational Resources Information Center

Tovey, David C.

1977-01-01

Most choral directors in schools today have been exposed to a variety of warm-up procedures. Yet, many do not use the warm-up time effectively as possible. Considers the factors appropriate to a warm-up exercise and three basic warm-up categories. (Author/RK)

Follow-up of cancer in primary care versus secondary care: systematic review

PubMed Central

Lewis, Ruth A; Neal, Richard D; Williams, Nefyn H; France, Barbara; Hendry, Maggie; Russell, Daphne; Hughes, Dyfrig A; Russell, Ian; Stuart, Nicholas SA; Weller, David; Wilkinson, Clare

2009-01-01

Background Cancer follow-up has traditionally been undertaken in secondary care, but there are increasing calls to deliver it in primary care. Aim To compare the effectiveness and cost-effectiveness of primary versus secondary care follow-up of cancer patients, determine the effectiveness of the integration of primary care in routine hospital follow-up, and evaluate the impact of patient-initiated follow-up on primary care. Design of study Systematic review. Setting Primary and secondary care settings. Method A search was carried out of 19 electronic databases, online trial registries, conference proceedings, and bibliographies of included studies. The review included comparative studies or economic evaluations of primary versus secondary care follow-up, hospital follow-up with formal primary care involvement versus conventional hospital follow-up, and hospital follow-up versus patient-initiated or minimal follow-up if the study reported the impact on primary care. Results There was no statistically significant difference for patient wellbeing, recurrence rate, survival, recurrence-related serious clinical events, diagnostic delay, or patient satisfaction. GP-led breast cancer follow-up was cheaper than hospital follow-up. Intensified primary health care resulted in increased home-care nurse contact, and improved discharge summary led to increased GP contact. Evaluation of patient-initiated or minimal follow-up found no statistically significant impact on the number of GP consultations or cancer-related referrals. Conclusion Weak evidence suggests that breast cancer follow-up in primary care is effective. Interventions improving communication between primary and secondary care could lead to greater GP involvement. Discontinuation of formal follow-up may not increase GP workload. However, the quality of the data in general was poor, and no firm conclusions can be reached. PMID:19566990

Acute Effect of Whole-Body Vibration Warm-up on Footspeed Quickness.

PubMed

Donahue, Ryan B; Vingren, Jakob L; Duplanty, Anthony A; Levitt, Danielle E; Luk, Hui-Ying; Kraemer, William J

2016-08-01

Donahue, RB, Vingren, JL, Duplanty, AA, Levitt, DE, Luk, H-Y, and Kraemer, WJ. Acute effect of whole-body vibration warm-up on footspeed quickness. J Strength Cond Res 30(8): 2286-2291, 2016-The warm-up routine preceding a training or athletic event can affect the performance during that event. Whole-body vibration (WBV) can increase muscle performance, and thus the inclusion of WBV to the warm-up routine might provide additional performance improvements. The purpose of this investigation was to examine the acute effect of a WBV warm-up, using a vertical oscillating platform and a more traditional warm-up protocol on feet quickness in physically active men. Twenty healthy and physically active men (18-25 years, 22 ± 3 years, 176.8 ± 6.4 cm, 84.4 ± 11.5 kg, 10.8 ± 1.4% body fat) volunteered for this study. A 2 × 2 factorial design was used to examine the effect of 4 warm-up scenarios (no warm-up, traditional warm-up only, WBV warm-up only, and combined traditional and WBV warm-up) on subsequent 3-second Quick feet count test (QFT) performance. The traditional warm-up consisted of static and dynamic exercises and stretches. The WBV warm-up consisted of 60 seconds of vertical sinusoidal vibration at a frequency of 35 Hz and amplitude of 4 mm on a vibration platform. The WBV protocol significantly (p ≤ 0.0005, η = 0.581) augmented QFT performance (WBV: 37.1 ± 3.4 touches; no-WBV: 35.7 ± 3.4 touches). The results demonstrate that WBV can enhance the performance score on the QFT. The findings of this study suggest that WBV warm-up should be included in warm-up routines preceding training and athletic events which include very fast foot movements.

Out with the Sit-Up, in with the Curl-Up!

ERIC Educational Resources Information Center

MacFarlane, Pamela A.

1993-01-01

Explains why physical education teachers should discourage full sit-ups and describes the Robertson Modified Curl-Up Test as a recommended alternative test of abdominal muscular strength. Curl-up test administration guidelines are included with some preliminary norms from adult groups. (SM)

The impact of multiple show-ups on eyewitness decision-making and innocence risk.

PubMed

Smith, Andrew M; Bertrand, Michelle; Lindsay, R C L; Kalmet, Natalie; Grossman, Deborah; Provenzano, Daniel

2014-09-01

If an eyewitness rejects a show-up, police may respond by finding a new suspect and conducting a second show-up with the same eyewitness. Police may continue finding suspects and conducting show-ups until the eyewitness makes an identification (Study 1). Relatively low criterion-setting eyewitnesses filter themselves out of the multiple show-ups procedure by choosing the first suspect with whom they are presented (Studies 2 and 3). Accordingly, response bias was more stringent on the second show-up when compared with the first, but became no more stringent with additional show-ups. Despite this stringent shift in response bias, innocence risk increased with additional show-ups, as false alarms cumulate (Studies 2 and 3). Although unbiased show-up instructions decreased innocent suspect identifications, the numbers were still discouraging (Study 4). Given the high number of innocent suspects who would be mistakenly identified through the use of multiple show-up procedures, using such identifications as evidence of guilt is questionable. Although evidence of guilt is limited to identifications from a single show-up, practical constraints might sometimes require police to use additional show-ups. Accordingly, we propose a stronger partition between evidentiary and investigative procedures. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Catch-up growth in stunted children: Definitions and predictors

PubMed Central

2017-01-01

This paper examines the incidence and correlates of linear growth catch up in early childhood among stunted children, using a range of definitions of catch up. Catch-up growth between two and five years of age is defined in both absolute terms (i.e. the centimetre height deficit from the healthy reference population mean is reduced) and relative terms (the height-for-age z-score improved or passed the -2SD or -1SD cut-off points). Data from a cohort study from urban South Africa are used to estimate the percentage of children who caught up and the predictors of catch-up growth according to these varying definitions. The results show that our sample of stunted children exhibits catch-up growth regardless of the definition used, however prevalence of catch up is highly sensitive to the way catch up is classified, ranging from 19%-93%. Of the biological, early growth, socioeconomic status and maternal reproductive variables included in the multivariate probit regressions, only a few were found to be consistent predictors of the incidence of catch-up growth. Mother’s height was positively correlated with the incidence of catch-up growth and early stunting at one year was associated with a lower likelihood of subsequent catch up. PMID:29236728

Catch-up growth in stunted children: Definitions and predictors.

PubMed

Desmond, Chris; Casale, Daniela

2017-01-01

This paper examines the incidence and correlates of linear growth catch up in early childhood among stunted children, using a range of definitions of catch up. Catch-up growth between two and five years of age is defined in both absolute terms (i.e. the centimetre height deficit from the healthy reference population mean is reduced) and relative terms (the height-for-age z-score improved or passed the -2SD or -1SD cut-off points). Data from a cohort study from urban South Africa are used to estimate the percentage of children who caught up and the predictors of catch-up growth according to these varying definitions. The results show that our sample of stunted children exhibits catch-up growth regardless of the definition used, however prevalence of catch up is highly sensitive to the way catch up is classified, ranging from 19%-93%. Of the biological, early growth, socioeconomic status and maternal reproductive variables included in the multivariate probit regressions, only a few were found to be consistent predictors of the incidence of catch-up growth. Mother's height was positively correlated with the incidence of catch-up growth and early stunting at one year was associated with a lower likelihood of subsequent catch up.

The Crystal Structure of Streptococcus pyogenes Uridine Phosphorylase Reveals a Distinct Subfamily of Nucleoside Phosphorylases

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

Tran, Timothy H.; Christoffersen, S.; Allan, Paula W.

2011-09-20

Uridine phosphorylase (UP), a key enzyme in the pyrimidine salvage pathway, catalyzes the reversible phosphorolysis of uridine or 2'-deoxyuridine to uracil and ribose 1-phosphate or 2'-deoxyribose 1-phosphate. This enzyme belongs to the nucleoside phosphorylase I superfamily whose members show diverse specificity for nucleoside substrates. Phylogenetic analysis shows Streptococcus pyogenes uridine phosphorylase (SpUP) is found in a distinct branch of the pyrimidine subfamily of nucleoside phosphorylases. To further characterize SpUP, we determined the crystal structure in complex with the products, ribose 1-phosphate and uracil, at 1.8 {angstrom} resolution. Like Escherichia coli UP (EcUP), the biological unit of SpUP is a hexamermore » with an ?/? monomeric fold. A novel feature of the active site is the presence of His169, which structurally aligns with Arg168 of the EcUP structure. A second active site residue, Lys162, is not present in previously determined UP structures and interacts with O2 of uracil. Biochemical studies of wild-type SpUP showed that its substrate specificity is similar to that of EcUP, while EcUP is {approx}7-fold more efficient than SpUP. Biochemical studies of SpUP mutants showed that mutations of His169 reduced activity, while mutation of Lys162 abolished all activity, suggesting that the negative charge in the transition state resides mostly on uracil O2. This is in contrast to EcUP for which transition state stabilization occurs mostly at O4.« less

Does increasing active warm-up duration affect afternoon short-term maximal performance during Ramadan?

PubMed

Baklouti, Hana; Aloui, Asma; Chtourou, Hamdi; Briki, Walid; Chaouachi, Anis; Souissi, Nizar

2015-01-01

The purpose of this study was to examine the effect of active warm-up duration on short-term maximal performance assessed during Ramadan in the afternoon. Twelve healthy active men took part in the study. The experimental design consisted of four test sessions conducted at 5 p.m., before and during Ramadan, either with a 5-minute or a 15-minute warm-up. The warm-up consisted in pedaling at 50% of the power output obtained at the last stage of a submaximal multistage cycling test. During each session, the subjects performed two vertical jump tests (squat jump and counter movement jump) for measurement of vertical jump height followed by a 30-second Wingate test for measurement of peak and mean power. Oral temperature was recorded at rest and after warming-up. Moreover, ratings of perceived exertion were obtained immediately after the Wingate test. Oral temperature was higher before Ramadan than during Ramadan at rest, and was higher after the 15-minute warm-up than the 5-minute warm-up both before and during Ramadan. In addition, vertical jump heights were not significantly different between the two warm-up conditions before and during Ramadan, and were lower during Ramadan than before Ramadan after both warm-up conditions. Peak and mean power were not significantly different between the two warm-up durations before Ramadan, but were significantly higher after the 5-minute warm-up than the 15-minute warm-up during Ramadan. Moreover, peak and mean power were lower during Ramadan than before Ramadan after both warm-up conditions. Furthermore, ratings of perceived exertion were higher after the 15-minute warm-up than the 5-minute warm-up only during Ramadan. The prolonged active warm-up has no effect on vertical jump height but impairs anaerobic power assessed during Ramadan in the afternoon.

Does Increasing Active Warm-Up Duration Affect Afternoon Short-Term Maximal Performance during Ramadan?

PubMed Central

Baklouti, Hana; Aloui, Asma; Chtourou, Hamdi; Briki, Walid; Chaouachi, Anis; Souissi, Nizar

2015-01-01

Aim The purpose of this study was to examine the effect of active warm-up duration on short-term maximal performance assessed during Ramadan in the afternoon. Methods Twelve healthy active men took part in the study. The experimental design consisted of four test sessions conducted at 5 p.m., before and during Ramadan, either with a 5-minute or a 15-minute warm-up. The warm-up consisted in pedaling at 50% of the power output obtained at the last stage of a submaximal multistage cycling test. During each session, the subjects performed two vertical jump tests (squat jump and counter movement jump) for measurement of vertical jump height followed by a 30-second Wingate test for measurement of peak and mean power. Oral temperature was recorded at rest and after warming-up. Moreover, ratings of perceived exertion were obtained immediately after the Wingate test. Results Oral temperature was higher before Ramadan than during Ramadan at rest, and was higher after the 15-minute warm-up than the 5-minute warm-up both before and during Ramadan. In addition, vertical jump heights were not significantly different between the two warm-up conditions before and during Ramadan, and were lower during Ramadan than before Ramadan after both warm-up conditions. Peak and mean power were not significantly different between the two warm-up durations before Ramadan, but were significantly higher after the 5-minute warm-up than the 15-minute warm-up during Ramadan. Moreover, peak and mean power were lower during Ramadan than before Ramadan after both warm-up conditions. Furthermore, ratings of perceived exertion were higher after the 15-minute warm-up than the 5-minute warm-up only during Ramadan. Conclusion The prolonged active warm-up has no effect on vertical jump height but impairs anaerobic power assessed during Ramadan in the afternoon. PMID:25646955

Graduate Follow-up. TEX-SIS FOLLOW-UP SC6.

ERIC Educational Resources Information Center

Lewis, Rayford T.

This report details the research activities conducted by San Antonio College (SAC) as a subcontractor of Project FOLLOW-UP, in the design, development, and implementation of a graduate follow-up system. Numerous information gathering techniques, including personal interviews and follow-up questionnaires, were attempted. Four different groups of…

DGIC Interconnection Insights | Distributed Generation Interconnection

Science.gov Websites

Up to 2 MW 5 15 20 NJ 3 Up to 10 kW 3 10 13 Up to 2 MW 3 15 18 CO 4 Up to 10 kW 10 15 25 Up to 2 MW Screens) Total Days for Application Review and Aproval CA 4 Up tp 2 MW 10 15 25 NY 3 Up to 50 kW 5 10 15 10 15 30 AZ N/A. As of the writing of this report, Arizona has no standard timeframe requirements in

Mn-Fe base and Mn-Cr-Fe base austenitic alloys

DOEpatents

Brager, Howard R.; Garner, Francis A.

1987-09-01

Manganese-iron base and manganese-chromium-iron base austenitic alloys designed to have resistance to neutron irradiation induced swelling and low activation have the following compositions (in weight percent): 20 to 40 Mn; up to about 15 Cr; about 0.4 to about 3.0 Si; an austenite stabilizing element selected from C and N, alone or in combination with each other, and in an amount effective to substantially stabilize the austenite phase, but less than about 0.7 C, and less than about 0.3 N; up to about 2.5 V; up to about 0.1 P; up to about 0.01 B; up to about 3.0 Al; up to about 0.5 Ni; up to about 2.0 W; up to about 1.0 Ti; up to about 1.0 Ta; and with the remainder of the alloy being essentially iron.

Mn-Fe base and Mn-Cr-Fe base austenitic alloys

DOEpatents

Brager, Howard R.; Garner, Francis A.

1987-01-01

Manganese-iron base and manganese-chromium-iron base austenitic alloys designed to have resistance to neutron irradiation induced swelling and low activation have the following compositions (in weight percent): 20 to 40 Mn; up to about 15 Cr; about 0.4 to about 3.0 Si; an austenite stabilizing element selected from C and N, alone or in combination with each other, and in an amount effective to substantially stabilize the austenite phase, but less than about 0.7 C, and less than about 0.3 N; up to about 2.5 V; up to about 0.1 P; up to about 0.01 B; up to about 3.0 Al; up to about 0.5 Ni; up to about 2.0 W; up to about 1.0 Ti; up to about 1.0 Ta; and with the remainder of the alloy being essentially iron.

Low-cost, high-strength Fe--Ni--Cr alloys for high temperature exhaust valve application

DOEpatents

Muralidharan, Govindarajan

2017-09-05

An Fe--Ni--Cr alloy is composed essentially of, in terms of wt. %: 2.4 to 3.7 Al, up to 1.05 Co, 14.8 to 15.9 Cr, 25 to 36 Fe, up to 1.2 Hf, up to 4 Mn, up to 0.6 Mo, up to 2.2 Nb, up to 1.05 Ta, 1.9 to 3.6 Ti, up to 0.08 W, up to 0.03 Zr, 0.18 to 0.27 C, up to 0.0015 N, balance Ni, wherein, in terms of atomic percent: 8.5.ltoreq.Al+Ti+Zr+Hf+Ta.ltoreq.11.5, 0.53.ltoreq.Al/(Al+Ti+Zr+Hf+Ta).ltoreq.0.65, and 0.16.ltoreq.Cr/(Fe+Ni+Cr+Mn).ltoreq.0.21, the alloy being essentially free of Cu, Si, and V.

Incidence of Endodontic Flare-ups and Its Related Factors: A Retrospective Study.

PubMed

Nair, Manuja; Rahul, J; Devadathan, A; Mathew, Josey

2017-01-01

The aim and objective of the study were to determine the incidence of flare-ups during endodontic treatment and to identify the risk factors associated with flare-ups. A total of 1725 patients who were treated during the time period of 2009-2014 by the same endodontist were reviewed. Incidence of flare-up, patients' age, gender, status of pulp, tooth position, number of roots, and treatment provided were taken from their dental records. Relationship between these factors and flare-ups was examined. Statistical analysis was done using Pearson Chi-square test and Fisher's exact test. A total of 2% incidence of endodontic flare-ups was seen out of 1725 cases. Patient's age, gender, and diagnosis had a significant effect on the development of flare-ups ( P < 0.05). Tooth type, position of tooth, number of root canals, number of visits, and treatment modality had no significant effect on flare-up incidence. Diagnosis plays an important role in predicting the incidence of flare-ups. Patients in the age group of 40-60 years had a higher risk of developing flare-ups. Women compared to men are more prone to flare-ups.

Incidence of Endodontic Flare-ups and Its Related Factors: A Retrospective Study

PubMed Central

Nair, Manuja; Rahul, J.; Devadathan, A.; Mathew, Josey

2017-01-01

Aims and Objectives: The aim and objective of the study were to determine the incidence of flare-ups during endodontic treatment and to identify the risk factors associated with flare-ups. Subjects and Methods: A total of 1725 patients who were treated during the time period of 2009–2014 by the same endodontist were reviewed. Incidence of flare-up, patients' age, gender, status of pulp, tooth position, number of roots, and treatment provided were taken from their dental records. Relationship between these factors and flare-ups was examined. Statistical analysis was done using Pearson Chi-square test and Fisher's exact test. Results: A total of 2% incidence of endodontic flare-ups was seen out of 1725 cases. Patient's age, gender, and diagnosis had a significant effect on the development of flare-ups (P < 0.05). Tooth type, position of tooth, number of root canals, number of visits, and treatment modality had no significant effect on flare-up incidence. Conclusions: Diagnosis plays an important role in predicting the incidence of flare-ups. Patients in the age group of 40–60 years had a higher risk of developing flare-ups. Women compared to men are more prone to flare-ups. PMID:28852632

The Natural History of Flare-Ups in Fibrodysplasia Ossificans Progressiva (FOP): A Comprehensive Global Assessment.

PubMed

Pignolo, Robert J; Bedford-Gay, Christopher; Liljesthröm, Moira; Durbin-Johnson, Blythe P; Shore, Eileen M; Rocke, David M; Kaplan, Frederick S

2016-03-01

Fibrodysplasia ossificans progressiva (FOP) leads to disabling heterotopic ossification (HO) from episodic flare-ups. However, the natural history of FOP flare-ups is poorly understood. A 78-question survey on FOP flare-ups, translated into 15 languages, was sent to 685 classically-affected patients in 45 countries (six continents). Five hundred patients or knowledgeable informants responded (73%; 44% males, 56% females; ages: 1 to 71 years; median: 23 years). The most common presenting symptoms of flare-ups were swelling (93%), pain (86%), or decreased mobility (79%). Seventy-one percent experienced a flare-up within the preceding 12 months (52% spontaneous; 48% trauma-related). Twenty-five percent of those who had received an intramuscular injection reported an immediate flare-up at the injection site, 84% of whom developed HO. Axial flare-ups most frequently involved the back (41.6%), neck (26.4%), or jaw (19.4%). Flare-ups occurred more frequently in the upper limbs before 8 years of age, but more frequently in the lower limbs thereafter. Appendicular flare-ups occurred more frequently at proximal than at distal sites without preferential sidedness. Seventy percent of patients reported functional loss from a flare-up. Thirty-two percent reported complete resolution of at least one flare-up and 12% without any functional loss (mostly in the head or back). The most disabling flare-ups occurred at the shoulders or hips. Surprisingly, 47% reported progression of FOP without obvious flare-ups. Worldwide, 198 treatments were reported; anti-inflammatory agents were most common. Seventy-five percent used short-term glucocorticoids as a treatment for flare-ups at appendicular sites. Fifty-five percent reported that glucocorticoids improved symptoms occasionally whereas 31% reported that they always did. Only 12% reported complete resolution of a flare-up with glucocorticoids. Forty-three percent reported rebound symptoms within 1 to 7 days after completing a course of glucocorticoids. This study is the first comprehensive global assessment of FOP flare-ups and establishes a critical foundation for the design and evaluation of future clinical trials. © 2015 American Society for Bone and Mineral Research.

Speaking up for patient safety by hospital-based health care professionals: a literature review

PubMed Central

2014-01-01

Background Speaking up is important for patient safety, but often, health care professionals hesitate to voice concerns. Understanding the influencing factors can help to improve speaking-up behaviour and team communication. This review focused on health care professionals’ speaking-up behaviour for patient safety and aimed at (1) assessing the effectiveness of speaking up, (2) evaluating the effectiveness of speaking-up training, (3) identifying the factors influencing speaking-up behaviour, and (4) developing a model for speaking-up behaviour. Methods Five databases (PubMed, MEDLINE, CINAHL, Web of Science, and the Cochrane Library) were searched for English articles describing health care professionals’ speaking-up behaviour as well as those evaluating the relationship between speaking up and patient safety. Influencing factors were identified and then integrated into a model of voicing behaviour. Results In total, 26 studies were identified in 27 articles. Some indicated that hesitancy to speak up can be an important contributing factor in communication errors and that training can improve speaking-up behaviour. Many influencing factors were found: (1) the motivation to speak up, such as the perceived risk for patients, and the ambiguity or clarity of the clinical situation; (2) contextual factors, such as hospital administrative support, interdisciplinary policy-making, team work and relationship between other team members, and attitude of leaders/superiors; (3) individual factors, such as job satisfaction, responsibility toward patients, responsibility as professionals, confidence based on experience, communication skills, and educational background; (4) the perceived efficacy of speaking up, such as lack of impact and personal control; (5) the perceived safety of speaking up, such as fear for the responses of others and conflict and concerns over appearing incompetent; and (6) tactics and targets, such as collecting facts, showing positive intent, and selecting the person who has spoken up. Conclusions Hesitancy to speak up can be an important contributing factor to communication errors. Our model helps us to understand how health care professionals think about voicing their concerns. Further research is required to investigate the relative importance of different factors. PMID:24507747

Warm-Up Exercises May Not Be So Important for Enhancing Submaximal Running Performance.

PubMed

Takizawa, Kazuki; Yamaguchi, Taichi; Shibata, Keisuke

2018-05-01

Takizawa, K, Yamaguchi, T, and Shibata, K. Warm-up exercises may not be so important for enhancing submaximal running performance. J Strength Cond Res 32(5): 1383-1390, 2018-The purpose of this study was to determine an appropriate warm-up intensity for enhancing performance in submaximal running at 90% vV[Combining Dot Above]O2max (it assumes 3,000-5,000 m in track events). Seven trained male university athletes took part in this study (age: 21.3 ± 2.1 years, height: 169.3 ± 4.7 cm, body mass: 58.4 ± 5.6 kg, V[Combining Dot Above]O2max: 73.33 ± 5.46 ml·kg·min). Each subject ran on a treadmill at 90% vV[Combining Dot Above]O2max until exhaustion after 1 of 4 warm-up treatments. The 4 warm-up treatments were no warm-up, 15 minutes running at 60% vV[Combining Dot Above]O2max, at 70% vV[Combining Dot Above]O2max, and at 80% vV[Combining Dot Above]O2max. The running performance was evaluated by time to exhaustion (TTE). V[Combining Dot Above]O2, and vastus lateralis muscle temperature were also measured. There were no significant differences in TTE among the warm-up exercises (p > 0.05). V[Combining Dot Above]O2 in no warm-up showed slower reaction than the other warm-up exercises. Regarding, the vastus lateralis muscle temperature immediately after warm-up, no warm-up was significantly (p < 0.01) lower compared with the other warm-up exercises. Our results suggested that submaximal running performance was not affected by the presence or absence of a warm-up or by warm-up intensity, although physiological changes occurred.

Characterisation of various grape seed oils by volatile compounds, triacylglycerol composition, total phenols and antioxidant capacity.

PubMed

Bail, Stefanie; Stuebiger, Gerald; Krist, Sabine; Unterweger, Heidrun; Buchbauer, Gerhard

2008-06-01

Grape seed oil (Oleum vitis viniferae) representing a promising plant fat, mainly used for culinary and pharmaceutical purposes as well as for various technical applications, was subject of the present investigation. HS-SPME-GC-MS was applied to study volatile compounds in several seed oil samples from different grape oils. The triacylglycerol (TAG) composition of these oils was analyzed by MALDI-TOF-MS/MS. In addition the total phenol content and the antioxidant capacity (using TEAC) of these oils were determined. The headspace of virgin grape oils from white and red grapes was dominated by ethyl octanoate (up to 27.5% related to the total level of volatiles), ethylacetate (up to 25.0%), ethanol (up to 22.7%), acetic acid (up to 17.2%), ethyl hexanoate (up to 17.4%) and 3-methylbutanol (up to 11.0%). Triacylglycerol composition was found to be dominated by LLL (up to 41.8%), LLP (up to 24.3%), LLO (up to 16.3%) and LOO (up to 11.7%), followed by LOP (up to 9.3%) and LOS/OOO (up to 4.3%). Total phenol content ranged between 59μg/g and 115.5μg/g GAE. Antioxidant capacity (TEAC) was analyzed to range between 0.09μg/g and 1.16μg/g. Copyright © 2007 Elsevier Ltd. All rights reserved.

Comparison of Effects Produced by Physiological Versus Traditional Vocal Warm-up in Contemporary Commercial Music Singers.

PubMed

Portillo, María Priscilla; Rojas, Sandra; Guzman, Marco; Quezada, Camilo

2018-03-01

The present study aimed to observe whether physiological warm-up and traditional singing warm-up differently affect aerodynamic, electroglottographic, acoustic, and self-perceived parameters of voice in Contemporary Commercial Music singers. Thirty subjects were asked to perform a 15-minute session of vocal warm-up. They were randomly assigned to one of two types of vocal warm-up: physiological (based on semi-occluded exercises) or traditional (singing warm-up based on open vowel [a:]). Aerodynamic, electroglottographic, acoustic, and self-perceived voice quality assessments were carried out before (pre) and after (post) warm-up. No significant differences were found when comparing both types of vocal warm-up methods, either in subjective or in objective measures. Furthermore, the main positive effect observed in both groups when comparing pre and post conditions was a better self-reported quality of voice. Additionally, significant differences were observed for sound pressure level (decrease), glottal airflow (increase), and aerodynamic efficiency (decrease) in the traditional warm-up group. Both traditional and physiological warm-ups produce favorable voice sensations. Moreover, there are no evident differences in aerodynamic and electroglottographic variables when comparing both types of vocal warm-ups. Some changes after traditional warm-up (decreased intensity, increased airflow, and decreased aerodynamic efficiency) could imply an early stage of vocal fatigue. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Efficient Warm-ups: Creating a Warm-up That Works.

ERIC Educational Resources Information Center

Lauffenburger, Sandra Kay

1992-01-01

Proper warm-up is important for any activity, but designing an effective warm-up can be time consuming. An alternative approach is to take a cue from Laban Movement Analysis (LMA) and consider movement design from the perspective of space and planes of motion. Efficient warm-up exercises using LMA are described. (SM)

Comparing the effects of education using telephone follow-up and smartphone-based social networking follow-up on self-management behaviors among patients with hypertension.

PubMed

Najafi Ghezeljeh, Tahereh; Sharifian, Sanaz; Nasr Isfahani, Mehdi; Haghani, Hamid

2018-03-05

Little is known about the benefits of social networks in the management of patients. The aim of this study was to compare the effects of self-management (SM) education using telephone follow-up and mobile phone-based social networking on SM behaviors among patients with hypertension. This randomized clinical trial was conducted with 100 patients. They were randomly allocated to four groups: (i) control, (ii) SM training without follow-up, (iii) telephone follow-up and (iv) smartphone-based social networking follow-up. The hypertension SM behavior questionnaire was used for data collection before and six weeks after the study. Those patients who underwent SM education training (with and without follow-up) had statistically significant differences from those in the control group in terms of SM behaviors (p < .001). There was no statistically significant difference between different types of follow-up. SM education using telephone follow-up and/or smartphone-based social networking follow-up influenced SM behaviors among patients with hypertension.

Influence of dietary slow-release urea on growth performance, organ development and serum biochemical parameters of mutton sheep.

PubMed

Ji, S K; Zhang, F; Sun, Y K; Deng, K D; Wang, B; Tu, Y; Zhang, N F; Jiang, C G; Wang, S Q; Diao, Q Y

2017-10-01

Eighty Dorper × thin-tailed Han cross-bred non-castrated male lambs [mean body weight (BW), 25.87 ± 1.06 kg] were randomly allocated to one of five different concentrations of slow-release urea (urea phosphate, UP). The feed consisted of an equal amount of concentrate diet and roughage; the concentrate feed was formulated to be isoenergetic and isonitrogenic and contained 0%, 1%, 2%, 4% and 8% UP (UP0.0, UP1.0, UP2.0, UP4.0 and UP8.0, respectively) as a replacement for soya bean meal. Feed intake, BW, average daily gain (ADG), feed utilisation efficiency (FUE), absolute and relative organ weights and biochemical and histopathological parameters were measured. Feed intake, BW, ADG and FUE significantly decreased in the group receiving UP8.0 (p < 0.05), but no difference was found among the other groups (p > 0.05). Quadratic equations were developed between the UP dosage in the concentrate feed and ADG or FUE (r 2  = 0.973 for ADG and r 2  = 0.761 for FUE) to determine the appropriate dosage of UP given the desire to maximise either ADG or FUE, the appropriate dosage (feed concentration) was calculated as 2.01% UP to achieve the greatest ADG or 2.13% UP to achieve the best FUE. The relative weight of the liver (% BW) in the UP2.0 groups was significantly greater than that of UP0.0 (p < 0.05), and the relative weight of the intestine in the UP8.0 was significantly greater than that of UP0.0 (p < 0.05); the relative weight of the carcass, heart, spleen, lung, kidney, rumen, reticulum, omasum and abomasum did not differ among treatments (p > 0.05). The UP8.0 treatment significantly increased serum phosphorus levels (p < 0.05) and decreased the levels of alkaline phosphatase, glucose and calcium (Ca) compared with the lower UP dosage (p < 0.05). No histopathological differences were found in either hepatic tissues or renal tissues among treatments. Dietary UP as a replacement for soya bean in concentrate feeds for mutton sheep should not exceed 4%, as higher dosing may cause malnutrition and mineral disorders. Journal of Animal Physiology and Animal Nutrition © 2016 Blackwell Verlag GmbH.

Loop Heat Pipe Startup Behaviors

NASA Technical Reports Server (NTRS)

Ku, Jentung

2014-01-01

A loop heat pipe must start successfully before it can commence its service. The start-up transient represents one of the most complex phenomena in the loop heat pipe operation. This paper discusses various aspects of loop heat pipe start-up behaviors. Topics include the four start-up scenarios, the initial fluid distribution between the evaporator and reservoir that determines the start-up scenario, factors that affect the fluid distribution between the evaporator and reservoir, difficulties encountered during the low power start-up, and methods to enhance the start-up success. Also addressed are the thermodynamic constraint between the evaporator and reservoir in the loop heat pipe operation, the superheat requirement for nucleate boiling, pressure spike and pressure surge during the start-up transient, and repeated cycles of loop start-up andshutdown under certain conditions.

The effects of precompetition massage on the kinematic parameters of 20-m sprint performance.

PubMed

Fletcher, Iain M

2010-05-01

The purpose of this study was to investigate what effect precompetition massage has on short-term sprint performance. Twenty male collegiate games players, with a minimum training/playing background of 3 sessions per week, were assigned to a randomized, counter-balanced, repeated-measures designed experiment used to analyze 20-m sprints performance. Three discrete warm-up modalities, consisting of precompetition massage, a traditional warm-up, and a precompetition massage combined with a traditional warm-up were used. Massage consisted of fast, superficial techniques designed to stimulate the main muscle groups associated with sprint running. Twenty-meter sprint performance and core temperature were assessed post warm-up interventions. Kinematic differences between sprints were assessed through a 2-dimensional computerized motion analysis system (alpha level p

Loss to specialist follow-up in congenital heart disease; out of sight, out of mind

PubMed Central

Wray, Jo; Frigiola, Alessandra; Bull, Catherine

2013-01-01

Objective To evaluate the scale and clinical importance of loss to follow-up of past patients with serious congenital heart disease, using a common malformation as an example. To better understand the antecedents of loss to specialist follow-up and patients’ attitudes to returning. Design Cohort study using NHS number functionality. Content and thematic analysis of telephone interviews of subset contacted after loss to follow-up. Patients, intervention and setting Longitudinal follow-up of complete consecutive list of all 1085 UK patients with repair of tetralogy of Fallot from single institution 1964–2009. Main outcome measures Survival, freedom from late pulmonary valve replacement, loss to specialist follow-up, shortfall in late surgical revisions related to loss to follow-up. Patients’ narrative about loss to follow-up. Results 216 (24%) of patients known to be currently alive appear not to be registered with specialist clinics; some are seen in general cardiology clinics. Their median age is 32 years and median duration of loss to follow-up is 22 years; most had been lost before Adult Congenital services had been consolidated in their present form. 48% of the late deaths to date have occurred in patients not under specialist follow-up. None of those lost to specialist follow-up has had secondary pulmonary valve replacement while 188 patients under specialist care have. Patients lost to specialist follow-up who were contacted by telephone had no knowledge of its availability. Conclusions Loss to specialist follow-up, typically originating many years ago, impacts patient management. PMID:23257171

Establishment and proteomic characterization of a novel cell line, NCC-UPS2-C1, derived from a patient with undifferentiated pleomorphic sarcoma.

PubMed

Oyama, Rieko; Kito, Fusako; Sakumoto, Marimu; Shiozawa, Kumiko; Toki, Shunichi; Yoshida, Akihiko; Kawai, Akira; Kondo, Tadashi

2018-03-01

Undifferentiated pleomorphic sarcoma (UPS) is an aggressive mesenchymal malignancy requiring novel therapeutic approaches to improve clinical outcome. Patient-derived cancer cell lines are an essential tool for investigating molecular mechanisms underlying cancer initiation and development; however, there is a lack of patient-derived cell lines of UPS available for research. The objective of this study was to develop a patient-derived cell model of UPS. A cell line designated NCC-UPS2-C1 was established from the primary tumor tissue of an 84-yr-old female patient with UPS. The short tandem repeat pattern of NCC-UPS2-C1 cells was identical to that of the original tumor and distinct from that of any other cell lines deposited in public cell banks. NCC-UPS2-C1 cells were maintained as a monolayer culture for over 80 passages during 30 mo and exhibited spindle-like morphology, continuous growth, and ability for spheroid formation and invasion. Proteomic profiling using mass spectrometry and functional treemap analysis revealed that the original tumor and the derived NCC-UPS2-C1 cells had similar but distinct protein expression patterns. Our results indicate that a novel UPS cell line was successfully established and could be used to study UPS development and effects of anti-cancer drugs. However, the revealed difference between proteomes of the original tumor and NCC-UPS2-C1 cells should be further investigated to determine the appropriate applications of this cell line in UPS research.

Warm-Up Strategies for Sport and Exercise: Mechanisms and Applications.

PubMed

McGowan, Courtney J; Pyne, David B; Thompson, Kevin G; Rattray, Ben

2015-11-01

It is widely accepted that warming-up prior to exercise is vital for the attainment of optimum performance. Both passive and active warm-up can evoke temperature, metabolic, neural and psychology-related effects, including increased anaerobic metabolism, elevated oxygen uptake kinetics and post-activation potentiation. Passive warm-up can increase body temperature without depleting energy substrate stores, as occurs during the physical activity associated with active warm-up. While the use of passive warm-up alone is not commonplace, the idea of utilizing passive warming techniques to maintain elevated core and muscle temperature throughout the transition phase (the period between completion of the warm-up and the start of the event) is gaining in popularity. Active warm-up induces greater metabolic changes, leading to increased preparedness for a subsequent exercise task. Until recently, only modest scientific evidence was available supporting the effectiveness of pre-competition warm-ups, with early studies often containing relatively few participants and focusing mostly on physiological rather than performance-related changes. External issues faced by athletes pre-competition, including access to equipment and the length of the transition/marshalling phase, have also frequently been overlooked. Consequently, warm-up strategies have continued to develop largely on a trial-and-error basis, utilizing coach and athlete experiences rather than scientific evidence. However, over the past decade or so, new research has emerged, providing greater insight into how and why warm-up influences subsequent performance. This review identifies potential physiological mechanisms underpinning warm-ups and how they can affect subsequent exercise performance, and provides recommendations for warm-up strategy design for specific individual and team sports.

Corrosion Inhibition in High Temperature Environment

DTIC Science & Technology

1993-06-28

levels of sodium , sulfur, and vanadium. Low quality 12 marine residual fuels, for example, may contain up to 0.2 weight 13 percent ash which contains...appreciable amounts of sodium , up to 5 14 weight percent sulfur and up to 0.06 weight percent or 600 ppm 15 vanadium. Low grades of marine distillate...fuels are allowed up to 16 0.05 weight percent ash which contains appreciable amounts of 17 sodium , up to 2 weight percent sulfur and up to 100 ppm

The Effects of Pop-up Harm Minimisation Messages on Electronic Gaming Machine Gambling Behaviour in New Zealand.

PubMed

Palmer du Preez, Katie; Landon, Jason; Bellringer, Maria; Garrett, Nick; Abbott, Max

2016-12-01

In New Zealand a simple pop-up message feature that provides gambling session information and forces a break in play is mandatory on all electronic gaming machines in all venues (EGMs). Previous research has demonstrated small effects of more sophisticated pop-up messages tested predominantly in laboratory environments. The present research examined gambler engagement with and views on the New Zealand pop-up messages and on the relationship between pop-up messages and EGM expenditure. A sample of gamblers was recruited at casino and non-casino (pub) EGM venues. Most participants were aware of pop-up messages (57 %) and many saw them often (38 %). Among gamblers who reported seeing pop-up messages, half read the message content, and a quarter believed that pop-up messages helped them control the amount of money they spend on gambling. Participants who reported being likely to stop gambling in response to pop-up messages spent significantly less money on gambling when variables that were independently associated with EGM expenditure were controlled for. A modest harm minimisation effect of the pop-up message feature that has been operating in New Zealand for 5 years was evident. Suggestions for improvement of the harm minimisation potential of the current pop-up message feature are discussed.

Synthesis of a novel reactive flame retardant containing phosphaphenanthrene and triazine-trione groups and its application in unsaturated polyester resin

NASA Astrophysics Data System (ADS)

Huo, Siqi; Wang, Jun; Yang, Shuang; Cai, Haopeng; Zhang, Bin; Chen, Xi; Wu, Qilei; Yang, Lingfeng

2018-03-01

A new-type compound (DT) which contained phosphaphenanthrene and triazine-trione groups was synthesized. DT was served as a reactive flame retardant for unsaturated polyester resin (UP). The thermal degradation, flame-retarded and mechanical properties of UP/DT samples were detected by different tests. According to the results, the addition of DT improved the initial thermal decomposition temperature (T5% and T10%) and the char yields of UP thermosets. Additionally, incorporation of DT resulted in the decrease of flexural and tensile strength of UP samples, and the increase of flexural modulus. The flame-retarded performance of UP/DT samples was greatly improved compared with the neat UP thermoset. For instance, the limited oxygen index (LOI) and vertical burning (UL94) rating of UP/DT-30 sample with 30 wt% DT came up to 29.8% and V-1. In comparison to pure UP thermoset, the average of heat release rate (av-HRR), total heat release (THR) and average of effective heat of combustion (av-EHC) of UP/DT-30 thermoset were decreased by 35.9%, 31.2% and 29.1%, respectively. Phosphaphenanthrene and triazine-trione groups in DT synergistically enhanced flame-retarded capability of UP in both gas phase and condensed phase.

Intensive follow-up for women with breast cancer: review of clinical, economic and patient's preference domains through evidence to decision framework.

PubMed

Lafranconi, Alessandra; Pylkkänen, Liisa; Deandrea, Silvia; Bramesfeld, Anke; Lerda, Donata; Neamțiu, Luciana; Saz-Parkinson, Zuleika; Posso, Margarita; Rigau, David; Sola, Ivan; Alonso-Coello, Pablo; Martinez-Zapata, Maria José

2017-10-19

Women treated for breast cancer are followed-up for monitoring of treatment effectiveness and for detecting recurrences at an early stage. The type of follow-up received may affect women's reassurance and impact on their quality of life. Anxiety and depression among women with breast cancer has been described, but little is known about how the intensity of the follow-up can affect women's psychological status. This study was undertaken to evaluate the effects of intensive vs. less-intensive follow-up on different health outcomes, to determine what are women's preferences and values regarding the follow-up received, and also assess the costs of these different types of follow-up. A systematic review following standard Cochrane Collaboration methods was carried out to assess the efficacy of intensive follow-up versus non-intensive follow-up in breast cancer patients. Two additional reviews on women's preferences and economic evidence were also carried out. The search was performed up to January 2016 in: MEDLINE, EMBASE, PDQ, McMaster Health Systems Evidence, CENTRAL, and NHS EED (through The Cochrane Library). The quality of evidence was assessed by GRADE (for quantitative studies) and CerQUAL (for qualitative studies). Several outcomes including mortality, breast cancer recurrences, quality of life, and patient satisfaction were evaluated. Six randomised trials (corresponding to 3534 women) were included for the evaluation of health outcomes; three studies were included for women's values and preferences and four for an economic assessment. There is moderate certainty of evidence showing that intensive follow-up, including more frequent diagnostic tests or visits, does not have effects on 5- or 10-year overall mortality and recurrences in women with breast cancer, compared with less intensive follow-up. Regarding women's preferences and values, there was important variability among studies and within studies (low confidence due to risk of bias and inconsistency). Furthermore, intensive follow-up, as opposed to less intensive follow-up, is not likely to be cost-effective. Less intensive follow-up appears to be justified and can be recommended over intensive follow-up. Resources could thus be mobilised to other aspects of breast cancer care, or other areas of healthcare.

Alternative Fuels Data Center: Phoenix Cleans Up with Natural Gas

Science.gov Websites

Phoenix Cleans Up with Natural Gas to someone by E-mail Share Alternative Fuels Data Center : Phoenix Cleans Up with Natural Gas on Facebook Tweet about Alternative Fuels Data Center: Phoenix Cleans Up with Natural Gas on Twitter Bookmark Alternative Fuels Data Center: Phoenix Cleans Up with Natural

TEX-SIS FOLLOW-UP: Student Follow-up Management Information System. Procedures Manual.

ERIC Educational Resources Information Center

Tarrant County Junior Coll. District, Ft. Worth, TX.

Project FOLLOW-UP was conducted to develop, test, and validate a statewide management information system for follow-up of Texas public junior and community college students. The results of this project was a student information system (TEX-SIS) consisting of seven subsystems: (1) Student's Educational Intent, (2) Nonreturning Student Follow-up,…

TEX-SIS FOLLOW-UP: Student Follow-up Management Information System. Data Processing Manual.

ERIC Educational Resources Information Center

Tarrant County Junior Coll. District, Ft. Worth, TX.

Project FOLLOW-UP was conducted to develop, test, and validate a statewide management information system for follow-up of Texas public junior and community college students. The result of this project was a student information system (TEX-SIS) consisting of seven subsystems: (1) Student's Educational Intent, (2) Nonreturning Student Follow-up, (3)…

Pop-Up Constructions Motivate and Reinforce Science Learning for Upper Elementary Students

ERIC Educational Resources Information Center

Olsen, Benjamin D.; Zhbanova, Ksenia S.; Parpucu, Harun; Alkouri, Zaid; Rule, Audrey C.

2013-01-01

Pop-up boxes and folder constructions support student inquiry while integrating art, craft, spatial, and creativity skills. Step-by-step illustrated directions for constructing pop-up boxes are provided with example images of pop-up boxes focused on ecological issues. Teachers used these pop-up constructions to assist fourth- and fifth-grade…

Vocal warm-up practices and perceptions in vocalists: a pilot survey.

PubMed

Gish, Allison; Kunduk, Melda; Sims, Loraine; McWhorter, Andrew J

2012-01-01

Investigated in a pilot study the type, duration, and frequency of vocal warm-up regimens in the singing community using a survey. One hundred seventeen participants completed an online survey. Participants included voice students from undergraduate, masters, and doctoral music programs and professional singers. Fifty-four percent of participants reported always using vocal warm-up before singing. Twenty-two percent of the participants used vocal cool down. The most preferred warm-up duration was of 5-10 minutes in duration. Despite using vocal warm-up, 26% of the participants reported experiencing voice problems. Females tended to use vocal warm-up more frequently than males. Females also tended to use longer warm-up sessions than males. Education of the participants did not appear to have any noticeable effect on the vocal warm-up practices. The most commonly used singing warm-up exercises were ascending/descending five-note scales, ascending/descending octave scales, legato arpeggios, and glissandi. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Offering Patients Therapy Options in Unplanned Start (OPTiONS): Implementation of an educational program is feasible and effective.

PubMed

Machowska, Anna; Alscher, Mark Dominik; Vanga, Satyanarayana Reddy; Koch, Michael; Aarup, Michael; Qureshi, Abdul Rashid; Lindholm, Bengt; Rutherford, Peter

2017-01-13

Patients with unplanned dialysis start (UPS) have worse clinical outcomes than non-UPS patients, and receive peritoneal dialysis (PD) less frequently. In the OPTiONS study of UPS patients, an educational programme (UPS-EP) aiming at improving care of UPS patients by facilitating care pathways and enabling informed choice of dialysis modality was implemented. We here report on impact of UPS-EP on modality choice and clinical outcomes in UPS patients. This non-interventional, prospective, multi-center, observational study included 270 UPS patients from 26 centers in 6 European countries (Austria, Germany, Denmark, France, United Kingdom and Sweden) who prior to inclusion presented acutely, or were being followed by nephrologists but required urgent dialysis commencement by an acutely placed CVC or PD catheter. Effects of UPS-EP on choice and final decision of dialysis therapy and outcomes within 12 months of follow up were analysed. Among 270 UPS patients who had an unplanned start to dialysis, 214 were able to receive and 203 complete UPS-EP while 56 patients - who were older (p = 0.01) and had higher Charlson comorbidity index (CCI; p < 0.01) - did not receive UPS-EP. Among 177 patients who chose dialysis modality after UPS-EP, 103 (58%) chose PD (but only 86% of them received PD) and 74 (42%) chose HD (95% received HD). Logistic regression analysis showed that diabetes 1.88 (1.05 - 3.37) and receiving UPS-EP, OR = 4.74 (CI, 2.05 - 10.98) predicted receipt of PD. Patients choosing PD had higher CCI (p = 0.01), higher prevalence of congestive heart failure (p < 0.01) and myocardial infarction (p = 0.02), and were more likely in-patients (p = 0.02) or referred from primary care (p = 0.02). One year survival did not differ significantly between PD and HD patients. Peritonitis and bacteraemia rates were better than international guideline standards. UPS-EP predicted patient use of PD but 14% of those choosing PD after UPS-EP still did not receive the modality they preferred. Patient survival in patients choosing and/or receiving PD was similar to HD despite age and comorbidity disadvantages of the PD groups.

Verbal Feedback in Therapeutic Communities: Pull-ups and Reciprocated Pull-ups as Predictors of Graduation

PubMed Central

Warren, Keith; Hiance, Danielle; Doogan, Nathan; De Leon, George; Phillips, Gary

2012-01-01

The most important proximal outcomes for residents of therapeutic communities (TCs) are retention and successful completion of the program. At this point there has been no quantitative analysis of the relationship between the exchange of corrective reminders, or pull-ups, between peers in TCs and graduation. This study draws on a database of pull-ups exchanged between 5,464 residents of three Midwestern TCs. Residents who send more pull-ups to peers and who reciprocate pull-ups with a larger percentage of peers are more likely to graduate. Residents who receive more pull-ups from peers and staff and a larger percentage of whose peers reciprocate pull-ups that they send are less likely to graduate. Implications of these findings for program theory and program improvement are discussed. PMID:23068980

Low-cost Fe--Ni--Cr alloys for high temperature valve applications

DOEpatents

Muralidharan, Govindarajan

2017-03-28

An Fe--Ni--Cr alloy is composed essentially of, in terms of weight percent: 1 to 3.5 Al, up to 2 Co, 15 to 19.5 Cr, up to 2 Cu, 23 to 40 Fe, up to 0.3 Hf, up to 4 Mn, 0.15 to 2 Mo, up to 0.15 Si, up to 1.05 Ta, 2.8 to 4.3 Ti, up to 0.5 W, up to 0.06 Zr, 0.02 to 0.15 C, 0.0001 to 0.007 N, balance Ni, wherein, in terms of atomic percent: 6.5.ltoreq.Al+Ti+Zr+Hf+Ta.ltoreq.10, 0.33.ltoreq.Al/(Al+Ti+Zr+Hf+Ta).ltoreq.0.065, 4.ltoreq.(Fe+Cr)/(Al+Ti+Zr+Hf+Ta).ltoreq.10, the alloy being essentially free of Nb and V.

Comparing Effectiveness of Active and Passive Client Follow-Up Approaches in Sustaining the Continued Use of Long Acting Reversible Contraceptives (LARC) in Rural Punjab: A Multicentre, Non-Inferiority Trial

PubMed Central

Hameed, Waqas; Azmat, Syed Khurram; Ali, Moazzam; Ishaque, Muhammad; Abbas, Ghazunfer; Munroe, Erik; Harrison, Rebecca; Shamsi, Wajahat Hussain; Mustafa, Ghulam; Khan, Omar Farooq; Ali, Safdar; Ahmed, Aftab

2016-01-01

Background The use of long-acting reversible contraceptive (LARC) methods is very low in Pakistan with high discontinuation rates mainly attributed to method-related side effects. Mixed evidence is available on the effectiveness of different client follow-up approaches used to ensure method continuation. We compared the effectiveness of active and passive follow-up approaches in sustaining the use of LARC—and within ‘active’ follow-up, we further compared a telephone versus home-based approach in rural Punjab, Pakistan. Methods This was a 12-month multicentre non-inferiority trial conducted in twenty-two (16 rural- and 6 urban-based) franchised reproductive healthcare facilities in district Chakwal of Punjab province, between November 2013 and December 2014. The study comprised of three groups of LARC clients: a) home-based follow-up, b) telephone-based follow-up, and c) passive or needs-based follow-up. Participants in the first two study groups received counselling on scheduled follow-up from the field workers at 1, 3, 6, 9, and 12 month post-insertion whereas participants in the third group were asked to contact the health facility if in need of medical assistance relating to LARC method use. Study participants were recruited with equal allocation to each study group, but participants were not randomized. The analyses are based on 1,246 LARC (intra-uterine contraceptive device and implant) users that completed approximately 12-months of follow-up. The non-inferiority margin was kept at five percentage points for the comparison of active and passive follow-up and six percentage points for telephone and home-based approach. The primary outcome was cumulative probability of method continuation at 12-month among LARC users. Results Women recruited in home-based, telephone-based, and passive groups were 400, 419 and 427, respectively. The cumulative probability of LARC continuation at 12 month was 87.6% (95% CI 83.8 to 90.6) among women who received home-based follow-up; 89.1% (95% CI 85.7, 91.8) who received telephone-based follow-up; and 83.8% (95% CI 79.8 to 87.1) who were in the passive or needs-based follow-up group. The probability of continuation among women who were actively followed-up by field health educators—either through home-based visit or telephone-based follow-up was, 88.3% (95% CI 85.9 to 90.0). An adjusted risk difference of -4.1 (95% CI -7.8 to -0.28; p-value = 0.035) was estimated between active and passive follow-up. Whereas, within the active client follow-up, the telephone-based follow-up was found to be as effective as the home-based follow-up with an adjusted risk difference of 1.8 (95% CI -2.7 to 6.4; p-value = 0.431). Conclusion A passive follow-up approach was 5% inferior to an active follow-up approach; whereas telephone-based follow-up was as effective as the home-based visits in sustaining the use of LARC, and was far more resource efficient. Therefore, active follow-up could improve method continuation especially in the critical post-insertion period. PMID:27584088

Flare-up incidence and related factors in Nigerian adults.

PubMed

Udoye, Christopher I; Jafarzadeh, Hamid; Aguwa, Emmanuel N; Habibi, Mehdi

2011-03-01

To determine the incidence of flare-up and the effect of age, gender, visit type, treatment duration, preoperative pain and intraoperative pain on flare-up in Nigerian adults. A total of 175 participants, aged 18 to 60 years with a necrotic central incisor, with or without preoperative pain, participated. They received postoperative paracetamol tablets and were asked to report back if unbearable pain/swelling developed. A 10% flare-up rate was recorded, while none of the studied factors had a significant relationship with flare-up. The relationships between flare-up and studied related factors were not proven. Age, gender, visit type, treatment duration, preoperative pain and intraoperative pain have no effect on flare-up incidence.

76 FR 64425 - Union Pacific Railroad Company-Abandonment Exemption-in Pottawattamie County, IA; Iowa Interstate...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-18

... trackage rights and UP's overhead trackage rights, UP will sell the UP lines to a shipper, Red Giant Oil Company (Red Giant), subject to a permanent access easement over the UP lines for another shipper, Midwest Walnut Company of Iowa (Midwest Walnut). Red Giant and Midwest Walnut are the only shippers on the UP...

AUTOMOTIVE DIESEL MAINTENANCE 1. UNIT VII, ENGINE TUNE-UP--DETROIT DIESEL ENGINE.

ERIC Educational Resources Information Center

Human Engineering Inst., Cleveland, OH.

THIS MODULE OF A 30-MODULE COURSE IS DESIGNED TO DEVELOP AN UNDERSTANDING OF TUNE-UP PROCEDURES FOR DIESEL ENGINES. TOPICS ARE SCHEDULING TUNE-UPS, AND TUNE-UP PROCEDURES. THE MODULE CONSISTS OF A SELF-INSTRUCTIONAL BRANCH PROGRAMED TRAINING FILM "ENGINE TUNE-UP--DETROIT DIESEL ENGINE" AND OTHER MATERIALS. SEE VT 005 655 FOR FURTHER INFORMATION.…

Construct Related Validity for the Baumgartner Modified Pull-Up Test

ERIC Educational Resources Information Center

Baumgartner, Ted A.; Gaunt, Sharon j.

2005-01-01

Traditionally the pull-up was used as a measure of arm and shoulder girdle strength and endurance. This measure did not discriminate among ability levels because many zero scores occur. Baumgartner (1978) developed a modified pull-up test that was easier than the traditional pull-up test. The Baumgartner Modified Pull-Up (BMPU) has been used as an…

34 CFR 694.11 - Under what conditions may a Partnership that does not participate in the GEAR UP scholarship...

Code of Federal Regulations, 2010 CFR

2010-07-01

... for postsecondary education to students under the GEAR UP early intervention component? 694.11 Section... education to students under the GEAR UP early intervention component? A GEAR UP Partnership that does not... early intervention component of GEAR UP if— (a) The financial assistance is directly related to, and in...

Assessing the Personal Negative Impacts of Hooking Up Experienced by College Students: Gender Differences and Mental Health.

PubMed

Napper, Lucy E; Montes, Kevin S; Kenney, Shannon R; LaBrie, Joseph W

2016-09-01

Hooking up is a normative behavior among college students that is associated with a range of positive and negative consequences. While previous research has primarily focused on women's negative experiences of hooking up, the current study explored the relationships among hooking up behaviors, psychological distress, and a broad range of negative effects of hooking up in both male and female college students. Using a multisite sample of college students, we developed the 14-item Negative Impact of Hookups Inventory (NIHI) to assess negative health outcomes, emotional responses, and social consequences associated with hooking up. Unprotected sex and having more hookup partners were associated with greater negative experiences of hooking up. Contrary to expectations, there were no gender differences in the total number of negative hookup effects, although men reported more frequent hookups. In addition, negative impacts of hooking up were positively associated with psychological distress regardless of gender. The NIHI may offer a useful tool to assess the negative impacts of hooking up. Understanding students' hookup experiences is an important step toward developing targeted health interventions related to hooking up behavior in young adult populations.

The experience of learning to speak up: a narrative inquiry on newly graduated registered nurses.

PubMed

Law, Bernice Yee-Shui; Chan, Engle Angela

2015-07-01

To explore the process of learning to speak up in practice among newly graduated registered nurses. Speaking up is an important aspect of communication to ensure patient safety within a healthcare team. However, nurses have reported being hesitant about speaking up or being unable to be heard, despite adopting various safety tools. A power differential could be a factor in their hesitation to speak up. While a large number of new graduates are employed in the lower rungs of the hospital hierarchy to resolve local and global nursing shortages, the process of their learning to speak up remains under-explored. The narrative concept of experience is addressed through the three-dimensional space of a narrative inquiry. Eighteen new graduates were recruited. Stories of experiences of speaking up emerged naturally during repeated unstructured interviews and ongoing email conversations with three participants. The complex process of learning to speak up is schematically represented. Three interrelated narrative threads were identified: (1) learning to speak up requires more than one-off training and safety tools, (2) mentoring speaking up in the midst of educative and miseducative experiences and (3) making public spaces safe for telling secret stories. Speaking up requires ongoing mentoring to see new possibilities for sustaining professional identities in the midst of miseducative experiences under the potential shaping of the Chinese culture and generational differences. Appreciative inquiry might be a new approach that can be used to promote positive cultural changes to encourage newly graduated registered nurses to learn to speak up to ensure patient safety. Cultivating a safe and open culture of communication and mentoring new graduates to speak up will benefit patient safety now and in the future by helping to retain committed patient advocates who could mentor future generations. © 2015 John Wiley & Sons Ltd.

Biofiltration using peat and a nutritional synthetic packing material: influence of the packing configuration on H2S removal.

PubMed

Dumont, Eric; Cabral, Flavia Da Silva; Le Cloirec, Pierre; Andrès, Yves

2013-01-01

This study aims to evaluate the feasibility of using a nutritional synthetic material (UP20) combined with fibrous peat as a packing material in treating H2S (up to 280 ppmv). Three identical laboratory-scale biofilters with different packing material configurations (peat only; peat + UP20 in a mixture; peat + UP20 in two layers) were used to determine the biofilter performances. The superficial velocity of the polluted gas on each biofilter was 65 m/h (gas flow rate 0.5 Nm3 /h) corresponding to an empty bed residence time = 57 s. Variations in elimination capacity, removal efficiency, temperature and pH were tracked during 111 d. A removal efficiency of 100% was obtained for loading rates up to 6 g/m3/h for the biofilter filled with 100% peat, and up to 10 g/m3/h for both biofilters using peat complemented with UP20. For higher loading rates (up to 25.5 g/m3/h), the configuration ofpeat-UP20 in a mixture provided the best removal efficiencies (around 80% compared to 65% for the configuration of peat-UP20 in two layers and 60% for peat only). Microbial characterization highlighted that peat is able to provide sulfide-oxidizing bacteria. Through kinetic analysis (Ottengrafand Michaelis-Menten models were applied), it appeared that the configuration peat-UP20 in two layers (80/20 v/v) did not show significant improvement compared with peat alone. Although the configuration of peat-UP20 in a mixture (80/20 v/v) offered a real advantage in improving H2S treatment, it was shown that this benefit was related to the bed configuration rather than the nutritional properties of UP20.

Classification tree analysis to enhance targeting for follow-up exam of colorectal cancer screening

PubMed Central

2013-01-01

Background Follow-up rate after a fecal occult blood test (FOBT) is low worldwide. In order to increase the follow-up rate, segmentation of the target population has been proposed as a promising strategy, because an intervention can then be tailored toward specific subgroups of the population rather than using one type of intervention for all groups. The aim of this study is to identify subgroups that share the same patterns of characteristics related to follow-up exams after FOBT. Methods The study sample consisted of 143 patients aged 50–69 years who were requested to undergo follow-up exams after FOBT. A classification tree analysis was performed, using the follow-up rate as a dependent variable and sociodemographic variables, psychological variables, past FOBT and follow-up exam, family history of colorectal cancer (CRC), and history of bowel disease as predictive variables. Results The follow-up rate in 143 participants was 74.1% (n = 106). A classification tree analysis identified four subgroups as follows; (1) subgroup with a high degree of fear of CRC, unemployed and with a history of bowel disease (n = 24, 100.0% follow-up rate), (2) subgroup with a high degree of fear of CRC, unemployed and with no history of bowel disease (n = 17, 82.4% follow-up rate), (3) subgroup with a high degree of fear of CRC and employed (n = 24, 66.7% follow-up rate), and (4) subgroup with a low degree of fear of CRC (n = 78, 66.7% follow-up rate). Conclusion The identification of four subgroups with a diverse range of follow-up rates for CRC screening indicates the direction to take in future development of an effective tailored intervention strategy. PMID:24112563

The Uniform Data System for Medical Rehabilitation

PubMed Central

Graham, James E.; Granger, Carl V.; Karmarkar, Amol M.; Deutsch, Anne; Niewczyk, Paulette; DiVita, Margaret A.; Ottenbacher, Kenneth J.

2013-01-01

Objective Present yearly aggregated summaries of rehabilitation outcomes at admission, discharge, and follow-up from a national sample of patients receiving inpatient medical rehabilitation for stroke, traumatic brain injury, lower extremity fracture, lower extremity joint replacement, traumatic spinal cord injury, or debility. Design Analysis of secondary data from more than 300 inpatient rehabilitation facilities in the United States that contributed inpatient and follow-up data to the Uniform Data System for Medical Rehabilitation during the period January 2002 through December 2010. Aggregate variables reported include demographic information, social situation, and functional status (FIM® instrument ratings at admission, discharge, and follow-up). Follow-up data were obtained 80–180 days post-discharge through telephone interviews by trained clinical staff. Results The final sample included 287,104 patients with follow-up information. Median time to follow-up was 95 days. Overall, more than 90% of patients within each impairment group were living in the community at follow-up. Follow-up FIM total ratings were stable to slightly increased over time. Change scores (discharge to follow-up) increased in all six groups. Mean FIM gains from discharge to follow-up, as a percentage of mean gains from admission to discharge, varied by impairment category: 46% for spinal cord injury to 71% for lower extremity fracture. Locomotion yielded the lowest ratings at all three assessments within each of the six impairment groups. Conclusions Follow-up data from a national sample of patients discharged from inpatient rehabilitation indicate that gains in mean functional independence scores from both admission to discharge and discharge to follow-up gradually increased from 2002 to 2010. At follow-up, more than 9 out of 10 patients in all 6 groups are living in the community. PMID:24088780

The development of insight and its relationship with suicidality over one year follow-up in patients with first episode psychosis.

PubMed

Barrett, Elizabeth A; Mork, Erlend; Færden, Ann; Nesvåg, Ragnar; Agartz, Ingrid; Andreassen, Ole A; Melle, Ingrid

2015-03-01

Insight into psychosis has been linked to suicidality, although inconsistently. The co-variation between insight and suicidality over time is under-investigated. The aim of the present study was to investigate predictors of suicidality in patients with first episode of psychosis (FEP) over one year, focusing on the relationship between insight and suicidality. Patients with FEP (n=146) were interviewed as soon as possible after treatment starts and at one year follow-up. At baseline 37% of patients were suicidal, significantly reduced to 20% at follow-up. The effect of insight on suicidality was in different directions at different time-points, with insight at baseline increasing and insight at follow-up decreasing the risk of suicidality at follow-up. Patients with stable levels of insight across baseline and follow-up did not differ in risk for suicidality at follow-up. However, patients who lost insight from baseline to follow-up were more often suicidal at follow-up, whilst patients who gained insight were more seldom suicidal at follow-up. Other predictors of suicidality at follow-up were more depressive episodes before study entry, longer duration of untreated psychosis, more suicide attempts six months prior to follow-up, and depression at follow-up. The results indicate that the effect of insight on suicidality in FEP-patients depends on time of assessment and of changes in insight. Gaining insight during treatment was associated with reduced risk for suicidality, whilst losing insight had the opposite effect, underlining the need to monitor insight over time and tailor interventions according to illness phase. Copyright © 2015 Elsevier B.V. All rights reserved.

A systematic review of the effects of upper body warm-up on performance and injury.

PubMed

McCrary, J Matt; Ackermann, Bronwen J; Halaki, Mark

2015-07-01

This systematic review was conducted to identify the impact of upper body warm-up on performance and injury prevention outcomes. Web of Science, MEDLINE, SPORTDiscus, PsycINFO and Cochrane databases were searched using terms related to upper extremity warm-up. Inclusion criteria were English language randomised controlled trials from peer-reviewed journals in which investigation of upper body warm-up on performance and injury prevention outcomes was a primary aim. Included studies were assessed for methodological quality using the PEDro scale. A wide variety of warm-up modes and outcomes precluded meta-analysis except for one group of studies. The majority of warm-ups were assessed as having 'positive', 'neutral', 'negative' or 'specific' effects on outcomes. Thirty-one studies met the inclusion criteria with 21 rated as having 'good' methodological quality. The studies investigated a total of 25 warm-up modes and 43 outcome factors that could be grouped into eight mode and performance outcome categories. No studies of upper body warm-up effects on injury prevention were discovered. Strong research-based evidence was found for the following: high-load dynamic warm-ups enhance power and strength performance; warm-up swings with a standard weight baseball bat are most effective for enhancing bat speed; short-duration static stretching warm-up has no effect on power outcomes; and passive heating/cooling is a largely ineffective warm-up mode. A clear knowledge gap in upper body warm-up literature is the lack of investigation of injury prevention outcomes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Disparities in abnormal mammogram follow-up time for Asian women compared to non-Hispanic Whites and between Asian ethnic groups

PubMed Central

Nguyen, KH; Pasick, RJ; Stewart, SL; Kerlikowske, K; Karliner, LS

2017-01-01

Background Delays in abnormal mammogram follow-up contribute to poor outcomes. We examined abnormal screening mammogram follow-up differences for non-Hispanic Whites (NHW) and Asian women. Methods Prospective cohort of NHW and Asian women with a Breast Imaging Reporting and Data System abnormal result of 0 or 3+ in the San Francisco Mammography Registry between 2000–2010. We performed Kaplan-Meier estimation for median-days to follow-up with a diagnostic radiologic test, and compared proportion with follow-up at 30, 60 and 90 days, and no follow-up at one-year for Asians overall (and Asian ethnic groups) and NHWs. We additionally assessed the relationship between race/ethnicity and time-to-follow-up with adjusted Cox proportional hazards models. Results Among Asian women, Vietnamese and Filipinas had the longest, and Japanese the shortest, median follow-up time (32, 28, 19 days, respectively) compared to NHWs (15 days). The proportion of women receiving follow-up at 30 days was lower for Asians vs NHWs (57% vs 77%, p<0.0001), and these disparities persisted at 60 and 90 days for all Asian ethnic groups except Japanese. Asians had a reduced hazard of follow-up compared with NHWs (aHR 0.70, 95% CI 0.69–0.72). Asians also had a higher rate than NHWs of no follow-up (15% vs 10%; p<0.001); among Asian ethnic groups, Filipinas had the highest percentage of women with no follow-up (18.1%). Conclusion Asian, particularly Filipina and Vietnamese, women were less likely than NHWs to receive timely follow-up after an abnormal screening mammogram. Research should disaggregate Asian ethnicity to better understand and address barriers to effective cancer prevention. PMID:28603859

The effect of position on the percentage of body mass supported during traditional and modified push-up variants.

PubMed

Suprak, David N; Dawes, Jay; Stephenson, Mark D

2011-02-01

The push-up is a popular upper-extremity weight-bearing exercise. However, limited information is available regarding its effectiveness. Much of the past research has focused on muscle activation levels, whereas very little has examined the forces encountered during push-up variants. The purpose of the present study was to examine the effect of position within the range of motion on the percentage of body mass (BM) supported by the upper extremities during the traditional and modified (knees-down) push-up. Twenty-eight highly strength-trained male subjects were positioned with their hands on a force platform in 4 static positions, consisting of the up and down position in both the traditional and modified push-up exercise. The performance measures included the average vertical ground reaction force (GRF), expressed as a percentage of BM, supported in each of the 4 static positions and the percentage of change between the up and down positions in each push-up exercise. In both the traditional and modified push-ups, subjects supported less weight in the up vs. the down position. The percentage change in % BM from the up to the down position was greater in the modified push-up variant. The pattern of resistances to the push-up exercises observed in this study may be a result of differing moment arms between the support surface contact point (knees or feet) and the hands. These results may be useful in prescribing programs for strengthening and/or rehabilitation for both the prime movers and stabilizers of the upper extremity. Further, range of motion may need to be altered to accommodate strength differences in beginners and clients rehabilitating from injury.

Dynamic pulse difference circuit

DOEpatents

Erickson, Gerald L.

1978-01-01

A digital electronic circuit of especial use for subtracting background activity pulses in gamma spectrometry comprises an up-down counter connected to count up with signal-channel pulses and to count down with background-channel pulses. A detector responsive to the count position of the up-down counter provides a signal when the up-down counter has completed one scaling sequence cycle of counts in the up direction. In an alternate embodiment, a detector responsive to the count position of the up-down counter provides a signal upon overflow of the counter.

Endoscopic follow-up of 383 patients with colorectal adenoma: an observational study in daily practice.

PubMed

Jonkers, Daisy; Ernst, Justi; Pladdet, Ingrid; Stockbrügger, Reinhold; Hameeteman, Wim

2006-06-01

Endoscopic removal of colorectal adenomas reduces the incidence and mortality of colorectal cancer (CRC), but follow-up surveillance is recommended. Compliance with the Dutch surveillance guidelines and detection of neoplasia during follow-up has been evaluated in daily practice. From 1987 to 1996, 383 consecutive patients with colorectal adenomas (56.4% male, 61.8+/-11.3 years) were included and followed until December 2000. The mean follow-up was 80.5+/-42.5 months with 2.2+/-0.9 follow-up endoscopies. A total of 32.5 and 27.3% of follow-up endoscopies were performed >25% (time between advised and actual endoscopy) too late or too early, respectively. At the end of follow-up, 33.4% of patients had left the follow-up (two-thirds died) and 60.1% were known with co-morbidity. A first, second, third, fourth and fifth follow-up endoscopy had been performed in 327, 238, 132, 64 and 35 patients, respectively. Adenomatous polyps (with high-risk polyps) were detected in 100% (42.6%) of the index endoscopies and in 25.1% (17.4%), 23.9% (10.5%), 28.0% (12.1%), 34.4% (25.0%) and 37.1% (17.1%) of the first to fifth follow-up endoscopy, respectively. CRC was diagnosed in seven patients (46.1+/-22.9 months after index endoscopy), resulting in a standardized incidence ratio of 1.4 (confidence interval 0.6-3.0, P=0.4) compared to the general population. In this daily practice, high numbers of total and high-risk adenomatous polyps were found during follow-up surveillance. The incidence of CRC was not significantly different from the general population, which might be due to the intensive follow-up and removal of polyps. These findings support the importance of follow-up surveillance. However, the high overall morbidity and mortality should be taken into account when selecting patients for an intensive follow-up programme.

Large Regional Differences in Serological Follow-Up of Q Fever Patients in The Netherlands

PubMed Central

Morroy, Gabriëlla; Wielders, Cornelia C. H.; Kruisbergen, Mandy J. B.; van der Hoek, Wim; Marcelis, Jan H.; Wegdam-Blans, Marjolijn C. A.; Wijkmans, Clementine J.; Schneeberger, Peter M.

2013-01-01

Background During the Dutch Q fever epidemic more than 4,000 Q fever cases were notified. This provided logistical challenges for the organisation of serological follow-up, which is considered mandatory for early detection of chronic infection. The aim of this study was to investigate the proportion of acute Q fever patients that received serological follow-up, and to identify regional differences in follow-up rates and contributing factors, such as knowledge of medical practitioners. Methods Serological datasets of Q fever patients diagnosed between 2007 and 2009 (N = 3,198) were obtained from three Laboratories of Medical Microbiology (LMM) in the province of Noord-Brabant. One LMM offered an active follow-up service by approaching patients; the other two only tested on physician's request. The medical microbiologist in charge of each LMM was interviewed. In December 2011, 240 general practices and 112 medical specialists received questionnaires on their knowledge and practices regarding the serological follow-up of Q fever patients. Results Ninety-five percent (2,226/2,346) of the Q fever patients diagnosed at the LMM with a follow-up service received at least one serological follow-up within 15 months of diagnosis. For those diagnosed at a LMM without this service, this was 25% (218/852) (OR 54, 95% CI 43–67). Although 80% (162/203) of all medical practitioners with Q fever patients reported informing patients of the importance of serological follow-up, 33% (67/203) never requested it. Conclusions Regional differences in follow-up are substantial and range from 25% to 95%. In areas with a low follow-up rate the proportion of missed chronic Q fever is potentially higher than in areas with a high follow-up rate. Medical practitioners lack knowledge regarding the need, timing and implementation of serological follow-up, which contributes to patients receiving incorrect or no follow-up. Therefore, this information should be incorporated in national guidelines and patient information forms. PMID:23577152

Comparison of Two Types of Warm-Up Upon Repeated-Sprint Performance in Experienced Soccer Players.

PubMed

van den Tillaar, Roland; von Heimburg, Erna

2016-08-01

van den Tillaar, R and von Heimburg, E. Comparison of two types of warm-up upon repeated-sprint performance in experienced soccer players. J Strength Cond Res 30(8): 2258-2265, 2016-The aim of the study was to compare the effects of a long warm-up and a short warm-up upon repeated-sprint performance in soccer players. Ten male soccer players (age, 21.9 ± 1.9 years; body mass, 77.7 ± 8.3 kg; body height, 1.85 ± 0.03 m) conducted 2 types of warm-ups with 1 week in between: a long warm-up (20 minutes: LWup) and a short warm-up (10 minutes: SWup). Each warm-up was followed by a repeated-sprint test consisting of 8 × 30 m sprints with a new start every 30th second. The best sprint time, total sprinting time, and % decrease in time together with heart rate, lactate, and rate of perceived exertion (RPE) were measured. No significant differences in performance were found for the repeated-sprint test parameters (total sprint time: 35.99 ± 1.32 seconds [LWup] and 36.12 ± 0.96 seconds [SWup]; best sprint time: 4.32 ± 0.13 seconds [LWup] and 4.30 ± 0.10 seconds [SWup]; and % sprint decrease: 4.16 ± 2.15% [LWup] and 5.02 ± 2.07% [SWup]). No differences in lactate concentration after the warm-up and after the repeated-sprint test were found. However, RPE and heart rate were significantly higher after the long warm-up and the repeated-sprint test compared with the short warm-up. It was concluded that a short warm-up is as effective as a long warm-up for repeated sprints in soccer. Therefore, in regular training, less warm-up time is needed; the extra time could be used for important soccer skill training.

The Uniform Data System for Medical Rehabilitation: report of follow-up information on patients discharged from inpatient rehabilitation programs in 2002-2010.

PubMed

Graham, James E; Granger, Carl V; Karmarkar, Amol M; Deutsch, Anne; Niewczyk, Paulette; Divita, Margaret A; Ottenbacher, Kenneth J

2014-03-01

The aim of this study was to present yearly aggregated summaries of rehabilitation outcomes at admission, discharge, and follow-up from a national sample of patients receiving inpatient medical rehabilitation for stroke, traumatic brain injury, lower extremity fracture, lower extremity joint replacement, traumatic spinal cord injury, or debility. This is an analysis of secondary data from more than 300 inpatient rehabilitation facilities in the United States that contributed inpatient and follow-up data to the Uniform Data System for Medical Rehabilitation during the period January 2002 through December 2010. Aggregate variables reported include demographic information, social situation, and functional status (Functional Independence Measure instrument ratings at admission, discharge, and follow-up). Follow-up data were obtained 80-180 days after discharge through telephone interviews by trained clinical staff. The final sample included 287,104 patients with follow-up information. The median time to follow-up was 95 days. Overall, more than 90% of the patients within each impairment group were living in the community at follow-up. Follow-up Functional Independence Measure total ratings were stable to slightly increased over time. Change scores (discharge to follow-up) increased in all six groups. The mean Functional Independence Measure gains from discharge to follow-up, as a percentage of mean gains from admission to discharge, varied by impairment category: 46% for spinal cord injury to 71% for lower extremity fracture. Locomotion yielded the lowest ratings at all three assessments within each of the six impairment groups. The follow-up data from the national sample of patients discharged from inpatient rehabilitation indicate that gains in mean functional independence scores from both admission to discharge and discharge to follow-up gradually increased from 2002 to 2010. At follow-up, more than nine of ten patients in all six groups are living in the community.

Prevalence of inter-appointment endodontic flare-ups and host-related factors.

PubMed

Azim, Adham A; Azim, Katharina A; Abbott, Paul V

2017-04-01

The aims of this study were to report the prevalence of inter-appointment flare-ups following adequate root canal disinfection and to investigate the host factors contributing to its occurrence. One thousand five hundred patient records were reviewed and the prevalence of flare-up was recorded. Patients' root canal space status (vital, non-vital or retreatment), medical condition and demographics (age, gender, tooth type and position) were recorded from their dental records. Statistical analyses were performed to determine the impact of the recorded factors on flare-up occurrence. Nine hundred fifty-one patient records met the inclusion criteria. The prevalence of flare-up was 2.3 %. There was a correlation between the canal space status and patient's age with flare-up development (P < 0.05). There was no association between flare-up occurrence and tooth type, location, gender or medical condition (P > 0.5). The root canal space status was the primary factor affecting flare-up occurrence. Patients >50 years had the highest risk in developing flare-ups. This article provides evidence that patients suffering from inflamed pulp will not develop flare-up if adequate cleaning and shaping of the root canal space was performed. It also shows that patients above the age of 50 are a high-risk group that is prone to flare-up development.

The effect of systematic set-up deviations on the absorbed dose distribution for left-sided breast cancer treated with respiratory gating

NASA Astrophysics Data System (ADS)

Edvardsson, A.; Ceberg, S.

2013-06-01

The aim of this study was 1) to investigate interfraction set-up uncertainties for patients treated with respiratory gating for left-sided breast cancer, 2) to investigate the effect of the inter-fraction set-up on the absorbed dose-distribution for the target and organs at risk (OARs) and 3) optimize the set-up correction strategy. By acquiring multiple set-up images the systematic set-up deviation was evaluated. The effect of the systematic set-up deviation on the absorbed dose distribution was evaluated by 1) simulation in the treatment planning system and 2) measurements with a biplanar diode array. The set-up deviations could be decreased using a no action level correction strategy. Not using the clinically implemented adaptive maximum likelihood factor for the gating patients resulted in better set-up. When the uncorrected set-up deviations were simulated the average mean absorbed dose was increased from 1.38 to 2.21 Gy for the heart, 4.17 to 8.86 Gy to the left anterior descending coronary artery and 5.80 to 7.64 Gy to the left lung. Respiratory gating can induce systematic set-up deviations which would result in increased mean absorbed dose to the OARs if not corrected for and should therefore be corrected for by an appropriate correction strategy.

Outpatient Follow-Up versus 30-day Readmission among General and Vascular Surgery Patients: A Case for Redesigning Transitional Care

PubMed Central

Saunders, Richard Scott; Fernandes-Taylor, Sara; Rathouz, Paul J.; Saha, Sandeep; Wiseman, Jason T.; Havlena, Jeffrey; Matsumura, Jon; Kent, K. Craig

2014-01-01

Background The association between early outpatient follow-up and 30-day readmission has not been evaluated in any surgical population. Our study characterizes the relationship between outpatient follow-up and early readmissions among surgical patients. Methods We queried the medical record at a large, tertiary care institution (July 2008-December 2012) to determine rates of 30-day outpatient follow-up and readmission for general or vascular surgical procedures. Results The majority of discharges for general (84% of 7552) and vascular (75% of 2362) surgery had a follow-up visit before readmission or within 30 days of discharge. General surgery patients who were not readmitted had high rates of follow-up (88%) and received follow-up at approximately 2-weeks post-discharge (median time 11 days after discharge). In contrast, readmitted general surgery patients received first follow-up at one week (a median time of 8 days); 49% had follow-up. Vascular surgery patients showed a similar trend. Over half of patients readmitted after follow-up were readmitted within 24 hours of their most recent outpatient visit. Conclusions Current routine follow-up does not occur early enough to detect adverse events and prevent readmission. Early outpatient care may prevent readmission in some patients, but often serves as a conduit for readmission among patients already experiencing complications. PMID:25239351

Effects of EAP follow-up on prevention of relapse among substance abuse clients.

PubMed

Foote, A; Erfurt, J C

1991-05-01

Clients entering an employee assistance program (EAP) of a large manufacturing plant in 1985 who were assessed as having an alcohol or drug abuse problem (N = 325) were randomized into an experimental "special follow-up" group and a control "regular care" group. The regular care group received follow-up only as needed (following the usual practice of the EAP), while a follow-up counselor was hired to make routine contacts with the special follow-up group. Study intake continued through 1985, and follow-up continued through the end of 1986. Data collected on study subjects included EAP participation data, absenteeism, number of hospitalizations, health care claims paid and disability claims paid. The major study hypothesis was that EAP clients randomly allocated to special follow-up would show better results than regular care clients (i.e., would have fewer relapses, better job attendance and lower health benefit utilization during the follow-up year). The follow-up intervention was incompletely implemented due to a variety of organizational problems. Differences between the two groups on the six outcome measures were not statistically significant, although clients in the special follow-up group did show better results than clients in the regular care group on the three measures related to substance abuse. Differences on these three measures were marginally significant in regression analyses after controlling for the effects of number of follow-up visits, age, race and chronicity.

A SCALE-UP Mock-Up: Comparison of Student Learning Gains in High- and Low-Tech Active-Learning Environments

PubMed Central

Soneral, Paula A. G.; Wyse, Sara A.

2017-01-01

Student-centered learning environments with upside-down pedagogies (SCALE-UP) are widely implemented at institutions across the country, and learning gains from these classrooms have been well documented. This study investigates the specific design feature(s) of the SCALE-UP classroom most conducive to teaching and learning. Using pilot survey data from instructors and students to prioritize the most salient SCALE-UP classroom features, we created a low-tech “Mock-up” version of this classroom and tested the impact of these features on student learning, attitudes, and satisfaction using a quasi-­experimental setup. The same instructor taught two sections of an introductory biology course in the SCALE-UP and Mock-up rooms. Although students in both sections were equivalent in terms of gender, grade point average, incoming ACT, and drop/fail/withdraw rate, the Mock-up classroom enrolled significantly more freshmen. Controlling for class standing, multiple regression modeling revealed no significant differences in exam, in-class, preclass, and Introduction to Molecular and Cellular Biology Concept Inventory scores between the SCALE-UP and Mock-up classrooms. Thematic analysis of student comments highlighted that collaboration and whiteboards enhanced the learning experience, but technology was not important. Student satisfaction and attitudes were comparable. These results suggest that the benefits of a SCALE-UP experience can be achieved at lower cost without technology features. PMID:28213582

What's an Asthma Flare-Up?

MedlinePlus

... Staying Safe Videos for Educators Search English Español Asthma Flare-Ups KidsHealth / For Parents / Asthma Flare-Ups Print en español Crisis asmáticas What Are Asthma Flare-Ups? Keeping asthma under control helps kids ...

Methods for successful follow-up of elusive urban populations: an ethnographic approach with homeless men.

PubMed Central

Conover, S.; Berkman, A.; Gheith, A.; Jahiel, R.; Stanley, D.; Geller, P. A.; Valencia, E.; Susser, E.

1997-01-01

Public health is paying increasing attention to elusive urban populations such as the homeless, street drug users, and illegal immigrants. Yet, valid data on the health of these populations remain scarce; longitudinal research, in particular, has been hampered by poor follow-up rates. This paper reports on the follow-up methods used in two randomized clinical trials among one such population, namely, homeless men with mental illness. Each of the two trials achieved virtually complete follow-up over 18 months. The authors describe the ethnographic approach to follow-up used in these trials and elaborate its application to four components of the follow-up: training interviewers, tracking participants, administering the research office, and conducting assessments. The ethnographic follow-up method is adaptable to other studies and other settings, and may provide a replicable model for achieving high follow-up rates in urban epidemiologic studies. PMID:9211004

Do the benefits outweigh the side effects of colorectal cancer surveillance? A systematic review.

PubMed

Augestad, Knut Magne; Rose, Johnie; Crawshaw, Benjamin; Cooper, Gregory; Delaney, Conor

2014-05-15

Most patients treated with curative intent for colorectal cancer (CRC) are included in a follow-up program involving periodic evaluations. The survival benefits of a follow-up program are well delineated, and previous meta-analyses have suggested an overall survival improvement of 5%-10% by intensive follow-up. However, in a recent randomized trial, there was no survival benefit when a minimal vs an intensive follow-up program was compared. Less is known about the potential side effects of follow-up. Well-known side effects of preventive programs are those of somatic complications caused by testing, negative psychological consequences of follow-up itself, and the downstream impact of false positive or false negative tests. Accordingly, the potential survival benefits of CRC follow-up must be weighed against these potential negatives. The present review compares the benefits and side effects of CRC follow-up, and we propose future areas for research.

GROWING UP WITHOUT SIBLINGS AND ADULT SOCIABILITY BEHAVIORS

PubMed Central

Trent, Katherine; Spitze, Glenna D.

2011-01-01

We use data from the National Survey of Families and Households to examine a range of sociability behaviors for adults who grew up with and without siblings. Compared to adults who grew up with siblings, adults who grew up without siblings have less frequent social activities with relatives, and the difference is greater among those who did not live with both parents growing up. Differences in engaging in certain social events between adults who grew up without and with siblings vary by age. Differences in participation in sports, youth, or school related group activities for those who grew up without and with siblings vary by gender. Thus, there are some differences in adult sociability behaviors between those who grew up with and without siblings; however, our pattern of findings suggests that these differences are not large or pervasive across a range of sociability behaviors and may grow smaller with age. PMID:22180694

The up and down of sleep: From molecules to electrophysiology.

PubMed

Navarro-Lobato, Irene; Genzel, Lisa

2018-03-12

Alternations of up and down can be seen across many different levels during sleep. Neural firing-rates, synaptic markers, molecular pathways, and gene expression all show differential up and down regulation across brain areas and sleep stages. And also the hallmarks of sleep - sleep stage specific oscillations - are characterized themselves by up and down as seen within the slow oscillation or theta cycles. In this review, we summarize the up and down of sleep covering molecules to electrophysiology and present different theories how this up and down could be regulated by the up and down of sleep oscillations. Further, we propose a tentative theory how this differential up and down could contribute to various outcomes of sleep related memory consolidation: enhancement of hippocampal representations of very novel memories and cortical consolidation of memories congruent with previous knowledge-networks. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Lack of behavioural responses of humpback whales (Megaptera novaeangliae) indicate limited effectiveness of sonar mitigation

PubMed Central

Kvadsheim, Petter H.; Lam, Frans-Peter A.; von Benda-Beckmann, Alexander M.; Sivle, Lise D.; Visser, Fleur; Curé, Charlotte; Tyack, Peter L.; Miller, Patrick J. O.

2017-01-01

ABSTRACT Exposure to underwater sound can cause permanent hearing loss and other physiological effects in marine animals. To reduce this risk, naval sonars are sometimes gradually increased in intensity at the start of transmission (‘ramp-up’). Here, we conducted experiments in which tagged humpback whales were approached with a ship to test whether a sonar operation preceded by ramp-up reduced three risk indicators – maximum sound pressure level (SPLmax), cumulative sound exposure level (SELcum) and minimum source–whale range (Rmin) – compared with a sonar operation not preceded by ramp-up. Whales were subject to one no-sonar control session and either two successive ramp-up sessions (RampUp1, RampUp2) or a ramp-up session (RampUp1) and a full-power session (FullPower). Full-power sessions were conducted only twice; for other whales we used acoustic modelling that assumed transmission of the full-power sequence during their no-sonar control. Averaged over all whales, risk indicators in RampUp1 (n=11) differed significantly from those in FullPower (n=12) by −3.0 dB (SPLmax), −2.0 dB (SELcum) and +168 m (Rmin), but not significantly from those in RampUp2 (n=9). Only five whales in RampUp1, four whales in RampUp2 and none in FullPower or control sessions avoided the sound source. For RampUp1, we found statistically significant differences in risk indicators between whales that avoided the sonar and whales that did not: −4.7 dB (SPLmax), −3.4 dB (SELcum) and +291 m (Rmin). In contrast, for RampUp2, these differences were smaller and not significant. This study suggests that sonar ramp-up has a positive but limited mitigative effect for humpback whales overall, but that ramp-up can reduce the risk of harm more effectively in situations when animals are more responsive and likely to avoid the sonar, e.g. owing to novelty of the stimulus, when they are in the path of an approaching sonar ship. PMID:29141878

The success factors of scaling-up Estonian sexual and reproductive health youth clinic network--from a grassroots initiative to a national programme 1991-2013.

PubMed

Kempers, Jari; Ketting, Evert; Chandra-Mouli, Venkatraman; Raudsepp, Triin

2015-01-08

A growing number of middle-income countries are scaling up youth-friendly sexual and reproductive health pilot projects to national level programmes. Yet, there are few case studies on successful national level scale-up of such programmes. Estonia is an excellent example of scale-up of a small grassroots adolescent sexual and reproductive health initiative to a national programme, which most likely contributed to improved adolescent sexual and reproductive health outcomes. This study; (1) documents the scale-up process of the Estonian youth clinic network 1991-2013, and (2) analyses factors that contributed to the successful scale-up. This research provides policy makers and programme managers with new insights to success factors of the scale-up, that can be used to support planning, implementation and scale-up of adolescent sexual and reproductive health programmes in other countries. Information on the scale-up process and success factors were collected by conducting a literature review and interviewing key stakeholders. The findings were analysed using the WHO-ExpandNet framework, which provides a step-by-step process approach for design, implementation and assessment of the results of scaling-up health innovations. The scale-up was divided into two main phases: (1) planning the scale-up strategy 1991-1995 and (2) managing the scaling-up 1996-2013. The planning phase analysed innovation, user organizations (youth clinics), environment and resource team (a national NGO and international assistance). The managing phase examines strategic choices, advocacy, organization, resource mobilization, monitoring and evaluation, strategic planning and management of the scale-up. The main factors that contributed to the successful scale-up in Estonia were: (1) favourable social and political climate, (2) clear demonstrated need for the adolescent services, (3) a national professional organization that advocated, coordinated and represented the youth clinics, (4) enthusiasm and dedication of personnel, (5) acceptance by user organizations and (6) sustainable funding through the national health insurance system. Finally, the measurement and recognition of the remarkable improvement of adolescent SRH outcomes in Estonia would not have been possible without development of good reporting and monitoring systems, and many studies and international publications.

Smartphone Application WeChat for Clinical Follow-up of Discharged Patients with Head and Neck Tumors: A Randomized Controlled Trial.

PubMed

Lyu, Ke-Xing; Zhao, Jing; Wang, Bin; Xiong, Guan-Xia; Yang, Wei-Qiang; Liu, Qi-Hong; Zhu, Xiao-Lin; Sun, Wei; Jiang, Ai-Yun; Wen, Wei-Ping; Lei, Wen-Bin

2016-12-05

Nowadays, social media tools such as short message service, Twitter, video, and web-based systems are more and more used in clinical follow-up, making clinical follow-up much more time- and cost-effective than ever before. However, as the most popular social media in China, little is known about the utility of smartphone WeChat application in follow-up. In this study, we aimed to investigate the feasibility and superiority of WeChat application in clinical follow-up. A total of 108 patients diagnosed with head and neck tumor were randomized to WeChat follow-up (WFU) group or telephone follow-up (TFU) group for 6-month follow-up. The follow-ups were delivered by WeChat or telephone at 2 weeks, 1, 2, 3, and 6 months to the patients after being discharged. The study measurements were time consumption for follow-up delivery, total economic cost, lost-to-follow-up rate, and overall satisfaction for the follow-up method. Time consumption in WFU group for each patient (23.36 ± 6.16 min) was significantly shorter than that in TFU group (42.89 ± 7.15 min) (P < 0.001); total economic cost in WFU group (RMB 90 Yuan) was much lower than that in TFU group (RMB 196 Yuan). Lost-to-follow-up rate in the WFU group was 7.02% (4/57) compared with TFU group, 9.80% (5/51), while no significance was observed (95% confidence interval [CI]: 0.176-2.740; P = 0.732). The overall satisfaction rate in WFU group was 94.34% (50/53) compared with 80.43% (37/46) in TFU group (95% CI: 0.057-0.067; P = 0.034). The smartphone WeChat application was found to be a viable option for follow-up in discharged patients with head and neck tumors. WFU was time-effective, cost-effective, and convenient in communication. This doctor-led follow-up model has the potential to establish a good physician-patient relationship by enhancing dynamic communications and providing individual health instructions. Chinese Clinical Trial Registry, ChiCTR-IOR-15007498; http://www.chictr.org.cn/ showproj.aspx?proj=12613.

The Effects of Three Physical and Vocal Warm-Up Procedures on Acoustic and Perceptual Measures of Choral Sound.

PubMed

Cook-Cunningham, Sheri L; Grady, Melissa L

2018-03-01

The purpose of this investigation was to assess the effects of three warm-up procedures (vocal-only, physical-only, physical/vocal combination) on acoustic and perceptual measures of choir sound. The researchers tested three videotaped, 5-minute, choral warm-up procedures on three university choirs. After participating in a warm-up procedure, each choir was recorded singing a folk song for long-term average spectra and pitch analysis. Singer participants responded to a questionnaire about preferences after each warm-up procedure. Warm-up procedures and recording sessions occurred during each choir's regular rehearsal time and in each choir's regular rehearsal space during three consecutive rehearsals. Long-term average spectra results demonstrated more resonant singing after the physical/vocal warm-up for two of the three choirs. Pitch analysis results indicate that all three choirs sang "in-tune" or with the least pitch deviation after participating in the physical/vocal warm-up. Singer questionnaire responses showed general preference for the physical/vocal combination warm-up, and singer ranking of the three procedures indicated the physical/vocal warm-up as the most favored for readiness to sing. In the context of this study with these three university choir participants, it seems that a combination choral warm-up that includes physical and vocal aspects is preferred by singers, enables more resonant singing, and more in-tune singing. Findings from this study could provide teachers and choral directors with important information as they structure and experiment with their choral warm-up procedures. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Numerical simulation of the helium gas spin-up channel performance of the relativity gyroscope

NASA Technical Reports Server (NTRS)

Karr, Gerald R.; Edgell, Josephine; Zhang, Burt X.

1991-01-01

The dependence of the spin-up system efficiency on each geometrical parameter of the spin-up channel and the exhaust passage of the Gravity Probe-B (GPB) is individually investigated. The spin-up model is coded into a computer program which simulates the spin-up process. Numerical results reveal optimal combinations of the geometrical parameters for the ultimate spin-up performance. Comparisons are also made between the numerical results and experimental data. The experimental leakage rate can only be reached when the gap between the channel lip and the rotor surface increases beyond physical limit. The computed rotating frequency is roughly twice as high as the measured ones although the spin-up torques fairly match.

Lack of behavioural responses of humpback whales (Megaptera novaeangliae) indicate limited effectiveness of sonar mitigation.

PubMed

Wensveen, Paul J; Kvadsheim, Petter H; Lam, Frans-Peter A; von Benda-Beckmann, Alexander M; Sivle, Lise D; Visser, Fleur; Curé, Charlotte; Tyack, Peter L; Miller, Patrick J O

2017-11-15

Exposure to underwater sound can cause permanent hearing loss and other physiological effects in marine animals. To reduce this risk, naval sonars are sometimes gradually increased in intensity at the start of transmission ('ramp-up'). Here, we conducted experiments in which tagged humpback whales were approached with a ship to test whether a sonar operation preceded by ramp-up reduced three risk indicators - maximum sound pressure level (SPL max ), cumulative sound exposure level (SEL cum ) and minimum source-whale range ( R min ) - compared with a sonar operation not preceded by ramp-up. Whales were subject to one no-sonar control session and either two successive ramp-up sessions (RampUp1, RampUp2) or a ramp-up session (RampUp1) and a full-power session (FullPower). Full-power sessions were conducted only twice; for other whales we used acoustic modelling that assumed transmission of the full-power sequence during their no-sonar control. Averaged over all whales, risk indicators in RampUp1 ( n =11) differed significantly from those in FullPower ( n =12) by -3.0 dB (SPL max ), -2.0 dB (SEL cum ) and +168 m ( R min ), but not significantly from those in RampUp2 ( n =9). Only five whales in RampUp1, four whales in RampUp2 and none in FullPower or control sessions avoided the sound source. For RampUp1, we found statistically significant differences in risk indicators between whales that avoided the sonar and whales that did not: -4.7 dB (SPL max ), -3.4 dB (SEL cum ) and +291 m ( R min ). In contrast, for RampUp2, these differences were smaller and not significant. This study suggests that sonar ramp-up has a positive but limited mitigative effect for humpback whales overall, but that ramp-up can reduce the risk of harm more effectively in situations when animals are more responsive and likely to avoid the sonar, e.g. owing to novelty of the stimulus, when they are in the path of an approaching sonar ship. © 2017. Published by The Company of Biologists Ltd.

Comparing effectiveness of two client follow-up approaches in sustaining the use of Long Acting Reversible Contraceptives (LARC) among the underserved in rural Punjab, Pakistan: a study protocol and participants' profile.

PubMed

Azmat, Syed Khurram; Hameed, Waqas; Ali, Moazzam; Ishaque, Muhammad; Mustafa, Ghulam; Khan, Omar Farooq; Abbas, Ghazunfer; Munroe, Erik

2015-03-18

Pakistan observes a very high i.e. 37 percent modern contraceptive method related discontinuation rates within 12 months of their initiation. And almost 10 percent of these episodes of discontinuation happened due to the side effects or health concerns experienced by the women. Most importantly, it was noted that more than 12,000 first-level care facilities are located in the rural areas, including rural health centers, basic health units, and family welfare centers, but more than 30% of these facilities are nonfunctional. This paper presents a study protocol and participants' profiling of a prospective cohort follow-up to compare the effectiveness of household based and telephonic approaches in sustaining the use of Long Acting Reversible Contraceptives (LARC) whilst to facilitate lowering method related discontinuation and increasing switching amongst the contraceptive users. A 12-month multi-centre, non-inferiority prospective user follow-up is employed using three different study categories: a) household based follow-up; b) telephonic follow-up; and c) passive or need-based follow-up along with the hypothetical assumption that the telephonic client follow-up is not inferior to the household based follow-up by continuation rate of LARC and the telephonic follow-up is less-costly than the household based client follow-up. This follow-up will be conducted in 22 health facilities - (16 rural and 6 urban based facilities) in district Chakwal. The first two study categories will receive scheduled but different follow-up from the field workers at 1, 3, 6, 9, and 12 month while the third one i.e. the 'passive or need-based follow-up' will serve as a control group. Using sampling software PASS 11, it was estimated to have 414 clients in each study category and around 1366 clients will be recruited to account for 10% attrition rate. The study will help us to examine a more convenient method of effective follow-up for managing side effects, decreasing method discontinuation and increasing switching amongst users. The study information will also facilitate to develop a robust, effective and efficient mechanism for client follow-up to promote the continuation rates of LARC methods. The follow-up results and lessons learnt will be widely shared with stakeholders for their implementation and streamlining in health system.

EFFECTS OF DIFFERENT WARM-UP PROGRAMS ON GOLF PERFORMANCE IN ELITE MALE GOLFERS

PubMed Central

Macfarlane, Alison

2012-01-01

Background: The physical demands required of the body to execute a shot in golf are enormous. Current evidence suggests that warm-up involving static stretching is detrimental to immediate performance in golf as opposed to active dynamic stretching. However the effect of resistance exercises during warm-up before golf on immediate performance is unknown. Therefore, the purpose of this study was to assess the effects of three different warm-up programs on immediate golf performance. Methods: Fifteen elite male golfers completed three different warm-up programs over three sessions on non-consecutive days. After each warm-up program each participant hit ten maximal drives with the ball flight and swing analyzed with Flightscope® to record maximum club head speed (MCHS), maximal driving distance (MDD), driving accuracy (DA), smash factor (SF) and consistent ball strike (CBS). Results: Repeated measures ANOVA tests showed statistically significant difference within 3 of the 5 factors of performance (MDD, CBS and SF). Subsequently, a paired t-test then showed statistically significant (p<0.05) improvements occurred in each of these three factors in the group performing a combined active dynamic and functional resistance (FR) warm-up as opposed to either the active dynamic (AD) warm-up or the combined AD with weights warm-up (WT). There were no statistically significant differences observed between the AD warm-up and the WT warm-up for any of the five performance factors and no statistical significant difference between any of the warm-ups for maximum clubhead speed (MCHS) and driving accuracy (DA). Conclusion: Performing a combined AD and FR warm up with Theraband® leads to significant increase in immediate performance of certain factors of the golf drive compared to performing an AD warm-up by itself or a combined AD with WT warm-up. No significant difference was observed between the three warm-up groups when looking at immediate effect on driving accuracy or maximum club head speed. The addition of functional resistance activities to active dynamic stretching has immediate benefits to elite male golfers in relation to some factors of their performance. Level of Evidence: This study is a Quantitative Experimental design using repeated measures and multiple crossovers. It cannot be classified using the descriptive level of evidence. PMID:23936749

Factors influencing access to education, decision making, and receipt of preferred dialysis modality in unplanned dialysis start patients.

PubMed

Machowska, Anna; Alscher, Mark Dominik; Reddy Vanga, Satyanarayana; Koch, Michael; Aarup, Michael; Qureshi, Abdul Rashid; Lindholm, Bengt; Rutherford, Peter A

2016-01-01

Unplanned dialysis start (UPS) leads to worse clinical outcomes than planned start, and only a minority of patients ever receive education on this topic and are able to make a modality choice, particularly for home dialysis. This study aimed to determine the predictive factors for patients receiving education, making a decision, and receiving their preferred modality choice in UPS patients following a UPS educational program (UPS-EP). The Offering Patients Therapy Options in Unplanned Start (OPTiONS) study examined the impact of the implementation of a specific UPS-EP, including decision support tools and pathway improvement on dialysis modality choice. Linear regression models were used to examine the factors predicting three key steps: referral and receipt of UPS-EP, modality decision making, and actual delivery of preferred modality choice. A simple economic assessment was performed to examine the potential benefit of implementing UPS-EP in terms of dialysis costs. The majority of UPS patients could receive UPS-EP (214/270 patients) and were able to make a decision (177/214), although not all patients received their preferred choice (159/177). Regression analysis demonstrated that the initial dialysis modality was a predictive factor for referral and receipt of UPS-EP and modality decision making. In contrast, age was a predictor for referral and receipt of UPS-EP only, and comorbidity was not a predictor for any step, except for myocardial infarction, which was a weak predictor for lower likelihood of receiving preferred modality. Country practices predicted UPS-EP receipt and decision making. Economic analysis demonstrated the potential benefit of UPS-EP implementation because dialysis modality costs were associated with modality distribution driven by patient preference. Education and decision support can allow UPS patients to understand their options and choose dialysis modality, and attention needs to be focused on ensuring equity of access to educational programs, especially for the elderly. Physician practice and culture across units/countries is an important predictor of UPS patient management and modality choice independent of patient-related factors. Additional work is required to understand and improve patient pathways to ensure that modality preference is enacted. There appears to be a cost benefit of delivering education, supporting choice, and ensuring that the choice is enacted in UPS patients.

Phytochemical and physical-chemical analysis of Polish willow (Salix spp.) honey: identification of the marker compounds.

PubMed

Jerković, Igor; Kuś, Piotr Marek; Tuberoso, Carlo Ignazio Giovanni; Šarolić, Mladenka

2014-02-15

The case study of Polish Salix spp. honey was compared with published data on willow honey from other regions. GC-FID/MS (after HS-SPME and ultrasonic solvent extraction) and targeted HPLC-DAD were applied. Phenolic content, FRAP/DPPH assays and the colour coordinates were determined spectrophotometrically. Beside ubiquitous linalool derivatives, borneol (up to 10.9%), bicyclic monoterpenes with pinane skeleton (pinocarvone up to 10.6%, myrtenal up to 4.8% and verbenone up to 3.4%) and trans-β-damascenone (up to 13.0%) dominated in the headspace. The main compounds of the extractives were vomifoliol (up to 39.6%) and methyl syringate (up to 16.5%) along with not common 4-hydroxy-3-(1-methylethyl)benzaldehyde (up to 11.1%). Abscisic acid (ABA) was found (up to 53.7 mg/kg) with the isomeric ratio (Z,E)-ABA:(E,E)-ABA=1:2. The honey exhibited low antioxidant potential with pale yellow colour. The composition of Polish willow honey is similar to Mediterranean willow honeys with several relevant differences. Copyright © 2013 Elsevier Ltd. All rights reserved.

Rank-based testing of equal survivorship based on cross-sectional survival data with or without prospective follow-up.

PubMed

Chan, Kwun Chuen Gary; Qin, Jing

2015-10-01

Existing linear rank statistics cannot be applied to cross-sectional survival data without follow-up since all subjects are essentially censored. However, partial survival information are available from backward recurrence times and are frequently collected from health surveys without prospective follow-up. Under length-biased sampling, a class of linear rank statistics is proposed based only on backward recurrence times without any prospective follow-up. When follow-up data are available, the proposed rank statistic and a conventional rank statistic that utilizes follow-up information from the same sample are shown to be asymptotically independent. We discuss four ways to combine these two statistics when follow-up is present. Simulations show that all combined statistics have substantially improved power compared with conventional rank statistics, and a Mantel-Haenszel test performed the best among the proposal statistics. The method is applied to a cross-sectional health survey without follow-up and a study of Alzheimer's disease with prospective follow-up. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Undecylprodigiosin conjugated monodisperse gold nanoparticles efficiently cause apoptosis in colon cancer cells in vitro

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

Nikodinovic-Runic, Jasmina; Mojic, Marija; Kang, Yijin

2014-01-01

Bacterial pigment undecylprodigiosin (UP) was produced using Streptomyces sp. JS520 and conjugated to monodisperse gold nanoparticles (UP-Au). Both UP and UP-Au showed cytocidal activity towards melanoma (A375), lung carcinoma (A549), breast cancer (MCF-7) and colon cancer (HCT-116) cells, inducing apoptosis with IC50 values ranging from 0.4 to 4 mu g ml(-1). Unconjugated UP had a tendency to lose its activity over time and to change biophysical characteristics over pH. The loss of the pigment potency was overcome by conjugation with gold nanoparticles. UP-Au exhibited high stability over pH 3.8 to 7.4 and its activity remained unaffected in time. Nano-packing changedmore » the mechanism of UP toxicity by converting the intracellular signals from a mitochondrial dependent to a mitochondrial independent apoptotic process. The availability of nonpyrogenic UP in high amounts, together with specific anticancer activity and improved stability in the complex with gold nanoparticles, presents a novel platform for further development of UP-Au complexes as an anticancer drug suitable for clinical applications.« less

High Nb, Ta, and Al creep- and oxidation-resistant austenitic stainless steel

DOEpatents

Brady, Michael P [Oak Ridge, TN; Santella, Michael L [Knoxville, TN; Yamamoto, Yukinori [Oak Ridge, TN; Liu, Chain-tsuan [Oak Ridge, TN

2010-07-13

An austenitic stainless steel HTUPS alloy includes, in weight percent: 15 to 30 Ni; 10 to 15 Cr; 2 to 5 Al; 0.6 to 5 total of at least one of Nb and Ta; no more than 0.3 of combined Ti+V; up to 3 Mo; up to 3 Co; up to 1 W; up to 0.5 Cu; up to 4 Mn; up to 1 Si; 0.05 to 0.15 C; up to 0.15 B; up to 0.05 P; up to 1 total of at least one of Y, La, Ce, Hf, and Zr; less than 0.05 N; and base Fe, wherein the weight percent Fe is greater than the weight percent Ni wherein said alloy forms an external continuous scale comprising alumina, nanometer scale sized particles distributed throughout the microstructure, said particles comprising at least one composition selected from the group consisting of NbC and TaC, and a stable essentially single phase fcc austenitic matrix microstructure, said austenitic matrix being essentially delta-ferrite-free and essentially BCC-phase-free.

78 FR 74218 - Agency Information Collection Activities: Request for Comments for a New Information Collection

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-10

... Transportation, Leo O'Brien Federal Building, Room 715, Albany, NY 12207. Office hours are from 7:30 a.m. to 4:00... Departments of Transportation = 50 (1 hour each) + [up to 10 individuals x up to 5 hours of meeting and travel] = up to 100 hours; State Enforcement Personnel = 50 (1 hour each) + [up to 10 individuals x up to 5...

Research: Detailed and Selective Follow-up of Students for Improvement of Programs/Program Components in Business & Office Education and Marketing & Distributive Education. Final Report.

ERIC Educational Resources Information Center

Scott, Gary D.; Chapman, Alberta

The Kentucky student follow-up system was studied to identify the current status of follow-up activities in business and office education and marketing and distributive education; to identify the impact of follow-up data on these programs; to identify program components for which detailed follow-up can provide information to assist in program…

NEUTRONIC REACTOR CONSTRUCTION AND OPERATION

DOEpatents

West, J.M.; Weills, J.T.

1960-03-15

A method is given for operating a nuclear reactor having a negative coefficient of reactivity to compensate for the change in reactor reactivity due to the burn-up of the xenon peak following start-up of the reactor. When it is desired to start up the reactor within less than 72 hours after shutdown, the temperature of the reactor is lowered prior to start-up, and then gradually raised after start-up.

Scaling up in international health: what are the key issues?

PubMed

Mangham, Lindsay J; Hanson, Kara

2010-03-01

The term 'scaling up' is now widely used in the international health literature, though it lacks an agreed definition. We review what is meant by scaling up in the context of changes in international health and development over the last decade. We argue that the notion of scaling up is primarily used to describe the ambition or process of expanding the coverage of health interventions, though the term has also referred to increasing the financial, human and capital resources required to expand coverage. We discuss four pertinent issues in scaling up the coverage of health interventions: the costs of scaling up coverage; constraints to scaling up; equity and quality concerns; and key service delivery issues when scaling up. We then review recent progress in scaling up the coverage of health interventions. This includes a considerable increase in the volume of aid, accompanied by numerous new health initiatives and financing mechanisms. There have also been improvements in health outcomes and some examples of successful large-scale programmes. Finally, we reflect on the importance of obtaining a better understanding of how to deliver priority health interventions at scale, the current emphasis on health system strengthening and the challenges of sustaining scaling up in the prevailing global economic environment.

Acute effects of a loaded warm-up protocol on change of direction speed in professional badminton players.

PubMed

Maloney, Sean J; Turner, Anthony N; Miller, Stuart

2014-10-01

It has previously been shown that a loaded warm-up may improve power performances. We examined the acute effects of loaded dynamic warm-up on change of direction speed (CODS), which had not been previously investigated. Eight elite badminton players participated in three sessions during which they performed vertical countermovement jump and CODS tests before and after undertaking the dynamic warm-up. The three warm-up conditions involved wearing a weighted vest (a) equivalent to 5% body mass, (b) equivalent to 10% body mass, and (c) a control where a weighted vest was not worn. Vertical jump and CODS performances were then tested at 15 seconds and 2, 4, and 6 minutes post warm-up. Vertical jump and CODS significantly improved following all warm-up conditions (P < .05). Post warm-up vertical jump performance was not different between conditions (P = .430). Post warm-up CODS was significantly faster following the 5% (P = .02) and 10% (P < .001) loaded conditions compared with the control condition. In addition, peak CODS test performances, independent of recovery time, were faster than the control condition following the 10% loaded condition (P = .012). In conclusion, the current study demonstrates that a loaded warm-up augmented CODS, but not vertical jump performance, in elite badminton players.

Structural basis of intramitochondrial phosphatidic acid transport mediated by Ups1-Mdm35 complex.

PubMed

Yu, Fang; He, Fangyuan; Yao, Hongyan; Wang, Chengyuan; Wang, Jianchuan; Li, Jianxu; Qi, Xiaofeng; Xue, Hongwei; Ding, Jianping; Zhang, Peng

2015-07-01

Ups1 forms a complex with Mdm35 and is critical for the transport of phosphatidic acid (PA) from the mitochondrial outer membrane to the inner membrane. We report the crystal structure of the Ups1-Mdm35-PA complex and the functional characterization of Ups1-Mdm35 in PA binding and transfer. Ups1 features a barrel-like structure consisting of an antiparallel β-sheet and three α-helices. Mdm35 adopts a three-helical clamp-like structure to wrap around Ups1 to form a stable complex. The β-sheet and α-helices of Ups1 form a long tunnel-like pocket to accommodate the substrate PA, and a short helix α2 acts as a lid to cover the pocket. The hydrophobic residues lining the pocket and helix α2 are critical for PA binding and transfer. In addition, a hydrophilic patch on the surface of Ups1 near the PA phosphate-binding site also plays an important role in the function of Ups1-Mdm35. Our study reveals the molecular basis of the function of Ups1-Mdm35 and sheds new light on the mechanism of intramitochondrial phospholipid transport by the MSF1/PRELI family proteins. © 2015 The Authors.

Photon up-conversion increases biomass yield in Chlorella vulgaris.

PubMed

Menon, Kavya R; Jose, Steffi; Suraishkumar, Gadi K

2014-12-01

Photon up-conversion, a process whereby lower energy radiations are converted to higher energy levels via the use of appropriate phosphor systems, was employed as a novel strategy for improving microalgal growth and lipid productivity. Photon up-conversion enables the utilization of regions of the solar spectrum, beyond the typical photosynthetically active radiation, that are usually wasted or are damaging to the algae. The effects of up-conversion of red light by two distinct sets of up-conversion phosphors were studied in the model microalgae Chlorella vulgaris. Up-conversion by set 1 phosphors led to a 2.85 fold increase in biomass concentration and a 3.2 fold increase in specific growth rate of the microalgae. While up-conversion by set 2 phosphors resulted in a 30% increase in biomass and 12% increase in specific intracellular neutral lipid, while the specific growth rates were comparable to that of the control. Furthermore, up-conversion resulted in higher levels of specific intracellular reactive oxygen species in C. vulgaris. Up-conversion of red light (654 nm) was shown to improve biomass yields in C. vulgaris. In principle, up-conversion can be used to increase the utilization range of the electromagnetic spectrum for improved cultivation of photosynthetic systems such as plants, algae, and microalgae. Copyright © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Testing normative and self-appraisal feedback in an online slot-machine pop-up in a real-world setting

PubMed Central

Auer, Michael M.; Griffiths, Mark D.

2015-01-01

Over the last few years, there have been an increasing number of gaming operators that have incorporated on-screen pop-up messages while gamblers play on slot machines and/or online as one of a range of tools to help encourage responsible gambling. Coupled with this, there has also been an increase in empirical research into whether such pop-up messages are effective, particularly in laboratory settings. However, very few studies have been conducted on the utility of pop-up messages in real-world gambling settings. The present study investigated the effects of normative and self-appraisal feedback in a slot machine pop-up message compared to a simple (non-enhanced) pop-up message. The study was conducted in a real-world gambling environment by comparing the behavioral tracking data of two representative random samples of 800,000 gambling sessions (i.e., 1.6 million sessions in total) across two conditions (i.e., simple pop-up message versus an enhanced pop-up message). The results indicated that the additional normative and self-appraisal content doubled the number of gamblers who stopped playing after they received the enhanced pop-up message (1.39%) compared to the simple pop-up message (0.67%). The data suggest that pop-up messages influence only a small number of gamblers to cease long playing sessions and that enhanced messages are slightly more effective in helping gamblers to stop playing in-session. PMID:25852630

Vibration exercise as a warm-up modality for deadlift power output.

PubMed

Cochrane, Darryl J; Coley, Karl W; Pritchard, Hayden J; Barnes, Matthew J

2015-04-01

Vibration exercise (VbX) has gained popularity as a warm-up modality to enhance performance in golf, baseball, and sprint cycling, but little is known about the efficacy of using VbX as a warm-up before resistance exercise, such as deadlifting. The aim of this study was to compare the effects of a deadlift (DL)-specific warm-up, VbX warm-up, and Control on DL power output (PO). The DL warm-up (DL-WU) included 10, 8, and 5 repetitions performed at 30, 40, and 50% 1-repetition maximum (1RM), respectively, where the number of repetitions was matched by body-weight squats performed with vibration and without vibration (Control). The warm-up conditions were randomized and performed at least 2 days apart. Peak power (PP), mean power, rate of force development (RFD), and electromyography (EMG) were measured during the concentric phase of 2 consecutive DLs (75% 1RM) at 30 seconds and 2:30 minutes after the warm-up conditions. There was no significant (p > 0.05) main effect or interaction effect between the DL-WU, VbX warm-up, and Control for PP, mean power, RFD, and EMG. Vibration exercise warm-up did not exhibit an ergogenic effect to potentiate muscle activity more than the specific DL-WU and Control. Therefore, DL PO is affected to a similar extent, irrespective of the type of stimuli, when the warm-up is not focused on raising muscle temperature.

Pulse pile-up identification and reconstruction for liquid scintillator based neutron detectors

NASA Astrophysics Data System (ADS)

Luo, X. L.; Modamio, V.; Nyberg, J.; Valiente-Dobón, J. J.; Nishada, Q.; de Angelis, G.; Agramunt, J.; Egea, F. J.; Erduran, M. N.; Ertürk, S.; de France, G.; Gadea, A.; González, V.; Goasduff, A.; Hüyük, T.; Jaworski, G.; Moszyński, M.; Di Nitto, A.; Palacz, M.; Söderström, P.-A.; Sanchis, E.; Triossi, A.; Wadsworth, R.

2018-07-01

The issue of pulse pile-up is frequently encountered in nuclear experiments involving high counting rates, which will distort the pulse shapes and the energy spectra. A digital method of off-line processing of pile-up pulses is presented. The pile-up pulses were firstly identified by detecting the downward-going zero-crossings in the first-order derivative of the original signal, and then the constituent pulses were reconstructed based on comparing the pile-up pulse with four models that are generated by combining pairs of neutron and γ standard pulses together with a controllable time interval. The accuracy of this method in resolving the pile-up events was investigated as a function of the time interval between two pulses constituting a pile-up event. The obtained results show that the method is capable of disentangling two pulses with a time interval among them down to 20 ns, as well as classifying them as neutrons or γ rays. Furthermore, the error of reconstructing pile-up pulses could be kept below 6% when successive peaks were separated by more than 50 ns. By applying the method in a high counting rate of pile-up events measurement of the NEutron Detector Array (NEDA), it was empirically found that this method can reconstruct the pile-up pulses and perform neutron- γ discrimination quite accurately. It can also significantly correct the distorted pulse height spectrum due to pile-up events.

Spatiotemporal Built-up Land Density Mapping Using Various Spectral Indices in Landsat-7 ETM+ and Landsat-8 OLI/TIRS (Case Study: Surakarta City)

NASA Astrophysics Data System (ADS)

Risky, Yanuar S.; Aulia, Yogi H.; Widayani, Prima

2017-12-01

Spectral indices variations support for rapid and accurate extracting information such as built-up density. However, the exact determination of spectral waves for built-up density extraction is lacking. This study explains and compares the capabilities of 5 variations of spectral indices in spatiotemporal built-up density mapping using Landsat-7 ETM+ and Landsat-8 OLI/TIRS in Surakarta City on 2002 and 2015. The spectral indices variations used are 3 mid-infrared (MIR) based indices such as the Normalized Difference Built-up Index (NDBI), Urban Index (UI) and Built-up and 2 visible based indices such as VrNIR-BI (visible red) and VgNIR-BI (visible green). Linear regression statistics between ground value samples from Google Earth image in 2002 and 2015 and spectral indices for determining built-up land density. Ground value used amounted to 27 samples for model and 7 samples for accuracy test. The classification of built-up density mapping is divided into 9 classes: unclassified, 0-12.5%, 12.5-25%, 25-37.5%, 37.5-50%, 50-62.5%, 62.5-75%, 75-87.5% and 87.5-100 %. Accuracy of built-up land density mapping in 2002 and 2015 using VrNIR-BI (81,823% and 73.235%), VgNIR-BI (78.934% and 69.028%), NDBI (34.870% and 74.365%), UI (43.273% and 64.398%) and Built-up (59.755% and 72.664%). Based all spectral indices, Surakarta City on 2000-2015 has increased of built-up land density. VgNIR-BI has better capabilities for built-up land density mapping on Landsat-7 ETM + and Landsat-8 OLI/TIRS.

Follow-up frequency and compliance in women with probably benign findings on breast magnetic resonance imaging.

PubMed

Marshall, Ariela L; Domchek, Susan M; Weinstein, Susan P

2012-04-01

Six-month short-interval follow-up is recommended for probably benign findings on breast magnetic resonance imaging (MRI). We wanted to examine patient adherence to follow-up recommendation for Breast Imaging-Reporting and Data System (BI-RADS) category 3 lesions at a tertiary care medical center. We performed a retrospective review of frequency and adherence rates to follow-up recommendation for women with an initial BI-RADS 3 breast MRI between 2005 and 2007. A total of 132 women with BI-RADS 3 breast MRI recommendations were included. Ninety-six of 132 (72.7%) women adhered to the first follow-up recommendation or elected to have tissue diagnosis; 78/132 (59.1%) had follow-up MRI and 18/132 (13.6%) had tissue diagnosis. Thirty-six of 132 (27.3%) women did not return for follow-up. Nine of nine (100%) of BRCA carriers returned for follow-up or had tissue diagnosis, compared to 87/123 (70.7%) of non-BRCA carriers. A total of 35/41 (85.4%) of patients with a prior history of breast cancer returned for follow-up or had tissue diagnosis, compared to 61/91 (67%) of patients without a history of breast cancer. Only 5/15 (33%) of patients undergoing MRI for symptom alone adhered to follow-up recommendations. Adherence to BI-RADS category 3 follow-up recommendation is often low. Women with a history of breast cancer or who were BRCA carriers were significantly more likely to adhere to follow-up recommendation than women without a history of breast cancer or women undergoing MRI for symptoms alone. Strategies to improve adherence should be developed. Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.

Undecylprodigiosin selectively induces apoptosis in human breast carcinoma cells independent of p53

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

Ho, T.-F.; Department of Life Sciences, National Chung Hsing University, Taichung, Taiwan; Department of Medical Technology, Central Taiwan University of Science and Technology, Taichung 40605, Taiwan

2007-12-15

Undecylprodigiosin (UP) is a bacterial bioactive metabolite produced by Streptomyces and Serratia. In this study, we explored the anticancer effect of UP. Human breast carcinoma cell lines BT-20, MCF-7, MDA-MB-231 and T47D and one nonmalignant human breast epithelial cell line, MCF-10A, were tested in this study. We found that UP exerted a potent cytotoxicity against all breast carcinoma cell lines in a dose- and time-dependent manner. In contrast, UP showed limited toxicity to MCF-10A cells, indicating UP's cytotoxic effect is selective for malignant cells. UP's cytotoxic effect was due to apoptosis, as confirmed by positive TUNEL signals, annexin V-binding, caspasemore » 9 activation and PARP cleavage. Notably, UP-induced apoptosis was blocked by the pan-caspase inhibitor z-VAD.fmk, further indicating the involvement of caspase activity. Moreover, UP caused a marked decrease of the levels of antiapoptotic BCL-X{sub L}, Survivin and XIAP while enhancing the levels of proapoptotic BIK, BIM, MCL-1S and NOXA, consequently favoring induction of apoptosis. Additionally, we found that cells with functional p53 (MCF-7, T47D) or mutant p53 (BT-20, MDA-MB-231) were both susceptible to UP's cytotoxicity. Importantly, UP was able to induce apoptosis in MCF-7 cells with p53 knockdown by RNA interference, confirming the dispensability of p53 in UP-induced apoptosis. Overall, our results establish that UP induces p53-independent apoptosis in breast carcinoma cells with no marked toxicity to nonmalignant cells, raising the possibility of its use as a new chemotherapeutic drug for breast cancer irrespective of p53 status.« less

Follow-up care of young childhood cancer survivors: attendance and parental involvement.

PubMed

Vetsch, Janine; Rueegg, Corina S; Mader, Luzius; Bergstraesser, Eva; Rischewski, Johannes; Kuehni, Claudia E; Michel, Gisela

2016-07-01

Despite recommendations, only a proportion of long-term childhood cancer survivors attend follow-up care. We aimed to (1) describe the follow-up attendance of young survivors aged 11-17 years; (2) describe the parental involvement in follow-up, and (3) investigate predictors of follow-up attendance and parental involvement. As part of the Swiss Childhood Cancer Survivor Study, a follow-up questionnaire was sent to parents of childhood cancer survivors aged 11-17 years. We assessed follow-up attendance of the child, parents' involvement in follow-up, illness perception (Brief IPQ), and sociodemographic data. Clinical data was available from the Swiss Childhood Cancer Registry. Of 309 eligible parents, 189 responded (67 %; mean time since diagnosis 11.3 years, range 6.8-17.2) and 75 % (n = 141) reported that their child still attended follow-up. Of these, 83 % (n = 117) reported ≥1 visit per year and 17 % (n = 23) reported <1 visit every year. Most survivors saw pediatric oncologists (n = 111; 79 % of 141), followed by endocrinologists (n = 24, 17 %) and general practitioners (n = 22, 16 %). Most parents (92 %) reported being involved in follow-up (n = 130). In multivariable and Cox regression analyses, longer time since diagnosis (p = 0.025) and lower perceived treatment control (assessed by IPQ4: how much parents thought follow-up can help with late effects; p = 0.009) were associated with non-attendance. Parents' overall information needs was significantly associated with parental involvement in the multivariable model (p = 0.041). Educating survivors and their parents on the importance and effectiveness of follow-up care might increase attendance in the longer term.

Follow-up after colon cancer treatment in the Netherlands; a survey of patients, GPs, and colorectal surgeons.

PubMed

Wind, J; Duineveld, L A; van der Heijden, R P; van Asselt, K M; Bemelman, W A; van Weert, H C

2013-08-01

Follow-up to detect recurrence is an important feature of care after colon cancer treatment. Currently, follow-up visits are surgeon-led with focus on recurrence. To date, there is increasing interest for general practitioners (GPs) providing this care, as GPs might provide more holistic care. The present study assessed how surgeons, GPs, and patients evaluate current surgeon-led colon cancer follow-up and to list their views on possible future GP-led follow-up. The study consists of a cross-sectional survey including colorectal surgeons, patients who participate or recently finished a follow-up programme, and GPs in the Netherlands. Eighty-seven out of 191 GPs, 113 out of 238 surgeons, and 186 out of 243 patients responded. Patients are satisfied about current surgeon-led follow-up, especially about recurrence detection and identification of physical problems (94% and 85% respectively). However, only 56% and 49% of the patients were satisfied about the identification of psychological and social problems respectively. Only 16% of the patients evaluated future GP-led follow-up positively. Regarding healthcare providers, surgeons were more positive compared to GPs; 49% of the surgeons, and only 30% of the GPs evaluated future GP-led follow-up positively (P = 0.002). Furthermore, several reservations and principle requirements for GP-led follow-up were identified. The results suggest an unfavourable view among patients and healthcare providers, especially GPs, regarding a central role for GPs in colon cancer follow-up. However, low satisfaction on psychosocial aspects in current follow-up points out a lack in care. Therefore, the results provide a justification to explore future GP-led care further. Copyright © 2013 Elsevier Ltd. All rights reserved.

Lack of active follow-up of cancer patients in Chennai, India: implications for population-based survival estimates

PubMed Central

Rama, Ranganathan; Shanta, Viswanathan

2008-01-01

Abstract Objective To measure the bias in absolute cancer survival estimates in the absence of active follow-up of cancer patients in developing countries. Methods Included in the study were all incident cases of the 10 most common cancers and corresponding subtypes plus all tobacco-related cancers not ranked among the top 10 that were registered in the population-based cancer registry in Chennai, India, during 1990–1999 and followed through 2001. Registered incident cases were first matched with those in the all-cause mortality database from the vital statistics division of the Corporation of Chennai. Unmatched incident cancer cases were then actively followed up to determine their survival status. Absolute survival was estimated by using an actuarial method and applying different assumptions regarding the survival status (alive/dead) of cases under passive and active follow-up. Findings Before active follow-up, matches between cases ranged from 20% to 66%, depending on the site of the primary tumour. Active follow-up of unmatched incident cases revealed that 15% to 43% had died by the end of the follow-up period, while the survival status of 4% to 38% remained unknown. Before active follow-up of cancer patients, 5-year absolute survival was estimated to be between 22% and 47% higher, than when conventional actuarial assumption methods were applied to cases that were lost to follow-up. The smallest survival estimates were obtained when cases lost to follow-up were excluded from the analysis. Conclusion Under the conditions that prevail in India and other developing countries, active follow-up of cancer patients yields the most reliable estimates of cancer survival rates. Passive case follow-up alone or applying standard methods to estimate survival is likely to result in an upward bias. PMID:18670662

Newborn follow-up after discharge from a tertiary care hospital in the Western Cape region of South Africa: a prospective observational cohort study.

PubMed

Milambo, Jean Paul Muambangu; Cho, KaWing; Okwundu, Charles; Olowoyeye, Abiola; Ndayisaba, Leonidas; Chand, Sanjay; Corden, Mark H

2018-01-01

Current practice in the Western Cape region of South Africa is to discharge newborns born in-hospital within 24 h following uncomplicated vaginal delivery and two days after caesarean section. Mothers are instructed to bring their newborn to a clinic after discharge for a health assessment. We sought to determine the rate of newborn follow-up visits and the potential barriers to timely follow-up. Mother-newborn dyads at Tygerberg Hospital in Cape Town, South Africa were enrolled from November 2014 to April 2015. Demographic data were obtained via questionnaire and medical records. Mothers were contacted one week after discharge to determine if they had brought their newborns for a follow-up visit, and if not, the barriers to follow-up. Factors associated with follow-up were analyzed using logistic regression. Of 972 newborns, 794 (82%) were seen at a clinic for a follow-up visit within one week of discharge. Mothers with a higher education level or whose newborns were less than 37 weeks were more likely to follow up. The follow-up rate did not differ based on hospital length of stay. Main reported barriers to follow-up included maternal illness, lack of money for transportation, and mother felt follow-up was unnecessary because newborn was healthy. Nearly 4 in 5 newborns were seen at a clinic within one week after hospital discharge, in keeping with local practice guidelines. Further research on the outcomes of this population and those who fail to follow up is needed to determine the impact of postnatal healthcare policy.

The association between physical activity and dementia in an elderly population: the Rotterdam Study.

PubMed

de Bruijn, Renée F A G; Schrijvers, Elisabeth M C; de Groot, Karen A; Witteman, Jacqueline C M; Hofman, Albert; Franco, Oscar H; Koudstaal, Peter J; Ikram, Mohammad Arfan

2013-03-01

Several studies have associated physical activity with the risk of dementia, but mostly did so during short follow-up. It remains unclear whether physical activity also affects dementia during longer follow-up. We examined the association between physical activity and risk of dementia during a follow-up period up to 14 years. From 1997 to 1999, physical activity was assessed using a validated questionnaire in 4,406 elderly persons (age range 61-97) from the prospective, population-based Rotterdam Study. Follow-up for dementia was complete until January 1, 2011. We used Cox proportional hazards models to assess the association between physical activity and incident dementia. Next, we stratified follow-up time using a cut-off of 4 years. We separately investigated dementia due to Alzheimer disease. During 38,631 person-years, 583 participants developed dementia. When adjusting for age and sex, we found a borderline significant association between higher physical activity and lower risk of dementia (HR 0.95; 95% CI 0.87-1.04). This association was confined to follow-up up to 4 years (HR 0.82; 95% CI 0.71-0.95), and not to follow-up of at least 4 years (HR 1.04; 95% CI 0.93-1.16). Additional adjustments only slightly attenuated the associations. A similar pattern was present for Alzheimer disease. We found a higher level of physical activity to be associated with a lower risk of dementia. This association was confined to follow-up for up to 4 years and not to longer follow-up, suggesting either a role for reverse causality or only a short term effect of late-life physical activity in an elderly population.

Insurance-Based Differences in Time to Diagnostic Follow-up after Positive Screening Mammography.

PubMed

Durham, Danielle D; Robinson, Whitney R; Lee, Sheila S; Wheeler, Stephanie B; Reeder-Hayes, Katherine E; Bowling, J Michael; Olshan, Andrew F; Henderson, Louise M

2016-11-01

Insurance may lengthen or inhibit time to follow-up after positive screening mammography. We assessed the association between insurance status and time to initial diagnostic follow-up after a positive screening mammogram. Using 1995-2010 data from a North Carolina population-based registry of breast imaging and cancer outcomes, we identified women with a positive screening mammogram. We compared receipt of follow-up within 60 days of screening using logistic regression and evaluated time to follow-up initiation using Cox proportional hazards regression. Among 43,026 women included in the study, 73% were <65 years and 27% were 65+ years. Median time until initial diagnostic follow-up was similar by age group and insurance status. In the adjusted model for women <65, uninsured women experienced a longer time to initiation of diagnostic follow-up [HR, 0.47; 95% confidence interval (CI), 0.25-0.89] versus women with private insurance. There were increased odds of these uninsured women not meeting the Centers for Disease Control and Prevention guideline for follow-up within 60 days (OR, 1.59; 95% CI, 1.31-1.94). Among women ages 65+, women with private insurance experienced a faster time to follow-up (adjusted HR, 2.09; 95% CI, 1.27-3.44) than women with Medicare and private insurance. Approximately 10% of women had no follow-up by 365 days. We found differences in time to initial diagnostic follow-up after a positive screening mammogram by insurance status and age group. Uninsured women younger than 65 years at a positive screening event had delayed follow-up. Replication of these findings and examination of their clinical significance warrant additional investigation. Cancer Epidemiol Biomarkers Prev; 25(11); 1474-82. ©2016 AACR. ©2016 American Association for Cancer Research.

A SCALE-UP Mock-Up: Comparison of Student Learning Gains in High- and Low-Tech Active-Learning Environments.

PubMed

Soneral, Paula A G; Wyse, Sara A

2017-01-01

Student-centered learning environments with upside-down pedagogies (SCALE-UP) are widely implemented at institutions across the country, and learning gains from these classrooms have been well documented. This study investigates the specific design feature(s) of the SCALE-UP classroom most conducive to teaching and learning. Using pilot survey data from instructors and students to prioritize the most salient SCALE-UP classroom features, we created a low-tech "Mock-up" version of this classroom and tested the impact of these features on student learning, attitudes, and satisfaction using a quasi--experimental setup. The same instructor taught two sections of an introductory biology course in the SCALE-UP and Mock-up rooms. Although students in both sections were equivalent in terms of gender, grade point average, incoming ACT, and drop/fail/withdraw rate, the Mock-up classroom enrolled significantly more freshmen. Controlling for class standing, multiple regression modeling revealed no significant differences in exam, in-class, preclass, and Introduction to Molecular and Cellular Biology Concept Inventory scores between the SCALE-UP and Mock-up classrooms. Thematic analysis of student comments highlighted that collaboration and whiteboards enhanced the learning experience, but technology was not important. Student satisfaction and attitudes were comparable. These results suggest that the benefits of a SCALE-UP experience can be achieved at lower cost without technology features. © 2017 P. A. G. Soneral and S. A. Wyse. CBE—Life Sciences Education © 2017 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

Heart-Rate Recovery After Warm-up in Swimming: A Useful Predictor of Training Heart-Rate Response?

PubMed

Ganzevles, Sander P M; de Haan, Arnold; Beek, Peter J; Daanen, Hein A M; Truijens, Martin J

2017-07-01

For training to be optimal, daily training load has to be adapted to the momentary status of the individual athlete, which is often difficult to establish. Therefore, the current study investigated the predictive value of heart-rate recovery (HRR) during a standardized warm-up for training load. Training load was quantified by the variation in heart rate during standardized training in competitive swimmers. Eight female and 5 male Dutch national-level swimmers participated in the study. They all performed 3 sessions consisting of a 300-m warm-up test and a 10 × 100-m training protocol. Both protocols were swum in front crawl at individually standardized velocities derived from an incremental step test. Velocity was related to 75% and 85% heart-rate reserve (% HR res ) for the warm-up and training, respectively. Relative HRR during the first 60 s after the warm-up (HR Rw-up ) and differences between the actual and intended heart rate for the warm-up and the training (ΔHR w-up and ΔHR tr ) were determined. No significant relationship between HRR w-up and ΔHR tr was found (F 1,37 = 2.96, P = .09, R 2 = .07, SEE = 4.65). There was considerable daily variation in ΔHR tr at a given swimming velocity (73-93% HR res ). ΔHR w-up and ΔHR tr were clearly related (F 1,37 = 74.31, P < .001, R 2 = .67, SEE = 2.78). HRR after a standardized warm-up does not predict heart rate during a directly subsequent and standardized training session. Instead, heart rate during the warm-up protocol seems a promising alternative for coaches to make daily individual-specific adjustments to training programs.

Variation in the Types of Providers Participating in Breast Cancer Follow-Up Care: A SEER-Medicare Analysis.

PubMed

Neuman, Heather B; Schumacher, Jessica R; Schneider, David F; Winslow, Emily R; Busch, Rebecca A; Tucholka, Jennifer L; Smith, Maureen A; Greenberg, Caprice C

2017-03-01

The current guidelines do not delineate the types of providers that should participate in early breast cancer follow-up care (within 3 years after completion of treatment). This study aimed to describe the types of providers participating in early follow-up care of older breast cancer survivors and to identify factors associated with receipt of follow-up care from different types of providers. Stages 1-3 breast cancer survivors treated from 2000 to 2007 were identified in the Surveillance, Epidemiology and End results Medicare database (n = 44,306). Oncologist (including medical, radiation, and surgical) follow-up and primary care visits were defined using Medicare specialty provider codes and linked American Medical Association (AMA) Masterfile. The types of providers involved in follow-up care were summarized. Stepped regression models identified factors associated with receipt of medical oncology follow-up care and factors associated with receipt of medical oncology care alone versus combination oncology follow-up care. Oncology follow-up care was provided for 80 % of the patients: 80 % with a medical oncologist, 46 % with a surgeon, and 39 % with a radiation oncologist after radiation treatment. The patients with larger tumor size, positive axillary nodes, estrogen receptor (ER)-positive status, and chemotherapy treatment were more likely to have medical oncology follow-up care than older patients with higher Charlson comorbidity scores who were not receiving axillary care. The only factor associated with increased likelihood of follow-up care with a combination of oncology providers was regular primary care visits (>2 visits/year). Substantial variation exists in the types of providers that participate in breast cancer follow-up care. Improved guidance for the types of providers involved and delineation of providers' responsibilities during follow-up care could lead to improved efficiency and quality of care.

Hospital Stay and Engagement in Outpatient Follow-Up After Alcohol Emergency Detox: A 1-Year Comparison Study.

PubMed

Azuar, Julien; Questel, Frank; Hispard, Eric; Scott, Jan; Vorspan, Florence; Bellivier, Frank

2016-02-01

Inpatient alcohol detoxifications are only proposed after motivational outpatient encounters because detoxification directly from the emergency department (ED) is believed to be associated with early dropout and poor adherence to outpatient follow-up. The aim of this prospective follow-up study was to test the feasibility of unscheduled (UP) alcohol detoxification directly from the ED and to compare the 1-year follow-up of these patients to that of scheduled (SP) patients. A quasi-naturalistic prospective follow-up study of 120 patients: 60 consecutively admitted patients referred directly by the ED for alcohol detoxification (UP) were compared to 60 consecutively admitted patients who had undergone the usual preparation for an inpatient detoxification program (SP). The length of hospitalization (in days) and attendance to postdischarge outpatient visits during the first year was compared. UP patients were older, less frequently employed, and had more somatic comorbidities compared with SP patients. The UP length of stay was significantly longer (20 ± 16 vs. 14 ± 6, p = 0.04). No difference in their postdischarge attendance was observed; the number of patients attending 1 session (57% UP vs. 65% SP, p = 0.227) and 5 sessions (22% UP vs. 32% SP, p = 0.151) and the mean number of postdischarge visits attended were comparable between the UP and SP groups (2.7 ± 6 vs. 4.5 ± 6; Mann-Whitney U = 1,517, p = 0.124). We did not find that UP patients who had been admitted for alcohol detoxification had a significantly higher dropout rate or lower postdischarge addiction treatment attendance. Because they may have several advantages, detoxification programs directly linked with EDs should be further evaluated. Copyright © 2016 by the Research Society on Alcoholism.

HIS-Based Support of Follow-Up Documentation – Concept and Implementation for Clinical Studies

PubMed Central

Herzberg, S.; Fritz, F.; Rahbar, K.; Stegger, L.; Schäfers, M.; Dugas, M.

2011-01-01

Objective Follow-up data must be collected according to the protocol of each clinical study, i.e. at certain time points. Missing follow-up information is a critical problem and may impede or bias the analysis of study data and result in delays. Moreover, additional patient recruitment may be necessary due to incomplete follow-up data. Current electronic data capture (EDC) systems in clinical studies are usually separated from hospital information systems (HIS) and therefore can provide limited functionality to support clinical workflow. In two case studies, we assessed the feasibility of HIS-based support of follow-up documentation. Methods We have developed a data model and a HIS-based workflow to provide follow-up forms according to clinical study protocols. If a follow-up form was due, a database procedure created a follow-up event which was translated by a communication server into an HL7 message and transferred to the import interface of the clinical information system (CIS). This procedure generated the required follow-up form and enqueued a link to it in a work list of the relating study nurses and study physicians, respectively. Results A HIS-based follow-up system automatically generated follow-up forms as defined by a clinical study protocol. These forms were scheduled into work lists of study nurses and study physicians. This system was integrated into the clinical workflow of two clinical studies. In a study from nuclear medicine, each scenario from the test concept according to the protocol of the single photon emission computer tomography/computer tomography (SPECT/CT) study was simulated and each scenario passed the test. For a study in psychiatry, 128 follow-up forms were automatically generated within 27 weeks, on average five forms per week (maximum 12, minimum 1 form per week). Conclusion HIS-based support of follow-up documentation in clinical studies is technically feasible and can support compliance with study protocols. PMID:23616857

Cost-effectiveness of follow-up of pulmonary nodules incidentally detected on cardiac computed tomographic angiography in patients with suspected coronary artery disease.

PubMed

Goehler, Alexander; McMahon, Pamela M; Lumish, Heidi S; Wu, Carol C; Munshi, Vidit; Gilmore, Michael; Chung, Jonathan H; Ghoshhajra, Brian B; Mark, Daniel; Truong, Quynh A; Gazelle, G Scott; Hoffmann, Udo

2014-08-19

Pulmonary nodules (PNs) are often detected incidentally during coronary computed tomographic (CT) angiography, which is increasingly being used to evaluate patients with chest pain symptoms. However, the efficiency of following up on incidentally detected PN is unknown. We determined demographic and clinical characteristics of stable symptomatic patients referred for coronary CT angiography in whom incidentally detected PNs warranted follow-up. A validated lung cancer simulation model was populated with data from these patients, and clinical and economic consequences of follow-up per Fleischner guidelines versus no follow-up were simulated. Of the 3665 patients referred for coronary CT angiography, 591 (16%) had PNs requiring follow-up. The mean age of patients with PNs was 59±10 years; 66% were male; 67% had ever smoked; and 21% had obstructive coronary artery disease. The projected overall lung cancer incidence was 5.8% in these patients, but the majority died of coronary artery disease (38%) and other causes (57%). Follow-up of PNs was associated with a 4.6% relative reduction in cumulative lung cancer mortality (absolute mortality: follow-up, 4.33% versus non-follow-up, 4.54%), more downstream testing (follow-up, 2.34 CTs per patient versus non-follow-up, 1.01 CTs per patient), and an average increase in quality-adjusted life of 7 days. Costs per quality-adjusted life-year gained were $154 700 to follow up the entire cohort and $129 800 per quality-adjusted life-year when only smokers were included. Follow-up of PNs incidentally detected in patients undergoing coronary CT angiography for chest pain evaluation is associated with a small reduction in lung cancer mortality. However, significant downstream testing contributes to limited efficiency, as demonstrated by a high cost per quality-adjusted life-year, especially in nonsmokers. © 2014 American Heart Association, Inc.

Preoperative warm-up the key to improved resident technique: a randomized study.

PubMed

Moran-Atkin, Erin; Abdalla, Gamal; Chen, Grace; Magnuson, Thomas H; Lidor, Anne O; Schweitzer, Michael A; Steele, Kimberley E

2015-05-01

The ACGME has required that a skills lab be incorporated into the surgical residency curriculum. While the value of warm-up is generally accepted in other areas requiring complex motor skills, there is little evidence to support the benefits of warm-up prior to performing surgery. We are conducting this study in an attempt to identify whether a warm-up period prior to operating impacts operative technique. All general surgery residents and MIS fellows were included in this IRB-approved randomized study. Participants were randomized to either warm-up or no warm-up groups. Participants randomized to the warm-up group completed a 10 min practice session in the simulation lab within 1 h of starting the case, using an FLS training box. At the conclusion of the operation, the participant was evaluated by the attending surgeon using the validated global rating scales of Reznick and Vassiliou. The attending surgeons were blinded to the use of pre-procedure warm-up. The results of the questionnaire were analyzed using student's t test with p < 0.05 for significance. Pilot data were obtained after completing 40 cases that were randomized to warm-up (19) or no warm-up (21). There was a statistically significant improvement in depth perception (p = 0.02), bimanual dexterity (p = 0.01), and efficiency of movements (p = 0.03) for those randomized to warm-up. There was statistical improvement when we preformed a composite scoring of the attending evaluations for each of the Reznick (p = 0.008) and the Vassiliou (p = 0.01) global rating scales. Preoperative warm-up significantly improves depth perception, bimanual dexterity, and efficiency of movements, as well as improvement in composite scores as judged by the attending surgeon. The lack of self-perceived improvement by the residents may be a reflection of the high standards and intense self-critique that is common among surgical trainees. We believe that our findings, while preliminary, reflect that surgical performance can be enhanced through structured warm-up activities.

Pharmacist care plans and documentation of follow-up before the Iowa Pharmaceutical Case Management program.

PubMed

Becker, CoraLynn; Bjornson, Darrel C; Kuhle, Julie W

2004-01-01

To document drug therapy problems and their causes and assess pharmacist follow-up of patients with identified drug therapy problems. Cross-sectional analysis. Iowa. 160 pharmacists who submitted 754 pharmaceutical care plans in an effort to qualify for participation in the Iowa Pharmaceutical Case Management program. Care plans were assessed for drug therapy problems and causes and for documentation of pharmacist follow-up (actual, none, or intent to follow up). Pharmacists documented a wide variety of drug therapy problems and causes, including adverse drug reactions (20.1% of care plans), need for additional drug therapy (18.9%), lack of patient adherence to therapy (16.3%), incorrect medication being prescribed (14.1%), and drug dose too high (10.0%). Pharmacist follow-up with patients was not optimal, with 31% of care plans providing documentation of actual follow-up. Another 42.2% of plans indicated that the pharmacist intended to contact the patient for follow-up but either did not do so or did not record the intervention. No actual follow-up or intent to follow up was recorded in 26.8% of care plans. Pharmacists practicing in independent pharmacies followed up with patients more frequently than those in other settings (36.4% of care plans, compared with 22.7%, 23.2%, and 28.4% for chain, clinic, and franchise pharmacies). Pharmacists were more likely to follow up when the identified problem involved drug safety rather than effectiveness (36.2% versus 28.3% of care plans). Documentation of pharmacist follow-up with patients was less than optimal. In addition to identifying drug therapy problems and causes, pharmacists must complete the care continuum through documentation of patient monitoring and follow-up to transform the philosophy and vision of the pharmaceutical care concept into a practice of pharmacy recognized and rewarded by patients and payers.

The relationship between baseline and follow-up left ventricular ejection fraction with adverse events among primary prevention ICD patients.

PubMed

Friedman, Daniel J; Fudim, Marat; Overton, Robert; Shaw, Linda K; Patel, Divyang; Pokorney, Sean D; Velazquez, Eric J; Al-Khatib, Sana M

2018-07-01

Left ventricular ejection fraction (LVEF) is used to select patients for primary prevention implantable cardioverter defibrillators (ICDs). The relationship between baseline and long-term follow-up LVEF and clinical outcomes among primary prevention ICD patients remains unclear. We studied 195 patients with a baseline LVEF ≤35% ≤6 months prior to ICD implantation and follow-up LVEF 1-3 years after ICD implantation without intervening left ventricular assist device (LVAD) or transplant. The co-primary study endpoints were: (1) a composite of time to death, LVAD, or transplant and (2) appropriate ICD therapy. We examined multivariable Cox proportional hazard models with a 3-year post-implant landmark view; the LVEF closest to the 3-year mark was considered the follow-up LVEF for analyses. Follow-up LVEF was examined using 2 definitions: (1) ≥10% improvement compared to baseline or (2) actual value of ≥40%. Fifty patients (26%) had a LVEF improvement of ≥10% and 44 (23%) had a follow-up LVEF ≥40%. Neither baseline nor follow-up LVEF was significantly associated with the composite endpoint. In contrast, both baseline and follow-up LVEF were associated with risk for long-term ICD therapies, whether follow-up LVEF was modeled as a ≥10% absolute improvement (baseline LVEF HR 0.87, CI 0.91-0.93, P < .001; follow-up LVEF HR 0.18, CI 0.06-0.53, P = .002) or a ≥40% follow-up value (baseline LVEF HR 0.89, CI 0.83-0.96, P = .001, follow-up LVEF HR 0.26, CI 0.08-0.87, P = .03). Among primary prevention ICD recipients, both baseline and follow-up LVEF were independently associated with long-term risk for appropriate ICD therapy, but they were not associated with time to the composite of LVAD, transplant, or death. Copyright © 2018 Elsevier Inc. All rights reserved.

Theoretical analysis of start-up power in helium pulsating heat pipe

NASA Astrophysics Data System (ADS)

Li, Monan; Huang, Rongjin; Xu, Dong; Li, Laifeng

2017-02-01

An analytical model for one-turn helium pulsating heat pipes (PHPs) with single liquid slug and vapor plug is established in present study. When an additional heat power takes place in the evaporating section, temperature and pressure will increase. The pressure wave travels through vapor and liquid phases at different speed, producing a pressure difference in the system, which acts as an exciting force to start up the oscillating motion. Results show that the start-up power of helium PHP is related to the filling ratio. The start-up power increases with the filling ration. However, there exist an upper limit. Furthermore, the start-up power also depends on the inclination angle of PHP. When the inclination angle increases, the heat input needed to start up the oscillating motion decreases. But for one-turn helium PHP, it can not be started up when the inclination angle is up to 90°, equalling to horizontal position,. While the inclination angle ranges between 0° (vertical position) and 75°, it can operate successfully.

Casual hook up sex during the first year of college: Prospective associations with attitudes about sex and love relationships.

PubMed

Katz, Jennifer; Schneider, Monica E

2013-11-01

This study examined bidirectional relationships among emerging adults' involvement in casual hook up sex and attitudes about sex and love relationships. At the start and end of their first year in college, undergraduates (N = 163) responded to measures of sexual behavior, sexual attitudes, and attitudes about love relationships. In cross-sectional analyses, attitudes about sex and love both were associated with involvement in casual hook up sex. In prospective analyses, initial attitudes about sexual instrumentality uniquely predicted involvement in later hook up sex, even after controlling for past hook up sex. Furthermore, involvement in hook up sex during the first year of college predicted greater sexual permissiveness and comfort with casual genital contact, even after controlling for initial sexual attitudes and hook up behaviors. None of the associations between attitudes and behavior were qualified by gender. Experiences of causal hook up sex appear to have implications primarily for emerging adults' attitudes about sexual interactions rather than their attitudes about love relationships.

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

Morrison-Saunders, Angus, E-mail: a.morrison-saunders@murdoch.edu.au; North-West University; Pope, Jenny, E-mail: jenny@integral-sustainability.net

This paper conceptualises what sustainability assessment follow-up might entail for three models of sustainability assessment: EIA-driven integrated assessment, objectives-led integrated assessment and the contribution to sustainability model. The first two are characterised by proponent monitoring and evaluation of individual impacts and indicators while the latter takes a holistic view based around focused sustainability criteria relevant to the context. The implications of three sustainability challenges on follow-up are also examined: contested time horizons and value changes, trade-offs, and interdisciplinarity. We conclude that in order to meet these challenges some form of adaptive follow-up is necessary and that the contribution to sustainabilitymore » approach is the best approach. -- Highlights: • We explore sustainability follow-up for three different sustainability models. • Long-time frames require adaptive follow-up and are a key follow-up challenge. • Other key challenges include interdisciplinarity, and trade-offs. • Sustainability follow-up should be a direction of travel and not an outcome. • Only the follow-up for contribution to sustainability model addresses sustainability challenges sufficiently.« less

SOP 98-5 brings uniformity to reporting start-up costs.

PubMed

Luecke, R W; Meeting, D T

1999-08-01

The American Institute of Certified Public Accountants (AICPA) issued Statement of Position (SOP) No. 98-5, Reporting on the Costs of Start-Up Activities, in April 1998 to provide organizations with guidance on how to report start-up and organization costs. Because some companies were expensing start-up costs while other companies were capitalizing start-up costs with a variety of periods over which to amortize costs, it was difficult to compare companies' financial statements. SOP No. 98-5 will bring uniformity to the treatment of start-up and organization costs by dictating that these costs be expensed as incurred. AICPA's Accounting Standards Executive Committee adopted an intentionally broad definition of start-up costs to capture the vast majority of costs associated with starting up an organization. SOP No. 98-5 takes effect for financial statements for fiscal years beginning after December 15, 1998, but can be applied earlier for fiscal years for which financial statements have not been issued.

Women's experiences and health care-seeking practices in relation to uterine prolapse in a hill district of Nepal.

PubMed

Shrestha, Binjwala; Onta, Sharad; Choulagai, Bishnu; Poudyal, Amod; Pahari, Durga Prasad; Uprety, Aruna; Petzold, Max; Krettek, Alexandra

2014-02-03

Although uterine prolapse (UP) occurs commonly in Nepal, little is known about the physical health and care-seeking practices of women with UP. This study aimed to explore women's experiences of UP and its effect on daily life, its perceived causes, and health care-seeking practices. Using a convenience sampling method, we conducted 115 semi-structured and 16 in-depth interviews with UP-affected women during September-December 2012. All interviews occurred in outreach clinics in villages of the Dhading district. Study participants were 23-82 years of age. Twenty-four percent were literate, 47.2% had experienced a teenage pregnancy, and 29% had autonomy to make healthcare decisions. Most participants (>85%) described the major physical discomforts of UP as difficulty with walking, standing, working, sitting, and lifting. They also reported urinary incontinence (68%) bowel symptoms (42%), and difficulty with sexual activity (73.9%). Due to inability to perform household chores or fulfill their husband's sexual desires, participants endured humiliation, harassment, and torture by their husbands and other family members, causing severe emotional stress. Following disclosure of UP, 24% of spouses remarried and 6% separated from the marital relationship. Women perceived the causes of UP as unsafe childbirth, heavy work during the postpartum period, and gender discrimination. Prior to visiting these camps some women (42%) hid UP for more than 10 years. Almost half (48%) of participants sought no health care; 42% ingested a herb and ate nutritious food. Perceived barriers to accessing health care included shame (48%) and feeling that care was unnecessary (12.5%). Multiple responses (29%) included shame, inability to share, male service provider, fear of stigma and discrimination, and perceiving UP as normal for childbearing women. UP adversely affects women's daily life and negatively influences their physical, mental, and social well-being. The results of our study are useful to generate information on UP symptoms and female health care seeking practices. Our findings can be helpful for effective development of UP awareness programs to increase service utilization at early stages of UP and thereby might contribute to both primary and secondary prevention of UP.

Multi-complexity measures of heart rate variability and the effect of vasopressor titration: a prospective cohort study of patients with septic shock.

PubMed

Brown, Samuel M; Sorensen, Jeffrey; Lanspa, Michael J; Rondina, Matthew T; Grissom, Colin K; Shahul, Sajid; Mathews, V J

2016-10-10

Septic shock is a common and often devastating syndrome marked by severe cardiovascular dysfunction commonly managed with vasopressors. Whether markers of heart rate complexity before vasopressor up-titration could be used to predict success of the up-titration is not known. We studied patients with septic shock requiring vasopressor, newly admitted to the intensive care unit. We measured the complexity of heart rate variability (using the ratio of fractal exponents from detrended fluctuation analysis) in the 5 min before all vasopressor up-titrations in the first 24 h of an intensive care unit (ICU) admission. A successful up-titration was defined as one that did not require further up-titration (or decrease in mean arterial pressure) for 60 min. We studied 95 patients with septic shock, with a median APACHE II of 27 (IQR: 20-37). The median number of up-titrations, normalized to 24 h, was 12.2 (IQR: 8-17) with a maximum of 49. Of the up-titrations, the median proportion of successful interventions was 0.28 (IQR: 0.12-0.42). The median of mean arterial pressure (MAP) at the time of a vasopressor up-titration was 66 mmHg; the average infusion rate of norepinephrine at the time of an up-titration was 0.11 mcg/kg/min. The ratio of fractal exponents was not associated with successful up-titration on univariate or multivariate regression. On exploratory secondary analyses, however, the long-term fractal exponent was associated (p = 0.003) with success of up-titration. Independent of heart rate variability, MAP was associated (p < 0.001) with success of vasopressor up-titration, while neither Sequential Organ Failure Assessment (SOFA) nor Acute Physiology and Chronic Health Evaluation II (APACHE II) score was associated with vasopressor titration. Only a third of vasopressor up-titrations were successful among patients with septic shock. MAP and the long-term fractal exponent were associated with success of up-titration. These two, complementary variables may be important to the development of rational vasopressor titration protocols.

[Comparison of four identical electronic noses and three measurement set-ups].

PubMed

Koczulla, R; Hattesohl, A; Biller, H; Hofbauer, J; Hohlfeld, J; Oeser, C; Wirtz, H; Jörres, R A

2011-08-01

Volatile organic compounds (VOCs) can be used as biomarkers in exhaled air. VOC profiles can be detected by an array of nanosensors of an electronic nose. These profiles can be analysed using bioinformatics. It is, however, not known whether different devices of the same model measure identically and to which extent different set-ups and the humidity of the inhaled air influence the VOC profile. Three different measuring set-ups were designed and three healthy control subjects were measured with each of them, using four devices of the same model (Cyranose 320™, Smiths Detection). The exhaled air was collected in a plastic bag. Either ambient air was used as reference (set-up Leipzig), or the reference air was humidified (100% relative humidity) (set-up Marburg and set-up Munich). In the set-up Marburg the subjects inhaled standardised medical air (Aer medicinalis Linde, AGA AB) out of a compressed air bottle through a demand valve; this air (after humidification) was also used as reference. In the set-up Leipzig the subjects inhaled VOC-filtered ambient air, in the set-up Munich unfiltered room air. The data were evaluated using either the real-time data or the changes in resistance as calculated by the device. The results were clearly dependent on the set-up. Apparently, humidification of the reference air could reduce the variance between devices, but this result was also dependent on the evaluation method used. When comparing the three subjects, the set-ups Munich and Marburg mapped these in a similar way, whereas not only the signals but also the variance of the set-up Leipzig were larger. Measuring VOCs with an electronic nose has not yet been standardised and the set-up significantly affects the results. As other researchers use further methods, it is currently not possible to draw generally accepted conclusions. More systematic tests are required to find the most sensitive and reliable but still feasible set-up so that comparability is improved. © Georg Thieme Verlag KG Stuttgart · New York.

Pile-up correction by Genetic Algorithm and Artificial Neural Network

NASA Astrophysics Data System (ADS)

Kafaee, M.; Saramad, S.

2009-08-01

Pile-up distortion is a common problem for high counting rates radiation spectroscopy in many fields such as industrial, nuclear and medical applications. It is possible to reduce pulse pile-up using hardware-based pile-up rejections. However, this phenomenon may not be eliminated completely by this approach and the spectrum distortion caused by pile-up rejection can be increased as well. In addition, inaccurate correction or rejection of pile-up artifacts in applications such as energy dispersive X-ray (EDX) spectrometers can lead to losses of counts, will give poor quantitative results and even false element identification. Therefore, it is highly desirable to use software-based models to predict and correct any recognized pile-up signals in data acquisition systems. The present paper describes two new intelligent approaches for pile-up correction; the Genetic Algorithm (GA) and Artificial Neural Networks (ANNs). The validation and testing results of these new methods have been compared, which shows excellent agreement with the measured data with 60Co source and NaI detector. The Monte Carlo simulation of these new intelligent algorithms also shows their advantages over hardware-based pulse pile-up rejection methods.

Variation in routine follow-up care after curative treatment for head-and-neck cancer: a population-based study in Ontario.

PubMed

Brennan, K E; Hall, S F; Owen, T E; Griffiths, R J; Peng, Y

2018-04-01

The actual practices of routine follow-up after curative treatment for head-and-neck cancer are unknown, and existing guidelines are not evidence-based. This retrospective population-based study used administrative data to describe 5 years of routine follow-up care in 3975 head-and-neck cancer patients diagnosed between 2007 and 2012 in Ontario. The mean number of visits per year declined during the follow-up period (from 7.8 to 1.9, p < 0.001). The proportion of patients receiving visits in concordance with guidelines ranged from 80% to 45% depending on the follow-up year. In at least 50% of patients, 1 head, neck, or chest imaging test was performed in the first follow-up year; that proportion subsequently declined ( p < 0.001). Factors associated with follow-up practices included comorbidity, tumour site, treatment, geographic region, and physician specialty ( p < 0.05). Given current practice variation and the absence of an evidence-based standard, the challenge in identifying a single optimal follow-up strategy might be better addressed with a harmonized approach to providing individualized follow-up care.

Geometrical effects of conventional and digital prosthodontic planning wax-ups on lateral occlusal contact number, contact area, and steepness.

PubMed

Abduo, Jaafar

2017-01-01

This study evaluated and compared the effect of conventional and digital wax-ups on three lateral occlusion variables: contact number, contact area, and steepness. Dental casts of 10 patients with Angle Class I relationship were included in the study. All patients required fixed prosthodontic treatment that would affect lateral occlusion. The casts of all patients received conventional and digital wax-ups. For pretreatment, conventional wax-up, and digital wax-up casts, contact number, contact area, and occlusion steepness were measured at four lateral positions, that is, at excursions of 0.5, 1.0, 2.0, and 3.0 mm from maximal intercuspation. Lateral occlusion scheme variables were affected by use of diagnostic wax-ups. For all types of casts, contact number decreased as excursion increased. The two types of wax-ups had similar contact number patterns, and contact number was significantly greater for these casts than for pretreatment casts in the earlier stages of excursion. Similarly, contact area gradually decreased with increasing excursion in the pretreatment and conventional and digital wax-up casts. There was only a minimal decrease in occlusion steepness as excursion increased. However, lateral occlusion was generally steeper for digital wax-up casts.

US line-ups outperform UK line-ups

PubMed Central

Seale-Carlisle, Travis M.

2016-01-01

In the USA and the UK, many thousands of police suspects are identified by eyewitnesses every year. Unfortunately, many of those suspects are innocent, which becomes evident when they are exonerated by DNA testing, often after having been imprisoned for years. It is, therefore, imperative to use identification procedures that best enable eyewitnesses to discriminate innocent from guilty suspects. Although police investigators in both countries often administer line-up procedures, the details of how line-ups are presented are quite different and an important direct comparison has yet to be conducted. We investigated whether these two line-up procedures differ in terms of (i) discriminability (using receiver operating characteristic analysis) and (ii) reliability (using confidence–accuracy characteristic analysis). A total of 2249 participants watched a video of a crime and were later tested using either a six-person simultaneous photo line-up procedure (USA) or a nine-person sequential video line-up procedure (UK). US line-up procedure yielded significantly higher discriminability and significantly higher reliability. The results do not pinpoint the reason for the observed difference between the two procedures, but they do suggest that there is much room for improvement with the UK line-up. PMID:27703695

Breaking Up is Hard to do: The Impact of Unmarried Relationship Dissolution on Mental Health and Life Satisfaction

PubMed Central

Rhoades, Galena K.; Kamp Dush, Claire M.; Atkins, David C.; Stanley, Scott M.; Markman, Howard J.

2011-01-01

This study was the first to examine the impact of unmarried relationship break-up on psychological distress and life satisfaction using a within-subjects design. Among unmarried 18 to 35-year olds (N = 1295), 36.5% had one or more break-ups over a 20-month period. Experiencing a break-up was associated with an increase in psychological distress and a decline in life satisfaction (from pre- to post-dissolution). In addition, several characteristics of the relationship or of the break-up were associated with the magnitude of the changes in life satisfaction following a break-up. Specifically, having been cohabiting and having had plans for marriage were associated with larger declines in life satisfaction while having begun to date someone new was associated with smaller declines. Interestingly, having higher relationship quality at the previous wave was associated with smaller declines in life satisfaction following a break-up. No relationship or break-up characteristics were significantly associated with the magnitude of changes in psychological distress after a break-up. Existing theories are used to explain the results. Implications for clinical work and future research on unmarried relationships are also discussed. PMID:21517174

Achieving community-based postpartum follow up in eastern Uganda: the field experience from the MamaMiso Study on antenatal distribution of misoprostol.

PubMed

Ditai, James; Frye, Laura J; Durocher, Jill; Byrne, Meagan E; Ononge, Sam; Winikoff, Beverly; Weeks, Andrew D

2017-10-26

Advance provision of misoprostol to women during antenatal care aims to achieve broader access to uterotonics for the prevention of postpartum hemorrhage. Studies of this community-based approach usually involve antenatal education as well as timely postpartum follow-up visits to confirm maternal and neonatal outcomes. The MamaMiso study in Mbale, Uganda sought to assess the feasibility of conducting follow-up visits in the postpartum period following advance provision of misoprostol for postpartum hemorrhage prevention. MamaMiso recruited women during antenatal care visits. Participants were asked to contact the research team within 48 h of giving birth so that postpartum follow-up visits could be carried out at their homes. Women's baseline and delivery characteristics were collected and analyzed with respect to follow-up time ('on time' ≤ 7 days, 'late' > 7 days, and 'lost to follow up'). Every woman who was followed up late due to a failure to report the delivery was asked for the underlying reasons for the delay. When attempts at following up participants were unsuccessful, a file note was generated explaining the details of the failure. We abstracted data and identified themes from these notes. Of 748 recruited women, 700 (94%) were successfully followed up during the study period, 465 (62%) within the first week postpartum. The median time to follow up was 4 days and was similar for women who delivered at home or in facilities and for women who had attended or unattended births. Women recruited at the urban hospital site (as opposed to rural health clinics) were more likely to be lost to follow up or followed up late. Of the women followed up late, 202 provided a reason. File notes explaining failed attempts at follow up were generated for 164 participants. Several themes emerged from qualitative analysis of these notes including phone difficulties, inaccurate baseline information, misperceptions, postpartum travel, and the condition of the mother and neonate. Keeping women connected to the health system in the postpartum period is feasible, though reaching them within the first week of their delivery is challenging. Understanding characteristics of women who are harder to reach can help tailor follow-up efforts and elucidate possible biases in postpartum study data. Trial Registration Number ISRCTN70408620 December 28, 2011.

Smartphone Application WeChat for Clinical Follow-up of Discharged Patients with Head and Neck Tumors: A Randomized Controlled Trial

PubMed Central

Lyu, Ke-Xing; Zhao, Jing; Wang, Bin; Xiong, Guan-Xia; Yang, Wei-Qiang; Liu, Qi-Hong; Zhu, Xiao-Lin; Sun, Wei; Jiang, Ai-Yun; Wen, Wei-Ping; Lei, Wen-Bin

2016-01-01

Background: Nowadays, social media tools such as short message service, Twitter, video, and web-based systems are more and more used in clinical follow-up, making clinical follow-up much more time- and cost-effective than ever before. However, as the most popular social media in China, little is known about the utility of smartphone WeChat application in follow-up. In this study, we aimed to investigate the feasibility and superiority of WeChat application in clinical follow-up. Methods: A total of 108 patients diagnosed with head and neck tumor were randomized to WeChat follow-up (WFU) group or telephone follow-up (TFU) group for 6-month follow-up. The follow-ups were delivered by WeChat or telephone at 2 weeks, 1, 2, 3, and 6 months to the patients after being discharged. The study measurements were time consumption for follow-up delivery, total economic cost, lost-to-follow-up rate, and overall satisfaction for the follow-up method. Results: Time consumption in WFU group for each patient (23.36 ± 6.16 min) was significantly shorter than that in TFU group (42.89 ± 7.15 min) (P < 0.001); total economic cost in WFU group (RMB 90 Yuan) was much lower than that in TFU group (RMB 196 Yuan). Lost-to-follow-up rate in the WFU group was 7.02% (4/57) compared with TFU group, 9.80% (5/51), while no significance was observed (95% confidence interval [CI]: 0.176–2.740; P = 0.732). The overall satisfaction rate in WFU group was 94.34% (50/53) compared with 80.43% (37/46) in TFU group (95% CI: 0.057–0.067; P = 0.034). Conclusions: The smartphone WeChat application was found to be a viable option for follow-up in discharged patients with head and neck tumors. WFU was time-effective, cost-effective, and convenient in communication. This doctor-led follow-up model has the potential to establish a good physician-patient relationship by enhancing dynamic communications and providing individual health instructions. Trial Registration: Chinese Clinical Trial Registry, ChiCTR-IOR-15007498; http://www.chictr.org.cn/ showproj.aspx?proj=12613. PMID:27900995

Inter-Rater Reliability and Intra-Rater Reliability of Assessing the 2-Minute Push-Up Test.

PubMed

Fielitz, Lynn; Coelho, Jeffrey; Horne, Thomas; Brechue, William

2016-02-01

The purpose of this study was to assess inter-rater reliability and intra-rater reliability of the 2-minute, 90° push-up test as utilized in the Army Physical Fitness Test. Analysis of rater assessment reliability included both total score agreement and agreement across individual push-up repetitions. This study utilized 8 Raters who assessed 15 different videotaped push-up performances over 4 iterations separated by a minimum of 1 week. The 15 push-up participants were videotaped during the semiannual Army Physical Fitness Test. Each Rater randomly viewed the 15 push-up and verbally responded with a "yes" or "no" to each push-up repetition. The data generated were analyzed using the Pearson product-moment correlation as well as the kappa, modified kappa and the intra-class correlation coefficient (3,1). An attribute agreement analysis was conducted to determine the percent of inter-rater and intra-rater agreement across individual push-ups.The results indicated that Raters varied a great deal in assessing push-ups. Over the 4 trials of 15 participants, the overall scores of the Raters varied between 3.0 and 35.7 push-ups. Post hoc comparisons found that there was significant increase in the grand mean of push-ups from trials 1-3 to trial 4 (p < 0.05). Also, there was a significant difference among raters over the 4 trials (p < 0.05). Pearson correlation coefficients for inter-rater and intra-rater reliability identified inter-rater reliability coefficients were between 0.10 and 0.97. Intra-rater coefficients were between 0.48 and 0.99. Intra-rater agreement for individual push-up repetitions ranged from 41.8% to 84.8%. The results indicated that the raters failed to assess the same push-up repetition with the same score (below 70% agreement) as well as failed to agree when viewed between raters (29%). Interestingly, as previously mentioned, scores on trial 4 increased significantly which might have been caused by rater drift or that the Raters did not maintain the push-up standard over the trials. It does appear that the final push-up scores received by each participant was a close approximation of actual performance (within 65%) but when assessing physical performance for retention in the Army, a more reliable test might be considered. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

DebriSat Pre Preshot Laboratory Analyses

DTIC Science & Technology

2015-03-27

plate on up range side. MLI Down range Up range SBU Marking Witness Plates: Post Test (protected) 17 Surfaces of samples under Whipple plates are...s SBU Marking Witness Plates Post Test : Whipple Plates 59 Bottom Middle Top Up range is to the right – note sharp band of deposits on up range side...Marking Hold down plates: Post test 63 Up range Note larger deposit fragments on the down range plate. Similar larger deposits were observed on

Tsunami Wave Run-up on a Vertical Wall in Tidal Environment

NASA Astrophysics Data System (ADS)

Didenkulova, Ira; Pelinovsky, Efim

2018-04-01

We solve analytically a nonlinear problem of shallow water theory for the tsunami wave run-up on a vertical wall in tidal environment. Shown that the tide can be considered static in the process of tsunami wave run-up. In this approximation, it is possible to obtain the exact solution for the run-up height as a function of the incident wave height. This allows us to investigate the tide influence on the run-up characteristics.

Impact of chemical plant start-up emissions on ambient ozone concentration

NASA Astrophysics Data System (ADS)

Ge, Sijie; Wang, Sujing; Xu, Qiang; Ho, Thomas

2017-09-01

Flare emissions, especially start-up flare emissions, during chemical plant operations generate large amounts of ozone precursors that may cause highly localized and transient ground-level ozone increment. Such an adverse ozone impact could be aggravated by the synergies of multiple plant start-ups in an industrial zone. In this paper, a systematic study on ozone increment superposition due to chemical plant start-up emissions has been performed. It employs dynamic flaring profiles of two olefin plants' start-ups to investigate the superposition of the regional 1-hr ozone increment. It also summaries the superposition trend by manipulating the starting time (00:00-10:00) of plant start-up operations and the plant distance (4-32 km). The study indicates that the ozone increment induced by simultaneous start-up emissions from multiple chemical plants generally does not follow the linear superposition of the ozone increment induced by individual plant start-ups. Meanwhile, the trend of such nonlinear superposition related to the temporal (starting time and operating hours of plant start-ups) and spatial (plant distance) factors is also disclosed. This paper couples dynamic simulations of chemical plant start-up operations with air-quality modeling and statistical methods to examine the regional ozone impact. It could be helpful for technical decision support for cost-effective air-quality and industrial flare emission controls.

Precompetition warm-up in elite and subelite rhythmic gymnastics.

PubMed

Guidetti, Laura; Di Cagno, Alessandra; Gallotta, Maria Chiara; Battaglia, Claudia; Piazza, Marina; Baldari, Carlo

2009-09-01

The aim of this study was to investigate which precompetition warm-up methodologies resulted in the best overall performance in rhythmic gymnastics. The coaches of national and international clubs (60 elite and 90 subelite) were interviewed. The relationship between sport performance and precompetition warm-up routines was examined. A total of 49% of the coaches interviewed spent more than 1 hour to prepare their athletes for the competition, including 45 minutes dedicated to warm-up exercises. In spite of previous studies' suggestions, the time between the end of warm-up and the beginning of competition was more than 5 minutes for 68% of those interviewed. A slow run was the activity of choice used to begin the warm-up (96%). Significant differences between elite and subelite gymnasts were found concerning the total duration of warm-up, duration of slow running, utilization of rhythmic steps and leaps during the warm-up, the use of dynamic flexibility exercises, competition performances repetition (p < 0.01), and utilization of imagery (p < 0.05). A precompetition warm-up in rhythmic gymnastics would include static stretching exercises at least 60 minutes prior to the competition starting time and the active stretching exercises alternated with analytic muscle strengthening aimed at increasing muscle temperature. Rhythmic gymnastics coaches at all levels can use this data as a review of precompetition warm-up practices and a possible source of new ideas.

Does Vibration Warm-up Enhance Kinetic and Temporal Sprint Parameters?

PubMed

Cochrane, D J; Cronin, M J; Fink, P W

2015-08-01

The aim of this study was to investigate the efficacy of vibration warm-up to enhance sprint performance. 12 males involved in representative team sports performed 4 warm-up conditions in a randomised order performed at least 24 h apart; VbX warm-up (VbX-WU); Neural activation warm-up (Neu-WU); Dynamic warm-up (Dyn-WU) and Control (No VbX). Participants completed 5 m sprint at 30 s, 2:30 min and 5 min post warm-up where sprint time, kinetics, and temporal components were recorded. There was no significant (p>0.05) main effect or interaction effect between the split sprint times of 1 m, 2.5 m, and 5 m. There was a condition effect where vertical mean force was significantly higher (p<0.05) in Dyn-WU and Control compared to Neu-WU. No other significant (p>0.05) main and interaction effects in sprint kinetic and temporal parameters existed. Overall, all 4 warm-up conditions produced comparable results for sprint performance, and there was no detrimental effect on short-duration sprint performance using VbX-WU. Therefore, VbX could be useful for adding variety to the training warm-up or be included into the main warm-up routine as a supplementary modality. © Georg Thieme Verlag KG Stuttgart · New York.

Speaking up behaviors and safety climate in an Austrian university hospital.

PubMed

Schwappach, David; Sendlhofer, Gerald; Häsler, Lynn; Gombotz, Veronika; Leitgeb, Karina; Hoffmann, Magdalena; Jantscher, Lydia; Brunner, Gernot

2018-04-26

To analyze speaking up behavior and safety climate with a validated questionnaire for the first time in an Austrian university hospital. Survey amongst healthcare workers (HCW). Data were analyzed using descriptive statistics, Cronbach's alpha was calculated as a measure of internal consistencies of scales. Analysis of variance and t-tests were used. The survey was conducted in 2017. About 2.149 HCW from three departments were asked to participate. To measure speaking up behavior and safety climate. To explore psychological safety, encouraging environment and resignation towards speaking up. About 859 evaluable questionnaires were returned (response rate: 40%). More than 50% of responders perceived specific concerns about patient safety within the last 4 weeks and observed a potential error or noticed rule violations. For the different items, between 16% and 42% of HCW reported that they remained silent though concerns for safety. In contrast, between 96% and 98% answered that they did speak up in certain situations. The psychological safety for speaking up was lower for HCW with a managerial function (P < 0.001). HCW with managerial functions perceived the environment as less encouraging to speak up (P < 0.05) than HCW without managerial function. We identified speaking up behaviors for the first time in an Austrian university hospital. Only moderately frequent concerns were in conflict with frequent speaking up behaviors. These results clearly show that a paradigm shift is needed to increase speaking up culture.

Comparison of isokinetic muscle strength and muscle power by types of warm-up.

PubMed

Sim, Young-Je; Byun, Yong-Hyun; Yoo, Jaehyun

2015-05-01

[Purpose] The purpose of this study was to clarify the influence of static stretching at warm-up on the isokinetic muscle torque (at 60°/sec) and muscle power (at 180°/sec) of the flexor muscle and extensor muscle of the knee joint. [Subjects and Methods] The subjects of this study were 10 healthy students with no medically specific findings. The warm-up group and warm-up with stretching group performed their respective warm-up prior to the isokinetic muscle torque evaluation of the knee joint. One-way ANOVA was performed by randomized block design for each variable. [Results] The results were as follows: First, the flexor peak torque and extensor peak torque of the knee joint tended to decrease at 60°/sec in the warm-up with stretching group compared with the control group and warm-up group, but without statistical significance. Second, extensor power at 180°/sec was also not statistically significant. However, it was found that flexor power increased significantly in the warm-up with stretching group at 180°/sec compared with the control group and warm-up group in which stretching was not performed. [Conclusion] Therefore, it is considered that in healthy adults, warm-up including two sets of stretching for 20 seconds per muscle group does not decrease muscle strength and muscle power.

Follow-up of early stage melanoma: specialist clinician perspectives on the functions of follow-up and implications for extending follow-up intervals.

PubMed

Rychetnik, Lucie; McCaffery, Kirsten; Morton, Rachael L; Thompson, John F; Menzies, Scott W; Irwig, Les

2013-04-01

There is limited evidence on the relative effectiveness of different follow-up schedules for patients with AJCC stage I or II melanoma, but less frequent follow-up than is currently recommended has been proposed. To describe melanoma clinicians' perspectives on the functions of follow-up, factors that influence follow-up intervals, and important considerations for extending intervals. Qualitative interviews with 16 clinicians (surgical oncologists, dermatologists, melanoma unit physicians) who conduct follow-up at two of Australia's largest specialist centers. Follow-up is conducted for early detection of recurrences or new primary melanomas, to manage patient anxiety, support patient self-care, and as part of shared care. Recommended intervals are based on guidelines but account for each patient's clinical risk profile, level of anxiety, patient education requirements, capacity to engage in skin self-examination, and how the clinician prefers to manage any suspicious lesions. To revise guidelines and implement change it is important to understand the rationale underpinning existing practice. Extended follow-up intervals for early stage melanoma are more likely to be adopted after the first year when patients are less anxious and sufficiently prepared to conduct self-examination. Clinicians may retain existing schedules for highly anxious patients or those unable to examine themselves. Copyright © 2012 Wiley Periodicals, Inc.

Resonant UPS topologies for the emerging hybrid fiber-coaxial networks

NASA Astrophysics Data System (ADS)

Pinheiro, Humberto

Uninterruptible power supply (UPS) systems have been extensively applied to feed critical loads in many areas. Typical examples of critical loads include life-support equipment, computers and telecommunication systems. Although all UPS systems have a common purpose to provide continuous power-to critical loads, the emerging hybrid fiber-coaxial networks have created the need for specific types of UPS topologies. For example, galvanic isolation for the load and the battery, small size, high input power factor, and trapezoidal output voltage waveforms are among the required features of UPS topologies for hybrid fiber-coaxial networks. None of the conventional UPS topologies meet all these requirements. Consequently. this thesis is directed towards the design and analysis of UPS topologies for this new application. Novel UPS topologies are proposed and control techniques are developed to allow operation at high switching frequencies without penalizing the converter efficiency. By the use of resonant converters in the proposed UPS topologies. a high input power factor is achieved without requiring a dedicated power factor correction stage. In addition, a self-sustained oscillation control method is proposed to ensure soft switching under all operating conditions. A detailed analytical treatment of the resonant converters in the proposed UPS topologies is presented and design procedures illustrated. Simulation and experimental results are presented to validate the analyses and to demonstrate the feasibility of the proposed schemes.

Cost and Expected Visual Effect of Interventions to Improve Follow-up After Cataract Surgery: Prospective Review of Early Cataract Outcomes and Grading (PRECOG) Study.

PubMed

Meltzer, Mirjam E; Congdon, Nathan; Kymes, Steven M; Yan, Xixi; Lansingh, Van C; Sisay, Alemayehu; Müller, Andreas; Chan, Ving Fai; Jin, Ling; Karumanchi, Sasipriya M; Guan, Chunhong; Vuong, Quy; Rivera, Nelson; McCleod-Omawale, Joan; He, Mingguang

2016-12-15

Some experts recommend increasing low rates of follow-up after cataract surgery in low- and middle-income countries using various interventions. However, little is known about the cost and effect of such interventions. To examine whether promoting follow-up after cataract surgery creates economic value. The Prospective Review of Early Cataract Outcomes and Grading (PRECOG) is a cohort study with data from patients undergoing cataract surgery from January 19, 2010, to April 18, 2012. Final follow-up was completed on August 10, 2012. Data were collected before surgery, at discharge, and at follow-up at least 40 days after surgery from 27 centers in 8 countries in Asia, Africa, and Latin America. Each center enrolled 40 to 120 consecutive patients undergoing cataract surgery. If patients did not return to the hospital for the follow-up visit, hospitals could use telephone calls or transportation subsidies to increase follow-up rate. Data were analyzed from December 2013 to January 2016. Cost of interventions (telephone calls and transportation subsidies) to increase follow-up at least 40 days after surgery, visual acuity (VA) in the eye undergoing cataract surgery, presence of complications, patient and facility costs per visit, and willingness to pay for treatment or glasses if needed. The maximum incremental cost of improving VA in 1 patient (incremental cost-effect ratio [ICER]) was calculated for spontaneous follow-up (compared with no follow-up) and follow-up with the telephone and transportation interventions. Expected ICERs were estimated including only those patients willing to pay. Among 2487 patients (1068 men [42.9%]; 1405 women [56.5%]; 14 missing [0.6%]; mean [SD] age, 68.4 [11.3] years), 2316 (93.1%) received follow-up, of whom 369 (16.0%) were seen in an outside facility or home and were in the cost-effectiveness analysis as unable to follow up. A grand mean (a mean of means of the different countries) of 56.3% of patients needed glasses, of whom 56.9% were willing to pay, and 1.6% had treatable complications, of whom 39.4% were willing to pay. Maximum proportions with improved VA (and corresponding ICERs) were 0.08 for no follow-up, 0.45 ($151.56) for spontaneous follow-up, 0.53 ($164.46) for a telephone intervention, and 0.53 ($133.07) for a transportation intervention. These results were most sensitive to the cost of follow-up. Expected proportions (ICERs) were 0.08, 0.27 ($232.69), 0.30 ($456.22), and 0.30 ($206.47), respectively. Most patients benefiting from follow-up after cataract surgery returned spontaneously when requested at discharge. Use of telephone calls or transportation subsidies to increase follow-up in low- and middle-income countries may not be cost-effective.

Endodontic flare up: incidence and association of possible risk factors.

PubMed

Gbadebo, S O; Sulaiman, A O; Anifowose, O O

2016-06-01

Endodontic emergency during root canal treatment (flare up) is a common occurrence in multivisit root canal treatment (RCT) and it may be associated with many factors. The occurrence however can affect the prognosis of the tooth and the patient -clinician relationship. To determine the incidence and risk factors associated with occurrence of flare up in a multi visit RCT. Patients planned for multi-visit (RCT) were recruited for the research. Standard protocol was followed in all cases. After the first visit, the patients were followed up for possible development of flare up. Patients' demographics, presence or absence of preoperative pain, status of the pulp and occurrence of flare up were among the data collected. Data was analyzed using SPSS version 20 with level of significance set at P <0.05. A total of 106 root treated teeth were analyzed in patients aged 17 to 73years with a mean of 33±13.2 and male to female ratio of 1:1.5. Incidence of flare up was 8.5%. Prior to treatment, 47% of the cases had pain, 61.3% had apical radioluscency and 83% had pulpal necrosis. Majority (7, 77.8%) of the flare up occurred after the first visit (p=0.000). Only pre- treatment pain had a statistical significant ielationship with occurrence of flare up (p=0.009). Incidence of flare up was 8.5% and the major risk factor was preoperative pain. First visit in a multi visit RCT is an important stage which if well handled, can reduce the incidence of flare up.

Interventions to Improve Follow-Up of Abnormal Findings in Cancer Screening

PubMed Central

Bastani, Roshan; Yabroff, K. Robin; Myers, Ronald E.; Glenn, Beth

2006-01-01

The potential reduction in morbidity and mortality through cancer screening cannot be realized without receipt of appropriate follow-up care for abnormalities identified via screening. In this paper, the authors critically examine the existing literature on correlates of receipt of appropriate follow-up care for screen-detected abnormalities, as well as the literature on interventions designed to increase rates of receipt of follow-up care. Lessons learned describe what is known and not known about factors that are related to or predict receipt of follow-up care. Similarly, effective interventions to increase follow-up are described and gaps identified. A conceptual model is developed that categorizes the health care system in the United States as comprising four levels: policy, practice, provider, and patient. Some patient-level factors that influence follow-up receipt are identified, but the lack of data severely limit the understanding of provider, practice, and policy-level correlates. The majority of intervention studies to increase follow-up receipt have focused on patient-level factors and have targeted follow-up of abnormal Papanicolaou smears. Insufficient information is available regarding the effectiveness of provider, practice, or policy-level interventions. Standard definitions of what constitutes appropriate follow-up are lacking, which severely limit comparability of findings across studies. The validity of various methods of obtaining outcome data has not been clearly established. More research is needed on interventions targeting provider, system, and policy-level factors, particularly interventions focusing on follow-up of colorectal and breast abnormalities. Standardization of definitions and measures is needed to facilitate comparisons across studies. PMID:15316914

Kinematic Analysis of Four Plyometric Push-Up Variations

PubMed Central

MOORE, LAURA H.; TANKOVICH, MICHAEL J.; RIEMANN, BRYAN L.; DAVIES, GEORGE J.

2012-01-01

Plyometric research in the upper extremity is limited, with the effects of open-chain plyometric exercises being studied most. Kinematic and ground reaction force data concerning closed-chain upper extremity plyometrics has yet to be examined. Twenty-one recreationally active male subjects performed four variations of plyometric push-ups in a counterbalanced order. These included box drop push-ups from 3.8 cm, 7.6 cm, 11.4 cm heights, and clap push-ups. Kinematics of the trunk, dominant extremity and both hands were collected to examine peak flight, elbow flexion at ground contact, elbow displacement, and hand separation. Additionally peak vertical ground reaction force was measured under the dominant extremity. The 11.4 cm and clap push-ups had significantly higher peak flight than the other variations (P<.001). At ground contact, the elbow was in significantly greater flexion for the 3.8 cm and clap push-up compared to the other variations (P<.001). The clap push-up had significantly more elbow displacement than the other variations (P<.001) while hand separation was not significantly different between variations (P=.129). Peak vertical ground reaction force was significantly greater for the clap push-ups than for all other variations (P< .001). Despite similar flight heights between the 11.4 cm and clap push-ups, the greater peak vertical ground reaction force and elbow displacement of the clap push-ups indicates the clap push-up is the most intense of the variations examined. Understanding the kinematic variables involved will aid in the creation of a closed chain upper-extremity plyometric progression. PMID:27182390

Effect of various practical warm-up protocols on acute lower-body power.

PubMed

Buttifant, David; Hrysomallis, Con

2015-03-01

The purpose of this study was to compare the acute effect of box squats with barbell (BBSquat), box squats with elastic resistance bands (BandSquat), and static stretches (SStretch) on external power during a 20-kg weighted jump squat. Twelve male athletes performed each of the 3 warm-up protocols on separate occasions in a randomized order. Weighted jump squat power was assessed using a linear position transducer attached to the bar of a Smith machine. Jump power was measured pre-warm-up and 5 and 10 minutes post-warm-up protocol. The BBSquat protocol involved 3 sets of 3RM, BandSquat involved 3 sets of 3 repetitions using highest resistance elastic bands, and the SStretch protocol comprises two 30-second stretches for muscles of the lower limbs. Jump power significantly increased from pre-warm-up to 5 and 10 minutes post-warm-up for both the BandSquat and BBSquat protocols. There was no statistical difference in power values between BandSquat and BBSquat. Power output significantly decreased from pre-warm-up to 5 and 10 minutes post-warm-up for the SStretch protocol. The BandSquat was just as effective as BBSquat in augmenting acute jump power. The SStretch was detrimental to jump performance. A practical warm-up using relatively inexpensive and portable equipment such as elastic resistance bands was just as effective as a warm-up protocol that requires more substantial and less transportable equipment such as a squat rack and associated free weights. The BandSquat warm-up may be considered more accessible for athletes at various competition levels.

1993 Michigan traffic crash facts

DOT National Transportation Integrated Search

1994-09-19

The 1993 traffic fatality count was 1,414, up 8.8% from the 1992 figure of 1,300. : Compared with 1992, injuries were up 13.3% and total crashes were up 5.4%. These : figures translated into a death rate of 1.6 per 100 million miles of travel, up fro...

47 CFR 54.411 - Link Up program defined.

Code of Federal Regulations, 2010 CFR

2010-10-01

... section. (c) A carrier's Link Up program shall allow a consumer to receive the benefit of the Link Up... SERVICE Universal Service Support for Low-Income Consumers § 54.411 Link Up program defined. (a) For... low-income consumers, which an eligible telecommunications carrier shall offer as part of its...

7 CFR 1205.25 - Supervision of sign-up period.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 10 2013-01-01 2013-01-01 false Supervision of sign-up period. 1205.25 Section 1205.25 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING... RESEARCH AND PROMOTION Procedures for Conduct of Sign-up Period Procedures § 1205.25 Supervision of sign-up...

7 CFR 1205.25 - Supervision of sign-up period.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 10 2014-01-01 2014-01-01 false Supervision of sign-up period. 1205.25 Section 1205.25 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING... RESEARCH AND PROMOTION Procedures for Conduct of Sign-up Period Procedures § 1205.25 Supervision of sign-up...

7 CFR 1205.25 - Supervision of sign-up period.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 10 2011-01-01 2011-01-01 false Supervision of sign-up period. 1205.25 Section 1205.25 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING... RESEARCH AND PROMOTION Procedures for Conduct of Sign-up Period Procedures § 1205.25 Supervision of sign-up...

7 CFR 1205.25 - Supervision of sign-up period.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Supervision of sign-up period. 1205.25 Section 1205.25 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING... RESEARCH AND PROMOTION Procedures for Conduct of Sign-up Period Procedures § 1205.25 Supervision of sign-up...

7 CFR 1205.25 - Supervision of sign-up period.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 10 2012-01-01 2012-01-01 false Supervision of sign-up period. 1205.25 Section 1205.25 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING... RESEARCH AND PROMOTION Procedures for Conduct of Sign-up Period Procedures § 1205.25 Supervision of sign-up...

Hooking Up and Identity Development of Female College Students

ERIC Educational Resources Information Center

Kooyman, Leslie; Pierce, Gloria; Zavadil, Amy

2011-01-01

Hooking up generally involves casual sex with noncommittal partners. Hooking up is prevalent on college campuses today and can negatively affect the identity development of female students. The authors examined this phenomenon with a feminist developmental perspective, evaluating hooking up in the context of sexual risk taking with physical and…

Forgetting ACT UP

ERIC Educational Resources Information Center

Juhasz, Alexandra

2012-01-01

When ACT UP is remembered as the pinnacle of postmodern activism, other forms and forums of activism that were taking place during that time--practices that were linked, related, just modern, in dialogue or even opposition to ACT UP's "confrontational activism"--are forgotten. In its time, ACT UP was embedded in New York City, and a…

Universal versus conditional day 3 follow-up for children with non-severe unclassified fever at the community level in Ethiopia: A cluster-randomised non-inferiority trial.

PubMed

Källander, Karin; Alfvén, Tobias; Funk, Tjede; Abebe, Ayalkibet; Hailemariam, Abreham; Getachew, Dawit; Petzold, Max; Steinhardt, Laura C; Gutman, Julie R

2018-04-01

With declining malaria prevalence and improved use of malaria diagnostic tests, an increasing proportion of children seen by community health workers (CHWs) have unclassified fever. Current community management guidelines by WHO advise that children seen with non-severe unclassified fever (on day 1) should return to CHWs on day 3 for reassessment. We compared the safety of conditional follow-up reassessment only in cases where symptoms do not resolve with universal follow-up on day 3. We undertook a 2-arm cluster-randomised controlled non-inferiority trial among children aged 2-59 months presenting with fever and without malaria, pneumonia, diarrhoea, or danger signs to 284 CHWs affiliated with 25 health centres (clusters) in Southern Nations, Nationalities, and Peoples' Region, Ethiopia. The primary outcome was treatment failure (persistent fever, development of danger signs, hospital admission, death, malaria, pneumonia, or diarrhoea) at 1 week (day 8) of follow-up. Non-inferiority was defined as a 4% or smaller difference in the proportion of treatment failures with conditional follow-up compared to universal follow-up. Secondary outcomes included the percentage of children brought for reassessment, antimicrobial prescription, and severe adverse events (hospitalisations and deaths) after 4 weeks (day 29). From December 1, 2015, to November 30, 2016, we enrolled 4,595 children, of whom 3,946 (1,953 universal follow-up arm; 1,993 conditional follow-up arm) adhered to the CHW's follow-up advice and also completed a day 8 study visit within ±1 days. Overall, 2.7% had treatment failure on day 8: 0.8% (16/1,993) in the conditional follow-up arm and 4.6% (90/1,953) in the universal follow-up arm (risk difference of treatment failure -3.81%, 95% CI -∞, 0.65%), meeting the prespecified criterion for non-inferiority. There were no deaths recorded by day 29. In the universal follow-up arm, 94.6% of caregivers reported returning for reassessment on day 3, in contrast to 7.5% in the conditional follow-up arm (risk ratio 22.0, 95% CI 17.9, 27.2, p < 0.001). Few children sought care from another provider after their initial visit to the CHW: 3.0% (59/1,993) in the conditional follow-up arm and 1.1% (22/1,953) in the universal follow-up arm, on average 3.2 and 3.4 days later, respectively, with no significant difference between arms (risk difference 1.79%, 95% CI -1.23%, 4.82%, p = 0.244). The mean travel time to another provider was 2.2 hours (95% CI 0.01, 5.3) in the conditional follow-up arm and 2.6 hours (95% CI 0.02, 4.5) in the universal follow-up arm (p = 0.82); the mean cost for seeking care after visiting the CHW was 26.5 birr (95% CI 7.8, 45.2) and 22.8 birr (95% CI 15.6, 30.0), respectively (p = 0.69). Though this study was an important step to evaluate the safety of conditional follow-up, the high adherence seen may have resulted from knowledge of the 1-week follow-up visit and may therefore not transfer to routine practice; hence, in an implementation setting it is crucial that CHWs are well trained in counselling skills to advise caregivers on when to come back for follow-up. Conditional follow-up of children with non-severe unclassified fever in a low malaria endemic setting in Ethiopia was non-inferior to universal follow-up through day 8. Allowing CHWs to advise caregivers to bring children back only in case of continued symptoms might be a more efficient use of resources in similar settings. www.clinicaltrials.gov, identifier NCT02926625.

Risk

NASA Technical Reports Server (NTRS)

Barshi, Immanuel

2016-01-01

Speaking up, i.e. expressing ones concerns, is a critical piece of effective communication. Yet, we see many situations in which crew members have concerns and still remain silent. Why would that be the case? And how can we assess the risks of speaking up vs. the risks of keeping silent? And once we do make up our minds to speak up, how should we go about it? Our workshop aims to answer these questions, and to provide us all with practical tools for effective risk assessment and effective speaking-up strategies..

Derivation of linearized transfer functions for switching-mode regulations. Phase A: Current step-up and voltage step-up converters

NASA Technical Reports Server (NTRS)

Wong, R. C.; Owen, H. A., Jr.; Wilson, T. G.

1981-01-01

Small-signal models are derived for the power stage of the voltage step-up (boost) and the current step-up (buck) converters. The modeling covers operation in both the continuous-mmf mode and the discontinuous-mmf mode. The power stage in the regulated current step-up converter on board the Dynamics Explorer Satellite is used as an example to illustrate the procedures in obtaining the small-signal functions characterizing a regulated converter.

Follow-up Methodology: A Comprehensive Study and Evaluation of Academic, Technical and Vocational Del Mar College Graduates from September 1, 1973, Through August 31, 1975, Including Ways, Means, Instruments, Relationships, and Methods of Follow-up. TEX-SIS FOLLOW-UP SC4.

ERIC Educational Resources Information Center

Fite, Ronald S.

This report details the research activities conducted by Del Mar College, as a subcontractor of Project FOLLOW-UP, in the design, development, and implementation of a graduate follow-up system. The activities included questionnaire design, development of manual and computerized record-keeping systems, student-graduate identification, and…

An analysis of the sliding pressure start-up of SCWR

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

Wang, F.; Yang, J.; Li, H.

In this paper, the preliminary sliding pressure start-up system and scheme of supercritical water-cooled reactor in CGNPC (CGN-SCWR) were proposed. Thermal-hydraulic behavior in start-up procedures was analyzed in detail by employing advanced reactor subchannel analysis software ATHAS. The maximum cladding temperature (MCT for short) and core power of fuel assembly during the whole start-up process were investigated comparatively. The results show that the recommended start-up scheme meets the design requirements from the perspective of thermal-hydraulic. (authors)

Mechanisms and concentrations dependence of up-conversion luminescence in Tm^3^+/Yb^3^+ codoped oxyfluoride glass-ceramics [rapid communication

NASA Astrophysics Data System (ADS)

Zhang, Junjie; He, Dongbing; Duan, Zhongchao; Zhang, Liyan; Dai, Shixun; Hu, Lili

2005-04-01

The up-conversion properties of Tm3+/Yb3+ codoped oxyfluoride glass-ceramics under 980 nm excitation were investigated. Intense blue up-conversion luminescence due to the Tm3+: 1G4 → 3H6 transition was observed in the glass-ceramics. The intensity of the blue up-conversion luminescence in a 1 mol% YbF3-containing glass-ceramic was found to be about 40 times stronger than that in the precursor oxyfluoride glass. The up-conversion mechanism is proposed. The reason for the intense Tm3+ up-conversion luminescence in the oxyfluoride glass-ceramics and the concentrations dependence of upconversion luminescence are also discussed.

Blow-up solutions for L 2 supercritical gKdV equations with exactly k blow-up points

NASA Astrophysics Data System (ADS)

Lan, Yang

2017-08-01

In this paper we consider the slightly L 2-supercritical gKdV equations \\partialt u+(uxx+u\\vert u\\vert p-1)_x=0 , with the nonlinearity 5 and 0<\\varepsilon\\ll 1 . In the previous work of the author, we know that there exists a stable self-similar blow-up dynamics for slightly L 2-supercritical gKdV equations. Such solutions can be viewed as solutions with a single blow-up point. In this paper we will prove the existence of solutions with multiple blow-up points, and give a description of the formation of the singularity near the blow-up time.

Quantitative analysis of seizure frequency 1 week and 6, 12, and 24 months after surgery of epilepsy.

PubMed

Lüders, H; Murphy, D; Awad, I; Wyllie, E; Dinner, D S; Morris, H H; Rothner, A D

1994-01-01

We made quantitative analysis of seizure frequency 1 week and 6, 12, and 24 months after seizure surgery. Seizure recurrence was significantly higher when seizures occurred in the first postoperative week. Seizure recurrence increased progressively with longer follow-ups, but the 6 month postoperative follow-up period was an excellent index of long-term outcome. In operative follow-up studies, seizure frequency should be reported at fixed follow-up periods, e.g., at 6 months and 1, 2, 5, and 10 years. Meaningful comparison of outcomes between different studies is possible only when reports include outcome at fixed postoperative follow-up periods (as opposed to ranges of follow-up periods).

Blow-up for a three dimensional Keller-Segel model with consumption of chemoattractant

NASA Astrophysics Data System (ADS)

Jiang, Jie; Wu, Hao; Zheng, Songmu

2018-04-01

We investigate blow-up properties for the initial-boundary value problem of a Keller-Segel model with consumption of chemoattractant when the spatial dimension is three. Through a kinetic reformulation of the Keller-Segel system, we first derive some higher-order estimates and obtain certain blow-up criteria for the local classical solutions. These blow-up criteria generalize the results in [4,5] from the whole space R3 to the case of bounded smooth domain Ω ⊂R3. Lower global blow-up estimate on ‖ n ‖ L∞ (Ω) is also obtained based on our higher-order estimates. Moreover, we prove local non-degeneracy for blow-up points.

Map display design

NASA Technical Reports Server (NTRS)

Aretz, Anthony J.

1990-01-01

This paper presents a cognitive model of a pilot's navigation task and describes an experiment comparing a visual momentum map display to the traditional track-up and north-up approaches. The data show the advantage to a track-up map is its congruence with the ego-centered forward view; however, the development of survey knowledge is hindered by the inconsistency of the rotating display. The stable alignment of a north-up map aids the acquisition of survey knowledge, but there is a cost associated with the mental rotation of the display to a track-up alignment for ego-centered tasks. The results also show that visual momentum can be used to reduce the mental rotation costs of a north-up display.

Flare-ups in endodontics and their relationship to various medicaments.

PubMed

Ehrmann, Ernest H; Messer, Harold H; Clark, Robert M

2007-12-01

The purpose of this research is to investigate the frequency of endodontic flare-ups using a visual analogue scale. Definitions of flare-ups vary widely as does their reported frequency. A flare-up was defined as an increase of 20 or more points on the visual analogue scale for a given tooth, within the periods of 4 h and 24 h after the initial treatment appointment. The data from a previous study were used to determine the incidence of flare-ups after using three modalities (Ledermix, calcium hydroxide and no medication) to manage patients presenting for relief of pain of endodontic origin. A statistical analysis showed that there were no significant differences in flare-up rates at both the 4-h and 24-h periods between the three modalities. Further research is required using the above definition of a flare-up and standardising treatment protocols.

78 FR 73753 - Partnerships; Start-Up Expenditures; Organization and Syndication Fees

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-09

... deduct start-up expenditures in the taxable year in which the active trade or business begins. The amount... begins. All start-up expenditures that relate to the active trade or business are considered in...(b) to amortize start-up expenditures for the taxable year in which the active trade or business to...

TEX-SIS FOLLOW-UP: Student Follow-up Management Information System. Activities Manual.

ERIC Educational Resources Information Center

Tarrant County Junior Coll. District, Ft. Worth, TX.

Project FOLLOW-UP was conducted to develop, test, and validate a statewide management information system for follow-up of Texas public junior and community college students. This activities manual provides an overview of the resultant student information system (TEX-SIS) and its characteristics. Seven subsystems comprise SIS, each with its own…

Student's Local Top-Up Higher Education Choices

ERIC Educational Resources Information Center

Agbola, Frank W.; Cheng, Calvin

2017-01-01

Making decisions about education choices is challenging and difficult for students. Utilising the theory of reasoned action, we specify and estimate a conceptual framework that captures the cognitive process of decision making of students in choosing top-up higher degrees in Hong Kong. Top-up higher or bachelor's degrees are top-up undergraduate…

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR CODING: FOLLOW UP QUESTIONNAIRE (UA-D-11.0)

EPA Science Inventory

The purpose of this SOP is to define the coding strategy for the Follow Up Questionnaire. This questionnaire was developed for use in the Arizona NHEXAS project and the "Border" study. Household and individual follow-up data were combined in a single Follow-up Questionnaire data...

The determination of the pulse pile-up reject (PUR) counting for X and gamma ray spectrometry

NASA Astrophysics Data System (ADS)

Karabıdak, S. M.; Kaya, S.

2017-02-01

The collection the charged particles produced by the incident radiation on a detector requires a time interval. If this time interval is not sufficiently short compared with the peaking time of the amplifier, a loss in the recovered signal amplitude occurs. Another major constraint on the throughput of modern x or gamma-ray spectrometers is the time required for the subsequent the pulse processing by the electronics. Two above-mentioned limitations are cause of counting losses resulting from the dead time and the pile-up. The pulse pile-up is a common problem in x and gamma ray radiation detection systems. The pulses pile-up in spectroscopic analysis can cause significant errors. Therefore, inhibition of these pulses is a vital step. A way to reduce errors due to the pulse pile-up is a pile-up inspection circuitry (PUR). Such a circuit rejects some of the pulse pile-up. Therefore, this circuit leads to counting losses. Determination of these counting losses is an important problem. In this work, a new method is suggested for the determination of the pulse pile-up reject.

Modeling effectiveness of gradual increases in source level to mitigate effects of sonar on marine mammals.

PubMed

Von Benda-Beckmann, Alexander M; Wensveen, Paul J; Kvadsheim, Petter H; Lam, Frans-Peter A; Miller, Patrick J O; Tyack, Peter L; Ainslie, Michael A

2014-02-01

Ramp-up or soft-start procedures (i.e., gradual increase in the source level) are used to mitigate the effect of sonar sound on marine mammals, although no one to date has tested whether ramp-up procedures are effective at reducing the effect of sound on marine mammals. We investigated the effectiveness of ramp-up procedures in reducing the area within which changes in hearing thresholds can occur. We modeled the level of sound killer whales (Orcinus orca) were exposed to from a generic sonar operation preceded by different ramp-up schemes. In our model, ramp-up procedures reduced the risk of killer whales receiving sounds of sufficient intensity to affect their hearing. The effectiveness of the ramp-up procedure depended strongly on the assumed response threshold and differed with ramp-up duration, although extending the duration of the ramp up beyond 5 min did not add much to its predicted mitigating effect. The main factors that limited effectiveness of ramp up in a typical antisubmarine warfare scenario were high source level, rapid moving sonar source, and long silences between consecutive sonar transmissions. Our exposure modeling approach can be used to evaluate and optimize mitigation procedures. © 2013 Society for Conservation Biology.

Modelling wave-induced sea ice break-up in the marginal ice zone

NASA Astrophysics Data System (ADS)

Montiel, F.; Squire, V. A.

2017-10-01

A model of ice floe break-up under ocean wave forcing in the marginal ice zone (MIZ) is proposed to investigate how floe size distribution (FSD) evolves under repeated wave break-up events. A three-dimensional linear model of ocean wave scattering by a finite array of compliant circular ice floes is coupled to a flexural failure model, which breaks a floe into two floes provided the two-dimensional stress field satisfies a break-up criterion. A closed-feedback loop algorithm is devised, which (i) solves the wave-scattering problem for a given FSD under time-harmonic plane wave forcing, (ii) computes the stress field in all the floes, (iii) fractures the floes satisfying the break-up criterion, and (iv) generates an updated FSD, initializing the geometry for the next iteration of the loop. The FSD after 50 break-up events is unimodal and near normal, or bimodal, suggesting waves alone do not govern the power law observed in some field studies. Multiple scattering is found to enhance break-up for long waves and thin ice, but to reduce break-up for short waves and thick ice. A break-up front marches forward in the latter regime, as wave-induced fracture weakens the ice cover, allowing waves to travel deeper into the MIZ.

Singer and listener perception of vocal warm-up.

PubMed

Moorcroft, Lynda; Kenny, Dianna T

2013-03-01

This study investigated changes perceived by singers and listeners after the singers had vocally warmed up. The study used a repeated measures within-subject design to assess changes in vibrato quality from pre (nonwarmed-up voice) to post (warmed-up voice) test. Intraclass correlation coefficients were calculated to assess singers' self-ratings pre- and posttest and intra- and interlistener rater reliability. Twelve classically trained female singers recorded and self-rated their performance of an eight bar solo before and after 25 minutes of vocal warm-up exercises. Six experienced listeners assessed the vocal samples for pre- to posttest differences in tone quality and for each singer's warm-up condition. Perceptual judgements were also compared with pre- to posttest changes in vibrato. All singers perceived significant changes in tone quality, psychophysiological factors, proprioceptive feedback and technical command. Significant pre- to posttest differences in tone quality and correct appraisal of the singer's warm-up condition from most of the listeners were only observed for singers who moderated extremely fast or extremely slow vibrato after warming up. The findings reveal the divide between listeners' and singers' perceptions of the warmed-up voice and highlight the importance of enhanced vibrato quality to listener perception of an improvement in vocal quality. Copyright © 2013 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Modelling wave-induced sea ice break-up in the marginal ice zone

PubMed Central

Squire, V. A.

2017-01-01

A model of ice floe break-up under ocean wave forcing in the marginal ice zone (MIZ) is proposed to investigate how floe size distribution (FSD) evolves under repeated wave break-up events. A three-dimensional linear model of ocean wave scattering by a finite array of compliant circular ice floes is coupled to a flexural failure model, which breaks a floe into two floes provided the two-dimensional stress field satisfies a break-up criterion. A closed-feedback loop algorithm is devised, which (i) solves the wave-scattering problem for a given FSD under time-harmonic plane wave forcing, (ii) computes the stress field in all the floes, (iii) fractures the floes satisfying the break-up criterion, and (iv) generates an updated FSD, initializing the geometry for the next iteration of the loop. The FSD after 50 break-up events is unimodal and near normal, or bimodal, suggesting waves alone do not govern the power law observed in some field studies. Multiple scattering is found to enhance break-up for long waves and thin ice, but to reduce break-up for short waves and thick ice. A break-up front marches forward in the latter regime, as wave-induced fracture weakens the ice cover, allowing waves to travel deeper into the MIZ. PMID:29118659

Health assessments for Indigenous Australians at Orange Aboriginal Medical Service: health problems identified and subsequent follow up.

PubMed

Dutton, Tegan; Stevens, Wendy; Newman, Jamie

2016-01-01

This study aimed to document the types, management and follow up of health issues identified by all Aboriginal Health Assessments (AHA) performed at Orange Aboriginal Medical Service from 1 January 2011 to 31 December 2012. This was done with a retrospective audit of clinical records. In total, 1169 AHAs were performed: 41% child, 53% adult and 6% older person AHAs. Newly identified health issues were documented in 85% (984). Being overweight (41%; 476) and smoking (26%; 301) were the common risk factors identified. As a result of the AHA, most children who were not up-to-date with their vaccinations received catch-up immunisations; 11% (36) of adult women (n=314) received a Pap smear, although Pap smear status was unknown or not up-to-date for 61% (192); 27% (311) of cases were prescribed new medication; and 1239 referrals were made but only 40% were attended. At 6 months following the AHA, 26% (240) of cases with newly identified health issues were completely managed and followed up, whereas 25% (226) received no follow up. The AHAs are useful for identifying new health issues; however, follow up of the identified health issues should be improved. If AHAs are to improve health outcomes, appropriate management and follow up of the identified health issues are essential.

Modelling wave-induced sea ice break-up in the marginal ice zone.

PubMed

Montiel, F; Squire, V A

2017-10-01

A model of ice floe break-up under ocean wave forcing in the marginal ice zone (MIZ) is proposed to investigate how floe size distribution (FSD) evolves under repeated wave break-up events. A three-dimensional linear model of ocean wave scattering by a finite array of compliant circular ice floes is coupled to a flexural failure model, which breaks a floe into two floes provided the two-dimensional stress field satisfies a break-up criterion. A closed-feedback loop algorithm is devised, which (i) solves the wave-scattering problem for a given FSD under time-harmonic plane wave forcing, (ii) computes the stress field in all the floes, (iii) fractures the floes satisfying the break-up criterion, and (iv) generates an updated FSD, initializing the geometry for the next iteration of the loop. The FSD after 50 break-up events is unimodal and near normal, or bimodal, suggesting waves alone do not govern the power law observed in some field studies. Multiple scattering is found to enhance break-up for long waves and thin ice, but to reduce break-up for short waves and thick ice. A break-up front marches forward in the latter regime, as wave-induced fracture weakens the ice cover, allowing waves to travel deeper into the MIZ.

An Acute Bout of Self-Myofascial Release in the Form of Foam Rolling Improves Performance Testing

PubMed Central

PEACOCK, COREY A.; KREIN, DARREN D.; SILVER, TOBIN A.; SANDERS, GABRIEL J.; VON CARLOWITZ, KYLE-PATRICK A.

2014-01-01

Recent developments in the strength and conditioning field have shown the incorporation of foam rolling self-myofascial release in adjunct with a dynamic warm-up. This is thought to improve overall training performance; however, minimal research exists supporting this theory. Therefore, determining if an acute bout of foam rolling self-myofascial release in addition to a dynamic warm-up could influence performance is of importance. In order to do so, eleven athletically trained male subjects participated in a two condition, counterbalanced, crossover within-subjects study comparing two particular warm-up routines. The two warm-up routines compared were a total-body dynamic warm-up (DYN) and a total-body dynamic warm-up in adjunct with a self-myofascial release, total-body foam rolling session (SMR). Following each warm-up condition, subjects performed tests of flexibility, power, agility, strength, and speed. Paired samples T-tests were utilized to determine if there were any significant differences in test results between conditions (DYN vs. SMR). The data indicated that SMR was effective at improving power, agility, strength, and speed when compared to DYN (P ≤ 0.024). A warm-up routine consisting of both a dynamic warm-up and a self-myofascial release, total-body foam rolling session resulted in overall improvements in athletic performance testing. PMID:27182404

Circulation system for flowing uranium hexafluoride cavity reactor experiments

NASA Technical Reports Server (NTRS)

Jaminet, J. F.; Kendall, J. S.

1976-01-01

Research related to determining the feasibility of producing continuous power from fissile fuel in the gaseous state is presented. The development of three laboratory-scale flow systems for handling gaseous UF6 at temperatures up to 500 K, pressure up to approximately 40 atm, and continuous flow rates up to approximately 50g/s is presented. A UF6 handling system fabricated for static critical tests currently being conducted is described. The system was designed to supply UF6 to a double-walled aluminum core canister assembly at temperatures between 300 K and 400 K and pressure up to 4 atm. A second UF6 handling system designed to provide a circulating flow of up to 50g/s of gaseous UF6 in a closed-loop through a double-walled aluminum core canister with controlled temperature and pressure is described. Data from flow tests using UF6 and UF6/He mixtures with this system at flow rates up to approximately 12g/s and pressure up to 4 atm are presented. A third UF6 handling system fabricated to provide a continuous flow of UF6 at flow rates up to 5g/s and at pressures up to 40 atm for use in rf-heated, uranium plasma confinement experiments is described.

Microstructural Characterization of High Burn-up Mixed Oxide Fast Reactor Fuel

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

Melissa C. Teague; Brian P. Gorman; Steven L. Hayes

2013-10-01

High burn-up mixed oxide fuel with local burn-ups of 3.4–23.7% FIMA (fissions per initial metal atom) were destructively examined as part of a research project to understand the performance of oxide fuel at extreme burn-ups. Optical metallography of fuel cross-sections measured the fuel-to-cladding gap, clad thickness, and central void evolution in the samples. The fuel-to-cladding gap closed significantly in samples with burn-ups below 7–9% FIMA. Samples with burn-ups in excess of 7–9% FIMA had a reopening of the fuel-to-cladding gap and evidence of joint oxide-gain (JOG) formation. Signs of axial fuel migration to the top of the fuel column weremore » observed in the fuel pin with a peak burn-up of 23.7% FIMA. Additionally, high burn-up structure (HBS) was observed in the two highest burn-up samples (23.7% and 21.3% FIMA). The HBS layers were found to be 3–5 times thicker than the layers found in typical LWR fuel. The results of the study indicate that formation of JOG and or HBS prevents any significant fuel-cladding mechanical interaction from occurring, thereby extending the potential life of the fuel elements.« less

Barriers to Follow-Up for Abnormal Papanicolaou Smears among Female Sex Workers in Lima, Peru.

PubMed

Aharon, Devora; Calderon, Martha; Solari, Vicky; Alarcon, Patricia; Zunt, Joseph

2017-01-01

Cervical cancer is the most prevalent cancer among Peruvian women. Female sex workers (FSW) in Peru are at elevated risk for HPV infection, and receive annual Papanicolaou screening. The objective of this study was to identify barriers to follow-up for abnormal Pap smears among FSW in Peru. 97 FSW attending the Alberto Barton Health Center in Lima were surveyed regarding their STI screening history. 17 women with a history of an abnormal Pap smear were interviewed about their experiences regarding follow-up care. Of the 27 HPV-positive women, only 8 (30%) received follow-up treatment. Of the 19 women who did not receive follow-up, 7 (37%) had not been informed of their abnormal result. Qualitative interviews revealed that the major barrier to follow-up was lack of knowledge about HPV and potential health consequences of an abnormal Pap smear. HPV infection is highly prevalent in Peruvian FSW, yet only 30% of FSW with abnormal Pap smears receive follow-up care. The predominant barriers to follow-up were lack of standardization in recording and communicating results and insufficient FSW knowledge regarding health consequences of HPV infection. Standardization of record-keeping and distribution of educational pamphlets have been implemented to improve follow-up for HPV.

[Statistical Process Control (SPC) can help prevent treatment errors without increasing costs in radiotherapy].

PubMed

Govindarajan, R; Llueguera, E; Melero, A; Molero, J; Soler, N; Rueda, C; Paradinas, C

2010-01-01

Statistical Process Control (SPC) was applied to monitor patient set-up in radiotherapy and, when the measured set-up error values indicated a loss of process stability, its root cause was identified and eliminated to prevent set-up errors. Set up errors were measured for medial-lateral (ml), cranial-caudal (cc) and anterior-posterior (ap) dimensions and then the upper control limits were calculated. Once the control limits were known and the range variability was acceptable, treatment set-up errors were monitored using sub-groups of 3 patients, three times each shift. These values were plotted on a control chart in real time. Control limit values showed that the existing variation was acceptable. Set-up errors, measured and plotted on a X chart, helped monitor the set-up process stability and, if and when the stability was lost, treatment was interrupted, the particular cause responsible for the non-random pattern was identified and corrective action was taken before proceeding with the treatment. SPC protocol focuses on controlling the variability due to assignable cause instead of focusing on patient-to-patient variability which normally does not exist. Compared to weekly sampling of set-up error in each and every patient, which may only ensure that just those sampled sessions were set-up correctly, the SPC method enables set-up error prevention in all treatment sessions for all patients and, at the same time, reduces the control costs. Copyright © 2009 SECA. Published by Elsevier Espana. All rights reserved.

Head-up transition behavior of pilots with and without head-up display in simulated low-visibility approaches

NASA Technical Reports Server (NTRS)

Haines, R. F.; Fischer, E.; Price, T. A.

1980-01-01

To quantify head-up transition behavior with and without a flightpath type head-up display, eight rated B-727 pilots each flew 31 manual and coupled approaches in a simulator with B-727 dynamics and collimated model board external scene. Data were also obtained on the roll played by the head-up display in the coupled-to-manual transition. Various wind shears, low visibilities, and ceilings were tested along with unexpected misalignment between the runway and head-up display symbology. The symbolic format used was a conformal scene. Every pilot except one stayed head-up, flying with the display after descending below the ceiling. Without the display and as altitude decreased, the number of lookups from the instrument panel decreased and the duration of each one increased. No large differences in mean number or duration of transitions up or down were found during the head-up display runs comparing the no-misalignment with the lateral instrument landing system offset misalignment runs. The head-up display led to fewer transitions after the pilot made a decision to land or execute a missed approach. Without the display, pilots generally waited until they had descended below the ceiling to look outside the first time, but with it several pilots looked down at their panel at relatively high altitudes (if they looked down at all). Manual takeover of control was rapid and smooth both with and without the display which permitted smoother engine power changes.

Psychological distress longitudinally mediates the effect of vertigo symptoms on vertigo-related handicap.

PubMed

Probst, Thomas; Dinkel, Andreas; Schmid-Mühlbauer, Gabriele; Radziej, Katharina; Limburg, Karina; Pieh, Christoph; Lahmann, Claas

2017-02-01

Vertigo symptoms can lead to more or less vertigo-related handicap. This longitudinal study investigated whether depression, anxiety, and/or somatization mediate the relationship between vertigo symptoms and vertigo-related handicap. N=111 patients with vertigo/dizziness provided complete data on the following measures: Vertigo symptoms at baseline, depression at 6-month follow-up, anxiety at 6-month follow-up, somatization at 6-month follow-up, and vertigo handicap at 12-month follow-up. Mediation analyses with bootstrapping were performed to investigate the mediating role of anxiety, depression, and somatization in the relationship between vertigo symptoms and vertigo-related handicap. When the mediating role of anxiety, depression, and somatization was evaluated separately from each other in single mediation models, the effect vertigo symptoms at baseline exerted on vertigo-related handicap at 12-month follow-up was significantly mediated by depression at 6-month follow-up (p<0.05), by anxiety at 6-month follow-up (p<0.05), as well as by somatization at 6-month follow-up (p<0.05). When statistically controlling for the other mediators in a multiple mediator model, only depression at 6-month follow-up mediated the effect of vertigo symptoms at baseline on vertigo-related handicap at 12-month follow-up (p<0.05). Psychological distress is an important mechanism in the process how vertigo symptoms lead to vertigo-related handicap. Copyright © 2016 Elsevier Inc. All rights reserved.

Muscular contribution to low-back loading and stiffness during standard and suspended push-ups.

PubMed

Beach, Tyson A C; Howarth, Samuel J; Callaghan, Jack P

2008-06-01

Push-up exercises are normally performed to challenge muscles that span upper extremity joints. However, it is also recognized that push-ups provide an effective abdominal muscle challenge, especially when the hands are in contact with a labile support surface. The purpose of this study was to compare trunk muscle activation levels and resultant intervertebral joint (IVJ) loading when standard and suspended push-ups were performed, and to quantify and compare the contribution of trunk muscles to IVJ rotational stiffness in both exercises. Eleven recreationally trained male volunteers performed sets of standard and suspended push-ups. Upper body kinematic, kinetic, and EMG data were collected and input into a 3D biomechanical model of the lumbar torso to quantify lumbar IVJ loading and the contributions of trunk muscles to IVJ rotational stiffness. When performing suspended push-ups, muscles of the abdominal wall and the latissimus dorsi were activated to levels that were significantly greater than those elicited when performing standard push-ups (p<.05). As a direct result of these increased activation levels, model-predicted muscle forces increased and consequently led to significantly greater mean (p=.0008) and peak (p=.0012) lumbar IVJ compressive forces when performing suspended push-ups. Also directly resulting from the increased activation levels of the abdominal muscles and the latissimus dorsi during suspended push-ups was increased muscular contribution to lumbar IVJ rotational stiffness (p<.05). In comparison to the standard version of the exercise, suspended push-ups appear to provide a superior abdominal muscle challenge. However, for individuals unable to tolerate high lumbar IVJ compressive loads, potential benefits gained by incorporating suspended push-ups into their resistance training regimen may be outweighed by the risk of overloading low-back tissues.

Incidence and factors related to flare-ups in a graduate endodontic programme.

PubMed

Iqbal, M; Kurtz, E; Kohli, M

2009-02-01

To investigate the incidence and factors related to endodontic flare-ups in nonsurgical root canal treatment (NSRCT) cases completed by graduate endodontic residents at University of Pennsylvania, USA. Residents at University of Pennsylvania enter all clinical patient records into an electronic database called PennEndo database. Analysis of records of 6580 patients treated from September 2000 to July 2005 revealed a total of 26 patients with flare-ups (0.39%). Patients were categorized to have undergone flare-up when they attended for an unscheduled visit and active treatment, and when they suffered from severe pain and or swelling after initiation or continuation of NSRCT. SAS software was used to develop a logistic regression model with flare-up as a dependent variable. Independent variables included in the model were: history of previous pain, one vs. two visit NSRCT, periapical diagnosis, tooth type, rotary versus hand instrumentation, and lateral versus vertical compaction of gutta-percha. The odds for developing a flare-up in teeth with a periapical radiolucency were 9.64 times greater than teeth without a periapical radiolucency (P = 0.0090). There was no statistically significant difference in flare-ups between one and two visits NSRCT. The odds of developing a flare-up increased 40 fold when NSRCT was completed in three or more visits. However, this result may have been confounded by addition of an unscheduled visit in patients suffering from flare-ups. Other independent variables did not have any statistically significant correlations. A low percentage of patients experienced flare-ups during NSRCT procedures. The presence of a periapical lesion was the single most important predictor of flare-ups during NSRCT.

Fracture resistance of five pin-retained core build-up materials on teeth with and without extracoronal preparation.

PubMed

Burke, F J; Shaglouf, A G; Combe, E C; Wilson, N H

2000-01-01

Core build-ups should provide satisfactory strength and resistance to fracture both before and after crown preparation. This paper examines the resistance to fracture of core build-ups in different materials and the fracture resistance of core build-ups when these have been reduced for full crown preparation. Standardized core build-ups were made on groups of extracted molar teeth of similar size, with 10 teeth per group. Three resin-composite (prisma APH: Dentsply, Weybridge, UK; Ti-Core, Essential Dental Systems, NJ, US and Coradent, Vivadent, Liechtenstein), one cermet (Ketac-Silver, ESPE GmbH, Seefeld, Germany) and one amalgam material (Duralloy, Degussa Ltd, Cheshire, UK). These specimens were subjected to compressive force on a universal testing machine and the force at fracture noted. Standardized full crown preparations were made on a further five groups of core build-up specimens using the same materials as above. These prepared specimens were subjected to compressive force on a universal testing machine and the force to fracture noted. The results indicated that amalgam core build-ups demonstrated higher fracture resistance than the other materials examined. There was a general decrease in the fracture strength of the specimens following crown preparation, with the teeth restored with the amalgam core build-ups showing a greater percentage reduction in fracture strength than the other materials tested. Prepared core build-ups in a hybrid composite material provided the highest fracture resistance. The cermet material used provided the lowest resistance to fracture in both the core build-up and crown preparation specimens. In terms of fracture resistance, no advantage was apparent in using the two composite materials designated as being specifically appropriate for core build-ups.

Physics of Tokamak Plasma Start-up

NASA Astrophysics Data System (ADS)

Mueller, Dennis

2012-10-01

This tutorial describes and reviews the state-of-art in tokamak plasma start-up and its importance to next step devices such as ITER, a Fusion Nuclear Science Facility and a Tokamak/ST demo. Tokamak plasma start-up includes breakdown of the initial gas, ramp-up of the plasma current to its final value and the control of plasma parameters during those phases. Tokamaks rely on an inductive component, typically a central solenoid, which has enabled attainment of high performance levels that has enabled the construction of the ITER device. Optimizing the inductive start-up phase continues to be an area of active research, especially in regards to achieving ITER scenarios. A new generation of superconducting tokamaks, EAST and KSTAR, experiments on DIII-D and operation with JET's ITER-like wall are contributing towards this effort. Inductive start-up relies on transformer action to generate a toroidal loop voltage and successful start-up is determined by gas breakdown, avalanche physics and plasma-wall interaction. The goal of achieving steady-sate tokamak operation has motivated interest in other methods for start-up that do not rely on the central solenoid. These include Coaxial Helicity Injection, outer poloidal field coil start-up, and point source helicity injection, which have achieved 200, 150 and 100 kA respectively of toroidal current on closed flux surfaces. Other methods including merging reconnection startup and Electron Bernstein Wave (EBW) plasma start-up are being studied on various devices. EBW start-up generates a directed electron channel due to wave particle interaction physics while the other methods mentioned rely on magnetic helicity injection and magnetic reconnection which are being modeled and understood using NIMROD code simulations.

Silence That Can Be Dangerous: A Vignette Study to Assess Healthcare Professionals’ Likelihood of Speaking up about Safety Concerns

PubMed Central

Schwappach, David L. B.; Gehring, Katrin

2014-01-01

Purpose To investigate the likelihood of speaking up about patient safety in oncology and to clarify the effect of clinical and situational context factors on the likelihood of voicing concerns. Patients and Methods 1013 nurses and doctors in oncology rated four clinical vignettes describing coworkers’ errors and rule violations in a self-administered factorial survey (65% response rate). Multiple regression analysis was used to model the likelihood of speaking up as outcome of vignette attributes, responder’s evaluations of the situation and personal characteristics. Results Respondents reported a high likelihood of speaking up about patient safety but the variation between and within types of errors and rule violations was substantial. Staff without managerial function provided significantly higher levels of decision difficulty and discomfort to speak up. Based on the information presented in the vignettes, 74%−96% would speak up towards a supervisor failing to check a prescription, 45%−81% would point a coworker to a missed hand disinfection, 82%−94% would speak up towards nurses who violate a safety rule in medication preparation, and 59%−92% would question a doctor violating a safety rule in lumbar puncture. Several vignette attributes predicted the likelihood of speaking up. Perceived potential harm, anticipated discomfort, and decision difficulty were significant predictors of the likelihood of speaking up. Conclusions Clinicians’ willingness to speak up about patient safety is considerably affected by contextual factors. Physicians and nurses without managerial function report substantial discomfort with speaking up. Oncology departments should provide staff with clear guidance and trainings on when and how to voice safety concerns. PMID:25116338

Identifying barriers to follow-up eye care for children after failed vision screening in a primary care setting.

PubMed

Su, Zhuo; Marvin, Elizabeth K; Wang, Bing Q; van Zyl, Tavé; Elia, Maxwell D; Garza, Esteban N; Salchow, Daniel J; Forster, Susan H

2013-08-01

To identify barriers to follow-up eye care in children who failed a visual acuity screening conducted by their primary care provider. Children aged 3-14 years who failed a visual acuity screening were identified. A phone survey with the parent of every child was conducted 4 months after the screening. Family demographics, parental awareness of childhood eye diseases and eye care for children, and barriers to follow-up eye care were assessed. Of 971 children sampled, 199 (20.5%) failed a visual acuity screening. The survey was completed by the parents of 58 children (29.1%), of whom 27 (46.6%) presented for follow-up examination. The most common reason for failure to follow-up was parental unawareness of screening results (29.3%). Follow-up rates were higher in children with previous eye examinations than in those without (81% versus 17%; P = 0.005) and in children who waited <2 months for a follow-up appointment than in those who had to wait longer (100% versus 63%; P = 0.024). Child's sex, ethnicity, and health insurance status, parent's marital, education and employment status, household income, and transportation access were not associated with statistically significant different follow-up rates. Parental unawareness of a failed visual acuity screening is an important barrier to obtaining follow-up. Strategies to improve follow-up rates after a failed visual acuity screening may include communicating the results clearly and consistently, providing education about the importance of timely follow-up, and offering logistic support for accessing eye appointments to families. Copyright © 2013 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

A randomised controlled trial of structured nurse-led outpatient clinic follow-up for dyspeptic patients after direct access gastroscopy.

PubMed

Chan, David; Harris, Scott; Roderick, Paul; Brown, David; Patel, Praful

2009-02-06

Dyspepsia is a common disorder in the community, with many patients referred for diagnostic gastroscopy by their General Practitioner (GP). The National Institute of Clinical Excellence (NICE) recommends follow-up after investigation for cost effective management, including lifestyle advice and drug use. An alternative strategy may be the use of a gastro-intestinal nurse practitioner (GNP) instead of the GP. The objective of this study is to compare the effectiveness and costs of systematic GNP led follow-up to usual care by GPs in dyspeptic patients following gastroscopy. Direct access adult dyspeptic patients referred for gastroscopy; without serious pathology, were followed-up in a structured nurse-led outpatient clinic. Outcome measurement used to compare the two study cohorts (GNP versus GP) included Glasgow dyspepsia severity (Gladys) score, Health Status Short Form 12 (SF12), ulcer healing drug (UHD) use and costs. One hundred and seventy five patients were eligible after gastroscopy, 89 were randomised to GNP follow-up and 86 to GP follow-up. Follow-up at 6 months was 81/89 (91%) in the GNP arm and 79/86 (92%) in the GP arm. On an intention to treat analysis, adjusted mean differences (95%CI) at follow-up between Nurse and GP follow-up were: Gladys score 2.30 (1.4-3.2) p < 0.001, SF12 140.6 (96.5-184.8) p =< 0.001 and UHD costs pound39.60 ( pound24.20- pound55.10) p =< 0.001, all in favour of nurse follow-up. A standardised and structured follow-up by one gastrointestinal nurse practitioner was effective and may save drug costs in patients after gastroscopy. These findings need replication in other centres.

Social Support, Self-Efficacy for Decision Making, and Follow-up Care Use in Long-term Cancer Survivors

PubMed Central

Forsythe, Laura P.; Alfano, Catherine M.; Kent, Erin E.; Weaver, Kathryn E.; Bellizzi, Keith; Arora, Neeraj; Aziz, Noreen; Keel, Gretchen; Rowland, Julia H.

2014-01-01

Objective Cancer survivors play an important role in coordinating their follow-up care and making treatment-related decisions. Little is known about how modifiable factors like social support are associated with active participation in follow-up care. This study tests associations between social support, cancer-related follow-up care use, and self-efficacy for participation in decision making related to follow-up care (SEDM). We also identified sociodemographic and clinical factors associated with social support among long-term survivors. Methods The FOllow-up Care Use among Survivors (FOCUS) study is a cross-sectional, population based survey of breast, prostate, colon, and gynecologic cancer survivors (n=1522) 4 to 14 years post-diagnosis. Multivariable regression models were used to test associations between perceived social support (tangible and emotional/informational support modeled separately), follow-up care use (past two years), and SEDM, as well as to identify factors associated with perceived support. Results Neither support type was associated with follow-up care use (all p>0.05), although marital status was uniquely, positively associated with follow-up care use (p<0.05). Both tangible support (B for a standard deviation increase (SE)=9.75(3.15), p<0.05) and emotional/informational support (B(SE)=12.61(3.05), p<0.001) were modestly associated with SEDM. Being married, having adequate financial resources, history of recurrence, and better perceived health status were associated with higher perceived tangible and emotional support (all p<0.05). Conclusions While perceived social support may facilitate survivor efficacy for participation in decision making during cancer follow-up care, other factors, including marital satisfaction, appear to influence follow-up care use. Marital status and social support may be important factors to consider in survivorship care planning. PMID:24481884

STS-109 Crew Return Ceremony at Ellington Field

NASA Image and Video Library

2002-03-13

Photographic documentation of the STS-109 Crew Return Ceremony. The events take place at Hangar 990 at Ellington Field. Views include: Overall view of crewmembers [09319]; View of crewmembers standing on stage talking to group [09320]; Unidentified crewmember waving to crowd [09321]; Unidentified crewmember autographing photo [09322]; Mission Specialist Michael J. Massimino holding crew photo as he talks to child in group [09323]; Pilot Duane G. Carey signing a crew photo for a visitor [09324]; Unidentified crewmember signing a photo for visitor [09325]; Commander Scott D. Altman talking to child in group [09326]; Unidentified crewmember giving a photo to visitor [09327]; Crewmembers exiting plane [09328]; Duane G. Carey shaking hands with visitor. Astronaut Scott Altman smiling in the background [09329); Astronaut Jim Newman kissing his child [09330]; Jim Newman holding his daughter as his son grabs at his pant leg [09331]; Close-up view of Payload Commander John Grunsfeld holding his daughter [09332]; Duane G. Carey standing with family members [09333]; Close-up view of Duane G. Carey placing his hand on a child's head as he is talking to him [09334]; Overall view of spectator watching ceremony [09335]; Close-up view of speaker during ceremony [09336]; Close-up view of Scott Altman speaking to crowd [09337]; Close-up view of a young spectator at ceremony [09338]; Close-up view of Duane G. Carey speaking to the crowd [09339]; Close-up view of Mission Specialist Nancy J. Currie speaking to the crowd [09340]; Close-up view of John M. Grunsfield speaking to the crowd [09341]; Close-up view of Mission Specialist Richard M. Linnehan speaking to the crowd [09342]; Close-up view of James H. Newman speaking to the crowd [09343]; Close-up view of Michael J. Massimino speaking to the crowd [09344

Processing noxious information at the subnucleus reticularis dorsalis (SRD) of anesthetized cats: wind-up mechanisms.

PubMed

Soto, Cristina; Martín-Cora, Francisco J; Leiras, Roberto; Velo, Patricia; Canedo, Antonio

2008-11-15

With the exception of one monkey's study, where wind-up was not reported, electrophysiological data from SRD neurons were obtained in rodents where they show wind-up. This work was designed to examine the response properties of SRD neurons in anesthetized cats to study how general the data from rats may be. Since cat's SRD cells showed wind-up, its underlying mechanisms were approached, an issue not previously addressed at supraspinal level. Electrical stimulation, extracellular (combined with microiontophoresis) and intracellular techniques revealed that A delta information reaches the SRD via the ventrolateral cord, whereas C information preferentially follows a dorsal route. Wind-up was usually generated by spinal and peripheral stimulation, but it was also evoked either by stimulating the nucleus reticularis gigantocellularis (NRGc), even after spinal cord section and bilateral full thickness removal of the cerebral cortex, or by applying microiontophoretic pulses of l-glutamate at 0.3-1 Hz. Wind-up relied on afferent repetitive activity gradually depolarizing the SRD neurons leading 3-4.5 Hz subthreshold membrane rhythmic activity to threshold. Riluzole retarded wind-up generation and decreased the number of spikes per stimulus during wind-up. GABA or glycine abolished spontaneous and sensory-evoked activity and bicuculline, but not strychnine, increased spontaneous and stimulus-evoked activity. These results demonstrate that wind-up at the SRD is not merely the reflection of spinal wind-up, but (i) can be locally generated, (ii) is partially dependent upon persistent sodium currents, and (iii) is under the modulation of a tonic GABAa-dependent inhibition decreasing SRD excitability. Injury and/or inflammation producing tonic C-fiber activation will surpass tonic inhibition generating wind-up.

Effectiveness of Glaucoma Counseling on Rates of Follow-up and Glaucoma Knowledge in a South Indian Population.

PubMed

Do, Anna T; Pillai, Manju R; Balakrishnan, Vijayakumar; Chang, Robert T; Robin, Alan L; Singh, Kuldev; Lee, Bradford W

2016-03-01

To evaluate the impact of traditional counseling and patient-centered counseling, either alone or with recorded audio counseling reinforcement, on glaucoma knowledge and clinical follow-up. Prospective randomized controlled trial. Newly diagnosed adult glaucoma patients were randomized to 1 of 3 categories of glaucoma counseling: traditional counseling, patient-centered counseling, or patient-centered counseling with audio counseling reinforcement. Demographic and clinical information from each subject was ascertained, and all subjects completed the Glaucoma Knowledge Assessment before and after counseling sessions at the time of diagnosis and at 1-month follow-up. Patients were instructed to return to clinic for routine follow-up at 1, 3, 6, 9, and 12 months after enrollment. A multivariate logistic regression model was used to determine factors associated with appropriate clinical follow-up. Overall, only 13.5% of subjects had appropriate clinical follow-up at 1 year, defined as attending at least 3 follow-up visits during that interval, and there was no significant difference between counseling groups. The mean glaucoma knowledge assessment score (GKAS) improved by 77.6% with the initial counseling intervention (P < .0001), decreased by 17.4% within a 1-month period following initial counseling, and improved by 22.8% (P < .001) after the second counseling intervention. Monthly household income over 2500 rupees, GKAS greater than 5 after initial counseling, and undergoing any ocular surgical procedure were all independent predictors of appropriate follow-up. While all 3 counseling methods resulted in transient improvement of patient knowledge regarding glaucomatous disease, follow-up rates were poor for all groups. Poor retention of glaucoma knowledge may impact the likelihood of patient follow-up, and reinforcement with repeated counseling may be beneficial with regard to both disease knowledge and follow-up. Copyright © 2016 Elsevier Inc. All rights reserved.

Effects of different re-warm up activities in football players' performance.

PubMed

Abade, Eduardo; Sampaio, Jaime; Gonçalves, Bruno; Baptista, Jorge; Alves, Alberto; Viana, João

2017-01-01

Warm up routines are commonly used to optimize football performance and prevent injuries. Yet, official pre-match protocols may require players to passively rest for approximately 10 to 15 minutes between the warm up and the beginning of the match. Therefore, the aim of this study was to explore the effect of different re-warm up activities on the physical performance of football players. Twenty-Two Portuguese elite under-19 football players participated in the study conducted during the competitive season. Different re-warm up protocols were performed 6 minutes after the same standardized warm up in 4 consecutive days in a crossover controlled approach: without, eccentric, plyometric and repeated changes of direction. Vertical jump and Sprint performances were tested immediately after warm up and 12 minutes after warm up. Results showed that repeated changes of direction and plyometrics presented beneficial effects to jump and sprint. Different practical implications may be taken from the eccentric protocol since a vertical jump impairment was observed, suggesting a possibly harmful effect. The absence of re-warm up activities may be detrimental to players' physical performance. However, the inclusion of re-warm up prior to match is a complex issue, since the manipulation of volume, intensity and recovery may positively or negatively affect the subsequent performance. In fact, this exploratory study shows that eccentric exercise may be harmful for physical performance when performed prior a football match. However, plyometric and repeated changes of direction exercises seem to be simple, quick and efficient activities to attenuate losses in vertical jump and sprint capacity after warm up. Coaches should aim to develop individual optimal exercise modes in order to optimize physical performance after re warm activities.

IMMEDIATE EFFECTS OF A DYNAMIC ROTATION-SPECIFIC WARM-UP ON X-FACTOR AND X-FACTOR STRETCH IN THE AMATEUR GOLFER.

PubMed

Henry, Elizabeth; Berglund, Kathy; Millar, Lynn; Locke, Frederick

2015-12-01

Recent evidence suggests performing a warm-up prior to golf can improve performance and reduce injuries. While some characteristics of effective golf warm-ups have been determined, no studies have explored the immediate effects of a rotational-specific warm-up with elements of motor control on the biomechanical aspects of the full X-Factor and X-Factor Stretch during the golf swing. Thirty-six amateur golfers (mean ± SD age: 64 ± 8 years old; 75% male) were randomized into a Dynamic Rotation-Specific Warm-up group (n=20), or a Sham Warm-up group (n=16). X-Factor and X-Factor Stretch were measured at baseline and immediately following the warm-up. Mixed model ANCOVAs were used to determine if a Group*Time interaction existed for each variable with group as the between-subjects variable and time as the within-subjects variable. The mixed model ANCOVAs did not reveal a statistically significant group*time interaction for X-Factor or X-Factor Stretch. There was not a significant main effect for time for X-Factor but there was for X-Factor Stretch. These results indicate that neither group had a significant effect on improving X-Factor, however performing either warm-up increased X-Factor Stretch without significant difference between the two. The results of this study suggest that performing the Dynamic Rotation-Specific Warm-up did not increase X-Factor or X-Factor Stretch when controlled for age compared to the Sham Warm-up. Further study is needed to determine the long-term effects of the Dynamic Rotation-Specific Warm-up on performance factors of the golf swing while examining across all ages. 2b.

Frequency and Determinants of a Short-Interval Follow-up Recommendation After an Abnormal Screening Mammogram.

PubMed

Pelletier, Eric; Daigle, Jean-Marc; Defay, Fannie; Major, Diane; Guertin, Marie-Hélène; Brisson, Jacques

2016-11-01

After imaging assessment of an abnormal screening mammogram, a follow-up examination 6 months later is recommended to some women. Our aim was to identify which characteristics of lesions, women, and physicians are associated to such short-interval follow-up recommendation in the Quebec Breast Cancer Screening Program. Between 1998 and 2008, 1,839,396 screening mammograms were performed and a total of 114,781 abnormal screens were assessed by imaging only. Multivariate analysis was done with multilevel Poisson regression models with robust variance and generalized linear mixed models. A short-interval follow-up was recommended in 26.7% of assessments with imaging only, representing 2.3% of all screens. Case-mix adjusted proportion of short-interval follow-up recommendations varied substantially across physicians (range: 4%-64%). Radiologists with high recall rates (≥15%) had a high proportion of short-interval follow-up recommendation (risk ratio: 1.82; 95% confidence interval: 1.35-2.45) compared to radiologists with low recall rates (<5%). The adjusted proportion of short-interval follow-up was high (22.8%) even when a previous mammogram was usually available. Short-interval follow-up recommendation at assessment is frequent in this Canadian screening program, even when a previous mammogram is available. Characteristics related to radiologists appear to be key determinants of short-interval follow-up recommendation, rather than characteristics of lesions or patient mix. Given that it can cause anxiety to women and adds pressure on the health system, it appears important to record and report short-interval follow-up and to identify ways to reduce its frequency. Short-interval follow-up recommendations should be considered when assessing the burden of mammography screening. Copyright © 2016 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

Local Burn-Up Effects in the NBSR Fuel Element

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

Brown N. R.; Hanson A.; Diamond, D.

2013-01-31

This study addresses the over-prediction of local power when the burn-up distribution in each half-element of the NBSR is assumed to be uniform. A single-element model was utilized to quantify the impact of axial and plate-wise burn-up on the power distribution within the NBSR fuel elements for both high-enriched uranium (HEU) and low-enriched uranium (LEU) fuel. To validate this approach, key parameters in the single-element model were compared to parameters from an equilibrium core model, including neutron energy spectrum, power distribution, and integral U-235 vector. The power distribution changes significantly when incorporating local burn-up effects and has lower power peakingmore » relative to the uniform burn-up case. In the uniform burn-up case, the axial relative power peaking is over-predicted by as much as 59% in the HEU single-element and 46% in the LEU single-element with uniform burn-up. In the uniform burn-up case, the plate-wise power peaking is over-predicted by as much as 23% in the HEU single-element and 18% in the LEU single-element. The degree of over-prediction increases as a function of burn-up cycle, with the greatest over-prediction at the end of Cycle 8. The thermal flux peak is always in the mid-plane gap; this causes the local cumulative burn-up near the mid-plane gap to be significantly higher than the fuel element average. Uniform burn-up distribution throughout a half-element also causes a bias in fuel element reactivity worth, due primarily to the neutronic importance of the fissile inventory in the mid-plane gap region.« less

Direct costs of unintended pregnancy in the Russian federation.

PubMed

Lowin, Julia; Jarrett, James; Dimova, Maria; Ignateva, Victoria; Omelyanovsky, Vitaly; Filonenko, Anna

2015-02-01

In 2010, almost every third pregnancy in Russia was terminated, indicating that unintended pregnancy (UP) is a public health problem. The aim of this study was to estimate the direct cost of UP to the healthcare system in Russia and the proportion attributable to using unreliable contraception. A cost model was built, adopting a generic payer perspective with a 1-year time horizon. The analysis cohort was defined as women of childbearing age between 18 and 44 years actively seeking to avoid pregnancy. Model inputs were derived from published sources or government statistics with a 2012 cost base. To estimate the number of UPs attributable to unreliable methods, the model combined annual typical use failure rates and age-adjusted utilization for each contraceptive method. Published survey data was used to adjust the total cost of UP by the number of UPs that were mistimed rather than unwanted. Scenario analysis considered alternate allocation of methods to the reliable and unreliable categories and estimate of the burden of UP in the target sub-group of women aged 18-29 years. The model estimated 1,646,799 UPs in the analysis cohort (women aged 18-44 years) with an associated annual cost of US$783 million. The model estimated 1,019,371 UPs in the target group of 18-29 years, of which 88 % were attributable to unreliable contraception. The total cost of UPs in the target group was estimated at approximately US$498 million, of which US$441 million could be considered attributable to the use of unreliable methods. The cost of UP attributable to use of unreliable contraception in Russia is substantial. Policies encouraging use of reliable contraceptive methods could reduce the burden of UP.

Social support, self-efficacy for decision-making, and follow-up care use in long-term cancer survivors.

PubMed

Forsythe, Laura P; Alfano, Catherine M; Kent, Erin E; Weaver, Kathryn E; Bellizzi, Keith; Arora, Neeraj; Aziz, Noreen; Keel, Gretchen; Rowland, Julia H

2014-07-01

Cancer survivors play an important role in coordinating their follow-up care and making treatment-related decisions. Little is known about how modifiable factors such as social support are associated with active participation in follow-up care. This study tests associations between social support, cancer-related follow-up care use, and self-efficacy for participation in decision-making related to follow-up care (SEDM). We also identified sociodemographic and clinical factors associated with social support among long-term survivors. The FOllow-up Care Use among Survivors study is a cross-sectional, population-based survey of breast, prostate, colon, and gynecologic cancer survivors (n=1522) 4-14 years post-diagnosis. Multivariable regression models were used to test associations between perceived social support (tangible and emotional/informational support modeled separately), follow-up care use (past 2 years), and SEDM, as well as to identify factors associated with perceived support. Neither support type was associated with follow-up care use (all p>0.05), although marital status was uniquely, positively associated with follow-up care use (p<0.05). Both tangible support (B for a standard deviation increase (SE)=9.75(3.15), p<0.05) and emotional/informational support (B(SE)=12.61(3.05), p<0.001) were modestly associated with SEDM. Being married, having adequate financial resources, history of recurrence, and better perceived health status were associated with higher perceived tangible and emotional support (all p<0.05). While perceived social support may facilitate survivor efficacy for participation in decision-making during cancer follow-up care, other factors, including marital satisfaction, appear to influence follow-up care use. Marital status and social support may be important factors to consider in survivorship care planning. Copyright © 2014 John Wiley & Sons, Ltd.

Follow-Up of Abnormal Breast and Colorectal Cancer Screening by Race/Ethnicity.

PubMed

McCarthy, Anne Marie; Kim, Jane J; Beaber, Elisabeth F; Zheng, Yingye; Burnett-Hartman, Andrea; Chubak, Jessica; Ghai, Nirupa R; McLerran, Dale; Breen, Nancy; Conant, Emily F; Geller, Berta M; Green, Beverly B; Klabunde, Carrie N; Inrig, Stephen; Skinner, Celette Sugg; Quinn, Virginia P; Haas, Jennifer S; Schnall, Mitchell; Rutter, Carolyn M; Barlow, William E; Corley, Douglas A; Armstrong, Katrina; Doubeni, Chyke A

2016-10-01

Timely follow-up of abnormal tests is critical to the effectiveness of cancer screening, but may vary by screening test, healthcare system, and sociodemographic group. Timely follow-up of abnormal mammogram and fecal occult blood testing or fecal immunochemical tests (FOBT/FIT) were compared by race/ethnicity using Population-Based Research Optimizing Screening through Personalized Regimens consortium data. Participants were women with an abnormal mammogram (aged 40-75 years) or FOBT/FIT (aged 50-75 years) in 2010-2012. Analyses were performed in 2015. Timely follow-up was defined as colonoscopy ≤3 months following positive FOBT/FIT; additional imaging or biopsy ≤3 months following Breast Imaging Reporting and Data System Category 0, 4, or 5 mammograms; or ≤9 months following Category 3 mammograms. Logistic regression was used to model receipt of timely follow-up adjusting for study site, age, year, insurance, and income. Among 166,602 mammograms, 10.7% were abnormal; among 566,781 FOBT/FITs, 4.3% were abnormal. Nearly 96% of patients with abnormal mammograms received timely follow-up versus 68% with abnormal FOBT/FIT. There was greater variability in receipt of follow-up across healthcare systems for positive FOBT/FIT than for abnormal mammograms. For mammography, black women were less likely than whites to receive timely follow-up (91.8% vs 96.0%, OR=0.71, 95% CI=0.51, 0.97). For FOBT/FIT, Hispanics were more likely than whites to receive timely follow-up than whites (70.0% vs 67.6%, OR=1.12, 95% CI=1.04, 1.21). Timely follow-up among women was more likely for abnormal mammograms than FOBT/FITs, with small variations in follow-up rates by race/ethnicity and larger variation across healthcare systems. Copyright © 2016 American Journal of Preventive Medicine. All rights reserved.

Missed opportunities for diabetes prevention: post-pregnancy follow-up of women with gestational diabetes mellitus in England

PubMed Central

Pierce, Mary; Modder, Jo; Mortagy, Iman; Springett, Anna; Hughes, Heather; Baldeweg, Stephanie

2011-01-01

Background Women with gestational diabetes mellitus (GDM) should be followed-up to exclude ongoing diabetes and for prevention of type 2 diabetes. The National Institute for Health and Clinical Excellence (NICE) diabetes in pregnancy guideline recommends checking fasting plasma glucose (FPG) at 6 weeks postpartum (short term), and annually thereafter (long term). Aim To examine the reported practice regarding GDM follow-up. Design and setting Nationwide postal survey in England 2008-2009. Method Questionnaires were distributed to a consultant diabetologist and obstetrician in all maternity units, and to a random sample of general practices (approximately 1 in 5). Results Response rates were: 60% (915/1532) GPs, 93% (342/368) specialists; 80% of GPs and 98% of specialists reported women with GDM had short-term follow-up. More GPs (55%) than specialists (13%) used a FPG test to exclude ongoing diabetes; 26% of GPs versus 89% of specialists thought the hospital was responsible for ordering the test. Twenty per cent of GPs had difficulty in discovering women had been diagnosed with GDM in secondary care. Seventy-three per cent of specialists recommended long-term follow-up; only 39% of GPs recalled women with GDM for this. A minority of GPs and specialists had joint follow-up protocols Conclusion Follow-up of GDM in England diverged from national guidance. Despite consensus that short-term follow-up occurred, primary and secondary care doctors disagreed about the tests and responsibility for follow-up. There was lack of long-term follow-up. Agreement about the NICE guideline, its promotion and effective implementation by primary and secondary care, and the systematic recall of women with GDM for long-term follow-up is required. PMID:22152832

Cost Analysis of Following Up Incomplete Low-Risk Fetal Anatomy Ultrasounds.

PubMed

O'Brien, Karen; Shainker, Scott A; Modest, Anna M; Spiel, Melissa H; Resetkova, Nina; Shah, Neel; Hacker, Michele R

2017-03-01

To examine the clinical utility and cost of follow-up ultrasounds performed as a result of suboptimal views at the time of initial second-trimester ultrasound in a cohort of low-risk pregnant women. We conducted a retrospective cohort study of women at low risk for fetal structural anomalies who had second-trimester ultrasounds at 16 to less than 24 weeks of gestation from 2011 to 2013. We determined the probability of women having follow-up ultrasounds as a result of suboptimal views at the time of the initial second-trimester ultrasound, and calculated the probability of detecting an anomaly on follow-up ultrasound. These probabilities were used to estimate the national cost of our current ultrasound practice, and the cost to identify one fetal anomaly on follow-up ultrasound. During the study period, 1,752 women met inclusion criteria. Four fetuses (0.23% [95% CI 0.06-0.58]) were found to have anomalies at the initial ultrasound. Because of suboptimal views, 205 women (11.7%) returned for a follow-up ultrasound, and one (0.49% [95% CI 0.01-2.7]) anomaly was detected. Two women (0.11%) still had suboptimal views and returned for an additional follow-up ultrasound, with no anomalies detected. When the incidence of incomplete ultrasounds was applied to a similar low-risk national cohort, the annual cost of these follow-up scans was estimated at $85,457,160. In our cohort, the cost to detect an anomaly on follow-up ultrasound was approximately $55,000. The clinical yield of performing follow-up ultrasounds because of suboptimal views on low-risk second-trimester ultrasounds is low. Since so few fetal abnormalities were identified on follow-up scans, this added cost and patient burden may not be warranted. © 2016 Wiley Periodicals, Inc.

Structured nursing follow-up: does it help in diabetes care?

PubMed Central

2014-01-01

Background In 1995 Clalit Health Services introduced a structured follow-up schedule, by primary care nurses, of diabetic patients. This was supplementary care, given in addition to the family physician’s follow-up care. This article aims to describe the performance of diabetes follow-up and diabetes control in patients with additional structured nursing follow-up care, compared to those patients followed only by their family physician. Methods We randomly selected 2,024 type 2 diabetic subjects aged 40–76 years. For each calendar year, from 2005–2007, patients who were “under physician follow-up only” were compared to those who received additional structured nursing follow-up care. Main outcomes Complete diabetes follow-up parameters including: HbA1c, LDL cholesterol, microalbumin, blood pressure measurements and fundus examination. Results The average age of study participants was 60.7 years, 52% were females and 38% were from low socioeconomic status (SES). In 2005, 39.5% of the diabetic patients received structured nursing follow-up, and the comparable figures for 2006 and 2007 were 42.1% 49.6%, respectively. The intervention subjects tended to be older, from lower SES, suffered from more chronic diseases and visited their family physician more frequently than the control patients. Patients in the study group were more likely to perform a complete diabetes follow-up plan: 52.8% vs. 21.5% (2005; p < 0.001) 55.5% vs. 30.3% (2006; p < 0.001), 52.3% vs. 35.7% (2007; p < 0.001). LDL cholesterol levels were lower in the study group only in 2005: 103.7 vs. 110.0 p < 0.001. Conclusion Subjects with supplementary structured nursing follow-up care were more likely to perform complete diabetes follow-up protocol. Our results reinforce the importance of teamwork in diabetic care. Further study is required to identify strategies for channeling the use of the limited resources to the patients who stand to benefit the most. PMID:25180073

Ranibizumab for exudative age-related macular degeneration: A five year study of adherence to follow-up in a real-life setting.

PubMed

Boulanger-Scemama, E; Querques, G; About, F; Puche, N; Srour, M; Mane, V; Massamba, N; Canoui-Poitrine, F; Souied, E H

2015-09-01

To analyze adherence to follow-up over 5 years in patients treated with intravitreal ranibizumab for exudative age-related macular degeneration (AMD) in a tertiary health care center. To investigate factors associated with failure to continue follow-up. Retrospective chart review of all consecutive patients with exudative AMD, who received their first intravitreal ranibizumab injection at the Créteil Intercommunal University Hospital Eye Clinic between October 1, 2006 and March 31, 2007. Patient clinical characteristics at baseline and at the last follow-up visit were recorded. Distance from home to hospital was measured for each patient. A multiple-choice telephone survey was conducted for patients lost to follow-up to determine the main reasons for failure to continue follow-up. Two hundred and one patients were included. The rate of loss to follow-up over the 5-year period was 57% (115/201). Fifty-eight patients lost to follow-up completed the questionnaire. The main reasons reported by patients for follow-up discontinuation were long distance from home to hospital (51.7%, 30/58), subjective dissatisfaction with the benefits of intravitreal injections (34.5%, 20/58), and the excessive burden of periodic follow-up visits (24.1%, 14/58). Three factors were significantly associated with follow-up discontinuation: high age at baseline (82.2 vs. 76.5 years, P<0.001), poor best-corrected visual acuity (BCVA) at baseline (42.5 vs. 51.0 letters, P=0.020), and long distance from home to hospital (132 vs. 17.1km, P<0.001). In this study, adherence to follow-up over 5 years was poor. Age and BCVA at baseline and distance from home to hospital were independently associated with long-term adherence. Copyright © 2015. Published by Elsevier Masson SAS.

Exploration of warm-up period in conceptual hydrological modelling

NASA Astrophysics Data System (ADS)

Kim, Kue Bum; Kwon, Hyun-Han; Han, Dawei

2018-01-01

One of the important issues in hydrological modelling is to specify the initial conditions of the catchment since it has a major impact on the response of the model. Although this issue should be a high priority among modelers, it has remained unaddressed by the community. The typical suggested warm-up period for the hydrological models has ranged from one to several years, which may lead to an underuse of data. The model warm-up is an adjustment process for the model to reach an 'optimal' state, where internal stores (e.g., soil moisture) move from the estimated initial condition to an 'optimal' state. This study explores the warm-up period of two conceptual hydrological models, HYMOD and IHACRES, in a southwestern England catchment. A series of hydrologic simulations were performed for different initial soil moisture conditions and different rainfall amounts to evaluate the sensitivity of the warm-up period. Evaluation of the results indicates that both initial wetness and rainfall amount affect the time required for model warm up, although it depends on the structure of the hydrological model. Approximately one and a half months are required for the model to warm up in HYMOD for our study catchment and climatic conditions. In addition, it requires less time to warm up under wetter initial conditions (i.e., saturated initial conditions). On the other hand, approximately six months is required for warm-up in IHACRES, and the wet or dry initial conditions have little effect on the warm-up period. Instead, the initial values that are close to the optimal value result in less warm-up time. These findings have implications for hydrologic model development, specifically in determining soil moisture initial conditions and warm-up periods to make full use of the available data, which is very important for catchments with short hydrological records.

Acceptability and feasibility of phone follow-up with a semiquantitative urine pregnancy test after medical abortion in Moldova and Uzbekistan.

PubMed

Platais, Ingrida; Tsereteli, Tamar; Comendant, Rodica; Kurbanbekova, Dilfuza; Winikoff, Beverly

2015-02-01

To evaluate the feasibility and acceptability of phone follow-up with a home semiquantitative pregnancy test and standardized checklist, and compare the alternative method of follow-up with in-clinic follow-up after medical abortion. Two thousand four hundred women undergoing medical abortion with mifepristone and misoprostol in Moldova and Uzbekistan were randomized to phone or clinic follow-up. All women in the clinic group returned to the clinic 2 weeks later. Women randomized to phone follow-up used a semiquantitative pregnancy test at the initial visit and repeated the test at home 2 weeks later when they also filled out a symptom checklist. Women were called at 2 weeks to review the test results and checklist. Participants who screened "positive" were referred to clinic to verify abortion completion. Most women in the phone group were successfully contacted on the phone (97.6%). Staff were unable to contact one woman in the phone follow-up group, and all women in clinic group returned to the clinic. The ongoing pregnancy rate was similar in both groups (0.4-0.6%), and the semiquantitative pregnancy test identified all ongoing pregnancies in the phone follow-up group. Women in the phone group found the test and checklist easy to use, and most (76.1%) preferred phone follow-up in the future. Overall, 92.8% of women in the phone group did not undergo in-clinic follow-up. Phone follow-up with a semiquantitative urine pregnancy test and symptom checklist is a feasible and a highly effective approach in identifying ongoing pregnancy after medical abortion. The semiquantitative pregnancy test can make home follow-up after medical abortion possible for many women and provide reassurance that ongoing pregnancies will be detected. Copyright © 2015 Elsevier Inc. All rights reserved.

The Primary Patency and Fracture Rates of Self-Expandable Nitinol Stents Placed in the Popliteal Arteries, Especially in the P2 and P3 Segments, in Korean Patients

PubMed Central

Chang, Il Soo; Park, Sang Woo; Yun, Ik Jin; Hwang, Jae Joon; Lee, Song Am; Kim, Jun Seok; Chang, Seong-Hwan; Jung, Hong Geun

2011-01-01

Objective We wanted to evaluate the status of self-expandable nitinol stents implanted in the P2 and P3 segments of the popliteal artery in Korean patients. Materials and Methods We retrospectively analyzed 189 consecutive patients who underwent endovascular treatment for stenoocclusive lesions in the femoropopliteal artery from July 2003 to March 2009, and 18 patients who underwent stent placement in popliteal arterial P2 and P3 segments were finally enrolled. Lesion patency was evaluated by ultrasound or CT angiography, and stent fracture was assessed by plain X-rays at 1, 3, 6 and 12 months and annually thereafter. Results At the 1-month follow-up, stent fracture (Type 2) was seen in one limb (up to P3, 1 of 18, 6%) and it was identified in seven limbs at the 3-month follow-up (Type 2, Type 3, Type 4) (n = 1: up to P2; n = 6: P3). At the 6-month follow-up, one more fracture (Type 1) (up to P3) was noted. At the 1-year follow-up, there were no additional stent fractures. Just four limbs (up to P2) at the 2-year follow-up did not have stent fracture. The primary patency was 94%, 61% and 44% at 1, 3 and 6 months, respectively, and the group with stent implantation up to P3 had a higher fracture rate than that of the group that underwent stenting up to P2 (p < 0.05). Conclusion We suggest that stent placement up to the popliteal arterial P3 segment and over P2 in an Asian population can worsen the stent patency owing to stent fracture. It may be necessary to develop a stent design and structure for the Asian population that can resist the bending force in the knee joint. PMID:21430937

Flavor and flavor chemistry differences among milks processed by high-temperature, short-time pasteurization or ultra-pasteurization.

PubMed

Jo, Y; Benoist, D M; Barbano, D M; Drake, M A

2018-05-01

Typical high-temperature, short-time (HTST) pasteurization encompasses a lower heat treatment and shorter refrigerated shelf life compared with ultra-pasteurization (UP) achieved by direct steam injection (DSI-UP) or indirect heat (IND-UP). A greater understanding of the effect of different heat treatments on flavor and flavor chemistry of milk is required to characterize, understand, and identify the sources of flavors. The objective of this study was to determine the differences in the flavor and volatile compound profiles of milk subjected to HTST, DSI-UP, or IND-UP using sensory and instrumental techniques. Raw skim and raw standardized 2% fat milks (50 L each) were processed in triplicate and pasteurized at 78°C for 15 s (HTST) or 140°C for 2.3 s by DSI-UP or IND-UP. Milks were cooled and stored at 4°C, then analyzed at d 0, 3, 7, and 14. Sensory attributes were determined using a trained panel, and aroma active compounds were evaluated by solid-phase micro-extraction or stir bar sorptive extraction followed by gas chromatography-mass spectrometry, gas chromatography-olfactometry, and gas chromatography-triple quad mass spectrometry. The UP milks had distinct cooked and sulfur flavors compared with HTST milks. The HTST milks had less diversity in aroma active compounds compared with UP milks. Flavor intensity of all milks decreased by d 14 of storage. Aroma active compound profiles were affected by heat treatment and storage time in both skim and 2% milk. High-impact aroma active compounds were hydrogen sulfide, dimethyl trisulfide, and methional in DSI-UP and 2 and 3-methylbutanal, furfural, 2-heptanone, 2-acetyl-1-pyrroline, 2-aminoacetophenone, benzaldehyde, and dimethyl sulfide in IND-UP. These results provide a foundation knowledge of the effect of heat treatments on flavor development and differences in sensory quality of UP milks. Copyright © 2018 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Inhibitory effect of hawthorn extract on heterocyclic aromatic amine formation in beef and chicken breast meat.

PubMed

Tengilimoglu-Metin, Mercan Merve; Hamzalioglu, Aytul; Gokmen, Vural; Kizil, Mevlude

2017-09-01

This study focused on the inhibitory effect of different levels of hawthorn extract (0, 0.5, and 1%) on the formation of heterocyclic aromatic amines (HAAs) in beef and chicken breast cooked by either pan-cooking or oven-cooking. All meat samples were cooked at three different temperatures (150, 200, and 250°C) and the levels of twelve HAAs were assessed (IQ, IQx, MeIQ, MeIQx, 4,8-DiMeIQx, 7,8-DiMeIQx, PhIP, harman, norharman, AαC, MeAαC, and Trp-P-2). Varying levels of IQ (up to 4.47ng/g), IQx (up to 0.69ng/g), MeIQ (up to 0.82ng/g), MeIQx (up to 1.01ng/g), 4,8-DiMeIQx (up to 0.10ng/g), 7,8-DiMeIQx (up to 0.23ng/g), PhIP (up to 0.75ng/g), harman (up to 2.15ng/g), norharman (up to 1.08ng/g), AαC (up to 1.86ng/g), MeAαC (up to 0.48ng/g), and Trp-P-2 (up to 12.88ng/g), were detected. Samples cooked at 150°C had very low amounts of HAAs, and the levels of HAAs increased gradually when the cooking temperature rose from 150 to 250°C. The total HAA content in chicken breast and beef ranged between not detectable to 17.60ng/g, and not detectable to 11.38ng/g, respectively. The inhibitory effects of hawthorn extract at 0.5% and 1% on total HAAs levels were found to be 12-100% and 19-97% in chicken breast, respectively, and 42-100% and 20-35% in beef, respectively. This study demonstrated that hawthorn extracts at 0.5% and 1% could mitigate HAA formation, especially at high cooking temperatures. Copyright © 2017 Elsevier Ltd. All rights reserved.

Speaking up about traditional and professionalism-related patient safety threats: a national survey of interns and residents.

PubMed

Martinez, William; Lehmann, Lisa Soleymani; Thomas, Eric J; Etchegaray, Jason M; Shelburne, Julia T; Hickson, Gerald B; Brady, Donald W; Schleyer, Anneliese M; Best, Jennifer A; May, Natalie B; Bell, Sigall K

2017-11-01

Open communication between healthcare professionals about care concerns, also known as 'speaking up', is essential to patient safety. Compare interns' and residents' experiences, attitudes and factors associated with speaking up about traditional versus professionalism-related safety threats. Anonymous, cross-sectional survey. Six US academic medical centres, 2013-2014. 1800 medical and surgical interns and residents (47% responded). Attitudes about, barriers and facilitators for, and self-reported experience with speaking up. Likelihood of speaking up and the potential for patient harm in two vignettes. Safety Attitude Questionnaire (SAQ) teamwork and safety scales; and Speaking Up Climate for Patient Safety (SUC-Safe) and Speaking Up Climate for Professionalism (SUC-Prof) scales. Respondents more commonly observed unprofessional behaviour (75%, 628/837) than traditional safety threats (49%, 410/837); p<0.001, but reported speaking up about unprofessional behaviour less commonly (46%, 287/628 vs 71%, 291/410; p<0.001). Respondents more commonly reported fear of conflict as a barrier to speaking up about unprofessional behaviour compared with traditional safety threats (58%, 482/837 vs 42%, 348/837; p<0.001). Respondents were also less likely to speak up to an attending physician in the professionalism vignette than the traditional safety vignette, even when they perceived high potential patient harm (20%, 49/251 vs 71%, 179/251; p<0.001). Positive perceptions of SAQ teamwork climate and SUC-Safe were independently associated with speaking up in the traditional safety vignette (OR 1.90, 99% CI 1.36 to 2.66 and 1.46, 1.02 to 2.09, respectively), while only a positive perception of SUC-Prof was associated with speaking up in the professionalism vignette (1.76, 1.23 to 2.50). Interns and residents commonly observed unprofessional behaviour yet were less likely to speak up about it compared with traditional safety threats even when they perceived high potential patient harm. Measuring SUC-Safe, and particularly SUC-Prof, may fill an existing gap in safety culture assessment. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Disparities in abnormal mammogram follow-up time for Asian women compared with non-Hispanic white women and between Asian ethnic groups.

PubMed

Nguyen, Kim H; Pasick, Rena J; Stewart, Susan L; Kerlikowske, Karla; Karliner, Leah S

2017-09-15

Delays in abnormal mammogram follow-up contribute to poor outcomes. In the current study, the authors examined differences in abnormal screening mammogram follow-up between non-Hispanic white (NHW) and Asian women. The authors used a prospective cohort of NHW and Asian women with a Breast Imaging, Reporting and Data System (BI-RADS) abnormal result of category 0 or 3-plus in the San Francisco Mammography Registry between 2000 and 2010. Kaplan-Meier estimation for the median number of days to follow-up with a diagnostic radiologic test was performed, and the authors compared the percentage of women with follow-up at 30 days, 60 days, and 90 days and no follow-up at 1 year for Asian women overall (and Asian ethnic groups) and NHW women. In addition, the authors assessed the relationship between race/ethnicity and time to follow-up with adjusted Cox proportional hazards models. Among Asian women, Vietnamese and Filipina women had the longest, and Japanese women the shortest, median follow-up (32 days, 28 days, and 19 days, respectively) compared with NHW women (15 days). The percentage of women receiving follow-up at 30 days was lower for Asians versus NHWs (57% vs 77%; P<.0001), and these disparities persisted at 60 days and 90 days for all Asian ethnic groups except Japanese. Asian women had a reduced hazard of follow-up compared with NHW women (adjusted hazard ratio, 0.70; 95% confidence interval, 0.69-0.72). Asian women also had a higher rate of receiving no follow-up compared with NHW women (15% vs 10%; P<.001); among Asian ethnic groups, Filipinas were found to have the highest percentage of women with no follow-up (18.1%). Asian women, particularly Filipina and Vietnamese women, were less likely than NHW women to receive timely follow-up after an abnormal screening mammogram. Research should disaggregate Asian ethnicity to better understand and address barriers to effective cancer prevention. Cancer 2017;123:3468-75. © 2017 American Cancer Society. © 2017 American Cancer Society.

Cost-Consequence Analysis Alongside a Randomised Controlled Trial of Hospital Versus Telephone Follow-Up after Treatment for Endometrial Cancer.

PubMed

Dixon, Padraig; Beaver, Kinta; Williamson, Susan; Sutton, Chris; Martin-Hirsch, Pierre; Hollingworth, William

2018-06-01

Regular outpatient follow-up programmes are usually offered to patients following treatment for gynaecological and other cancers. Despite the substantial resources involved in providing these programmes, there is evidence that routine follow-up programmes do not affect survival or the likelihood of detecting recurrence and may not meet patient needs. Alternative follow-up modalities may offer the same outcomes at lower cost. We examined the costs of using telephone-based routine follow-up of women treated for endometrial cancer undertaken by specialist gynaecology oncology nurses in comparison to routine hospital-based follow-up. The ENDCAT trial randomised 259 women at five centres in the north west of England with a known diagnosis of Stage I endometrial cancer who had completed primary treatment on a 1:1 basis to receive either standard hospital outpatient follow-up or a telephone follow-up intervention administered by specialist nurses. A cost-consequence analysis was undertaken in which we compared costs to the health system and to individuals with the trial's co-primary outcomes of psychological morbidity and participant satisfaction with information received. Psychological morbidity, psychosocial needs, patient satisfaction and quality of life did not differ between arms. Patients randomised to telephone follow-up underwent more and longer consultations. There was no difference in total health service mean per patient costs at 6 months (mean difference £8, 95% percentile confidence interval: - £147 to £141) or 12 months (mean difference: - £77, 95% percentile confidence interval: - £334 to £154). Estimated return journey costs per patient for hospital consultations were £11.47. Productivity costs were approximately twice as high under hospital follow-up. Telephone follow-up was estimated to be cost-neutral for the NHS and may free up clinic time for other patients. There was some evidence that telephone follow-up may be more efficient for patients and wider society, and is not associated with additional psychological morbidity, lower patient satisfaction or reduced quality of life. ISRCTN: 75220876, prospectively registered 28 October 2011.

Warm-up for Sprint Swimming: Race-Pace or Aerobic Stimulation? A Randomized Study.

PubMed

Neiva, Henrique P; Marques, Mário C; Barbosa, Tiago M; Izquierdo, Mikel; Viana, João L; Teixeira, Ana M; Marinho, Daniel A

2017-09-01

Neiva, HP, Marques, MC, Barbosa, TM, Izquierdo, M, Viana, JL, Teixeira, AM, and Marinho, DA. Warm-up for sprint swimming: race-pace or aerobic stimulation? A randomized study. J Strength Cond Res 31(9): 2423-2431, 2017-The aim of this study was to compare the effects of 2 different warm-up intensities on 100-m swimming performance in a randomized controlled trial. Thirteen competitive swimmers performed two 100-m freestyle time-trials on separate days after either control or experimental warm-up in a randomized design. The control warm-up included a typical race-pace set (4 × 25 m), whereas the experimental warm-up included an aerobic set (8 × 50 m at 98-102% of critical velocity). Cortisol, testosterone, blood lactate ([La]), oxygen uptake (V[Combining Dot Above]O2), heart rate, core (Tcore and Tcorenet) and tympanic temperatures, and rating of perceived exertion (RPE) were monitored. Stroke length (SL), stroke frequency (SF), stroke index (SI), and propelling efficiency (ηp) were assessed for each 50-m lap. We found that V[Combining Dot Above]O2, heart rate, and Tcorenet were higher after experimental warm-up (d > 0.73), but only the positive effect for Tcorenet was maintained until the trial. Performance was not different between conditions (d = 0.07). Experimental warm-up was found to slow SF (mean change ±90% CL = 2.06 ± 1.48%) and increase SL (1.65 ± 1.40%) and ηp (1.87 ± 1.33%) in the first lap. After the time-trials, this warm-up had a positive effect on Tcorenet (d = 0.69) and a negative effect on [La] (d = 0.56). Although the warm-ups had similar outcomes in the 100-m freestyle, performance was achieved through different biomechanical strategies. Stroke length and efficiency were higher in the first lap after the experimental warm-up, whereas SF was higher after control warm-up. Physiological adaptations were observed mainly through an increased Tcore after experimental warm-up. In this condition, the lower [La] after the trial suggests lower dependency on anaerobic metabolism.

Balancing medicine prices and business sustainability: analyses of pharmacy costs, revenues and profit shed light on retail medicine mark-ups in rural Kyrgyzstan

PubMed Central

2010-01-01

Background Numerous not-for-profit pharmacies have been created to improve access to medicines for the poor, but many have failed due to insufficient financial planning and management. These pharmacies are not well described in health services literature despite strong demand from policy makers, implementers, and researchers. Surveys reporting unaffordable medicine prices and high mark-ups have spurred efforts to reduce medicine prices, but price reduction goals are arbitrary in the absence of information on pharmacy costs, revenues, and profit structures. Health services research is needed to develop sustainable and "reasonable" medicine price goals and strategic initiatives to reach them. Methods We utilized cost accounting methods on inventory and financial information obtained from a not-for-profit rural pharmacy network in mountainous Kyrgyzstan to quantify costs, revenues, profits and medicine mark-ups during establishment and maintenance periods (October 2004-December 2007). Results Twelve pharmacies and one warehouse were established in remote Kyrgyzstan with < US $25,000 due to governmental resource-sharing. The network operated at break-even profit, leaving little room to lower medicine prices and mark-ups. Medicine mark-ups needed for sustainability were greater than originally envisioned by network administration. In 2005, 55%, 35%, and 10% of the network's top 50 products revealed mark-ups of < 50%, 50-99% and > 100%, respectively. Annual mark-ups increased dramatically each year to cover increasing recurrent costs, and by 2007, only 19% and 46% of products revealed mark-ups of < 50% and 50-99%, respectively; while 35% of products revealed mark-ups > 100%. 2007 medicine mark-ups varied substantially across these products, ranging from 32% to 244%. Mark-ups needed to sustain private pharmacies would be even higher in the absence of government subsidies. Conclusion Pharmacy networks can be established in hard-to-reach regions with little funding using public-private partnership, resource-sharing models. Medicine prices and mark-ups must be interpreted with consideration for regional costs of business. Mark-ups vary dramatically across medicines. Some mark-ups appear "excessive" but are likely necessary for pharmacy viability. Pharmacy financial data is available in remote settings and can be used towards determination of "reasonable" medicine price goals. Health systems researchers must document the positive and negative financial experiences of pharmacy initiatives to inform future projects and advance access to medicines goals. PMID:20626904

Uridine adenosine tetraphosphate (Up{sub 4}A) is a strong inductor of smooth muscle cell migration via activation of the P2Y{sub 2} receptor and cross-communication to the PDGF receptor

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

Wiedon, Annette; Toelle, Markus; Bastine, Joschika

2012-01-20

Highlights: Black-Right-Pointing-Pointer Up{sub 4}A induces VSMC migration. Black-Right-Pointing-Pointer VSMC migration towards Up{sub 4}A involves P2Y{sub 2} activation. Black-Right-Pointing-Pointer Up{sub 4}A-induced VSMC migration is OPN-dependent. Black-Right-Pointing-Pointer Activation of ERK1/2 pathway is necessary for VSMC migration towards Up{sub 4}A. Black-Right-Pointing-Pointer Up{sub 4}A-directed VSMC migration cross-communicates with the PDGFR. -- Abstract: The recently discovered dinucleotide uridine adenosine tetraphosphate (Up{sub 4}A) was found in human plasma and characterized as endothelium-derived vasoconstrictive factor (EDCF). A further study revealed a positive correlation between Up{sub 4}A and vascular smooth muscle cell (VSMC) proliferation. Due to the dominant role of migration in the formation of atherosclerotic lesions ourmore » aim was to investigate the migration stimulating potential of Up{sub 4}A. Indeed, we found a strong chemoattractant effect of Up{sub 4}A on VSMC by using a modified Boyden chamber. This migration dramatically depends on osteopontin secretion (OPN) revealed by the reduction of the migration signal down to 23% during simultaneous incubation with an OPN-blocking antibody. Due to inhibitory patterns using specific and unspecific purinoreceptor inhibitors, Up{sub 4}A mediates it's migratory signal mainly via the P2Y{sub 2}. The signaling behind the receptor was investigated with luminex technique and revealed an activation of the extracellular signal-regulated kinases 1 and 2 (ERK1/2) pathway. By use of the specific PDGF receptor (PDGFR) inhibitor AG1296 and siRNA technique against PDGFR-{beta} we found a strongly reduced migration signal after Up{sub 4}A stimulation in the PDGFR-{beta} knockdown cells compared to control cells. In this study, we present substantiate data that Up{sub 4}A exhibits migration stimulating potential probably involving the signaling cascade of MEK1 and ERK1/2 as well as the matrix protein OPN. We further suggest that the initiation of the migration process occurs predominant through direct activation of the P2Y{sub 2} by Up{sub 4}A and via transactivation of the PDGFR.« less

Different modes of continental break-up triggered by a sole mantle plume: a 2D and 3D numerical study

NASA Astrophysics Data System (ADS)

Beniest, Anouk; Koptev, Alexander; Leroy, Sylvie; Burov, Evgueni

2017-04-01

We used 2D and 3D numerical models to investigate the impact of a single mantle plume on continental rifting and breakup processes. We varied the thermo-rheological structure of the continental lithosphere, its geometry and the initial plume position. Based on the results of our 2D experiments, three continental break-up modes can be distinguished: A) 'central' continental break-up, the break-up center is located directly above the original mantle anomaly position, B) 'shifted' break-up, the break-up center is 50 to 200 km displaced from the initial plume location and C) 'distant' break-up, due to convection and/or slab-subduction/delamination, the break-up center is considerably shifted (300 to 800 km) from the primary plume position. Our 3D model, with a laterally homogeneous initial setup also results in continental break-up with the axis of continental break-up hundreds of kilometers shifted from the original plume location. The model results show that the classical, 'central' view of mantle plume induced continental break-up is not the only mode of break-up. When considering a diversity of break-up styles, it is possible to explain a variety of observed geophysical and geological features. For example, the mantle material glued to the base of the lithosphere at shallower depths corresponds geometrically and location-wise to high-velocity/high-density bodies observed on seismic data below the thinned continental lithosphere and the transition zone of the South Atlantic domain. During migration, products of partial melting of the mantle material can move vertically to (shallow) lower crustal levels. They might resemble high density bodies observed at lower crustal levels inside continental crust with similar geometries observed with gravity modelling. Also, topographic variation form in the very early stages of rifting on the first impingement of upwelled plume material. These variations remain visible, as the final position of the spreading center is shifted from the point of impingement and can be interpreted as aborted rifts, observed along passive margins. Our modelling demonstrates that both simple and perfectly symmetric preliminary settings as well as complex initial setups can result in a variety of break-up systems.

Balancing medicine prices and business sustainability: analyses of pharmacy costs, revenues and profit shed light on retail medicine mark-ups in rural Kyrgyzstan.

PubMed

Waning, Brenda; Maddix, Jason; Soucy, Lyne

2010-07-13

Numerous not-for-profit pharmacies have been created to improve access to medicines for the poor, but many have failed due to insufficient financial planning and management. These pharmacies are not well described in health services literature despite strong demand from policy makers, implementers, and researchers. Surveys reporting unaffordable medicine prices and high mark-ups have spurred efforts to reduce medicine prices, but price reduction goals are arbitrary in the absence of information on pharmacy costs, revenues, and profit structures. Health services research is needed to develop sustainable and "reasonable" medicine price goals and strategic initiatives to reach them. We utilized cost accounting methods on inventory and financial information obtained from a not-for-profit rural pharmacy network in mountainous Kyrgyzstan to quantify costs, revenues, profits and medicine mark-ups during establishment and maintenance periods (October 2004-December 2007). Twelve pharmacies and one warehouse were established in remote Kyrgyzstan with < US $25,000 due to governmental resource-sharing. The network operated at break-even profit, leaving little room to lower medicine prices and mark-ups. Medicine mark-ups needed for sustainability were greater than originally envisioned by network administration. In 2005, 55%, 35%, and 10% of the network's top 50 products revealed mark-ups of < 50%, 50-99% and > 100%, respectively. Annual mark-ups increased dramatically each year to cover increasing recurrent costs, and by 2007, only 19% and 46% of products revealed mark-ups of < 50% and 50-99%, respectively; while 35% of products revealed mark-ups > 100%. 2007 medicine mark-ups varied substantially across these products, ranging from 32% to 244%. Mark-ups needed to sustain private pharmacies would be even higher in the absence of government subsidies. Pharmacy networks can be established in hard-to-reach regions with little funding using public-private partnership, resource-sharing models. Medicine prices and mark-ups must be interpreted with consideration for regional costs of business. Mark-ups vary dramatically across medicines. Some mark-ups appear "excessive" but are likely necessary for pharmacy viability. Pharmacy financial data is available in remote settings and can be used towards determination of "reasonable" medicine price goals. Health systems researchers must document the positive and negative financial experiences of pharmacy initiatives to inform future projects and advance access to medicines goals.

Predicting complete loss to follow-up after a health-education program: number of absences and face-to-face contact with a researcher.

PubMed

Park, M J; Yamazaki, Yoshihiko; Yonekura, Yuki; Yukawa, Keiko; Ishikawa, Hirono; Kiuchi, Takahiro; Green, Joseph

2011-10-27

Research on health-education programs requires longitudinal data. Loss to follow-up can lead to imprecision and bias, and complete loss to follow-up is particularly damaging. If that loss is predictable, then efforts to prevent it can be focused on those program participants who are at the highest risk. We identified predictors of complete loss to follow-up in a longitudinal cohort study. Data were collected over 1 year in a study of adults with chronic illnesses who were in a program to learn self-management skills. Following baseline measurements, the program had one group-discussion session each week for six weeks. Follow-up questionnaires were sent 3, 6, and 12 months after the baseline measurement. A person was classified as completely lost to follow-up if none of those three follow-up questionnaires had been returned by two months after the last one was sent.We tested two hypotheses: that complete loss to follow-up was directly associated with the number of absences from the program sessions, and that it was less common among people who had had face-to-face contact with one of the researchers. We also tested predictors of data loss identified previously and examined associations with specific diagnoses.Using the unpaired t-test, the U test, Fisher's exact test, and logistic regression, we identified good predictors of complete loss to follow-up. The prevalence of complete loss to follow-up was 12.2% (50/409). Complete loss to follow-up was directly related to the number of absences (odds ratio; 95% confidence interval: 1.78; 1.49-2.12), and it was inversely related to age (0.97; 0.95-0.99). Complete loss to follow-up was less common among people who had met one of the researchers (0.51; 0.28-0.95) and among those with connective tissue disease (0.29; 0.09-0.98). For the multivariate logistic model the area under the ROC curve was 0.77. Complete loss to follow-up after this health-education program can be predicted to some extent from data that are easy to collect (age, number of absences, and diagnosis). Also, face-to-face contact with a researcher deserves further study as a way of increasing participation in follow-up, and health-education programs should include it.

Women’s experiences and health care-seeking practices in relation to uterine prolapse in a hill district of Nepal

PubMed Central

2014-01-01

Background Although uterine prolapse (UP) occurs commonly in Nepal, little is known about the physical health and care-seeking practices of women with UP. This study aimed to explore women’s experiences of UP and its effect on daily life, its perceived causes, and health care-seeking practices. Methods Using a convenience sampling method, we conducted 115 semi-structured and 16 in-depth interviews with UP-affected women during September–December 2012. All interviews occurred in outreach clinics in villages of the Dhading district. Results Study participants were 23–82 years of age. Twenty-four percent were literate, 47.2% had experienced a teenage pregnancy, and 29% had autonomy to make healthcare decisions. Most participants (>85%) described the major physical discomforts of UP as difficulty with walking, standing, working, sitting, and lifting. They also reported urinary incontinence (68%) bowel symptoms (42%), and difficulty with sexual activity (73.9%). Due to inability to perform household chores or fulfill their husband’s sexual desires, participants endured humiliation, harassment, and torture by their husbands and other family members, causing severe emotional stress. Following disclosure of UP, 24% of spouses remarried and 6% separated from the marital relationship. Women perceived the causes of UP as unsafe childbirth, heavy work during the postpartum period, and gender discrimination. Prior to visiting these camps some women (42%) hid UP for more than 10 years. Almost half (48%) of participants sought no health care; 42% ingested a herb and ate nutritious food. Perceived barriers to accessing health care included shame (48%) and feeling that care was unnecessary (12.5%). Multiple responses (29%) included shame, inability to share, male service provider, fear of stigma and discrimination, and perceiving UP as normal for childbearing women. Conclusions UP adversely affects women’s daily life and negatively influences their physical, mental, and social well-being. The results of our study are useful to generate information on UP symptoms and female health care seeking practices. Our findings can be helpful for effective development of UP awareness programs to increase service utilization at early stages of UP and thereby might contribute to both primary and secondary prevention of UP. PMID:24490616

Impact of a Submaximal Warm-Up on Endurance Performance in Highly Trained and Competitive Male Runners.

PubMed

Zourdos, Michael C; Bazyler, Caleb D; Jo, Edward; Khamoui, Andy V; Park, Bong-Sup; Lee, Sang-Rok; Panton, Lynn B; Kim, Jeong-Su

2017-03-01

The purpose of this investigation was to examine the effects of a submaximal running warm-up on running performance in male endurance athletes (n = 16, M age  = 21 ± 2 years, M VO2max  = 69.3 ± 5.1 mL/kg/min). Endurance performance was determined by a 30-min distance trial after control and submaximal running warm-up conditions in a randomized crossover fashion. The warm-up began with 5 min of quiet sitting, followed by 6 min of submaximal running split into 2-min intervals at speeds corresponding to 45%, 55%, and 65% maximal oxygen consumption (VO 2 max). A 2-min walk at 3.2 km/hr concluded the 13-min warm-up protocol. For the control condition, participants sat quietly for 13 min. VO 2 and heart rate (HR) were determined at Minutes 0, 5, and 13 of the pre-exercise protocol in each condition. At the end of 13 min prior to the distance trial, mean VO 2 (warm-up = 14.1 ± 2.2 mL/kg/min vs. control = 5.5 ± 1.7 mL/kg/min) and mean HR (warm-up = 105 ± 11 bpm vs. control = 67 ± 11 bpm) were statistically greater (p < .001) in the warm-up condition compared with the control condition. The distance run did not statistically differ (p = .37) between the warm-up (7.8 ± 0.5 km) and control (7.7 ± 0.6 km) conditions; however, effect size calculation revealed a small effect (d = 0.2) in favor of the warm-up condition. Thus, the warm-up employed may have important and practical implications to determine placing among high-level athletes in close races. These findings suggest a submaximal running warm-up may have a small but critical effect on a 30-min distance trial in competitive endurance athletes. Further, the warm-up elicited increases in physiological variables VO 2 and HR prior to performance; thus, a submaximal specific warm-up should warrant consideration.

Replacing Ambulatory Surgical Follow-Up Visits With Mobile App Home Monitoring: Modeling Cost-Effective Scenarios

PubMed Central

Semple, John L; Coyte, Peter C

2014-01-01

Background Women’s College Hospital (WCH) offers specialized surgical procedures, including ambulatory breast reconstruction in post-mastectomy breast cancer patients. Most patients receiving ambulatory surgery have low rates of postoperative events necessitating clinic visits. Increasingly, mobile monitoring and follow-up care is used to overcome the distance patients must travel to receive specialized care at a reduced cost to society. WCH has completed a feasibility study using a mobile app (QoC Health Inc, Toronto) that suggests high patient satisfaction and adequate detection of postoperative complications. Objective The proposed cost-effectiveness study models the replacement of conventional, in-person postoperative follow-up care with mobile app follow-up care following ambulatory breast reconstruction in post-mastectomy breast cancer patients. Methods This is a societal perspective cost-effectiveness analysis, wherein all costs are assessed irrespective of the payer. The patient/caregiver, health care system, and externally borne costs are calculated within the first postoperative month based on cost information provided by WCH and QoC Health Inc. The effectiveness of telemedicine and conventional follow-up care is measured as successful surgical outcomes at 30-days postoperative, and is modeled based on previous clinical trials containing similar patient populations and surgical risks. Results This costing assumes that 1000 patients are enrolled in bring-your-own-device (BYOD) mobile app follow-up per year and that 1.64 in-person follow-ups are attended in the conventional arm within the first month postoperatively. The total cost difference between mobile app and in-person follow-up care is $245 CAD ($223 USD based on the current exchange rate), with in-person follow-up being more expensive ($381 CAD) than mobile app follow-up care ($136 CAD). This takes into account the total of health care system, patient, and external borne costs. If we examine health care system costs alone, in-person follow-up is $38 CAD ($35 USD) more expensive than mobile app follow-up care over the first postoperative month. The baseline difference in effect is modeled to be zero based on clinical trials examining the effectiveness of telephone follow-up care in similar patient populations. An incremental cost-effectiveness ratio (ICER) is not reportable in this scenario. An incremental net benefit (INB) is reportable, and reflects merely the cost difference between the two interventions for any willingness-to-pay value (INB=$245 CAD). The cost-effectiveness of mobile app follow-up even holds in scenarios where all mobile patients attend one in-person follow-up. Conclusions Mobile app follow-up care is suitably targeted to low-risk postoperative ambulatory patients. It can be cost-effective from a societal and health care system perspective. PMID:25245774

Effects of Run-Up Velocity on Performance, Kinematics, and Energy Exchanges in The Pole Vault

PubMed Central

Linthorne, Nicholas P.; Weetman, A. H. Gemma

2012-01-01

This study examined the effect of run-up velocity on the peak height achieved by the athlete in the pole vault and on the corresponding changes in the athlete's kinematics and energy exchanges. Seventeen jumps by an experienced male pole vaulter were video recorded in the sagittal plane and a wide range of run-up velocities (4.5-8.5 m/s) was obtained by setting the length of the athlete's run-up (2-16 steps). A selection of performance variables, kinematic variables, energy variables, and pole variables were calculated from the digitized video data. We found that the athlete's peak height increased linearly at a rate of 0.54 m per 1 m/s increase in run-up velocity and this increase was achieved through a combination of a greater grip height and a greater push height. At the athlete's competition run-up velocity (8.4 m/s) about one third of the rate of increase in peak height arose from an increase in grip height and about two thirds arose from an increase in push height. Across the range of run-up velocities examined here the athlete always performed the basic actions of running, planting, jumping, and inverting on the pole. However, he made minor systematic changes to his jumping kinematics, vaulting kinematics, and selection of pole characteristics as the run-up velocity increased. The increase in run-up velocity and changes in the athlete's vaulting kinematics resulted in substantial changes to the magnitudes of the energy exchanges during the vault. A faster run-up produced a greater loss of energy during the take-off, but this loss was not sufficient to negate the increase in run-up velocity and the increase in work done by the athlete during the pole support phase. The athlete therefore always had a net energy gain during the vault. However, the magnitude of this gain decreased slightly as run-up velocity increased. Key pointsIn the pole vault the optimum technique is to run-up as fast as possible.The athlete's vault height increases at a rate of about 0.5 m per 1 m/s increase in run-up velocity.The increase in vault height is achieved through a greater grip height and a greater push height. At the athlete's competition run-up velocity about one third of the rate of increase in vault height arises from an increase in grip height and two thirds arises from an increase in push height.The athlete has a net energy gain during the vault. A faster run-up velocity produces a greater loss of energy during the take-off but this loss of energy is not sufficient to negate the increase in run-up velocity and the increase in the work done by the athlete during the pole support phase. PMID:24149197

Bringing up Gender: Academic Abjection?

ERIC Educational Resources Information Center

Henderson, Emily F.

2014-01-01

The principal questions raised in this article are: what does it mean to bring up the topic of gender in a space where it is not known, and how can this moment of bringing up gender--or not bringing it up--be conceptualised? The article departs from the thoughts and questions that were provoked by an interview conducted with a Gender Studies…

Recent trends at the state and federal level in accelerating CERCLA clean-ups

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

Clegg, B.

Efforts at accelerating remedial action at the federal level focus on the following: the Superfund accelerated clean-up model (SCAM); Brownfields economic redevelopment initiative; guidance documents and policies; and collaboration with state voluntary cleanup programs. At the state level efforts involved in accelerating clean-ups include voluntary clean-up programs and Brownfields initiatives.

Warm-Ups: The Key to the Beginning of a Great Lesson

ERIC Educational Resources Information Center

James, Alisa R.; Collier, Douglas H.

2011-01-01

Historically, traditional pre-lesson warm-ups in physical education have consisted of callisthenic exercises such as jumping jacks, pushups, sit-ups, and running laps, as well as static stretching activities. These warm-ups are used to increase core body temperature and to assist blood flow to the working muscles. Although the traditional warm-up…

Alternative Fuels Data Center: New Hampshire Fleet Revs up With Natural Gas

Science.gov Websites

New Hampshire Fleet Revs up With Natural Gas to someone by E-mail Share Alternative Fuels Data Center: New Hampshire Fleet Revs up With Natural Gas on Facebook Tweet about Alternative Fuels Data Center: New Hampshire Fleet Revs up With Natural Gas on Twitter Bookmark Alternative Fuels Data Center

Alternative Fuels Data Center: Virginia Cleans up With Natural Gas Refuse

Science.gov Websites

Trucks Virginia Cleans up With Natural Gas Refuse Trucks to someone by E-mail Share Alternative Fuels Data Center: Virginia Cleans up With Natural Gas Refuse Trucks on Facebook Tweet about Alternative Fuels Data Center: Virginia Cleans up With Natural Gas Refuse Trucks on Twitter Bookmark Alternative

26 CFR 1.195-1T - Election to amortize start-up expenditures (temporary).

Code of Federal Regulations, 2010 CFR

2010-04-01

... business, or $5,000 (reduced (but not below zero) by the amount by which the start-up expenditures exceed... beginning with the month in which the active trade or business begins. All start-up expenditures that relate to the active trade or business are considered in determining whether the start-up expenditures...

75 FR 37311 - Airplane and Engine Certification Requirements in Supercooled Large Drop, Mixed Phase, and Ice...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-29

... maximum time interval between any engine run-ups from idle and the minimum ambient temperature associated with that run-up interval. This limitation is necessary because we do not currently have any specific requirements for run-up procedures for engine ground operation in icing conditions. The engine run-up procedure...

49 CFR 375.501 - Must I write up an order for service?

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 5 2011-10-01 2011-10-01 false Must I write up an order for service? 375.501... TRANSPORTATION OF HOUSEHOLD GOODS IN INTERSTATE COMMERCE; CONSUMER PROTECTION REGULATIONS Pick Up of Shipments of Household Goods Before Loading § 375.501 Must I write up an order for service? (a) Before you receive a...

Assessing the Employment Experiences of Community College Vocational Program Graduates: A Review of Institutional Follow-Up Studies.

ERIC Educational Resources Information Center

Palmer, Jim

This paper reviews a sample of follow-up studies conducted by community colleges to determine the employment experiences of occupational program graduates. Part I discusses the types of follow-up studies conducted, including institutional follow-up studies of graduates from individual vocational programs, of all vocational graduates, and of…

U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR CODING: FOLLOW UP QUESTIONNAIRE (UA-D-11.0)

EPA Science Inventory

The purpose of this SOP is to define the coding strategy for the Follow Up Questionnaire. This questionnaire was developed for use in the Arizona NHEXAS project and the Border study. Household and individual follow-up data were combined in a single Follow-up Questionnaire data f...

29 CFR 99.315 - Audit findings follow-up.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 1 2010-07-01 2010-07-01 true Audit findings follow-up. 99.315 Section 99.315 Labor Office... § 99.315 Audit findings follow-up. (a) General. The auditee is responsible for follow-up and corrective... include the reference numbers the auditor assigns to audit findings under § 99.510(c). Since the summary...

41 CFR 102-2.105 - What information must agencies include in their follow-up analysis?

Code of Federal Regulations, 2013 CFR

2013-07-01

... agencies include in their follow-up analysis? In your follow-up analysis, provide information that may... 41 Public Contracts and Property Management 3 2013-07-01 2013-07-01 false What information must agencies include in their follow-up analysis? 102-2.105 Section 102-2.105 Public Contracts and Property...

41 CFR 102-2.105 - What information must agencies include in their follow-up analysis?

Code of Federal Regulations, 2011 CFR

2011-01-01

... agencies include in their follow-up analysis? In your follow-up analysis, provide information that may... 41 Public Contracts and Property Management 3 2011-01-01 2011-01-01 false What information must agencies include in their follow-up analysis? 102-2.105 Section 102-2.105 Public Contracts and Property...

41 CFR 102-2.105 - What information must agencies include in their follow-up analysis?

Code of Federal Regulations, 2010 CFR

2010-07-01

... agencies include in their follow-up analysis? In your follow-up analysis, provide information that may... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What information must agencies include in their follow-up analysis? 102-2.105 Section 102-2.105 Public Contracts and Property...

41 CFR 102-2.105 - What information must agencies include in their follow-up analysis?

Code of Federal Regulations, 2014 CFR

2014-01-01

... agencies include in their follow-up analysis? In your follow-up analysis, provide information that may... 41 Public Contracts and Property Management 3 2014-01-01 2014-01-01 false What information must agencies include in their follow-up analysis? 102-2.105 Section 102-2.105 Public Contracts and Property...

41 CFR 102-2.105 - What information must agencies include in their follow-up analysis?

Code of Federal Regulations, 2012 CFR

2012-01-01

... agencies include in their follow-up analysis? In your follow-up analysis, provide information that may... 41 Public Contracts and Property Management 3 2012-01-01 2012-01-01 false What information must agencies include in their follow-up analysis? 102-2.105 Section 102-2.105 Public Contracts and Property...

Up-conversion fluorescence: noncoherent excitation by sunlight.

PubMed

Baluschev, S; Miteva, T; Yakutkin, V; Nelles, G; Yasuda, A; Wegner, G

2006-10-06

We demonstrate up-conversion of noncoherent sunlight realized by ultralow excitation intensity. The bimolecular up-conversion process in our systems relies on the presence of a metastable triplet excited state, and thus has dramatically different photophysical characteristics relative to the other known methods for photon up-conversion (two-photon absorption, parametric processes, second harmonic generation, sequential multiphoton absorption, etc.).

Experimental damping-in-pitch of two slender cones at Mach 2 and incidences up to 30 deg

NASA Technical Reports Server (NTRS)

Iyenger, S.

1972-01-01

Oscillatory experiments were performed on two slender cones at Mach 2 and incidences up to 30 deg, using three different experimental arrangements. The damping-in-pitch was found to remain constant at incidences of up to a value approximately corresponding to the cone semi-angle, after which an almost linear increase with incidence was noted. The results obtained with the different techniques were in very good agreement up to an incidence of 15 deg and in some cases up to 25 deg.

[Health management system in outpatient follow-up of kidney transplantation patients].

PubMed

Zhang, Hong; Xie, Jinliang; Yao, Hui; Liu, Ling; Tan, Jianwen; Geng, Chunmi

2014-07-01

To develop a health management system for outpatient follow-up of kidney transplant patients. Access 2010 database software was used to establish the health management system for kidney transplantation patients in Windows XP operating system. Database management and post-operation follow-up of the kidney transplantation patients were realized through 6 function modules including data input, data query, data printing, questionnaire survey, data export, and follow-up management. The system worked stably and reliably, and the data input was easy and fast. The query, the counting and printing were convenient. Health management system for patients after kidney transplantation not only reduces the work pressure of the follow-up staff, but also improves the efficiency of outpatient follow-up.

Sarcocystis chloropusae (protozoa: Sarcocystidae) n. sp. from the common moorhen (Gallinula chloropus) from Egypt.

PubMed

El-Morsey, A; El-Seify, M; Desouky, A Y; Abdel-Aziz, M M; Sakai, H; Yanai, T

2015-07-01

A new name Sarcocystis chloropusae is proposed for a parasite previously found in two of 25 common moorhen (Gallinula chloropus) from Brolos Lake, Egypt. Sarcocysts were microscopic, up to 650 μm long, the cyst wall was up to 4.5 μm thick, and contained villar protrusions that were up to 4 μm long and up to 2 μm wide. The villar protrusions were crowded, contained vesicles but lacked microtubules. The ground substance layer was smooth. The bradyzoites were up to 12 μm long and up to 2 μm wide. Molecular characterization and phylogenetic analysis of the (ITS-1) supported the conclusion that the Sarcocystis in G. chloropus is a distinct species.

Top-down and bottom-up competition in visual stimuli processing.

PubMed

Ligeza, Tomasz S; Tymorek, Agnieszka D; Wyczesany, Mirosław

2017-01-01

Limited attention capacity results that not all the stimuli present in the visual field are equally processed. While processing of salient stimuli is automatically boosted by bottom‑up attention, processing of task‑relevant stimuli can be boosted volitionally by top‑down attention. Usually, both top‑down and bottom‑up influences are present simultaneously, which creates a competition between these two types of attention. We examined this competition using both behavioral and electrophysiological measures. Participants responded to letters superimposed on background pictures. We assumed that responding to different conditions of the letter task engages top‑down attention to different extent, whereas processing of background pictures of varying salience engages bottom‑up attention to different extent. To check how manipulation of top‑down attention influences bottom‑up processing, we measured evoked response potentials (ERPs) in response to pictures (engaging mostly bottom‑up attention) during three conditions of a letter task (different levels of top‑down engagement). Conversely, to check how manipulation of bottom‑up attention influences top‑down processing, we measured ERP responses for letters (engaging mostly top‑down attention) while manipulating the salience of background pictures (different levels of bottom‑up engagement). The correctness and reaction times in response to letters were also analyzed. As expected, most of the ERPs and behavioral measures revealed a trade‑off between both types of processing: a decrease of bottom‑up processing was associated with an increase of top‑down processing and, similarly, a decrease of top‑down processing was associated with an increase in bottom‑up processing. Results proved competition between the two types of attentions.

Compliance with follow-up after cataract surgery in rural China.

PubMed

Huang, Guofu; Crooms, Rita; Chen, Qianyun; Congdon, Nathan; He, Mingguang

2012-04-01

To evaluate reasons for non-compliance with post-cataract surgical follow-up in rural China, and assess the impact of incentives on improving compliance. Patients having undergone cataract surgery more than 3 months previously at cataract surgery training hospitals in Guangdong were invited by telephone and advertisements to a hospital-based study examination, with compensation for travel costs (US$7). Information on prior post-surgical follow up was collected by questionnaire at the hospital or by telephone. Logistic regression was used to assess predictors of post-operative attendance with or without compensation. Among 518 eligible patients, 426 (82.2%) underwent interviews and 342 (66.0%) attended the compensated study examination. Ninety nine participants (23.2%) reported previously returning for uncompensated follow-up ≥ 3 months post-operatively, and 225 (52.8%) had returned for any prior post-operative examination. Uncompensated follow-up at ≥ 3 months was associated with higher income (P = 0.037), and recalling instruction by a doctor to follow-up (P = 0.001), while age, gender, travel cost, and post-operative satisfaction and vision were not associated. Younger (P = 0.002) patients and those reporting being instructed to follow up (P = 0.008) were more likely to return for the compensated research examination. Among all interviewed subjects, only 170 (39.9%) reported knowing they were to return to hospital. Modest compensation, advertisements and telephone contact can increase medium-term follow-up rates after cataract surgery by three-fold. Better communication of specific targets for follow-up may improve follow-up compliance.

Analytical investigation of the hygrothermal effects and parametric study of the Edge Crack Torsion (ECT) mode 3 test lay-ups

NASA Technical Reports Server (NTRS)

Li, Jian; Obrien, T. Kevin

1995-01-01

A shear deformation theory including residual thermal and moisture effects is developed for the analysis of either symmetric or unsymmetric laminates with mid-plane edge delamination under torsion loading. The theory is based on an assumed displacement field which includes shear deformation. The governing equations and boundary conditions are obtained from the principle of virtual work. The analysis of the (90/(+/- 45)(n)/(-/+ 45)(n)/90)(s) ECT mode 3 test lay-up indicates that there are no hygrothermal effects on the mode 3 strain energy release rate because the laminate, and both sublaminates above and below the delamination, are symmetric lay-ups. A further parametric study reveals that some other lay-ups can have negligible hygrothermal effects even when the sublaminates above and below the delamination are not symmetric about their own mid-planes. However, these lay-ups may suffer from distortion after the curing process. Another Interesting set of lay-ups investigated is a class of antisymmetric laminates with (+/-(theta/(theta -90)(2)/theta))(n) lay-ups. It is observed that when n takes on even numbers (2 and 4), both hygrothermal and mode 1 effects can be neglected. From this point of view, these lay-ups provide a way to determine the mode 3 toughness between two dissimilar layers. However, when n takes on odd numbers (1 and 3), both hygrothermal and mode 1 effects may be strong in these lay-ups. In particular, when theta equals 45 deg, the lay-ups are free from both hygrothermal and mode 1 effects irrespective of n.

Follow-up treatment effects of contingency management and motivational interviewing on substance use: A meta-analysis.

PubMed

Sayegh, Caitlin S; Huey, Stanley J; Zara, Erica J; Jhaveri, Kinnari

2017-06-01

Motivation is an integral factor in substance use treatment and long-term recovery. However, it is unclear what role intrinsic and extrinsic motivation play across different treatment modalities. A meta-analysis (N = 84) was performed to estimate the pooled effect size of Motivational Interviewing (MI; primarily targeting intrinsic motivation) and contingency management (CM; primarily targeting extrinsic motivation) at different follow-up periods. Collapsed across all substance types, CM had a significant effect at 3-month follow-up, only. In contrast, MI had a significant effect at 6-month follow-up, only. CM had small and medium effects on multiple substances at 3-month follow-up (i.e., tobacco, marijuana, stimulants, polysubstances), but not at 6-month follow-up. MI had 1 significant medium effect at 3-month follow-up (i.e., marijuana), but several significant small effects at 6-month follow-up (i.e., alcohol, tobacco, polysubstances). This meta-analysis suggests that both CM and MI promote reductions in a range of substances, even several months after the intervention concludes. Further, these results provide some evidence that extrinsically focused CM may produce medium follow-up effects in the short run, but intrinsically focused MI may produce small but durable follow-up effects. However, this interpretation is complicated by the differences between the MI and CM studies that preclude statistical tests comparing effect sizes, and few studies assessed motivation itself. Future researchers should investigate how motivational dynamics impact lasting outcomes in substance use treatment. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Application of instant messaging software in the follow-up of patients using peritoneal dialysis, a randomised controlled trial.

PubMed

Cao, Fang; Li, Lanfei; Lin, Miao; Lin, Qinyu; Ruan, Yiping; Hong, Fuyuan

2018-04-20

This study aims to investigate the application value of Internet-based instant messaging software in the follow-up of patients using peritoneal dialysis. Peritoneal dialysis is an effective renal replacement treatment for end-stage renal disease. The clinical usefulness of Internet-based instant messaging software in the follow-up of peritoneal dialysis patients, including the incidence of peritonitis and exit-site infection, the levels of albumin and electrolytes and the degree of patients' satisfaction, remains unknown. Between January 2009-April 2016, a total of 160 patients underwent continuous peritoneal dialysis in the Department of Nephrology, Fujian Provincial Hospital were invited to participate voluntarily in this study. The patients were randomly assigned to the instant messenger (QQ) follow-up group (n = 80) and the traditional follow-up group (n = 80). The differences in death, hospitalisation, peritonitis, exit-site infection, and patients' satisfaction were investigated during 1 year of follow-up. The mean follow-up duration is 11.4 ± 1.5 months. Compared with the patients in the traditional follow-up group, patients in the QQ follow-up group showed higher levels of serum albumin (p = .009) and haemoglobin (p = .009), lower levels of phosphorus (p < .001) and calcium-phosphorus product (p = .001), and better degree of satisfaction (p < .001). Internet-based follow-up by instant messaging software appears to be a feasible and acceptable method of delivering peritoneal dialysis treatment for patients with end-stage renal disease. © 2018 John Wiley & Sons Ltd.

The evaluation of endodontic flare-ups and their relationship to various risk factors.

PubMed

Onay, Emel Olga; Ungor, Mete; Yazici, A Canan

2015-11-14

To evaluate the incidence of flare-ups and identify the risk factors including age, gender, tooth type, number of root canals, initial diagnosis, the type of irrigation regimen, treatment modality and the number of visits, in patients who received root canal treatment from January 2002 to January 2008. Records of 1819 teeth belonging to 1410 patients treated by 1 endodontics specialist during 6-year period were kept. Patient, tooth, and treatment characteristics were evaluated and the relationships between these characteristics and flare-ups were studied. Statistical analysis was carried out by using Pearson Chi-square test, Fisher's Exact test, and Binary Logistic regression analyses. The incidence of flare-ups was 59 (3.2 %) out of 1819 teeth that received endodontic therapy. Pulpal necrosis without periapical pathosis was the most common indication for flare-up (6 %) (p < 0.01). Teeth undergoing multiple visits had a higher risk of developing flare-ups compared to those with single appointments (OR: 3.14, CI: 1.414-7.009, p < 0.01). There were also no statistically significant differences in the incidence of flare-ups regarding to age, gender, tooth type, number of root canals, treatment modality, and the irrigation solutions that used during the treatment. The incidence of flare-up is minimal when teeth are treated in one visit. Absence of a periapical lesion in necrotic teeth is a significant risk factor for flare-ups.

Uroplakins, specific membrane proteins of urothelial umbrella cells, as histological markers of metastatic transitional cell carcinomas.

PubMed Central

Moll, R.; Wu, X. R.; Lin, J. H.; Sun, T. T.

1995-01-01

Uroplakins (UPs) Ia, Ib, II, and III, transmembrane proteins constituting the asymmetrical unit membrane of urothelial umbrella cells, are the first specific urothelial differentiation markers described. We investigated the presence and localization patterns of UPs in various human carcinomas by applying immunohistochemistry (avidin-biotin-peroxidase complex method), using rabbit antibodies against UPs II and III, to paraffin sections. Positive reactions for UP III (sometimes very focal) were noted in 14 of the 16 papillary noninvasive transitional cell carcinomas (TCCs) (88%), 29 of the 55 invasive TCCs (53%), and 23 of the 35 TCC metastases (66%). Different localization patterns of UPs could be distinguished, including superficial membrane staining like that found in normal umbrella cells (in papillary carcinoma), luminal (microluminal) membrane staining (in papillary and invasive carcinoma), and, against expectations, peripheral membrane staining (in invasive carcinoma). Non-TCC carcinomas of various origins (n = 177) were consistently negative for UPs. The presence of UPs in metastatic TCCs represents a prime example of even advanced tumor progression being compatible with the (focal) expression of highly specialized differentiation repertoires. Although of only medium-grade sensitivity, UPs do seem to be highly specific urothelial lineage markers, thus operating up interesting histodiagnostic possibilities in cases of carcinoma metastases of uncertain origin. Images Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 PMID:7485401

Adolescent Suicide Risk Screening: The Effect of Communication about Type of Follow-Up on Adolescents’ Screening Responses

PubMed Central

King, Cheryl A.; Hill, Ryan M.; Wynne, Henry A.; Cunningham, Rebecca M.

2013-01-01

Objective This experimental study examined the effect of communication about type of screening follow-up (in-person follow-up versus no in-person follow-up) on adolescents’ responses to a self-report suicide risk screen. Method Participants were 245 adolescents (131 girls, 114 boys; ages 13 to 17; 80% White, 21.6% Black; 9.8% American Indian; 2.9% Asian), seeking medical emergency services. They were randomized to a screening follow-up condition. Screening measures assessed primary risk factors for suicidal behavior, including suicidal thoughts, depressive symptoms, alcohol use, and aggressive/delinquent behavior. Results There was no main effect of follow-up condition on adolescents’ screening scores; however, significant interactions between follow-up condition and public assistance status were evident. Adolescents whose families received public assistance were less likely to report aggressive-delinquent behavior if assigned to In-Person Follow-Up. Adolescents whose families did not receive public assistance reported significantly higher levels of suicidal ideation if assigned to In-Person Follow-Up. Conclusions Findings suggest that response biases impact some adolescents’ responses to suicide risk screenings. Because national policy strongly recommends suicide risk screening in emergency settings, and because screening scores are used to make critical decisions regarding risk management and treatment recommendations, findings indicate the importance of improving the reliability and validity of suicide risk screening for adolescents. PMID:22540534

Clinical utility of spot urine protein-to-creatinine ratio modified by estimated daily creatinine excretion in children.

PubMed

Yang, Eun Mi; Yoon, Bo Ae; Kim, Soo Wan; Kim, Chan Jong

2017-06-01

The spot urine protein-to-creatinine ratio (UPCR) is widely used to predict 24-h urine protein (24-h UP) excretion. In patients with low daily urine creatinine excretion (UCr), however, the UPCR may overestimate 24-h UP. The aim of this study was to predict 24-h UP using UPCR adjusted by estimated 24-h UCr in children. This study included 442 children whose 24-h UP and spot UPCR were measured concomitantly. Estimated 24-h UCr was calculated using three previously existing equations. We estimated the 24-h UP excretion from UPCR by multiplying the estimated UCr. The results were compared with the measured 24-h UP. There was a strong correlation between UPCR and 24-h UP (r = 0.801, P < 0.001), and the correlation improved after multiplying the UPCR by the measured UCr (r = 0.847, P < 0.001). Using the estimated UCr rather than the measured UCr, there was high accuracy and strong correlation between the estimated UPCR weighted by the Cockcroft-Gault equation and 24-h UP. Improvement was also observed in the subgroup (proteinuria vs. non-proteinuria) analysis, particularly in the proteinuria group. The spot UPCR multiplied by the estimated UCr improved the accuracy of prediction of the 24-h UP in children.

Follow-up methods for retrospective cohort studies in New Zealand.

PubMed

Fawcett, Jackie; Garrett, Nick; Bates, Michael N

2002-01-01

To define a general methodology for maximising the success of follow-up processes for retrospective cohort studies in New Zealand, and to illustrate an approach to developing country-specific follow-up methodologies. We recently conducted a cohort study of mortality and cancer incidence in New Zealand professional fire fighters. A number of methods were used to trace vital status, including matching with records of the New Zealand Health Information Service (NZHIS), pension records of Work and Income New Zealand (WINZ), and electronic electoral rolls. Non-electronic methods included use of paper electoral rolls and the records of the Registrar of Births Deaths and Marriages. 95% of the theoretical person-years of follow-up of the cohort were traced using these methods. In terms of numbers of cohort members traced to end of follow-up, the most useful tracing methods were fire fighter employment records, the NZHIS, WINZ, and the electronic electoral rolls. The follow-up process used for the cohort study was highly successful. On the basis of this experience, we propose a generic, but flexible, model for follow-up of retrospective cohort studies in New Zealand. Similar models could be constructed for other countries. Successful follow-up of cohort studies is possible in New Zealand using established methods. This should encourage the use of cohort studies for the investigation of epidemiological issues. Similar models for follow-up processes could be constructed for other countries.

Tephra fall clean-up in urban environments

NASA Astrophysics Data System (ADS)

Hayes, Josh L.; Wilson, Thomas M.; Magill, Christina

2015-10-01

Tephra falls impact urban communities by disrupting transport systems, contaminating and damaging buildings and infrastructures, and are potentially hazardous to human health. Therefore, prompt and effective tephra clean-up measures are an essential component of an urban community's response to tephra fall. This paper reviews case studies of tephra clean-up operations in urban environments around the world, spanning 50 years. It identifies methods used in tephra clean-up and assesses a range of empirical relationships between level of tephra accumulation and clean-up metrics such as collected tephra volume, costs, and duration of operations. Results indicate the volume of tephra collected from urban areas is proportional to tephra accumulation. Urban areas with small tephra accumulations (1,000 m3/km2 or an average of 1 mm thickness) may collect < 1% of the total deposit, whereas urban areas which experience large accumulations (> 50,000 m3/km2 or an average of 50 mm thickness) remove up to 80%. This relationship can inform impact and risk assessments by providing an estimate of the likely response required for a given tephra fall. No strong relationship was found between tephra fall accumulation and clean-up cost or duration for urban environments which received one-off tephra falls, suggesting that these aspects of tephra fall clean-up operations are context specific. Importantly, this study highlights the advantage of effective planning for tephra clean-up and disposal in potentially exposed areas.

Adolescent suicide risk screening: the effect of communication about type of follow-up on adolescents' screening responses.

PubMed

King, Cheryl A; Hill, Ryan M; Wynne, Henry A; Cunningham, Rebecca M

2012-01-01

This experimental study examined the effect of communication about type of screening follow-up (in-person follow-up vs. no in-person follow-up) on adolescents' responses to a self-report suicide risk screen. Participants were 245 adolescents (131 girls, 114 boys; ages 13-17; 80% White, 21.6% Black, 9.8% American Indian, 2.9% Asian) seeking medical emergency services. They were randomized to a screening follow-up condition. Screening measures assessed primary risk factors for suicidal behavior, including suicidal thoughts, depressive symptoms, alcohol use, and aggressive/delinquent behavior. There was no main effect of follow-up condition on adolescents' screening scores; however, significant interactions between follow-up condition and public assistance status were evident. Adolescents whose families received public assistance were less likely to report aggressive-delinquent behavior if assigned to in-person follow-up. Adolescents whose families did not receive public assistance reported significantly higher levels of suicidal ideation if assigned to in-person follow-up. Findings suggest that response biases impact some adolescents' responses to suicide risk screenings. Because national policy strongly recommends suicide risk screening in emergency settings, and because screening scores are used to make critical decisions regarding risk management and treatment recommendations, findings indicate the importance of improving the reliability and validity of suicide risk screening for adolescents.

Shoulder kinematics during the wall push-up plus exercise.

PubMed

Lunden, Jason B; Braman, Jonathan P; Laprade, Robert F; Ludewig, Paula M

2010-03-01

The push-up plus exercise is a common therapeutic exercise for improving shoulder function and treating shoulder pathology. To date, the kinematics of the push-up plus exercise have not been studied. Our hypothesis was that the wall push-up plus exercise would demonstrate increased scapular internal rotation and increased humeral anterior translation during the plus phase of the exercise, thereby potentially impacting the subacromial space. Bone pins were inserted in the humerus and scapula in 12 healthy volunteers with no history of shoulder pathology. In vivo motion during the wall push-up plus exercise was tracked using an electromagnetic tracking system. During the wall push-up plus exercise, from a starting position to the push-up plus position, there was a significant increase in scapular downward rotation (P < .05) and internal rotation (P < .05). The pattern of glenohumeral motion was humeral elevation (P < .05) and movement anterior to the scapular plane (P < .05), with humeral external rotation remaining relatively constant. We found that during a wall push-up plus exercise in healthy volunteers, the scapula was placed in a position potentially associated with shoulder impingement. Because of the shoulder kinematics of the wall push-up plus exercise, utilization of this exercise without modification early on in shoulder rehabilitation, especially in patients with subacromial impingement, should be considered cautiously. Copyright 2010 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

The association between compliance with recommended follow-up and glaucomatous disease severity in a county hospital population.

PubMed

Ung, Cindy; Murakami, Yohko; Zhang, Elisa; Alfaro, Tatyana; Zhang, Monica; Seider, Michael I; Singh, Kuldev; Lin, Shan C

2013-08-01

To assess the association between insufficient follow-up and clinical parameters such as disease severity and medication use among glaucoma patients at a metropolitan county hospital. Cross-sectional study. Two-hundred and six patients with established glaucoma were recruited from San Francisco General Hospital. Subjects were classified based on compliance with recommended follow-up examination intervals over the year preceding commencement of the study, as determined by patient medical records. Glaucoma severity was determined based on the American Academy of Ophthalmology Preferred Practice Patterns guidelines. Multivariate logistic regression analysis was used to assess the relationship between adherence with follow-up visits and disease severity. After adjustment for the impact of potential confounding variables, subjects with severe glaucomatous disease were found to have been less adherent to their recommended follow-up than those patients with mild or moderate glaucomatous disease (adjusted OR 1.89, 95% CI 1.21-2.94; P = .01). Subjects who were on glaucoma medications were found to be less adherent to follow-up recommendations (adjusted OR 3.29, 95% CI 1.41-7.65, P = .01). Subjects with poor follow-up adherence were significantly more likely to have severe glaucomatous disease, suggesting that poor follow-up may contribute to disease worsening or, alternatively, those with more severe disease are less inclined to follow up at appropriate intervals. Published by Elsevier Inc.

Electronically transmitted prescriptions not picked up at pharmacies in Sweden.

PubMed

Ax, Fredrik; Ekedahl, Anders

2010-03-01

Electronically transmitted prescriptions (ETPs) became common after 1995 in Sweden; however, it is accompanied by a substantial increase in the number of prescriptions not picked up at pharmacies. To investigate the "no pick-up" rates of ETPs at pharmacies across type of drug and patient age and gender and the reasons patients' report for no pick-up. A cross-sectional study examining no pick-up of ETPs transmitted during 3 months in 2002, and a mail survey of patients to determine the reasons for failure to pick-up in the county of Sörmland, Sweden, with a population of 261,000, and 21 pharmacies. Chi-square tests were used for calculations of frequency differences among groups. The overall no pick-up rate of ETPs was 2.5%; men had consistently higher rates than women. The highest rates were seen for adolescents and young adults. Rates were higher than average for antibiotics. About 60% of the answers indicated that prescriptions not picked up were duplicate prescriptions or not needed. "Unintentional nonadherence" was reported by one-fifth of patients. No pick-up rate in general was low (2.5%), but there were differences across patient age and gender, the rates being higher among adolescents and young adults. Duplicate prescriptions may explain a significant share of the abandoned prescriptions. Copyright 2010 Elsevier Inc. All rights reserved.

Wave run-up on a high-energy dissipative beach

USGS Publications Warehouse

Ruggiero, P.; Holman, R.A.; Beach, R.A.

2004-01-01

Because of highly dissipative conditions and strong alongshore gradients in foreshore beach morphology, wave run-up data collected along the central Oregon coast during February 1996 stand in contrast to run-up data currently available in the literature. During a single data run lasting approximately 90 min, the significant vertical run-up elevation varied by a factor of 2 along the 1.6 km study site, ranging from 26 to 61% of the offshore significant wave height, and was found to be linearly dependent on the local foreshore beach slope that varied by a factor of 5. Run-up motions on this high-energy dissipative beach were dominated by infragravity (low frequency) energy with peak periods of approximately 230 s. Incident band energy levels were 2.5 to 3 orders of magnitude lower than the low-frequency spectral peaks and typically 96% of the run-up variance was in the infragravity band. A broad region of the run-up spectra exhibited an f-4 roll off, typical of saturation, extending to frequencies lower than observed in previous studies. The run-up spectra were dependent on beach slope with spectra for steeper foreshore slopes shifted toward higher frequencies than spectra for shallower foreshore slopes. At infragravity frequencies, run-up motions were coherent over alongshore length scales in excess of 1 km, significantly greater than decorrelation length scales on moderate to reflective beaches. Copyright 2004 by the American Geophysical Union.

Investigating GEAR-Up College Readiness Program's Influence on Postsecondary Decisions of Rural Hispanic Youth

ERIC Educational Resources Information Center

Boydstun, Kelli Dawn

2016-01-01

This qualitative case study investigated how the GEAR-Up college readiness program influenced the postsecondary decisions of Hispanic students who participated in the GEAR-Up program for the recommended six-year period in a rural school district in Texas. It was not known how long-term participation in the GEAR-Up program at a rural school…

41 CFR 102-34.285 - Where can we obtain help in setting up a maintenance program?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 41 Public Contracts and Property Management 3 2011-01-01 2011-01-01 false Where can we obtain help in setting up a maintenance program? 102-34.285 Section 102-34.285 Public Contracts and Property... obtain help in setting up a maintenance program? For help in setting up a maintenance program, contact...

Securing Volunteers to Fix up the School. Research Brief

ERIC Educational Resources Information Center

Johnston, Howard

2011-01-01

How can schools secure volunteers to help fix up the building and grounds? There isn't much research on how to secure volunteers to participate in school clean-ups and fix-ups, but some key ideas can be found in anecdotal examples from many communities around the nation. The first recommendation is that securing volunteers is easier when the…

A SCALE-UP Mock-Up: Comparison of Student Learning Gains in High- and Low-Tech Active-Learning Environments

ERIC Educational Resources Information Center

Soneral, Paula A. G.; Wyse, Sara A.

2017-01-01

Student-centered learning environments with upside-down pedagogies (SCALE-UP) are widely implemented at institutions across the country, and learning gains from these classrooms have been well documented. This study investigates the specific design feature(s) of the SCALE-UP classroom most conducive to teaching and learning. Using pilot survey…

77 FR 56683 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-13

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

Benefits of a Sport-Specific Warm-Up in Physical Education

ERIC Educational Resources Information Center

Reed, Julian; Banks, Aaron; Brathwaite, Rock

2004-01-01

Participating in some form of a warm-up prior to engaging in physical activity is considered an acceptable and valid practice. Nonetheless, the topic has been debated among those in the sport and physical education field for a number of years. Some professionals believe warm-up is essential to physical activity, while others believe warm-up is not…

13 CFR 123.504 - How do you apply for a Military Reservist EIDL?

Code of Federal Regulations, 2011 CFR

2011-01-01

... Disaster Area Office) including: (a) A copy of the essential employee's official call-up orders for active duty showing the date of call-up, and, if known, the date of release from active duty. For an essential employee who expects to be called up and who has not received official call-up orders, the application...

ACT UP, Racism, and the Question of How to Use History

ERIC Educational Resources Information Center

Gould, Deborah B.

2012-01-01

The author's reflections on this 25th anniversary of ACT UP's founding were spurred by a comment made to her recently that indicated that ACT UP's memory and legacy are haunted by the perception that it was racist. In this essay, the author considers the claim that ACT UP was a racist organization. In addition to the question of historical…

Modeling Resources Allocation in Attacker-Defender Games with "Warm Up" CSF.

PubMed

Guan, Peiqiu; Zhuang, Jun

2016-04-01

Like many other engineering investments, the attacker's and defender's investments may have limited impact without initial capital to "warm up" the systems. This article studies such "warm up" effects on both the attack and defense equilibrium strategies in a sequential-move game model by developing a class of novel and more realistic contest success functions. We first solve a single-target attacker-defender game analytically and provide numerical solutions to a multiple-target case. We compare the results of the models with and without consideration of the investment "warm up" effects, and find that the defender would suffer higher expected damage, and either underestimate the attacker effort or waste defense investment if the defender falsely believes that no investment "warm up" effects exist. We illustrate the model results with real data, and compare the results of the models with and without consideration of the correlation between the "warm up" threshold and the investment effectiveness. Interestingly, we find that the defender is suggested to give up defending all the targets when the attack or the defense "warm up" thresholds are sufficiently high. This article provides new insights and suggestions on policy implications for homeland security resource allocation. © 2015 Society for Risk Analysis.

Arsenate tolerance mechanism of Oenothera odorata from a mine population involves the induction of phytochelatins in roots.

PubMed

Kim, Dae-Yeon; Park, Hyun; Lee, Sang-Hwan; Koo, Namin; Kim, Jeong-Gyu

2009-04-01

We investigated the arsenate tolerance mechanisms of Oenothera odorata by comparing two populations [i.e., one population from the mine site (MP) and the other population from an uncontaminated site (UP)] via the exposure of hydroponic solution containing arsenate (i.e., 0-50 microM). The MP plants were significantly more tolerant to arsenate than UP plants. The UP plants accumulated more As in their shoots and roots than did the MP plants. The UP plants translocated up to 21 microg g(-1) of As into shoots, whereas MP plants translocated less As (up to 4.5 microg g(-1)) to shoots over all treatments. The results of lipid peroxidation indicated that MP plants were less damaged by oxidative stress than were UP plants. Phytochelatin (PC) content correlated linearly with root As concentration in the MP (i.e., [PCs](root)=1.69x[As](root), r(2)=0.945) and UP (i.e., [PCs](root)=0.89x[As](root), r(2)=0.979) plants. This relationship means that increased PC to As ratio may be associated with increased tolerance. Our results suggest that PC induction in roots plays a critical role in As tolerance of O. odorata.

Re-examining the role of interscholastic sport participation in education.

PubMed

Yin, Zenong; Moore, Justin B

2004-06-01

The purpose of the present study was to examine the relationships of interscholastic sports participation with locus of control, self-concept, cognitive test scores, and school dropout in adolescents via a secondary analysis of National Educational Longitudinal Study 1988 (NELS:88). Subjects were 1,883 students who completed all measurements in 8th grade (1988), at Follow-up 1 (10th, 1990), and Follow-up 2 (12th, 1992). Scales utilized to measure locus of control, self-concept, and cognitive ability were developed by the National Center for Educational Statistics. Dropout was assessed through school records and contact with participants. At baseline and Follow-up 1, students self-reporting sport participation displayed higher self-concept and locus of control; however, these differences were no longer observed at Follow-up 2. Drop-out rate for boys at Follow-up 2 was significantly lower for students reporting interscholastic sport participation at baseline or at Follow-up 1. Similarly, drop-out rate for girls at Follow-up 2 was significantly lower for students reporting interscholastic sport participation at baseline or at Follow-up 1. These findings support the presumed positive role of sport participation for adolescents in American schools.

T cell cytokine responses to stimulation with Ureaplasma parvum in pregnancy.

PubMed

Friedland, Yael D; Lee-Pullen, Tracey F; Nathan, Elizabeth A; Watts, Rory; Keelan, Jeffrey A; Payne, Matthew S; Ireland, Demelza J

2016-08-01

Ureaplasma spp. are a common vaginal microorganism causally linked to inflammation-driven preterm birth (PTB). The nature of the immune response to Ureaplasma spp. may influence PTB risk. This study sought to define maternal T cell cytokine responses to in vitro stimulation with Ureaplasma parvum serovar 3 (UpSV3) in vaginally colonised (UP+) and non-colonised (UP-) pregnant women. Whole blood flow cytometry demonstrated an increase (p=0.027) in the baseline frequency of IFNγ-positive CD3(+)CD4(-)(CD8(+)) T cells in UP+ women. UpSV3 stimulation resulted in a significant and specific increase (p=0.001) in the frequency of IFNγ-positive CD3(+)CD4(-)(CD8(+)) T cells, regardless of vaginal colonisation status. UpSV3 stimulation also increased the frequency of IFNγ-positive CD3(+)CD4(+) T cells, particularly in the UP+ group (p=0.003). This is the first published study to examine T cell responses to Ureaplasma spp. Future appropriately-powered studies are needed to assess whether insufficient priming or a loss of tolerance to Ureaplasma spp. is occurring in UP+ women at risk of PTB. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The Relationship Between Perceived Hookup Attitudes and Negative Hookup Consequences: Do Perceived Attitudes of Close Friends Matter?

PubMed

Montes, Kevin S; Blanco, Lyzette; LaBrie, Joseph W

2017-01-01

Research suggests that the perceived hookup attitudes of close referents are generally a poor predictor of hookup behavior and likely a poor direct predictor of negative hookup consequences. The current study aimed to examine three intervening variables as mediators of the relationship between the perceived hookup attitudes of college students' close friends and negative hookup consequences (e.g., regret, embarrassment). Self-report data were collected from 589 heavy-drinking college students from three midsized universities. The results indicated that students' own attitudes toward hooking up, motivation to hook up, and self-reported number of hookup partners significantly mediated the relationship between the perceived hookup attitudes of close friends and negative hookup consequences. The perceived hookup attitudes of close friends were positively associated with participants' attitudes toward hooking up. Participants' attitudes toward hooking up were positively associated with social-sexual motivation to hook up. Elevated social-sexual motivation to hook up was positively associated with hooking up with multiple partners, with hooking up with multiple partners positively associated with negative hookup consequences. A better understanding of the predictors and mediators of negative hookup consequences has the potential to inform prevention and intervention efforts.

Fully non-inductive plasma start-up with lower-hybrid waves using the outboard-launch and top-launch antennas on the TST-2 spherical tokamak

NASA Astrophysics Data System (ADS)

Tsujii, Naoto; Takase, Yuichi; Ejiri, Akira; Shinya, Takahiro; Yajima, Satoru; Yamazaki, Hibiki; Togashi, Hiro; Moeller, Charles P.; Roidl, Benedikt; Takahashi, Wataru; Toida, Kazuya; Yoshida, Yusuke

2017-10-01

Removal of the central solenoid is essential to realize an economical spherical tokamak fusion reactor, but non-inductive plasma start-up is a challenge. On the TST-2 spherical tokamak, non-inductive plasma start-up using lower-hybrid (LH) waves has been investigated. Using the capacitively-coupled combline (CCC) antenna installed at the outboard midplane, fully non-inductive plasma current ramp-up up to a quarter of that of the typical Ohmic discharges has been achieved. Although it was desirable to keep the density low during the plasma current ramp-up to avoid the LH density limit, it was recognized that there was a maximum current density that could be carried by a given electron density. Since the density needed to increase as the plasma current was ramped-up, the achievable plasma current was limited by the maximum operational toroidal field of TST-2. The top-launch CCC antenna was installed to access higher density with up-shift of the parallel index of refraction. Numerical analysis of LH current drive with the outboard-launch and top-launch antennas was performed and the results were qualitatively consistent with the experimental observations.

Warm-up with weighted bat and adjustment of upper limb muscle activity in bat swinging under movement correction conditions.

PubMed

Ohta, Yoichi; Ishii, Yasumitsu; Ikudome, Sachi; Nakamoto, Hiroki

2014-02-01

The effects of weighted bat warm-up on adjustment of upper limb muscle activity were investigated during baseball bat swinging under dynamic conditions that require a spatial and temporal adjustment of the swinging to hit a moving target. Seven male college baseball players participated in this study. Using a batting simulator, the task was to swing the standard bat coincident with the arrival timing and position of a moving target after three warm-up swings using a standard or weighted bat. There was no significant effect of weighted bat warm-up on muscle activity before impact associated with temporal or spatial movement corrections. However, lower inhibition of the extensor carpi ulnaris muscle activity was observed in a velocity-changed condition in the weighted bat warm-up, as compared to a standard bat warm-up. It is suggested that weighted bat warm-up decreases the adjustment ability associated with inhibition of muscle activation under movement correction conditions.

Barriers to primary care hospital follow-up among older adults in rural or semi-rural communities.

PubMed

Hardman, Bobbi; Newcomb, Patricia

2016-02-01

Failure to follow-up with a primary care provider (PCP) following discharge from an acute care setting is strongly associated with readmission within 90 days among elderly patients. The purpose of this study was to identify barriers to primary care follow-up among older adults in rural communities. This was an explanatory mixed methods study which included scaled survey and interview techniques. Descriptive and inferential statistics were calculated for scaled concepts. Standard content analysis was performed on the qualitative items. Correlation between intention to follow-up with a PCP and actual follow-up was poor (r=0.20). Patients encountered substantial obstacles to the PCP follow-up visit. Obstacles clustered into two groups: 1) healthcare or social system barriers and 2) personal characteristics of patients. Individualized discharge planning that reflects the complexities of post-hospitalization adaptation for elders is most likely to be useful for ensuring PCP follow-up. Copyright © 2015 Elsevier Inc. All rights reserved.

Make-up wells drilling cost in financial model for a geothermal project

NASA Astrophysics Data System (ADS)

Oktaviani Purwaningsih, Fitri; Husnie, Ruly; Afuar, Waldy; Abdurrahman, Gugun

2017-12-01

After commissioning of a power plant, geothermal reservoir will encounter pressure decline, which will affect wells productivity. Therefore, further drilling is carried out to enhance steam production. Make-up wells are production wells drilled inside an already confirmed reservoir to maintain steam production in a certain level. Based on Sanyal (2004), geothermal power cost consists of three components, those are capital cost, O&M cost and make-up drilling cost. The make-up drilling cost component is a major part of power cost which will give big influence in a whole economical value of the project. The objective of this paper it to analyse the make-up wells drilling cost component in financial model of a geothermal power project. The research will calculate make-up wells requirements, drilling costs as a function of time and how they influence the financial model and affect the power cost. The best scenario in determining make-up wells strategy in relation with the project financial model would be the result of this research.

Preventive health care for women in Croatia: ongoing trends from 1995 to 2012.

PubMed

Pavlov, Renata; Babič, Ivana; Trstenjak, Vlatka Hajdinjak; Srček, Igor; Sošić, Zvonko

2014-12-01

The privatization of gynecological services and the introduction of additional reimbursements to capitation fees are ongoing mini reforms in Croatia. In order to evaluate the outcomes of this, study was performed with the main aim of determining trends in preventive activities carried out in public and private gynecological practices from 1995 to 2012. The Croatian Health Service Yearbooks served as the basis for data collection. Data were collected on the number of general check-ups, the number of targeted check-ups, and the number of follow-up check-ups. The results indicate a trend of continuous decline in the number of general and follow-up check-ups, as well as breast examinations and Pap smears, in public gynecological practices even after the introduction of contractual obligations and additional reimbursements and fee-for-service payments. One important note is that many resources were invested in general checks-up interventions, which proved to be ineffective, while fewer resources were invested in the more effective Pap smear interventions.

International Survey on the Management of Wake-Up Stroke.

PubMed

de Castro-Afonso, Luís Henrique; Nakiri, Guilherme Seizem; Pontes-Neto, Octávio Marques; dos Santos, Antônio Carlos; Abud, Daniel Giansante

2016-01-01

Patients who wake up having experienced a stroke while asleep represent around 20% of acute stroke admissions. According to international guidelines for the management of acute stroke, patients presenting with wake-up stroke are not currently eligible to receive revascularization treatments. In this study, we aimed to assess the opinions of stroke experts about the management of patients with wake-up stroke by using an international multicenter electronic survey. This study consisted of 8 questions on wake-up stroke treatment. Two hundred invitations to participate in the survey were sent by e-mail. Fifty-nine participants started the survey, 4 dropped out before completing it, and 55 completed the full questionnaire. We had 55 participants from 22 countries. In this study, most stroke experts recommended a recanalization treatment for wake-up stroke. However, there was considerable disagreement among experts regarding the best brain imaging method and the best recanalization treatment. The results of ongoing randomized trials on wake-up stroke are urgently needed.

Structural and mechanistic insights into phospholipid transfer by Ups1-Mdm35 in mitochondria

NASA Astrophysics Data System (ADS)

Watanabe, Yasunori; Tamura, Yasushi; Kawano, Shin; Endo, Toshiya

2015-08-01

Eukaryotic cells are compartmentalized into membrane-bounded organelles whose functions rely on lipid trafficking to achieve membrane-specific compositions of lipids. Here we focused on the Ups1-Mdm35 system, which mediates phosphatidic acid (PA) transfer between the outer and inner mitochondrial membranes, and determined the X-ray structures of Mdm35 and Ups1-Mdm35 with and without PA. The Ups1-Mdm35 complex constitutes a single domain that has a deep pocket and flexible Ω-loop lid. Structure-based mutational analyses revealed that a basic residue at the pocket bottom and the Ω-loop lid are important for PA extraction from the membrane following Ups1 binding. Ups1 binding to the membrane is enhanced by the dissociation of Mdm35. We also show that basic residues around the pocket entrance are important for Ups1 binding to the membrane and PA extraction. These results provide a structural basis for understanding the mechanism of PA transfer between mitochondrial membranes.

Up-conversion luminescence of Er3+ ions in lead-free germanate glasses under 800 nm and 980 nm cw diode laser excitation

NASA Astrophysics Data System (ADS)

Janek, J.; Lisiecki, R.; Ryba-Romanowski, W.; Pisarska, J.; Pisarski, W. A.

2017-12-01

Up-conversion luminescence spectra of Er3+ ions in multicomponent oxyfluoride glasses GeO2 - BaO - BaF2 - Ga2O3 - Er2O3 were examined. It was found that the up-conversion luminescence spectra of Er3+ are dependent on pumping wavelengths. The spectra recorded upon the excitation at 800 nm contained an intense green up-conversion luminescence corresponding to the 2H11/2,4S3/2 → 4I15/2 transitions and a very weak red luminescence related to the 4F9/2 - 4I15/2 transition. In spectra recorded upon 980 nm excitation the contribution of the red luminescence was markedly higher. The interaction mechanisms involved in up-conversion processes are proposed and observed dependence of intensity of up-converted luminescence on excitation power is discussed. The experimental results suggest that Er3+ singly doped lead-free oxyfluoride germanate glass is useful for up-conversion luminescence applications.

Augmented reality for the surgeon: Systematic review.

PubMed

Yoon, Jang W; Chen, Robert E; Kim, Esther J; Akinduro, Oluwaseun O; Kerezoudis, Panagiotis; Han, Phillip K; Si, Phong; Freeman, William D; Diaz, Roberto J; Komotar, Ricardo J; Pirris, Stephen M; Brown, Benjamin L; Bydon, Mohamad; Wang, Michael Y; Wharen, Robert E; Quinones-Hinojosa, Alfredo

2018-04-30

Since the introduction of wearable head-up displays, there has been much interest in the surgical community adapting this technology into routine surgical practice. We used the keywords augmented reality OR wearable device OR head-up display AND surgery using PubMed, EBSCO, IEEE and SCOPUS databases. After exclusions, 74 published articles that evaluated the utility of wearable head-up displays in surgical settings were included in our review. Across all studies, the most common use of head-up displays was in cases of live streaming from surgical microscopes, navigation, monitoring of vital signs, and display of preoperative images. The most commonly used head-up display was Google Glass. Head-up displays enhanced surgeons' operating experience; common disadvantages include limited battery life, display size and discomfort. Due to ergonomic issues with dual-screen devices, augmented reality devices with the capacity to overlay images onto the surgical field will be key features of next-generation surgical head-up displays. Copyright © 2018 John Wiley & Sons, Ltd.

Extremely low order time-fractional differential equation and application in combustion process

NASA Astrophysics Data System (ADS)

Xu, Qinwu; Xu, Yufeng

2018-11-01

Fractional blow-up model, especially which is of very low order of fractional derivative, plays a significant role in combustion process. The order of time-fractional derivative in diffusion model essentially distinguishes the super-diffusion and sub-diffusion processes when it is relatively high or low accordingly. In this paper, the blow-up phenomenon and condition of its appearance are theoretically proved. The blow-up moment is estimated by using differential inequalities. To numerically study the behavior around blow-up point, a mixed numerical method based on adaptive finite difference on temporal direction and highly effective discontinuous Galerkin method on spatial direction is proposed. The time of blow-up is calculated accurately. In simulation, we analyze the dynamics of fractional blow-up model under different orders of fractional derivative. It is found that the lower the order, the earlier the blow-up comes, by fixing the other parameters in the model. Our results confirm the physical truth that a combustor for explosion cannot be too small.

High Mn austenitic stainless steel

DOEpatents

Yamamoto, Yukinori [Oak Ridge, TN; Santella, Michael L [Knoxville, TN; Brady, Michael P [Oak Ridge, TN; Maziasz, Philip J [Oak Ridge, TN; Liu, Chain-tsuan [Knoxville, TN

2010-07-13

An austenitic stainless steel alloy includes, in weight percent: >4 to 15 Mn; 8 to 15 Ni; 14 to 16 Cr; 2.4 to 3 Al; 0.4 to 1 total of at least one of Nb and Ta; 0.05 to 0.2 C; 0.01 to 0.02 B; no more than 0.3 of combined Ti+V; up to 3 Mo; up to 3 Co; up to 1W; up to 3 Cu; up to 1 Si; up to 0.05 P; up to 1 total of at least one of Y, La, Ce, Hf, and Zr; less than 0.05 N; and base Fe, wherein the weight percent Fe is greater than the weight percent Ni, and wherein the alloy forms an external continuous scale including alumina, nanometer scale sized particles distributed throughout the microstructure, the particles including at least one of NbC and TaC, and a stable essentially single phase FCC austenitic matrix microstructure that is essentially delta-ferrite-free and essentially BCC-phase-free.

Optimization of Passive Voltage Multipliers for Fast Start-up and Multi-voltage Power Supplies in Electromagnetic Energy Harvesting Systems

NASA Astrophysics Data System (ADS)

Yang, G.; Stark, B. H.; Burrow, S. G.; Hollis, S. J.

2014-11-01

This paper demonstrates the use of passive voltage multipliers for rapid start-up of sub-milliwatt electromagnetic energy harvesting systems. The work describes circuit optimization to make as short as possible the transition from completely depleted energy storage to the first powering-up of an actively controlled switched-mode converter. The dependency of the start-up time on component parameters and topologies is derived by simulation and experimentation. The resulting optimized multiplier design reduces the start-up time from several minutes to 1 second. An additional improvement uses the inherent cascade structure of the voltage multiplier to power sub-systems at different voltages. This multi-rail start-up is shown to reduce the circuit losses of the active converter by 72% with respect to the optimized single-rail system. The experimental results provide insight into the multiplier's transient behaviour, including circuit interactions, in a complete harvesting system, and offer important information to optimize voltage multipliers for rapid start-up.

Evidence for oxygen vacancies movement during wake-up in ferroelectric hafnium oxide

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

Starschich, S.; Böttger, U.; Menzel, S.

The wake-up effect which is observed in ferroelectric hafnium oxide is investigated in yttrium doped hafnium oxide prepared by chemical solution deposition. It can be shown that not the amount of cycles but the duration of the applied electrical field is essential for the wake-up. Temperature dependent wake-up cycling in a range of −160 °C to 100 °C reveals a strong temperature activation of the wake-up, which can be attributed to ion rearrangement during cycling. By using asymmetrical electrodes, resistive valence change mechanism switching can be observed coincident with ferroelectric switching. From the given results, it can be concluded that redistribution ofmore » oxygen vacancies is the origin of the wake-up effect.« less

Intense blue up-conversion luminescence in Tm 3+/Yb 3+ codoped oxyfluoride glass-ceramics containing β-PbF 2 nanocrystals

NASA Astrophysics Data System (ADS)

Zhang, Junjie; Duan, Zhongchao; He, Dongbing; Dai, Shixun; Zhang, Liyan; Hu, Lili

2005-12-01

Up-conversion luminescence properties of a Tm 3+/Yb 3+ codoped oxyfluoride glass-ceramics under 980 nm excitation are investigated. Intense blue emission centered at 476 nm, corresponding to 1G 4 → 3H 6 transitions of Tm 3+ was simultaneously observed in the transparent oxyfluoride glass ceramics at room temperature. The intensity of the blue up-conversion luminescence in a 1 mol% YbF 3-containing glass-ceramic was found to be about 40 times stronger than that in the precursor oxyfluoride glass. The reason for the intense Tm 3+ up-conversion luminescence in the oxyfluoride glass-ceramics is discussed. The dependence of up-conversion intensities on excitation power and possible up-conversion mechanism are also evaluated.

Intense blue up-conversion luminescence in Tm3+/Yb3+ codoped oxyfluoride glass-ceramics containing beta-PbF2 nanocrystals.

PubMed

Zhang, Junjie; Duan, Zhongchao; He, Dongbing; Dai, Shixun; Zhang, Liyan; Hu, Lili

2005-12-01

Up-conversion luminescence properties of a Tm3+/Yb3+ codoped oxyfluoride glass-ceramics under 980 nm excitation are investigated. Intense blue emission centered at 476 nm, corresponding to 1G4-->3H6 transitions of Tm3+ was simultaneously observed in the transparent oxyfluoride glass ceramics at room temperature. The intensity of the blue up-conversion luminescence in a 1 mol% YbF3-containing glass-ceramic was found to be about 40 times stronger than that in the precursor oxyfluoride glass. The reason for the intense Tm3+ up-conversion luminescence in the oxyfluoride glass-ceramics is discussed. The dependence of up-conversion intensities on excitation power and possible up-conversion mechanism are also evaluated.

Impact of Pharmacists’ Participation in a Pharmacotherapy Follow-Up Program

PubMed Central

Dualde, Elena; Santonja, Francisco J.; Faus, Maria J.

2012-01-01

Objective. To evaluate the impact of a continuing pharmacy education (CPE) course on Spanish community pharmacists’ participation in a pharmacotherapy follow-up program. Design. Participation in a CPE course offered 4 times over a 4-year period via satellite teleconferencing was monitored and the data analyzed to determine the course’s impact on community pharmacists’ participation in a pharmacotherapy follow-up program. Assessment. Community pharmacists’ participation in the pharmaceutical care CPE course had a slightly positive impact on their participation in the pharmacotherapy follow-up program. In the best profiles, there was a probability of 7.3% that participants would participate in the pharmacotherapy follow-up program. Conclusions. Completion of pharmaceutical care CPE courses did not have a significant impact on pharmacists’ participation in a pharmacotherapy follow-up program. PMID:22438606

Predicting and Preventing Loss to Follow-up of Adult Trauma Patients in Randomized Controlled Trials: An Example from the FLOW Trial.

PubMed

Madden, Kim; Scott, Taryn; McKay, Paula; Petrisor, Brad A; Jeray, Kyle J; Tanner, Stephanie L; Bhandari, Mohit; Sprague, Sheila

2017-07-05

High loss-to-follow-up rates are a risk in even the most rigorously designed randomized controlled trials (RCTs). Consequently, predicting and preventing loss to follow-up are important methodological considerations. We hypothesized that certain baseline characteristics are associated with a greater likelihood of patients being lost to follow-up. Our primary objective was to determine which baseline characteristics are associated with loss to follow-up within 12 months after an open fracture in adult patients participating in the Fluid Lavage of Open Wounds (FLOW) trial. We also present strategies to reduce loss to follow-up in trauma trials. Data for this study were derived from the FLOW trial, a funded trial in which payments to clinical sites were tied to participant retention. We conducted a binary logistic regression analysis with loss to follow-up as the dependent variable to determine participant characteristics associated with a higher risk of loss to follow-up. Complete data were available for 2,381 of 2,447 participants. One hundred and sixty-three participants (6.7%) were lost to follow-up. Participants who received treatment in the U.S. were more likely to be lost to follow-up than those who received treatment in other countries (odds ratio [OR] = 3.56, 95% confidence interval [CI]: 2.46 to 5.17, p < 0.001). Male sex (OR = 1.75, 95% CI: 1.15 to 2.67, p = 0.009), current smoking (OR = 1.82, 95% CI: 1.28 to 2.58, p = 0.001), high-risk alcohol consumption (OR = 1.88, 95% CI: 1.16 to 3.05, p = 0.010), and an age of <30 years (OR = 2.16, 95% CI: 1.19 to 3.95, p = 0.012) all significantly increased the odds of a patient being lost to follow-up. Conversely, participants who had sustained polytrauma (OR = 0.52, 95% CI: 0.37 to 0.73, p < 0.001) or had a Gustilo-Anderson type-IIIA, B, or C fracture (OR = 0.60, 95% CI: 0.38 to 0.94, p = 0.024) had lower odds of being lost to follow-up. Using a number of strategies, we were able to reduce the loss-to-follow-up rate to <7%. Males, current smokers, young participants, participants who consumed a high-risk amount of alcohol, and participants in the U.S. were more likely to be lost to follow-up even after these strategies had been employed; therefore, additional strategies should be developed to target these high-risk participants. This study highlights an important need to develop additional strategies to minimize loss to follow-up, including targeted participant-retention strategies. Male sex, an age of <30 years, current smoking, high-risk alcohol consumption, and treatment in a developed country with a predominantly privately funded health-care system increased the likelihood of participants being lost to follow-up. Therefore, strategies should be targeted to these participants. Use of the planning and prevention strategies outlined in the current study can minimize loss to follow-up in orthopaedic trials.

Effect of Radiologists’ Diagnostic Work-up Volume on Interpretive Performance

PubMed Central

Anderson, Melissa L.; Smith, Robert A.; Carney, Patricia A.; Miglioretti, Diana L.; Monsees, Barbara S.; Sickles, Edward A.; Taplin, Stephen H.; Geller, Berta M.; Yankaskas, Bonnie C.; Onega, Tracy L.

2014-01-01

Purpose To examine radiologists’ screening performance in relation to the number of diagnostic work-ups performed after abnormal findings are discovered at screening mammography by the same radiologist or by different radiologists. Materials and Methods In an institutional review board–approved HIPAA-compliant study, the authors linked 651 671 screening mammograms interpreted from 2002 to 2006 by 96 radiologists in the Breast Cancer Surveillance Consortium to cancer registries (standard of reference) to evaluate the performance of screening mammography (sensitivity, false-positive rate [FPRfalse-positive rate], and cancer detection rate [CDRcancer detection rate]). Logistic regression was used to assess the association between the volume of recalled screening mammograms (“own” mammograms, where the radiologist who interpreted the diagnostic image was the same radiologist who had interpreted the screening image, and “any” mammograms, where the radiologist who interpreted the diagnostic image may or may not have been the radiologist who interpreted the screening image) and screening performance and whether the association between total annual volume and performance differed according to the volume of diagnostic work-up. Results Annually, 38% of radiologists performed the diagnostic work-up for 25 or fewer of their own recalled screening mammograms, 24% performed the work-up for 0–50, and 39% performed the work-up for more than 50. For the work-up of recalled screening mammograms from any radiologist, 24% of radiologists performed the work-up for 0–50 mammograms, 32% performed the work-up for 51–125, and 44% performed the work-up for more than 125. With increasing numbers of radiologist work-ups for their own recalled mammograms, the sensitivity (P = .039), FPRfalse-positive rate (P = .004), and CDRcancer detection rate (P < .001) of screening mammography increased, yielding a stepped increase in women recalled per cancer detected from 17.4 for 25 or fewer mammograms to 24.6 for more than 50 mammograms. Increases in work-ups for any radiologist yielded significant increases in FPRfalse-positive rate (P = .011) and CDRcancer detection rate (P = .001) and a nonsignificant increase in sensitivity (P = .15). Radiologists with a lower annual volume of any work-ups had consistently lower FPRfalse-positive rate, sensitivity, and CDRcancer detection rate at all annual interpretive volumes. Conclusion These findings support the hypothesis that radiologists may improve their screening performance by performing the diagnostic work-up for their own recalled screening mammograms and directly receiving feedback afforded by means of the outcomes associated with their initial decision to recall. Arranging for radiologists to work up a minimum number of their own recalled cases could improve screening performance but would need systems to facilitate this workflow. © RSNA, 2014 Online supplemental material is available for this article. PMID:24960110

Effect of radiologists' diagnostic work-up volume on interpretive performance.

PubMed

Buist, Diana S M; Anderson, Melissa L; Smith, Robert A; Carney, Patricia A; Miglioretti, Diana L; Monsees, Barbara S; Sickles, Edward A; Taplin, Stephen H; Geller, Berta M; Yankaskas, Bonnie C; Onega, Tracy L

2014-11-01

To examine radiologists' screening performance in relation to the number of diagnostic work-ups performed after abnormal findings are discovered at screening mammography by the same radiologist or by different radiologists. In an institutional review board-approved HIPAA-compliant study, the authors linked 651 671 screening mammograms interpreted from 2002 to 2006 by 96 radiologists in the Breast Cancer Surveillance Consortium to cancer registries (standard of reference) to evaluate the performance of screening mammography (sensitivity, false-positive rate [ FPR false-positive rate ], and cancer detection rate [ CDR cancer detection rate ]). Logistic regression was used to assess the association between the volume of recalled screening mammograms ("own" mammograms, where the radiologist who interpreted the diagnostic image was the same radiologist who had interpreted the screening image, and "any" mammograms, where the radiologist who interpreted the diagnostic image may or may not have been the radiologist who interpreted the screening image) and screening performance and whether the association between total annual volume and performance differed according to the volume of diagnostic work-up. Annually, 38% of radiologists performed the diagnostic work-up for 25 or fewer of their own recalled screening mammograms, 24% performed the work-up for 0-50, and 39% performed the work-up for more than 50. For the work-up of recalled screening mammograms from any radiologist, 24% of radiologists performed the work-up for 0-50 mammograms, 32% performed the work-up for 51-125, and 44% performed the work-up for more than 125. With increasing numbers of radiologist work-ups for their own recalled mammograms, the sensitivity (P = .039), FPR false-positive rate (P = .004), and CDR cancer detection rate (P < .001) of screening mammography increased, yielding a stepped increase in women recalled per cancer detected from 17.4 for 25 or fewer mammograms to 24.6 for more than 50 mammograms. Increases in work-ups for any radiologist yielded significant increases in FPR false-positive rate (P = .011) and CDR cancer detection rate (P = .001) and a nonsignificant increase in sensitivity (P = .15). Radiologists with a lower annual volume of any work-ups had consistently lower FPR false-positive rate , sensitivity, and CDR cancer detection rate at all annual interpretive volumes. These findings support the hypothesis that radiologists may improve their screening performance by performing the diagnostic work-up for their own recalled screening mammograms and directly receiving feedback afforded by means of the outcomes associated with their initial decision to recall. Arranging for radiologists to work up a minimum number of their own recalled cases could improve screening performance but would need systems to facilitate this workflow.

A Prospective Cohort Study of Outpatient Interdisciplinary Rehabilitation of Chronic Headache Patients.

PubMed

Krause, Steven J; Stillman, Mark J; Tepper, Deborah E; Zajac, Deborah

2017-03-01

To evaluate the efficacy of an intensive outpatient program designed to improve functioning and reduce psychological impairment in chronic headache patients. Chronic headaches, occurring 15 or more days per month, for three or more months, may arise from multiple International Classification of Headache Disorders diagnoses: Chronic Migraine, Chronic Tension Type Headache, New Daily Persistent Headache, Chronic Post Traumatic Headaches, and Medication Overuse Headache. Several interdisciplinary programs that treat patients with chronic headaches have reported decreases in headache frequency. This study sought to evaluate the effect of a 3 week interdisciplinary treatment program for patients with chronic headache disorders on headache severity, functional status, and psychological impairment. Subjects were 379 patients admitted to an outpatient chronic headache treatment program. Assessments of headache severity, psychological status, and functional impairment were completed by 371 (97.8%) of these at the time of admission. At discharge, 340 subjects (89.7%) provided assessment data, and 152 (40.1%) provided data at 1-year follow-up. Subjects' mean ratings on a 0-10 scale for their headache pain in the prior week declined, and these improvements were maintained at follow-up. (Estimated marginal means on a 0-10 scale for Average pain: admission 6.1, discharge 3.5, follow-up 3.3; for Least pain: admission 3.2; discharge 1.5; follow-up 1.3; for Worst pain: admission 8.2; discharge 6.4; follow-up 5.7), and similar results were found for current pain (admission 4.7; discharge 2.8; follow-up 2.4): Measures of functional impairment also improved following treatment, and these gains were maintained at 12 month follow up (Estimated marginal mean Headache Impact Test-6 score: admission 66.1, discharge 55.4, follow-up 51.9; Estimated marginal mean Pain Disability Index score: admission 36.2, discharge 14.1, follow-up 11.6). As measured by the Depression, Anxiety and Stress Scale, anxiety and reactivity to stress decreased following treatment, and remained improved at follow-up (Estimated marginal mean score for Anxiety: admission 8.7, discharge 5.2, follow-up 4.4; Estimated marginal mean score for stress: admission 14.9, discharge 7.2, follow-up 7.6). Depression decreased with treatment, but while 1-year follow-up depression scores remained significantly lower than at admission, they were also significantly higher than at discharge (Estimated marginal means: admission 13.3, discharge 4.1, follow-up 6.6). The study supports the efficacy of the treatment model. Limitations of the study and suggestions for future research are also discussed. © 2017 American Headache Society.

Blood glucose lowering activity of aloe based composition, UP780, in alloxan induced insulin dependent mouse diabetes model

PubMed Central

2014-01-01

Background There are a few nutritional approaches to address the increased needs of managing diabetic conditions. Previously it has been reported that UP780, a standardized composition of aloe chromone formulated with an aloe polysaccharide, has a significant impact in reducing HbA1C, fasting blood glucose, fructosamine and plasma insulin level in humans and improved impaired glucose and insulin resistance in high-fat diet-induced and db/db non-insulin dependent diabetic mouse models. Here we describe activity of UP780 and its constituents to improve insulin sensitivity in alloxan induced insulin dependent diabetic mouse model. Materials and method Insulin dependent diabetes was induced by administering a single intraperitoneal injection of alloxan monohydrate at a dose of 150 mg/kg to CD-1 mice. Aloesin (UP394) was formulated with an Aloe vera inner leaf gel powder polysaccharide (Qmatrix) to yield a composition designated UP780. Efficacy of oral administration of UP780 at 2000 mg/kg and its constituents (aloesin at 80 mg/kg and Qmatrix at 1920 mg/kg) were evaluated in this model. Glyburide, a sulfonylurea drug used in the treatment of type 2 diabetes, was used at 5 mg/kg as a positive control. Effect of UP780 on non-diabetic normal mice was also addressed. Results Mice administered intraperitoneal alloxan monohydrate developed progressive type-1 diabetes like symptom. After 4 weeks of daily oral administration, reductions of 35.9%, 17.2% and 11.6% in fasting blood glucose levels were observed for UP780, the UP780 Aloe vera inner leaf gel polysaccharide preparation without chromone (Qmatrix), and Aloesin (UP394), treated animals respectively, compared to vehicle treated animals. UP780 has no impact on blood glucose level of non-diabetic healthy mice. UP780 showed statistically significant improvement for blood glucose clearance in oral glucose tolerance tests. Similarly, enhanced improvement in plasma insulin level and statistically significant reduction in triglyceride level was also observed for animals treated with the composition. Conclusion These findings suggest that UP780, a chromone standardized Aloe based composition, could possibly be used as a natural supplement alternative to facilitate maintenance of healthy blood glucose levels. PMID:24891878

Mortality and morbidity in necrotizing pancreatitis managed on principles of step-up approach: 7 years experience from a single surgical unit.

PubMed

Aparna, Deshpande; Kumar, Sunil; Kamalkumar, Shukla

2017-10-27

To determine percentage of patients of necrotizing pancreatitis (NP) requiring intervention and the types of interventions performed. Outcomes of patients of step up necrosectomy to those of direct necrosectomy were compared. Operative mortality, overall mortality, morbidity and overall length of stay were determined. After institutional ethics committee clearance and waiver of consent, records of patients of pancreatitis were reviewed. After excluding patients as per criteria, epidemiologic and clinical data of patients of NP was noted. Treatment protocol was reviewed. Data of patients in whom step-up approach was used was compared to those in whom it was not used. A total of 41 interventions were required in 39% patients. About 60% interventions targeted the pancreatic necrosis while the rest were required to deal with the complications of the necrosis. Image guided percutaneous catheter drainage was done in 9 patients for infected necrosis all of whom required further necrosectomy and in 3 patients with sterile necrosis. Direct retroperitoneal or anterior necrosectomy was performed in 15 patients. The average time to first intervention was 19.6 d in the non step-up group (range 11-36) vs 18.22 d in the Step-up group (range 13-25). The average hospital stay in non step-up group was 33.3 d vs 38 d in step up group. The mortality in the step-up group was 0% (0/9) vs 13% (2/15) in the non step up group. Overall mortality was 10.3% while post-operative mortality was 8.3%. Average hospital stay was 22.25 d. Early conservative management plays an important role in management of NP. In patients who require intervention, the approach used and the timing of intervention should be based upon the clinical condition and local expertise available. Delaying intervention and use of minimal invasive means when intervention is necessary is desirable. The step-up approach should be used whenever possible. Even when the classical retroperitoneal catheter drainage is not feasible, there should be an attempt to follow principles of step-up technique to buy time. The outcome of patients in the step-up group compared to the non step-up group is comparable in our series. Interventions for bowel diversion, bypass and hemorrhage control should be done at the appropriate times.

77 FR 66190 - Submission for Review: It's Time To Sign Up for Direct Deposit or Direct Express, RI 38-128

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-02

... OFFICE OF PERSONNEL MANAGEMENT Submission for Review: It's Time To Sign Up for Direct Deposit or... request (ICR) 3206-0226, It's Time To Sign up for Direct Deposit or Direct Express. As required by the..., Retirement Services, Office of Personnel Management. Title: It's Time To Sign Up for Direct Deposit or Direct...

Analysis of Turbulent Boundary-Layer over Rough Surfaces with Application to Projectile Aerodynamics

DTIC Science & Technology

1988-12-01

12 V. APPLICATION IN COMPONENT BUILD-UP METHODOLOGIES ....................... 12 1. COMPONENT BUILD-UP IN DRAG...dimensional roughness. II. CLASSIFICATION OF PREDICTION METHODS Prediction methods can be classified into two main approache-: 1) Correlation methodologies ...data are availaNe. V. APPLICATION IN COMPONENT BUILD-UP METHODOLOGIES 1. COMPONENT BUILD-UP IN DRAG The new correlation can be used for an engine.ring

49 CFR 40.309 - What are the employer's responsibilities with respect to the SAP's directions for follow-up tests?

Code of Federal Regulations, 2010 CFR

2010-10-01

... respect to the SAP's directions for follow-up tests? 40.309 Section 40.309 Transportation Office of the... responsibilities with respect to the SAP's directions for follow-up tests? (a) As the employer, you must carry out the SAP's follow-up testing requirements. You may not allow the employee to continue to perform safety...

Where Are They Now? Assessing if Persons Returned to HIV Care Following Loss to Follow-Up by Public Health Case Workers Were Engaged in Care in Follow-Up Years.

PubMed

Udeagu, Chi-Chi N; Shah, Sharmila; Misra, Kavita; Sepkowitz, Kent A; Braunstein, Sarah L

2018-05-01

We examined care engagement and viral suppression (VS) over a 1- to 5-year period among persons re-engaged in HIV care using retrospective cohort study and longitudinal follow-up. The population comprised five cohorts of persons re-engaged in care from 2009 to 2013. We used surveillance data [CD4 T cell count or HIV viral load (VL) RNA] to measure four outcomes 1-5 years post-care engagement. Engagement-in-care indicated persons with laboratory reports in each follow-up year. Continuous engagement or sustained engagement, respectively, included persons with ≥1 or ≥2 (separated by 90 days) CD4 or VL reports in each follow-up year. VS indicated persons living with HIV (PLWH) re-engaged in care with VL ≤200 copies/mL in any follow-up year, and we measured re-engaged PLWH who subsequently became out of care (OOC) in each follow-up year. Overall, 84-86% PLWH were engaged in care in any follow-up year. The proportions of PLWH cohorts continuously engaged in care [86% (1 year), 77% (2 years), 72% (3 years), 67% (4 years), and 63% (5 years)] declined over time. Thirty-four percent of the PLWH who were re-engaged in care were subsequently OOC in the follow-up years. Most re-engaged PLWH became OOC in their first (40%) and second (30%) follow-up years. In follow-up years (1-5 years), fewer PLWH continuously engaged in care with ≥1 CD4 or VL reports in the registry had VS ≤200 copies/mL: 65%, 58%, 49%, 44%, and 42%, respectively. Encouragingly, higher proportions had VL ≤1500 copies/mL in follow-up years (1-5): (75%, 72%, 73%, 75%, and 70%), likely reflecting levels of HIV treatment. Our results support the use of surveillance data to identify and re-engage OOC PLWH in care. However, structures and programs are needed to support retention in care and reduce repeat OOC.

Common Cause Case Study: An Estimated Probability of Four Solid Rocket Booster Hold-down Post Stud Hang-ups

NASA Technical Reports Server (NTRS)

Cross, Robert

2005-01-01

Until Solid Rocket Motor ignition, the Space Shuttle is mated to the Mobil Launch Platform in part via eight (8) Solid Rocket Booster (SRB) hold-down bolts. The bolts are fractured using redundant pyrotechnics, and are designed to drop through a hold-down post on the Mobile Launch Platform before the Space Shuttle begins movement. The Space Shuttle program has experienced numerous failures where a bolt has "hung-up." That is, it did not clear the hold-down post before liftoff and was caught by the SRBs. This places an additional structural load on the vehicle that was not included in the original certification requirements. The Space Shuttle is currently being certified to withstand the loads induced by up to three (3) of eight (8) SRB hold-down post studs experiencing a "hang-up." The results af loads analyses performed for four (4) stud-hang ups indicate that the internal vehicle loads exceed current structural certification limits at several locations. To determine the risk to the vehicle from four (4) stud hang-ups, the likelihood of the scenario occurring must first be evaluated. Prior to the analysis discussed in this paper, the likelihood of occurrence had been estimated assuming that the stud hang-ups were completely independent events. That is, it was assumed that no common causes or factors existed between the individual stud hang-up events. A review of the data associated with the hang-up events, showed that a common factor (timing skew) was present. This paper summarizes a revised likelihood evaluation performed for the four (4) stud hang-ups case considering that there are common factors associated with the stud hang-ups. The results show that explicitly (i.e. not using standard common cause methodologies such as beta factor or Multiple Greek Letter modeling) taking into account the common factor of timing skew results in an increase in the estimated likelihood of four (4) stud hang-ups of an order of magnitude over the independent failure case.

Common Cause Case Study: An Estimated Probability of Four Solid Rocket Booster Hold-Down Post Stud Hang-ups

NASA Technical Reports Server (NTRS)

Cross, Robert

2005-01-01

Until Solid Rocket Motor ignition, the Space Shuttle is mated to the Mobil Launch Platform in part via eight (8) Solid Rocket Booster (SRB) hold-down bolts. The bolts are fractured using redundant pyrotechnics, and are designed to drop through a hold-down post on the Mobile Launch Platform before the Space Shuttle begins movement. The Space Shuttle program has experienced numerous failures where a bolt has hung up. That is, it did not clear the hold-down post before liftoff and was caught by the SRBs. This places an additional structural load on the vehicle that was not included in the original certification requirements. The Space Shuttle is currently being certified to withstand the loads induced by up to three (3) of eight (8) SRB hold-down experiencing a "hang-up". The results of loads analyses performed for (4) stud hang-ups indicate that the internal vehicle loads exceed current structural certification limits at several locations. To determine the risk to the vehicle from four (4) stud hang-ups, the likelihood of the scenario occurring must first be evaluated. Prior to the analysis discussed in this paper, the likelihood of occurrence had been estimated assuming that the stud hang-ups were completely independent events. That is, it was assumed that no common causes or factors existed between the individual stud hang-up events. A review of the data associated with the hang-up events, showed that a common factor (timing skew) was present. This paper summarizes a revised likelihood evaluation performed for the four (4) stud hang-ups case considering that there are common factors associated with the stud hang-ups. The results show that explicitly (i.e. not using standard common cause methodologies such as beta factor or Multiple Greek Letter modeling) taking into account the common factor of timing skew results in an increase in the estimated likelihood of four (4) stud hang-ups of an order of magnitude over the independent failure case.

Tracking the seasonal cycle of coastal sea ice: Community-based observations and satellite remote sensing in service of societal needs

NASA Astrophysics Data System (ADS)

Eicken, Hajo; Lee, Olivia A.; Johnson, Mark A.; Pulsifer, Peter; Danielsen, Finn

2017-04-01

Break-up and freeze-up of coastal sea ice determine the timing and extent of a number of human activities, ranging from ice use by Indigenous hunters to coastal shipping. Yet, while major reductions in the extent of Arctic summer sea ice have been well studied, changes in its seasonal cycle have received less attention. Here, we discuss decadal scale changes and interannual variability in the timing of spring break-up and fall freeze-up, with a focus on coastal communities in Arctic Alaska. Observations of ice conditions by Indigenous sea-ice experts since 2006 indicate significant interannual variability in both the character and timing of freeze-up and break-up in the region. To aid in the archival and sharing of such observations, we have developed a database for community ice observations (eloka-arctic.org/sizonet). Development of this database addressed key questions ranging from community guidance on different levels of data sharing and access to the development of protocols that may lend themselves for implementation in the context of operational programs such as Global Cryosphere Watch. The lessons learned and tools developed through this effort may help foster the emergence of common observation protocols and sharing practices across the Arctic, as explored jointly with the Greenlandic PISUNA initiative and the European INTAROS project. For the Arctic Alaska region, we developed an algorithm to extract the timing of break-up and freeze-up from passive microwave satellite data, drawing on community-based observations. Data from 1979 to 2013 show break-up start arriving earlier by 5-9 days per decade and freeze-up start arriving later by 7-14 days per decade in the Chukchi and Beaufort Seas. The trends towards a shorter ice season observed over the past several decades point towards a substantial change in the winter ice regime by mid-century with incipient overlap of the end of the freeze-up and start of the break-up season as defined by coastal ice users.

Effect of various warm-up devices on bat velocity of intercollegiate softball players.

PubMed

Szymanski, David J; Bassett, Kylie E; Beiser, Erik J; Till, Megan E; Medlin, Greg L; Beam, Jason R; Derenne, Coop

2012-01-01

Numerous warm-up devices are available for use by softball players while they are in the on-deck circle. It is difficult to know which warm-up device produces the greatest bat velocity (BV) in the batter's box for softball players because on-deck studies with these individuals are sparse. Because the majority of warm-up device research has been conducted with baseball players, the primary purpose of this study was to examine the effect of various warm-up devices on the BV of female intercollegiate softball players and compare the results with those of male baseball players. A secondary purpose was to evaluate 2 new commercially available resistance devices as warm-up aids. Nineteen Division I intercollegiate softball players (age = 19.8 ± 1.2 years, height = 167.0 ± 4.7 cm, body mass = 69.2 ± 8.6 kg, lean body mass = 49.6 ± 3.6 kg, % body fat = 27.9 ± 5.9) participated in a warm-up with 1 of 8 resistance devices on separate days. Each of the 8 testing sessions had players perform a standardized dynamic warm-up, 3 maximal dry swings mimicking their normal game swing with the assigned warm-up device, 2 comfortable dry swings with a standard 83.8-cm, 652-g (33-in., 23-oz) softball bat followed by 3 maximal game swings (20-second rest between swings) while hitting a softball off a batting tee with the same standard softball bat. Results indicated that there were no statistically significant differences in BV after using any of the 8 warm-up devices (510.3-2,721.5 g or 18-96 oz) similar to in previous baseball research. This indicates that the results for both male and female intercollegiate players are similar and that intercollegiate softball players can use any of the 8 warm-up devices in the on-deck circle and have similar BVs. However, similar to in other previous baseball research, it is not recommended that female intercollegiate softball players warm up with the popular commercial donut ring in the on-deck circle because it produced the slowest BV.

Pathways for scaling up public health interventions.

PubMed

Indig, Devon; Lee, Karen; Grunseit, Anne; Milat, Andrew; Bauman, Adrian

2017-08-01

To achieve population-wide health improvement, public health interventions found effective in selected samples need to be 'scaled up' and implemented more widely. The pathways through which interventions are scaled up are not well characterised. The aim of this paper is to identify examples of public health interventions which have been scaled up and to develop a conceptual framework which quantifies and describes this process. A multi-stage international literature search was undertaken to identify examples of public health interventions in high income countries that have been scaled up or implemented at scale. Initial abstract review identified articles which met all the criteria of being a: 1) public health intervention; 2) chronic disease prevention focus; 3) program delivered at a wide geographical scale (state, national or international). Interventions were reviewed and coded into a conceptual framework pathway to document their scaling up process. For each program, an in-depth review of the identified articles was undertaken along with a broad internet based search to determine the outcomes of the dissemination process. A conceptual framework of scaling up pathways was developed that involved four stages (development, efficacy testing, real world trial and dissemination) to which the 40 programs were mapped. The search identified 40 public health interventions that showed evidence of being scaled up. Four pathways were identified to capture the different scaling up trajectories taken which included: 'Type I - Comprehensive' (55%) which passed through all four stages, 'Type II - Efficacy omitters' (5%) which did not conduct efficacy testing, 'Type III - Trial omitters' (25%) which did not conduct a real world trial, and 'Type IV - At scale dissemination' (15%) which skipped both efficacy testing and a real world trial. This is the first study to classify and quantify the potential pathways through which public health interventions in high income countries are scaled up to reach the broader population. Mapping these pathways not only demonstrates the different trajectories that occur in scaling up public health interventions, but also allows the variation across scaling up pathways to be classified. The policy and practice determinants leading to each pathway remain for future study, especially to identify the conditions under which efficacy and replication stages are missing.

Characterization of nicotine binding to the rat brain P/sub 2/ preparation: the identification of multiple binding sites which include specific up-regulatory site(s)

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

Sloan, J.W.

1984-01-01

These studies show that nicotine binds to the rat brain P/sub 2/ preparation by saturable and reversible processes. Multiple binding sites were revealed by the configuration of saturation, kinetic and Scatchard plots. A least squares best fit of Scatchard data using nonlinear curve fitting programs confirmed the presence of a very high affinity site, an up-regulatory site, a high affinity site and one or two low affinity sites. Stereospecificity was demonstrated for the up-regulatory site where (+)-nicotine was more effective and for the high affinity site where (-)-nicotine had a higher affinity. Drugs which selectively up-regulate nicotine binding site(s) havemore » been identified. Further, separate very high and high affinity sites were identified for (-)- and (+)-(/sup 3/H)nicotine, based on evidence that the site density for the (-)-isomer is 10 times greater than that for the (+)-isomer at these sites. Enhanced nicotine binding has been shown to be a statistically significant phenomenon which appears to be a consequence of drugs binding to specific site(s) which up-regulate binding at other site(s). Although Scatchard and Hill plots indicate positive cooperatively, up-regulation more adequately describes the function of these site(s). A separate up-regulatory site is suggested by the following: (1) Drugs vary markedly in their ability to up-regulate binding. (2) Both the affinity and the degree of up-regulation can be altered by structural changes in ligands. (3) Drugs with specificity for up-regulation have been identified. (4) Some drugs enhance binding in a dose-related manner. (5) Competition studies employing cold (-)- and (+)-nicotine against (-)- and (+)-(/sup 3/H)nicotine show that the isomers bind to separate sites which up-regulate binding at the (-)- and (+)-nicotine high affinity sites and in this regard (+)-nicotine is more specific and efficacious than (-)-nicotine.« less

Electromyographic analysis of traditional and nontraditional abdominal exercises: implications for rehabilitation and training.

PubMed

Escamilla, Rafael F; Babb, Eric; DeWitt, Ryan; Jew, Patrick; Kelleher, Patrick; Burnham, Toni; Busch, Juliann; D'Anna, Kristen; Mowbray, Ryan; Imamura, Rodney T

2006-05-01

Performing nontraditional abdominal exercises with devices such as abdominal straps, the Power Wheel, and the Ab Revolutionizer has been suggested as a way to activate abdominal and extraneous (nonabdominal) musculature as effectively as more traditional abdominal exercises, such as the crunch and bent-knee sit-up. The purpose of this study was to test the effectiveness of traditional and nontraditional abdominal exercises in activating abdominal and extraneous musculature. Twenty-one men and women who were healthy and between 23 and 43 years of age were recruited for this study. Surface electromyography (EMG) was used to assess muscle activity from the upper and lower rectus abdominis, external and internal oblique, rectus femoris, latissimus dorsi, and lumbar paraspinal muscles while each exercise was performed. The EMG data were normalized to maximum voluntary muscle contractions. Differences in muscle activity were assessed by a 1-way, repeated-measures analysis of variance. Upper and lower rectus abdominis, internal oblique, and latissimus dorsi muscle EMG activity were highest for the Power Wheel (pike, knee-up, and roll-out), hanging knee-up with straps, and reverse crunch inclined 30 degrees. External oblique muscle EMG activity was highest for the Power Wheel (pike, knee-up, and roll-out) and hanging knee-up with straps. Rectus femoris muscle EMG activity was highest for the Power Wheel (pike and knee-up), reverse crunch inclined 30 degrees, and bent-knee sit-up. Lumbar paraspinal muscle EMG activity was low and similar among exercises. The Power Wheel (pike, knee-up, and roll-out), hanging knee-up with straps, and reverse crunch inclined 30 degrees not only were the most effective exercises in activating abdominal musculature but also were the most effective in activating extraneous musculature. The relatively high rectus femoris muscle activity obtained with the Power Wheel (pike and knee-up), reverse crunch inclined 30 degrees, and bent-knee sit-up may be problematic for some people with low back problems.

Current Warm-Up Practices and Contemporary Issues Faced by Elite Swimming Coaches.

PubMed

McGowan, Courtney J; Pyne, David B; Raglin, John S; Thompson, Kevin G; Rattray, Ben

2016-12-01

McGowan, CJ, Pyne, DB, Raglin, JS, Thompson, KG, and Rattray, B. Current warm-up practices and contemporary issues faced by elite swimming coaches. J Strength Cond Res 30(12): 3471-3480, 2016-A better understanding of current swimming warm-up strategies is needed to improve their effectiveness. The purpose of this study was to describe current precompetition warm-up practices and identify contemporary issues faced by elite swimming coaches during competition. Forty-six state-international level swimming coaches provided information through a questionnaire on their prescription of volume, intensity, and recovery within their pool and dryland-based competition warm-ups, and challenges faced during the final stages of event preparation. Coaches identified four key objectives of the precompetition warm-up: physiological (elevate body temperature and increase muscle activation), kinesthetic (tactile preparation, increase "feel" of the water), tactical (race-pace rehearsal), and mental (improve focus, reduce anxiety). Pool warm-up volume ranged from ∼1300 to 2100 m, beginning with 400-1000 m of continuous, low-intensity (∼50-70% of perceived maximal exertion) swimming, followed by 200-600 m of stroke drills and 1-2 sets (100-400 m in length) of increasing intensity (∼60-90%) swimming, concluding with 3-4 race or near race-pace efforts (25-100 m; ∼90-100%) and 100-400 m easy swimming. Dryland-based warm-up exercises, involving stretch cords and skipping, were also commonly prescribed. Coaches preferred swimmers complete their warm-up 20-30 minutes before race start. Lengthy marshalling periods (15-20+ minutes) and the time required to don racing suits (>10 minutes) were identified as complicating issues. Coaches believed that the pool warm-up affords athletes the opportunity to gain a tactile feel for the water and surrounding pool environment. The combination of dryland-based activation exercises followed by pool-based warm-up routines seems to be the preferred approach taken by elite swimming coaches preparing their athletes for competition.

Utilisation of preventative health check-ups in the UK: findings from individual-level repeated cross-sectional data from 1992 to 2008

PubMed Central

Labeit, Alexander; Peinemann, Frank; Baker, Richard

2013-01-01

Objectives To analyse and compare the determinants of screening uptake for different National Health Service (NHS) health check-ups in the UK. Design Individual-level analysis of repeated cross-sectional surveys with balanced panel data. Setting The UK. Participants Individuals taking part in the British Household Panel Survey (BHPS), 1992–2008. Outcome measure Uptake of NHS health check-ups for cervical cancer screening, breast cancer screening, blood pressure checks, cholesterol tests, dental screening and eyesight tests. Methods Dynamic panel data models (random effects panel probit with initial conditions). Results Having had a health check-up 1 year before, and previously in accordance with the recommended schedule, was associated with higher uptake of health check-ups. Individuals who visited a general practitioner (GP) had a significantly higher uptake in 5 of the 6 health check-ups. Uptake was highest in the recommended age group for breast and cervical cancer screening. For all health check-ups, age had a non-linear relationship. Lower self-rated health status was associated with increased uptake of blood pressure checks and cholesterol tests; smoking was associated with decreased uptake of 4 health check-ups. The effects of socioeconomic variables differed for the different health check-ups. Ethnicity did not have a significant influence on any health check-up. Permanent household income had an influence only on eyesight tests and dental screening. Conclusions Common determinants for having health check-ups are age, screening history and a GP visit. Policy interventions to increase uptake should consider the central role of the GP in promoting screening examinations and in preserving a high level of uptake. Possible economic barriers to access for prevention exist for dental screening and eyesight tests, and could be a target for policy intervention. Trial registration This observational study was not registered. PMID:24366576

Impact factors on expansion of built-up areas in Zhejiang Province, China

NASA Astrophysics Data System (ADS)

Liu, Dong; Zhu, Qiankun; Li, Yan; Gong, Fang

2017-10-01

Built-up areas are the results of human activities. Not only are they the real reflection of human and society activities, but also one of the most important input parameters for the simulation of biogeochemical cycle. Therefore, it is very necessary to map the distribution of built-up areas and monitor their changes by using new technologies and methods at high spatiotemporal resolution. By combining technologies of GIS (Geographic Information System) and RS (Remote Sensing), this study mainly explored the expansion and driving factors of built-up areas at the beginning of the 21st century in Zhejiang Province, China. Firstly, it introduced the mapping processes of LULC (Land Use and Land Cover) based on the method which combined object-oriented method and binary decision tree. Then, it analyzed the expansion features of built-up areas in Zhejiang from 2000 to 2005 and 2005 to 2010. In addition to these, potential driving factors on the expansion of built-up areas were also explored, which contained physical geographical factors, railways, highways, rivers, urban centers, elevation, and slop. Results revealed that the expansions of built-up areas in Zhejiang from 2000 to 2005 and from 2005 to 2010 were very obvious and they showed high levels of variation in spatial heterogeneity. Except those, increased built-up areas with distance to railways, highways, rivers, and urban centers could be fitted with power function (y = a*xb ), with minimum R2 of 0.9507 for urban centers from 2000 to 2005; the increased permillages of built-up areas to mean elevation and mean slop could be fitted with exponential functions (y = a*ebx), with minimum R2 of 0.6657 for mean slop from 2005 to 2010. Besides, government policy could also impact expansion of built-up areas. In a nutshell, a series of conclusions were obtained through this study about the spatial features and driving factors of evolution of built-up areas in Zhejiang from 2000 to 2010.

The Effect of Variation of Plyometric Push-Ups on Force-Application Kinetics and Perception of Intensity.

PubMed

Dhahbi, Wissem; Chaouachi, Anis; Dhahbi, Anis Ben; Cochrane, Jodie; Chèze, Laurence; Burnett, Angus; Chamari, Karim

2017-02-01

To examine differences between ground-reaction-force (GRF)-based parameters collected from 5 types of plyometric push-ups. Between-trials reliability and the relationships between parameters were also assessed. Thirty-seven highly active commando soldiers performed 3 trials of 5 variations of the plyometric push-up in a counterbalanced order: standard countermovement push-up (SCPu), standard squat push-up (SSPu), kneeling countermovement push-up (KCPu), kneeling squat push-up (KSPu), and drop-fall push-up (DFPu). Vertical GRF was measured during these exercises using a portable Kistler force plate. The GRF applied by the hands in the starting position (initial force supported), peak GRF and rate of force development during takeoff, flight time, impact force, and rate of force development impact on landing were determined. During standard-position exercises (SCPu and SSPu) the initial force supported and impact force were higher (P < .001) than with kneeling exercises (KCPu, KSPu, and DFPu). The peak GRF and rate of force development during takeoff were higher (P < .001) in the countermovement push-up exercises ([CMP] SCPu, KCPu, and DFPu) than squat push-up exercises ([SP] SSPu and KSPu). Furthermore, the flight time was greater (P < .001) during kneeling exercises than during standard-position exercises. A significant relationship (P < .01) between impact force and the rate of force development impact was observed for CMP and SP exercises (r = .83 and r = .62, respectively). The initial force supported was also negatively related (P < .01) to the flight time for both CMP and SP (r = -.74 and r = -.80, respectively). It was revealed that the initial force supported and the peak GRF during takeoff had excellent reliability; however, other parameters had poor absolute reliability. It is possible to adjust the intensity of plyometric push-up exercises and train athletes' muscle power by correctly interpreting GRF-based parameters. However, caution is required as some parameters had marginal absolute reliability.

Imaging Follow-up of Low-Risk Incidental Pancreas and Kidney Findings: Effects of Patient Age and Comorbidity on Projected Life Expectancy.

PubMed

Raphel, Tiana J; Weaver, Davis T; Berland, Lincoln L; Herts, Brian R; Megibow, Alec J; Knudsen, Amy B; Pandharipande, Pari V

2018-05-01

Purpose To determine the effects of patient age and comorbidity level on life expectancy (LE) benefits associated with imaging follow-up of Bosniak IIF renal cysts and pancreatic side-branch (SB) intraductal papillary mucinous neoplasms (IPMNs). Materials and Methods A decision-analytic Markov model to evaluate LE benefits was developed. Hypothetical cohorts with varied age (60-80 years) and comorbidities (none, mild, moderate, or severe) were evaluated. For each finding, LE projections from two strategies were compared: imaging follow-up and no imaging follow-up. Under follow-up, it was assumed that cancers associated with the incidental finding were successfully treated before they spread. For patients without follow-up, mortality risks from Bosniak IIF cysts (renal cell carcinoma) and SBIPMNs (pancreatic ductal adenocarcinoma) were incorporated. Model assumptions and parameter uncertainty were evaluated in sensitivity analysis. Results In the youngest, healthiest cohorts (age, 60 years; no comorbidities), projected LE benefits from follow-up were as follows: Bosniak IIF cyst, 6.5 months (women) and 5.8 months (men); SBIPMN, 6.4 months (women) and 5.3 months (men). Follow-up of Bosniak IIF cysts in 60-year-old women with severe comorbidities yielded a LE benefit of 3.9 months; in 80-year-old women with no comorbidities, the benefit was 2.8 months, and with severe comorbidities the benefit was 1.5 months. Similar trends were observed in men and for SBIPMN. Results were sensitive to the performance of follow-up for cancer detection; malignancy risks; and stage at presentation of malignant, unfollowed Bosniak IIF cysts. Conclusion With progression of age and comorbidity level, follow-up of low-risk incidental findings yields increasingly limited benefits for patients. © RSNA, 2018 Online supplemental material is available for this article.

[Built-up land change and its impact on ecological quality in a fast-growing economic zone: Jinjiang County, Fujian Province, China].

PubMed

Shi, Ting Ting; Xu, Han Qiu; Tang, Fei

2017-04-18

Since China's reform and opening-up, the rapid growth of China's economy has greatly accelerated the expansion of built-up land, which has affected regional ecological environment to a great extent. Taking Jinjiang County of Fujian Province, one of the fastest economic-developing counties in the coastal areas of southeastern China, as a case study area, this paper focused on analyzing the rapid built-up land expansion process of the county and its impact on county's ecological quality using remote sensing techniques. Based on two Landsat images of 1996 and 2015 of Jinjiang, the built-up land of the county was extracted using the index-based built-up index (IBI) and its change was analyzed. In the meantime, the ecological status of Jinjiang was evaluated with a recently-proposed remote sensing based ecological index (RSEI) and the relationship between the built-up land dynamics and the ecological status changes of the county was quantitatively examined. The results showed that during the period from 1996 to 2015, the area of built-up land of Jinjiang had a net increase of 68.54 km 2 , a growth of 45%, and the expansion intensity was 0.55. The expansion of the built-up lands has caused overall degradation of the county's ecological quality. The mean value of RSEI of the county had declined from 0.532 in 1996 to 0.460 in 2015, a drop of13.5%. The area proportion of high ecological-quality grades also significantly fell from 39% in 1996 to 21% in 2015. The built-up land expansion intensity was negatively correlated with the ecological quality change.

Using Combination of Planar and Height Features for Detecting Built-Up Areas from High-Resolution Stereo Imagery

NASA Astrophysics Data System (ADS)

Peng, F.; Cai, X.; Tan, W.

2017-09-01

Within-class spectral variation and between-class spectral confusion in remotely sensed imagery degrades the performance of built-up area detection when using planar texture, shape, and spectral features. Terrain slope and building height are often used to optimize the results, but extracted from auxiliary data (e.g. LIDAR data, DSM). Moreover, the auxiliary data must be acquired around the same time as image acquisition. Otherwise, built-up area detection accuracy is affected. Stereo imagery incorporates both planar and height information unlike single remotely sensed images. Stereo imagery acquired by many satellites (e.g. Worldview-4, Pleiades-HR, ALOS-PRISM, and ZY-3) can be used as data source of identifying built-up areas. A new method of identifying high-accuracy built-up areas from stereo imagery is achieved by using a combination of planar and height features. The digital surface model (DSM) and digital orthophoto map (DOM) are first generated from stereo images. Then, height values of above-ground objects (e.g. buildings) are calculated from the DSM, and used to obtain raw built-up areas. Other raw built-up areas are obtained from the DOM using Pantex and Gabor, respectively. Final high-accuracy built-up area results are achieved from these raw built-up areas using the decision level fusion. Experimental results show that accurate built-up areas can be achieved from stereo imagery. The height information used in the proposed method is derived from stereo imagery itself, with no need to require auxiliary height data (e.g. LIDAR data). The proposed method is suitable for spaceborne and airborne stereo pairs and triplets.

Early growth patterns are associated with intelligence quotient scores in children born small-for-gestational age.

PubMed

Varella, Marcia H; Moss, William J

2015-08-01

To assess whether patterns of growth trajectory during infancy are associated with intelligence quotient (IQ) scores at 4 years of age in children born small-for-gestational age (SGA). Children in the Collaborative Perinatal Project born SGA were eligible for analysis. The primary outcome was the Stanford-Binet IQ score at 4 years of age. Growth patterns were defined based on changes in weight-for-age z-scores from birth to 4 months and 4 to 12 months of age and consisted of steady, early catch-up, late catch-up, constant catch-up, early catch-down, late catch-down, constant catch-down, early catch-up & late catch-down, and early catch-down & late catch-up. Multivariate linear regression was used to assess associations between patterns of growth and IQ. We evaluated patterns of growth and IQ in 5640 children. Compared with children with steady growth, IQ scores were 2.9 [standard deviation (SD)=0.54], 1.5 (SD=0.63), and 2.2 (SD=0.9) higher in children with early catch-up, early catch-up and later catch-down, and constant catch-up growth patterns, respectively, and 4.4 (SD=1.4) and 3.9 (SD=1.5) lower in children with early catch-down & late catch-up, and early catch-down growth patterns, respectively. Patterns in weight gain before 4 months of age were associated with differences in IQ scores at 4 years of age, with children with early catch-up having slightly higher IQ scores than children with steady growth and children with early catch-down having slightly lower IQ scores. These findings have implications for early infant nutrition in children born SGA. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Obesity, Gynecological Factors, and Abnormal Mammography Follow-Up in Minority and Medically Underserved Women

PubMed Central

Wujcik, Debra; Lin, Jin-Mann S.; Grau, Ana; Wilson, Veronica; Champion, Victoria; Zheng, Wei; Egan, Kathleen M.

2009-01-01

Abstract Background The relationship between obesity and screening mammography adherence has been examined previously, yet few studies have investigated obesity as a potential mediator of timely follow-up of abnormal (Breast Imaging Reporting and Data System [BIRADS-0]) mammography results in minority and medically underserved patients. Methods We conducted a retrospective cohort study of 35 women who did not return for follow-up >6 months from index abnormal mammography and 41 who returned for follow-up ≤6 months in Nashville, Tennessee. Patients with a BIRADS-0 mammography event in 2003–2004 were identified by chart review. Breast cancer risk factors were collected by telephone interview. Multivariate logistic regression was performed on selected factors with return for diagnostic follow-up. Results Obesity and gynecological history were significant predictors of abnormal mammography resolution. A significantly higher frequency of obese women delayed return for mammography resolution compared with nonobese women (64.7% vs. 35.3%). A greater number of hysterectomized women returned for diagnostic follow-up compared with their counterparts without a hysterectomy (77.8% vs. 22.2%). Obese patients were more likely to delay follow-up >6 months (adjusted OR 4.09, p = 0.02). Conversely, hysterectomized women were significantly more likely to return for timely mammography follow-up ≤6 months (adjusted OR 7.95, p = 0.007). Conclusions Study results suggest that weight status and gynecological history influence patients' decisions to participate in mammography follow-up studies. Strategies are necessary to reduce weight-related barriers to mammography follow-up in the healthcare system including provider training related to mammography screening of obese women. PMID:19558307

University Start-ups: A Better Business Model

NASA Astrophysics Data System (ADS)

Dehn, J.; Webley, P. W.

2015-12-01

Many universities look to start-up companies as a way to attract faculty, supporting research and students as traditional federal sources become harder to come by. University affiliated start-up companies can apply for a broader suite of grants, as well as market their services to a broad customer base. Often university administrators see this as a potential panacea, but national statistics show this is not the case. Rarely do universities profit significantly from their start-ups. With a success rates of around 20%, most start-ups end up costing the university money as well as faculty-time. For the faculty, assuming they want to continue in academia, a start-up is often unattractive because it commonly leads out of academia. Running a successful business as well as maintaining a strong teaching and research load is almost impossible to do at the same time. Most business models and business professionals work outside of academia, and the models taught in business schools do not merge well in a university environment. To mitigate this a new business model is proposed where university start-ups are aligned with the academic and research missions of the university. A university start-up must work within the university, directly support research and students, and the work done maintaining the business be recognized as part of the faculty member's university obligations. This requires a complex conflict of interest management plan and for the companies to be non-profit in order to not jeopardize the university's status. This approach may not work well for all universities, but would be ideal for many to conserve resources and ensure a harmonious relationship with their start-ups and faculty.

A Facebook Follow-Up Strategy for Rural Drug-Using Women.

PubMed

Dickson, Megan F; Staton-Tindall, Michele; Smith, Kirsten E; Leukefeld, Carl; Webster, J Matthew; Oser, Carrie B

2017-06-01

Facebook (FB) use has grown exponentially over the past decade, including in rural areas. Despite its popularity, FB has been underutilized as a research follow-up approach to maintain contact with research participants and may have advantages in less densely populated areas and among more hard-to-reach, at-risk groups. The overall goal of this study was to examine FB as a supplemental follow-up approach to other follow-up strategies with rural drug-using women. Face-to-face interviews were conducted with randomly selected women who completed baseline interviews in 3 rural jails in 1 state. Analyses focus on participants who were released from jail and were eligible for 3-month follow-up (n = 284). Bivariate analyses were used to examine differences between FB users and nonusers, and multivariate logistic regression models examined predictors of 3-month follow-up participation and being located for follow-up using FB. About two-thirds (64.4%) of participants were regular FB users. Bivariate analyses indicated that FB users were younger, more educated, and more likely to have used alcohol in the 30 days before incarceration but less likely to have a chronic health problem. Regression analyses indicated that rural FB users had more than 5 times the odds of being located for the 3-month follow-up interview, even after controlling for other variables. There were no significant predictors of being followed up using FB. Findings suggest that FB is widely used and well accepted among rural drug-using women. Among hard-to-reach populations, including those in rural, geographically isolated regions, FB serves as a method to improve participant follow-up. © 2016 National Rural Health Association.

Economic analysis of measles elimination program in the Republic of Korea, 2001: a cost benefit analysis study.

PubMed

Bae, Geun-Ryang; Choe, Young June; Go, Un Yeong; Kim, Yong-Ik; Lee, Jong-Koo

2013-05-31

In this study, we modeled the cost benefit analysis for three different measles vaccination strategies based upon three different measles-containing vaccines in Korea, 2001. We employed an economic analysis model using vaccination coverage data and population-based measles surveillance data, along with available estimates of the costs for the different strategies. In addition, we have included analysis on benefit of reduction of complication by mumps and rubella. We evaluated four different strategies: strategy 1, keep-up program with a second dose measles-mumps-rubella (MMR) vaccine at 4-6 years without catch-up campaign; strategy 2, additional catch-up campaign with measles (M) vaccine; strategy 3, catch-up campaign with measles-rubella (MR) vaccine; and strategy 4, catch-up campaign with MMR vaccine. The cost of vaccination included cost for vaccines, vaccination practices and other administrative expenses. The direct benefit of estimated using data from National Health Insurance Company, a government-operated system that reimburses all medical costs spent on designated illness in Korea. With the routine one-dose MMR vaccination program, we estimated a baseline of 178,560 measles cases over the 20 years; when the catch-up campaign with M, MR or MMR vaccines was conducted, we estimated the measles cases would decrease to 5936 cases. Among all strategies, the two-dose MMR keep-up program with MR catch-up campaign showed the highest benefit-cost ratio of 1.27 with a net benefit of 51.6 billion KRW. Across different vaccination strategies, our finding suggest that MR catch-up campaign in conjunction with two-dose MMR keep-up program was the most appropriate option in terms of economic costs and public health effects associated with measles elimination strategy in Korea. Copyright © 2013 Elsevier Ltd. All rights reserved.

Outcomes after management of young women with cervical intraepithelial neoplasia 2 with a 6-month observation protocol.

PubMed

Bleecker, Elizabeth; Koehler, Elizabeth; Smith, Jennifer; Budwit, Debra; Rahangdale, Lisa

2014-01-01

Recommendations regarding treatment of cervical intraepithelial neoplasia (CIN) 2 in women have evolved over the years: young women with CIN 2 may be offered observation with Pap smears and colposcopy every 6 months instead of immediate excision or ablation of disease. The purpose of this study was to observe patient follow-up during the initiation of this management protocol for young women with CIN 2. This was a retrospective review of clinical outcomes of women younger than 30 years with CIN 2 on index biopsy and planned follow-up at UNC between July 2009 and August 2010. A chart review for clinical variables, follow-up visits, and progression of disease was conducted. Primary analysis determined the rate of follow-up and pathology at 6 months. Secondary analysis investigated risk factors for incomplete follow-up. Seventy women met inclusion criteria; 46 were managed with observation. Twenty-eight (60.8%; 28/46) women completed a follow-up visit. Demographic and clinical variables did not reach statistical significance in predicting the likelihood of completion of a follow-up visit, although there was a trend toward greater follow-up in employed patients (odds ratio = 5.25, 95% confidence interval = 0.84-34.78). Approximately half (52.4%; 11/21) of women with a completed cervical biopsy demonstrated regression of disease during the study period. On the basis of these data, follow-up in this population was unpredictable based on basic demographic or clinical factors that we often use to judge likelihood of compliance with medical recommendations. The percentage of patients with regression at follow-up was as expected from the natural history of CIN 2.

Post-discharge follow-up visits and hospital utilization by Medicare patients, 2007-2010.

PubMed

DeLia, Derek; Tong, Jian; Gaboda, Dorothy; Casalino, Lawrence P

2014-01-01

Document trends in time to post-discharge follow-up visit for Medicare patients with an index admission for heart failure (HF), acute myocardial infarction (AMI), or community-acquired pneumonia (CAP). Determine factors predicting whether the first post-discharge utilization event is a follow-up visit, treat-and-release emergency department (ED) visit, or readmission. Using Medicare claims data from 2007-2010, we plotted annual cumulative incidence functions for the time frame post-discharge to follow-up visit, accounting for competing risks with censoring at 30 days. We used multinomial probit regression to determine factors predicting the probability of first-occurring post-discharge utilization events within 30 days. For each cohort, the cumulative incidence of follow-up visits increased during the study period. For example, in 2010, 54.6% of HF patients had a follow-up visit within 10 days of discharge compared to 47.9% in 2007. Within each cohort, the largest increase in follow-up visits took place between 2008 and 2009. Follow-up visits were less likely for patients who were Black, Hispanic, and enrolled in Medicaid or Medicare Advantage, and they were more likely for patients with greater comorbidities and prior procedures as well as those with private or supplemental Medicare coverage. There were no changes in 30-day readmission rates. Although increases in follow-up visits may have been influenced by the introduction of publicly reported readmission rates in 2009, these increases did not continue in 2010 and were not associated with a change in readmissions. Patients who were Black, Hispanic, and/or enrolled in Medicaid or Medicare Advantage were less likely to have follow-up visits.

The Acute Effects of Static Stretching Compared to Dynamic Stretching with and without an Active Warm up on Anaerobic Performance

PubMed Central

KENDALL, BRADLEY J.

2017-01-01

The Wingate Anaerobic Test (WAnT) has been used in many studies to determine anaerobic performance. However, there has been poor reporting of warm-up protocols and limited consistency between warm-up methods that have been used. With the WAnT being such a commonly-used test, consistency in warm-up methods is essential in order to compare results across studies. Therefore, this study was designed to compare how static stretching, dynamic stretching, and an active warm-up affect WAnT performance. Ten recreationally active participants (5 males, 5 females) with a mean (SD) age of 23.3 (0.7) volunteered for this study. Subjects were randomized to a specific order of five warm-up protocols, which were performed on individual days followed by a WAnT. Peak power, mean power, power drop, and fatigue index were compared for each trial using a repeated measures ANOVA. For peak power, results revealed that warm-up protocol had a significant effect, F(4,36) = 3.90, p = .01, partial η2 = .302. It was hypothesized that the dynamic stretching would lead to greater peak power than the static stretching protocol. However, results of post hoc analyses failed to detect a significant difference (p =.065). For the other measured variables no significant differences were found. The findings from this study suggest that warm-up protocols may have significantly different impacts on peak power during the WAnT. Additional research should use larger sample sizes and further explore these warm-up protocols. Developing a standardized warm-up protocol for the WAnT may improve consistency between studies. PMID:28479947

Recognition and Binding of Human Telomeric G-Quadruplex DNA by Unfolding Protein 1

PubMed Central

2015-01-01

The specific recognition by proteins of G-quadruplex structures provides evidence of a functional role for in vivo G-quadruplex structures. As previously reported, the ribonucleoprotein, hnRNP Al, and it is proteolytic derivative, unwinding protein 1 (UP1), bind to and destabilize G-quadruplex structures formed by the human telomeric repeat d(TTAGGG)n. UP1 has been proposed to be involved in the recruitment of telomerase to telomeres for chain extension. In this study, a detailed thermodynamic characterization of the binding of UP1 to a human telomeric repeat sequence, the d[AGGG(TTAGGG)3] G-quadruplex, is presented and reveals key insights into the UP1-induced unfolding of the G-quadruplex structure. The UP1–G-quadruplex interactions are shown to be enthalpically driven, exhibiting large negative enthalpy changes for the formation of both the Na+ and K+ G-quadruplex–UP1 complexes (ΔH values of −43 and −19 kcal/mol, respectively). These data reveal three distinct enthalpic contributions from the interactions of UP1 with the Na+ form of G-quadruplex DNA. The initial interaction is characterized by a binding affinity of 8.5 × 108 M–1 (strand), 200 times stronger than the binding of UP1 to a single-stranded DNA with a comparable but non-quadruplex-forming sequence [4.1 × 106 M–1 (strand)]. Circular dichroism spectroscopy reveals the Na+ form of the G-quadruplex to be completely unfolded by UP1 at a binding ratio of 2:1 (UP1:G-quadruplex DNA). The data presented here demonstrate that the favorable energetics of the initial binding event are closely coupled with and drive the unfolding of the G-quadruplex structure. PMID:24831962

Impact of body fat percentage change on future diabetes in subjects with normal glucose tolerance.

PubMed

Zhao, Tianxue; Lin, Ziwei; Zhu, Hui; Wang, Chen; Jia, Weiping

2017-12-01

The aim of the work was to determine the effect of body fat change on risk of diabetes in normal glucose tolerance (NGT) population. A total of 1,857 NGT subjects were included and followed up for an average period of 44.57 months. Body fat percentage (BF%) was measured by bioelectrical impedance analysis. Subjects were grouped based on the BF% and/or body mass index (BMI) state. Among all subjects, 28 developed diabetes after follow-up. Compared with subjects with stable normal BF% (control), subjects who became obesity at follow-up were defects in insulin secretion and had a higher risk of developing diabetes (7.102, 95% confidence intervals [CI] 1.740-28.993), while no difference in diabetic risk could be viewed between subjects with abnormal BF% at baseline but normal at the end of follow-up and control subjects after adjustment of confounding factors. Moreover, compared with those keeping normal BF% and BMI both at baseline and follow-up, subjects who had normal BMI at baseline and follow-up, but abnormal BF% at baseline or/and follow-up still had a higher risk to develop diabetes (4.790, 95% CI 1.061-21.621), while those with normal BF% at baseline and follow-up, but abnormal BMI at baseline or/and follow-up had not. Subjects from normal BF% at baseline to obese at follow-up are associated with an increased risk of diabetes. Maintaining normal body fat is more relevant than BMI in preventing diabetes. © 2017 IUBMB Life, 69(12):947-955, 2017. © 2017 International Union of Biochemistry and Molecular Biology.

Motivators and barriers to uptake of post-operative voluntary medical male circumcision follow-up in Yala division, Siaya County, Kenya

PubMed Central

Abunah, Bonface; Onkoba, Rueben; Nyagero, Josephat; Muhula, Samuel; Omondi, Edward; Guyah, Bernard; Omondi, Gregory Barnabas

2016-01-01

Introduction Follow-up visits are recommended to all voluntary medical male circumcision clients (VMMC), however, adherence is variable. High lost-to-follow-up cases limit knowledge about clinical status of clients and adverse events. This study sought to establish Motivators and Barriers to the Uptake of VMMC post-operative follow-up services in Siaya County, Kenya. Methods 277 clients from five VMMC sites in Yala were recruited immediately post-operation to participate in a telephone interview between the 21st and 31st day post-surgery during which a semi-structured questionnaire was administered. Descriptive and inferential statistics was used to analyse quantitative information using SPSS while responses from open ended questions were grouped into themes, sieved out, coded and analyzed. Results 137(49.5%) of the 277 participants utilized the follow-up services. Health education (31.4%) and emergency reviews/adverse events (24.1%) were the main motivation for returning for follow-up while occupational and other engagements (29.7%) and presumption of healing (24.6%) were the main barriers. Type of facility attended (p=0.0173), satisfaction with the discharge process (p=0.0150) and residency in Yala (p<0.001) were statistically significant to the respondents’ return for follow-up. 85(62.0%) of the participants returned on the 7th day, 9(6.6%) returned after 7 days, and 43(31.4%) returned before 7 days. Conclusion VMMC health education should include and emphasize the benefits of follow-up care to the clients and the providers should address the barriers to accessing follow-up services. Our results will inform the programme on areas identified to improve care for VMMC clients and reduce subsequent lost-to-follow-up cases. PMID:28439331

Motivators and barriers to uptake of post-operative voluntary medical male circumcision follow-up in Yala division, Siaya County, Kenya.

PubMed

Abunah, Bonface; Onkoba, Rueben; Nyagero, Josephat; Muhula, Samuel; Omondi, Edward; Guyah, Bernard; Omondi, Gregory Barnabas

2016-01-01

Follow-up visits are recommended to all voluntary medical male circumcision clients (VMMC), however, adherence is variable. High lost-to-follow-up cases limit knowledge about clinical status of clients and adverse events. This study sought to establish Motivators and Barriers to the Uptake of VMMC post-operative follow-up services in Siaya County, Kenya. 277 clients from five VMMC sites in Yala were recruited immediately post-operation to participate in a telephone interview between the 21st and 31st day post-surgery during which a semi-structured questionnaire was administered. Descriptive and inferential statistics was used to analyse quantitative information using SPSS while responses from open ended questions were grouped into themes, sieved out, coded and analyzed. 137(49.5%) of the 277 participants utilized the follow-up services. Health education (31.4%) and emergency reviews/adverse events (24.1%) were the main motivation for returning for follow-up while occupational and other engagements (29.7%) and presumption of healing (24.6%) were the main barriers. Type of facility attended (p=0.0173), satisfaction with the discharge process (p=0.0150) and residency in Yala (p<0.001) were statistically significant to the respondents' return for follow-up. 85(62.0%) of the participants returned on the 7th day, 9(6.6%) returned after 7 days, and 43(31.4%) returned before 7 days. VMMC health education should include and emphasize the benefits of follow-up care to the clients and the providers should address the barriers to accessing follow-up services. Our results will inform the programme on areas identified to improve care for VMMC clients and reduce subsequent lost-to-follow-up cases.

Scapula kinematics of pull-up techniques: Avoiding impingement risk with training changes.

PubMed

Prinold, Joe A I; Bull, Anthony M J

2016-08-01

Overhead athletic activities and scapula dyskinesia are linked with shoulder pathology; pull-ups are a common training method for some overhead sports. Different pull-up techniques exist: anecdotally some are easier to perform, and others linked to greater incidences of pathology. This study aims to quantify scapular kinematics and external forces for three pull-up techniques, thus discussing potential injury implications. An observational study was performed with eleven participants (age=26.8±2.4 years) who regularly perform pull-ups. The upward motions of three pull-up techniques were analysed: palms facing anterior, palms facing posterior and wide-grip. A skin-fixed scapula tracking technique with attached retro-reflective markers was used. High intra-participant repeatability was observed: mean coefficients of multiple correlations of 0.87-1.00 in humerothoracic rotations and 0.77-0.90 for scapulothoracic rotations. Standard deviations of hand force was low: <5% body weight. Significantly different patterns of humerothoracic, scapulothoracic and glenohumeral kinematics were observed between the pull-up techniques. The reverse technique has extreme glenohumeral internal-external rotation and large deviation from the scapula plane. The wide technique has a reduced range of pro/retraction in the same HT plane of elevation and 90° of arm abduction with 45° external rotation was observed. All these factors suggest increased sub-acromial impingement risk. The scapula tracking technique showed high repeatability. High arm elevation during pull-ups reduces sub-acromial space and increases pressure, increasing the risk of impingement injury. Wide and reverse pull-ups demonstrate kinematics patterns linked with increased impingement risk. Weight-assisted front pull-ups require further investigation and could be recommended for weaker participants. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Up-titration of allopurinol in patients with gout.

PubMed

Jennings, Claudine G; Mackenzie, Isla S; Flynn, Rob; Ford, Ian; Nuki, George; De Caterina, Raffaele; Riches, Philip L; Ralston, Stuart H; MacDonald, Thomas M

2014-08-01

European League against Rheumatism (EULAR) gout management guidelines recommend achieving a target urate level <6.0 mg/dL (<357 µmol/L). Allopurinol is the most widely used urate-lowering therapy; however, many gout patients who are prescribed allopurinol do not have urate levels optimally controlled. The objective of this analysis was to review the efficacy and tolerability of allopurinol up-titration in achieving the EULAR target levels. The Febuxostat versus Allopurinol Streamlined Trial (FAST) is an ongoing multi-centre study comparing the cardiovascular safety of febuxostat and allopurinol (target recruitment: 5706 patients). Recruited patients were already taking allopurinol and the protocol required up-titration of daily allopurinol dose, in 100 mg increments, to achieve the EULAR urate target level prior to randomisation. We reviewed pre-randomisation data from the first 400 recruited and subsequently randomised FAST patients. Of 400 patients, 144 (36%) had urate levels ≥357 µmol/L at screening and required allopurinol up-titration. Higher urate levels were significantly associated with lower allopurinol dose, male sex, increased BMI, increased alcohol intake and diuretic use. Mean fall in urate levels after a single 100-mg dose increase was 71 µmol/L. The number of up-titrations required ranged from one to five (median = 1) with 65% of patients controlled after one 100-mg up-titration. Overall, 97% of up-titrated patients achieved target urate levels with median final allopurinol dose of 300 mg daily. Side effects and complications of up-titration were minimal. Overall, 36% of FAST patients were not at target urate levels and required up-titration. Allopurinol up-titration was effective in achieving urate target levels and was generally well tolerated by patients. Copyright © 2014 Elsevier Inc. All rights reserved.

Protein degradation by ubiquitin–proteasome system in formation and labilization of contextual conditioning memory

PubMed Central

Sol Fustiñana, María; de la Fuente, Verónica; Federman, Noel; Freudenthal, Ramiro

2014-01-01

The ubiquitin–proteasome system (UPS) of protein degradation has been evaluated in different forms of neural plasticity and memory. The role of UPS in such processes is controversial. Several results support the idea that the activation of this system in memory consolidation is necessary to overcome negative constrains for plasticity. In this case, the inhibition of the UPS during consolidation impairs memory. Similar results were reported for memory reconsolidation. However, in other cases, the inhibition of UPS had no effect on memory consolidation and reconsolidation but impedes the amnesic action of protein synthesis inhibition after retrieval. The last finding suggests a specific action of the UPS inhibitor on memory labilization. However, another interpretation is possible in terms of the synthesis/degradation balance of positive and negative elements in neural plasticity, as was found in the case of long-term potentiation. To evaluate these alternative interpretations, other reconsolidation-interfering drugs than translation inhibitors should be tested. Here we analyzed initially the UPS inhibitor effect in contextual conditioning in crabs. We found that UPS inhibition during consolidation impaired long-term memory. In contrast, UPS inhibition did not affect memory reconsolidation after contextual retrieval but, in fact, impeded memory labilization, blocking the action of drugs that does not affect directly the protein synthesis. To extend these finding to vertebrates, we performed similar experiments in contextual fear memory in mice. We found that the UPS inhibitor in hippocampus affected memory consolidation and blocked memory labilization after retrieval. These findings exclude alternative interpretations to the requirement of UPS in memory labilization and give evidence of this mechanism in both vertebrates and invertebrates. PMID:25135196

Parents' Perspectives on Navigating the Work of Speaking Up in the NICU.

PubMed

Lyndon, Audrey; Wisner, Kirsten; Holschuh, Carrie; Fagan, Kelly M; Franck, Linda S

To describe parents' perspectives and likelihood of speaking up about safety concerns in the NICU and identify barriers and facilitators to parents speaking up. Exploratory, qualitatively driven, mixed-methods design. A 50-bed U.S. academic medical center, open-bay NICU. Forty-six parents completed questionnaires, 14 of whom were also interviewed. Questionnaires, interviews, and observations with parents of newborns in the NICU were used. The qualitative investigation was based on constructivist grounded theory. Quantitative measures included ratings and free-text responses about the likelihood of speaking up in response to a hypothetical scenario about lack of clinician hand hygiene. Qualitative and quantitative analyses were integrated in the final interpretation. Most parents (75%) rated themselves likely or very likely to speak up in response to lack of hand hygiene; 25% of parents rated themselves unlikely to speak up in the same situation. Parents engaged in a complex process of Navigating the work of speaking up in the NICU that entailed learning the NICU, being deliberate about decisions to speak up, and at times choosing silence as a safety strategy. Decisions about how and when to speak up were influenced by multiple factors including knowing my baby, knowing the team, having a defined pathway to voice concerns, clinician approachability, clinician availability and friendliness, and clinician responsiveness. To engage parents as full partners in safety, clinicians need to recognize the complex social and personal dimensions of the NICU experience that influence parents' willingness to speak up about their safety concerns. Copyright © 2017 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

Can the theory of planned behavior help explain attendance to follow-up care of childhood cancer survivors?

PubMed

Baenziger, Julia; Roser, Katharina; Mader, Luzius; Christen, Salome; Kuehni, Claudia E; Gumy-Pause, Fabienne; Tinner, Eva Maria; Michel, Gisela

2018-06-01

Childhood cancer survivors are at high risk for late effects. Regular attendance to long-term follow-up care is recommended and helps monitoring survivors' health. Using the theory of planned behavior, we aimed to (1) investigate the predictors of the intention to attend follow-up care, and (2) examine the associations between perceived control and behavioral intention with actual follow-up care attendance in Swiss childhood cancer survivors. We conducted a questionnaire survey in Swiss childhood cancer survivors (diagnosed with cancer aged <16 years between 1990 and 2005; ≥5 years since diagnosis). We assessed theory of planned behavior-related predictors (attitude, subjective norm, perceived control), intention to attend follow-up care, and actual attendance. We applied structural equation modeling to investigate predictors of intention, and logistic regression models to study the association between intention and actual attendance. Of 299 responders (166 [55.5%] females), 145 (48.5%) reported attending follow-up care. We found that subjective norm, ie, survivors' perceived social pressure and support (coef = 0.90, P < 0.001), predicted the intention to attend follow-up; attitude and perceived control did not. Perceived control (OR = 1.58, 95%CI:1.04-2.41) and intention to attend follow-up (OR = 6.43, 95%CI:4.21-9.81) were positively associated with attendance. To increase attendance, an effort should be made to sensitize partners, friends, parents, and health care professionals on their important role in supporting survivors regarding follow-up care. Additionally, interventions promoting personal control over the follow-up attendance might further increase regular attendance. Copyright © 2018 John Wiley & Sons, Ltd.

The long-term effect of 1550 nm erbium:glass fractional laser in acne vulgaris.

PubMed

Liu, Yale; Zeng, Weihui; Hu, Die; Jha, Smita; Ge, Qin; Geng, Songmei; Xiao, Shengxiang; Hu, Guanglei; Wang, Xiaoxiao

2016-04-01

We evaluated the short-term and long-term effects of the 1550 nm erbium:glass (Er:glass) fractional laser in the treatment of facial acne vulgaris. Forty-five (9 male and 36 female) acne patients were treated 4 times at 4-week intervals with the following parameters: 169 spot density and 15-30 mJ/cm(2) fluence. There was no control group. The laser spots were adjustable (maximum overlap: 20%) according to the treatment area, and delivered in rows in order to cover all the face. Clinical photographs were taken. The IGA scores and lesion counts were performed for each treatment. Their current state was obtained by phone call follow-up to determine the long-term effect and photographs were offered by themselves or taken in hospital. After four treatments, all patients had an obvious reduction of lesion counts and IGA score and the peak lesion counts decreased to 67.7% after the initial four treatment sessions. For long-term effect, 8 patients lost follow-up, hence 37 patients were followed-up. 8 patients were 2-year follow up, 27 at the 1-year follow-up, and all patients at the half-year follow-up. The mean percent reduction was 72% at the half-year follow-up, 79 at the 1-year follow-up and 75% at the 2-year follow-up. Side effects and complications were limited to transient erythema and edema, and few patients suffered from transient acne flare-ups and sensitivity. All patients responded that their skin was less prone to oiliness. In conclusion, acne can be successfully treated by 1550 nm Er:glass fractional laser, with few side effects and prolonged acne clearing.

Step-down vs. step-up noxious stimulation: differential effects on pain perception and patterns of brain activation.

PubMed

Choi, J C; Kim, J; Kang, E; Choi, J-H; Park, W Y; Choi, Y-S; Cha, J; Han, C; Park, S K; Kim, M H; Lee, G H; Do, H-J; Jung, S W; Lee, J-M

2016-01-01

We hypothesize that pain and brain responses are affected by changes in the presentation sequence of noxious stimuli that are, overall, identical in intensity and duration. During functional magnetic resonance imaging (fMRI) scanning, 21 participants experienced three patterns of noxious stimulation: Up-type (step-up noxious stimulation, 15 s), Down-type (step-down noxious stimulation, 15 s), and Down-up-type (decreasing and increasing pattern of noxious stimulation, 15 s). The total intensity and duration of the three noxious stimulation patterns were identical, but the stimulation sequences were different. Pain and unpleasantness ratings in the Down- and Down-up-type noxious stimulations were lower than in the Up-type noxious stimulation. The left prefrontal cortex [(PFC, BA (Brodmann area) 10, (-45, 50, 1)] was more highly activated in the Down- and Down-up-type noxious stimulations than in the Up-type noxious stimulation. The S1, S2, insula, bilateral PFC (BA 46), and midcingulate cortex were more highly activated in the Up-type noxious stimulation than in the Down-type noxious stimulation. PFC BA 10 was located at an inferior level compared to the bilateral PFC BA 46 (Z axis = 1 for BA 10, compared to 22 and 25 for the right and left BA 46, respectively). When cortisol level was increased, the left hippocampal cortex, along with the left parahippocampal cortex, was greatly activated for the Up-type noxious stimulation. When pain cannot be avoided in clinical practice, noxious stimuli should be applied to patients in a step-down pattern that delivers the most intense pain first and the least intense pain last. © 2015 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

The acoustic and perceptual differences to the non-singer's singing voice before and after a singing vocal warm-up

NASA Astrophysics Data System (ADS)

DeRosa, Angela

The present study analyzed the acoustic and perceptual differences in non-singer's singing voice before and after a vocal warm-up. Experiments were conducted with 12 females who had no singing experience and considered themselves to be non-singers. Participants were recorded performing 3 tasks: a musical scale stretching to their most comfortable high and low pitches, sustained productions of the vowels /a/ and /i/, and singing performance of the "Star Spangled Banner." Participants were recorded performing these three tasks before a vocal warm-up, after a vocal warm-up, and then again 2-3 weeks later after 2-3 weeks of practice. Acoustical analysis consisted of formant frequency analysis, singer's formant/singing power ratio analysis, maximum phonation frequency range analysis, and an analysis of jitter, noise to harmonic ratio (NHR), relative average perturbation (RAP), and voice turbulence index (VTI). A perceptual analysis was also conducted with 12 listeners rating comparison performances of before vs. after the vocal warm-up, before vs. after the second vocal warm-up, and after both vocal warm-ups. There were no significant findings for the formant frequency analysis of the vowel /a/, but there was significance for the 1st formant frequency analysis of the vowel /i/. Singer's formant analyzed via Singing Power Ratio analysis showed significance only for the vowel /i/. Maximum phonation frequency range analysis showed a significant increase after the vocal warm-ups. There were no significant findings for the acoustic measures of jitter, NHR, RAP, and VTI. Perceptual analysis showed a significant difference after a vocal warm-up. The results indicate that a singing vocal warm-up can have a significant positive influence on the singing voice of non-singers.

Preferred parental method of post-operative tonsillectomy and adenoidectomy follow-up (phone call vs. clinic visit).

PubMed

Anderson, Martin E; Brancazio, Brianna; Mehta, Deepak K; Georg, Matthew; Choi, Sukgi S; Jabbour, Noel

2017-01-01

Tonsillectomy is the second most common procedure performed in the United States. Over 530,000 tonsillectomies are performed on children under 15 years of age in the United States, accounting for 16% of surgeries in this age group, resulting in missed school for patients of school-age and also resulting in missed work for caregivers. This study compared parent preferences for in-clinic follow-up (CFU) to telephone interview follow-up (TFU) after tonsillectomy. One hundred twenty-one parents of children who underwent a tonsillectomy and/or adenoidectomy were recruited to complete a survey about their child's post-operative visit. Statistical analyses were performed using t-test, Wilcoxon rank-sum, and Fischer's exact tests where appropriate. 60.3% of the surveys were completed as a TFU and the remainder were completed as a CFU. There were no statistical differences in the children's age, the time to follow-up, satisfaction with their follow-up, or the frequency of unresolved symptoms. Of parents receiving TFU, 91.8% disagreed they would have preferred a CFU, with 86.3% strongly disagreeing, and only 5.5% expressing that they would have preferred a CFU. Of the parents with CFU, 47.9% expressed a preference for a TFU. For CFU, 43.9% of parents missed work and 58.1% of their school-age children missed school. Our study results indicate that parents receiving phone follow-up strongly preferred this method to an in-clinic follow-up, and that nearly half of all parents receiving in-clinic follow-up would have preferred a telephone follow-up. In select patients, telephone follow-up after tonsillectomy may increase patient satisfaction and decrease days of missed work and school. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Understanding pathways for scaling up health services through the lens of complex adaptive systems.

PubMed

Paina, Ligia; Peters, David H

2012-08-01

Despite increased prominence and funding of global health initiatives, efforts to scale up health services in developing countries are falling short of the expectations of the Millennium Development Goals. Arguing that the dominant assumptions for scaling up are inadequate, we propose that interpreting change in health systems through the lens of complex adaptive systems (CAS) provides better models of pathways for scaling up. Based on an understanding of CAS behaviours, we describe how phenomena such as path dependence, feedback loops, scale-free networks, emergent behaviour and phase transitions can uncover relevant lessons for the design and implementation of health policy and programmes in the context of scaling up health services. The implications include paying more attention to local context, incentives and institutions, as well as anticipating certain types of unintended consequences that can undermine scaling up efforts, and developing and implementing programmes that engage key actors through transparent use of data for ongoing problem-solving and adaptation. We propose that future efforts to scale up should adapt and apply the models and methodologies which have been used in other fields that study CAS, yet are underused in public health. This can help policy makers, planners, implementers and researchers to explore different and innovative approaches for reaching populations in need with effective, equitable and efficient health services. The old assumptions have led to disappointed expectations about how to scale up health services, and offer little insight on how to scale up effective interventions in the future. The alternative perspectives offered by CAS may better reflect the complex and changing nature of health systems, and create new opportunities for understanding and scaling up health services.

The Acute Effects of Static Stretching Compared to Dynamic Stretching with and without an Active Warm up on Anaerobic Performance.

PubMed

Kendall, Bradley J

2017-01-01

The Wingate Anaerobic Test (WAnT) has been used in many studies to determine anaerobic performance. However, there has been poor reporting of warm-up protocols and limited consistency between warm-up methods that have been used. With the WAnT being such a commonly-used test, consistency in warm-up methods is essential in order to compare results across studies. Therefore, this study was designed to compare how static stretching, dynamic stretching, and an active warm-up affect WAnT performance. Ten recreationally active participants (5 males, 5 females) with a mean (SD) age of 23.3 (0.7) volunteered for this study. Subjects were randomized to a specific order of five warm-up protocols, which were performed on individual days followed by a WAnT. Peak power, mean power, power drop, and fatigue index were compared for each trial using a repeated measures ANOVA. For peak power, results revealed that warm-up protocol had a significant effect, F (4,36) = 3.90, p = .01, partial η 2 = .302. It was hypothesized that the dynamic stretching would lead to greater peak power than the static stretching protocol. However, results of post hoc analyses failed to detect a significant difference (p =.065). For the other measured variables no significant differences were found. The findings from this study suggest that warm-up protocols may have significantly different impacts on peak power during the WAnT. Additional research should use larger sample sizes and further explore these warm-up protocols. Developing a standardized warm-up protocol for the WAnT may improve consistency between studies.

Current state of high-risk infant follow-up care in the United States: results of a national survey of academic follow-up programs.

PubMed

Kuppala, V S; Tabangin, M; Haberman, B; Steichen, J; Yolton, K

2012-04-01

High-risk infant follow-up programs have the potential to act as multipurpose clinics by providing continuity of clinical care, education of health care trainees and facilitating outcome data research. Currently there are no nationally representative data on high-risk infant follow-up practices in the United States. The objective of this study is to collect information about the composition of high-risk infant follow-up programs associated with academic centers in the United States, with respect to their structure, function, funding resources and developmental assessment practices, and to identify the barriers to establishment of such programs. Staff neonatologists, follow-up program directors and division directors of 170 Neonatal Intensive Care Units (NICU) associated with pediatric residency programs were invited to participate in an anonymous online survey from October 2009 to January 2010. The overall response rate was 84%. Ninety three percent of the respondents have a follow-up program associated with their NICU. Birth weight, gestational age and critical illness in the NICU were the major criteria for follow-up care. Management of nutrition and neurodevelopmental assessments was the most common service provided. Over 70% have health care trainees in the clinic. About 75% of the respondents have the neurodevelopmental outcome data available. Most of the respondents reported multiple funding sources. Lack of personnel and funding were the most common causes for not having a follow-up program. High-risk infant follow-up programs associated with academic centers in the United States are functioning as multidisciplinary programs providing clinical care, trainee education and facilitating outcomes research.

Loss to follow-up in tuberculosis treatment and its relationship with patients' knowledge of the disease and other associated factors.

PubMed

Belchior, Aylana De S; Mainbourg, Evelyne Marie T; Ferreira-Gonçalves, Maria J

2016-01-01

To identify factors associated with loss to follow-up in Tuberculosis (TB) treatment, including patients' level of knowledge regarding treatment of this disease. 42 loss to follow-up cases and 84 control cases that were finishing the sixth month of their first treatment for tuberculosis were selected for this study. Primary data were gathered through interviews, while secondary data were obtained from the notification form of the disease, between December 2011 and April 2012. Factors associated with loss to follow-up were analyzed by means of a conditional logistic regression multivariate model for matched case-control groups. No significant differences were observed between loss to follow-up cases and controls regarding socioeconomic factors, lifestyle, clinical condition, treatment-related behaviors and the access of patients to sources of information on TB. In the regression multivariate analysis, significant associations with retreatment after loss to follow-up that were detected include: scarce knowledge on tuberculosis, lack of adherence to consultation during the current treatment, noncompliance with follow-up consultation deadline, smoking and HIV negative. When compared to controls, cases undergoing TB retreatment after loss to follow-up have less knowledge on the disease, which is a sign for the professionals responsible for health education of the need to invest more time and efforts in activities that help the patient understand the disease and its treatment, as well as to have higher levels of adherence. In addition, noncompliance with the follow-up consultation deadline, failure to attend consultations during the current treatment and smoking are also factors that may be influenced by poor knowledge on the disease, which leads to the treatment loss to follow-up.

Barriers to Safety Event Reporting in an Academic Radiology Department: Authority Gradients and Other Human Factors.

PubMed

Siewert, Bettina; Swedeen, Suzanne; Brook, Olga R; Eisenberg, Ronald L; Hochman, Mary

2018-05-15

Purpose To investigate barriers to reporting safety concerns in an academic radiology department and to evaluate the role of human factors, including authority gradients, as potential barriers to safety concern reporting. Materials and Methods In this institutional review board-approved, HIPAA-compliant retrospective study, an online questionnaire link was emailed four times to all radiology department staff members (n = 648) at a tertiary care institution. Survey questions included frequency of speaking up about safety concerns, perceived barriers to speaking up, and the annual number of safety concerns that respondents were unsuccessful in reporting. Respondents' sex, role in the department, and length of employment were recorded. Statistical analysis was performed with the Fisher exact test. Results The survey was completed by 363 of the 648 employees (56%). Of those 363 employees, 182 (50%) reported always speaking up about safety concerns, 134 (37%) reported speaking up most of the time, 36 (10%) reported speaking up sometimes, seven (2%) reported rarely speaking up, and four (1%) reported never speaking up. Thus, 50% of employees spoke up about safety concerns less than 100% of the time. The most frequently reported barriers to speaking up included high reporting threshold (69%), reluctance to challenge someone in authority (67%), fear of disrespect (53%), and lack of listening (52%). Conclusion Of employees in a large academic radiology department, 50% do not attain 100% reporting of safety events. The most common human barriers to speaking up are high reporting threshold, reluctance to challenge authority, fear of disrespect, and lack of listening, which suggests that existing authority gradients interfere with full reporting of safety concerns. © RSNA, 2018.

Muscle Activation during Push-Ups with Different Suspension Training Systems.

PubMed

Calatayud, Joaquin; Borreani, Sebastien; Colado, Juan C; Martín, Fernando F; Rogers, Michael E; Behm, David G; Andersen, Lars L

2014-09-01

The purpose of this study was to analyze upper extremity and core muscle activation when performing push-ups with different suspension devices. Young fit male university students (n = 29) performed 3 push-ups each with 4 different suspension systems. Push-up speed was controlled using a metronome and testing order was randomized. Average amplitude of the electromyographic root mean square of Triceps Brachii, Upper Trapezius, Anterior Deltoid, Clavicular Pectoralis, Rectus Abdominis, Rectus Femoris, and Lumbar Erector Spinae was recorded. Electromyographic signals were normalized to the maximum voluntary isometric contraction (MVIC). Electromyographic data were analyzed with repeated-measures analysis of variance with a Bonferroni post hoc. Based upon global arithmetic mean of all muscles analyzed, the suspended push-up with a pulley system provided the greatest activity (37.76% of MVIC; p < 0.001). Individually, the suspended push-up with a pulley system also provided the greatest triceps brachii, upper trapezius, rectus femoris and erector lumbar spinae muscle activation. In contrast, more stable conditions seem more appropriate for pectoralis major and anterior deltoid muscles. Independent of the type of design, all suspension systems were especially effective training tools for reaching high levels of rectus abdominis activation. Key PointsCompared with standard push-ups on the floor, suspended push-ups increase core muscle activation.A one-anchor system with a pulley is the best option to increase TRICEP, TRAPS, LUMB and FEM muscle activity.More stable conditions such as the standard push-up or a parallel band system provide greater increases in DELT and PEC muscle activation.A suspended push-up is an effective method to achieve high muscle activity levels in the ABS.

Muscle Activation during Push-Ups with Different Suspension Training Systems

PubMed Central

Calatayud, Joaquin; Borreani, Sebastien; Colado, Juan C.; Martín, Fernando F; Rogers, Michael E.; Behm, David G.; Andersen, Lars L.

2014-01-01

The purpose of this study was to analyze upper extremity and core muscle activation when performing push-ups with different suspension devices. Young fit male university students (n = 29) performed 3 push-ups each with 4 different suspension systems. Push-up speed was controlled using a metronome and testing order was randomized. Average amplitude of the electromyographic root mean square of Triceps Brachii, Upper Trapezius, Anterior Deltoid, Clavicular Pectoralis, Rectus Abdominis, Rectus Femoris, and Lumbar Erector Spinae was recorded. Electromyographic signals were normalized to the maximum voluntary isometric contraction (MVIC). Electromyographic data were analyzed with repeated-measures analysis of variance with a Bonferroni post hoc. Based upon global arithmetic mean of all muscles analyzed, the suspended push-up with a pulley system provided the greatest activity (37.76% of MVIC; p < 0.001). Individually, the suspended push-up with a pulley system also provided the greatest triceps brachii, upper trapezius, rectus femoris and erector lumbar spinae muscle activation. In contrast, more stable conditions seem more appropriate for pectoralis major and anterior deltoid muscles. Independent of the type of design, all suspension systems were especially effective training tools for reaching high levels of rectus abdominis activation. Key Points Compared with standard push-ups on the floor, suspended push-ups increase core muscle activation. A one-anchor system with a pulley is the best option to increase TRICEP, TRAPS, LUMB and FEM muscle activity. More stable conditions such as the standard push-up or a parallel band system provide greater increases in DELT and PEC muscle activation. A suspended push-up is an effective method to achieve high muscle activity levels in the ABS. PMID:25177174

Myoelectric activation and kinetics of different plyometric push-up exercises.

PubMed

García-Massó, Xavier; Colado, Juan C; González, Luis M; Salvá, Pau; Alves, Joao; Tella, Víctor; Triplett, N Travis

2011-07-01

The kinetic and myoelectric differences between 3 types of plyometric push-ups were investigated. Twenty-seven healthy, physically active men served as subjects and completed both familiarization and testing sessions. During these sessions, subjects performed 2 series of 3 plyometric push-up variations in a counterbalanced order according to the following techniques: Countermovement push-ups (CPUs) were push-ups performed with the maximum speed of movement; jump push-ups (JPUs) were similar to clapping push-ups; and fall push-ups (FPUs) required kneeling subjects to drop and then attempt to return to their initial position. Vertical ground reaction forces were determined by using a force plate. Myoelectric activity was recorded by means of electromyography. Impact force and impact rate of force development were significantly (p < 0.05) higher for FPUs than for JPUs. The maximum rate of force development was higher for CPUs (p < 0.05) than for JPUs, and the maximum force was higher for the CPUs than for the FPUs (p < 0.05). There were differences among exercises for the mean muscle activation of the pectoralis major (PM; p < 0.001), triceps brachii (p < 0.001), external oblique (p < 0.005) and anterior deltoid (p < 0.001), and in the maximum muscle activation of the PM (p < 0.001). Plyometric push-ups with countermovement achieved a higher maximum force and rate of force and did not cause impact forces. Thus, this type of push-up exercise may be regarded as the best for improving explosive force. The FPU exercise achieved higher levels of muscular activation in the agonist and synergist muscle groups, and greater impact forces and impact force development rates.

Is Follow-Up Testing with the FilmArray Gastrointestinal Multiplex PCR Panel Necessary?

PubMed Central

Park, Sholhui; Hitchcock, Matthew M.; Gomez, Carlos A.

2017-01-01

ABSTRACT The FilmArray gastrointestinal (GI) panel (BioFire Diagnostics, Salt Lake City, UT) is a simple, sample-to-answer, on-demand, multiplex, nucleic acid amplification test for syndromic diagnosis of infectious gastroenteritis. The aim of this study was to measure the yield of follow-up testing with FilmArray GI panel within 4 weeks of an initial test. Consecutive adult and pediatric patients tested at an academic institution between August 2015 and June 2016 were included in this study. Of 145 follow-up tests in 106 unique patients with an initial negative result, 134 (92.4%) tests and 98 (92.5%) patients remained negative upon follow-up testing. Excluding targets that are not reported at this institution (Clostridium difficile, enteroaggregative Escherichia coli, enteropathogenic E. coli, and enterotoxigenic E. coli), 137 (94.5%) follow-up tests and 101 (95.3%) patients remained negative. Weekly conversion rates were not significantly different across the 4-week follow-up interval. No epidemiological or clinical factors were significantly associated with a negative to positive conversion. Of 80 follow-up tests in patients with an initial positive result, 43 (53.8%) remained positive for the same target, 34 (42.5%) were negative, and 3 were positive for a different target (3.8%). Follow-up testing with FilmArray GI panel within 4 weeks of a negative result rarely changed the initial result, and the follow-up test reverted to negative less than half the time after an initial positive result. In the absence of clinical or epidemiological evidence for a new infection, follow-up testing should be limited and FilmArray GI panel should not be used as a test of cure. PMID:28122874

Effectiveness of a financial incentive to physicians for timely follow-up after hospital discharge: a population-based time series analysis.

PubMed

Lapointe-Shaw, Lauren; Mamdani, Muhammad; Luo, Jin; Austin, Peter C; Ivers, Noah M; Redelmeier, Donald A; Bell, Chaim M

2017-10-02

Timely follow-up after hospital discharge may decrease readmission to hospital. Financial incentives to improve follow-up have been introduced in the United States and Canada, but it is unknown whether they are effective. Our objective was to evaluate the impact of an incentive program on timely physician follow-up after hospital discharge. We conducted an interventional time series analysis of all medical and surgical patients who were discharged home from hospital between Apr. 1, 2002, and Jan. 30, 2015, in Ontario, Canada. The intervention was a supplemental billing code for physician follow-up within 14 days of discharge from hospital, introduced in 2006. The primary outcome was an outpatient visit within 14 days of discharge. Secondary outcomes were 7-day follow-up and a composite of emergency department visits, nonelective hospital readmission and death within 14 days. We included 8 008 934 patient discharge records. The incentive code was claimed in 31% of eligible visits by 51% of eligible physicians, and cost $17.5 million over the study period. There was no change in the average monthly rate of outcomes in the year before the incentive was introduced compared with the year following introduction: 14-day follow-up (66.5% v. 67.0%, overall p = 0.5), 7-day follow-up (44.9% v. 44.9%, overall p = 0.5) and composite outcome (16.7% v. 16.9%, overall p = 0.2). Despite uptake by physicians, a financial incentive did not alter follow-up after hospital discharge. This lack of effect may be explained by features of the incentive or by extra-physician barriers to follow-up. These barriers should be considered by policymakers before introducing similar initiatives. © 2017 Canadian Medical Association or its licensors.

The Cost of Unintended Pregnancies in Canada: Estimating Direct Cost, Role of Imperfect Adherence, and the Potential Impact of Increased Use of Long-Acting Reversible Contraceptives.

PubMed

Black, Amanda Y; Guilbert, Edith; Hassan, Fareen; Chatziheofilou, Ismini; Lowin, Julia; Jeddi, Mark; Filonenko, Anna; Trussell, James

2015-12-01

Unintended pregnancies (UPs) are associated with a significant cost burden, but the full cost burden in Canada is not known. The objectives of this study were to quantify the direct cost of UPs in Canada, the proportion of cost attributable to UPs and imperfect contraceptive adherence and the potential cost savings with increased uptake of long-acting reversible contraceptives (LARCs). A cost model was constructed to estimate the annual number and direct costs of UP in women aged 18 to 44 years. Adherence-associated UP rates were estimated using perfect- and typical-use contraceptive failure rates. Change in annual number of UPs and impact on cost burden were projected in three scenarios of increased LARC usage. One-way sensitivity analyses were conducted to assess the impact of key variables on scenarios of increased LARC use. There are more than 180 700 UPs annually in Canada. The associated direct cost was over $320 million. Fifty-eight percent (58%) of UPs occurred in women aged 20 to 29 years at an annual cost of $175 million; 82% of this cost ($143 million) was attributable to contraceptive non-adherence. Increased LARC uptake produced cost savings of over $34 million in all three switching scenarios; the largest savings ($35 million) occurred when 10% of oral contraceptive users switched to LARCs. The minimum duration of LARC usage required before cost savings was realized was 12 months. The cost of UPs in Canada is significant and much of it can be attributed to imperfect contraceptive adherence. Increased LARC uptake may reduce contraceptive non-adherence, thereby reducing rates of UP and generating significant cost savings, particularly in women aged 20 to 29.

Heads Up to High School Sports

MedlinePlus

... submit" value="Submit" /> HEADS UP to School Sports Recommend on Facebook Tweet Share Compartir To help ... organizations, developed the HEADS UP: Concussion in School Sports initiative and materials. Specific Concussion Information for... Coaches ...

In-pile testing of ITER first wall mock-ups at relevant thermal loading conditions

NASA Astrophysics Data System (ADS)

Litunovsky, N.; Gervash, A.; Lorenzetto, P.; Mazul, I.; Melder, R.

2009-04-01

The paper describes the experimental technique and preliminary results of thermal fatigue testing of ITER first wall (FW) water-cooled mock-ups inside the core of the RBT-6 experimental fission reactor (RIAR, Dimitrovgrad, Russia). This experiment has provided simultaneous effect of neutron fluence and thermal cycling damages on the mock-ups. A PC-controlled high-temperature graphite ohmic heater was applied to provide cyclic thermal load onto the mock-ups surface. This experiment lasted for 309 effective irradiation days with a final damage level (CuCrZr) of 1 dpa in the mock-ups. About 3700 thermal cycles with a heat flux of 0.4-0.5 MW/m 2 onto the mock-ups were realized before the heater fails. Then, irradiation was continued in a non-cycling mode.

Ubiquitin-Dependent Degradation of Mitochondrial Proteins Regulates Energy Metabolism.

PubMed

Lavie, Julie; De Belvalet, Harmony; Sonon, Sessinou; Ion, Ana Madalina; Dumon, Elodie; Melser, Su; Lacombe, Didier; Dupuy, Jean-William; Lalou, Claude; Bénard, Giovanni

2018-06-05

The ubiquitin proteasome system (UPS) regulates many cellular functions by degrading key proteins. Notably, the role of UPS in regulating mitochondrial metabolic functions is unclear. Here, we show that ubiquitination occurs in different mitochondrial compartments, including the inner mitochondrial membrane, and that turnover of several metabolic proteins is UPS dependent. We specifically detailed mitochondrial ubiquitination and subsequent UPS-dependent degradation of succinate dehydrogenase subunit A (SDHA), which occurred when SDHA was minimally involved in mitochondrial energy metabolism. We demonstrate that SDHA ubiquitination occurs inside the organelle. In addition, we show that the specific inhibition of SDHA degradation by UPS promotes SDHA-dependent oxygen consumption and increases ATP, malate, and citrate levels. These findings suggest that the mitochondrial metabolic machinery is also regulated by the UPS. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Duty to speak up in the health care setting a professionalism and ethics analysis.

PubMed

Topazian, Rachel J; Hook, C Christopher; Mueller, Paul S

2013-11-01

Staff and students working in health care settings are sometimes reluctant to speak up when they perceive patients to be at risk for harm. In this article, we describe four incidents that occurred at our institution (Mayo Clinic). In two of them, health care professionals failed to speak up, which resulted in harm; in the other two, they did speak up, which prevented harm and improved patient care. We analyzed each scenario using the Physician's Charter on Medical Professionalism and prima facie ethics principles to determine whether principles were violated or upheld. We conclude that anyone who works in a health care setting has a duty to speak up when a patient faces harm. We also provide guidance for health care institutions on promoting a culture in which speaking up is encouraged and integrated into routine practice.

Secure Wake-Up Scheme for WBANs

NASA Astrophysics Data System (ADS)

Liu, Jing-Wei; Ameen, Moshaddique Al; Kwak, Kyung-Sup

Network life time and hence device life time is one of the fundamental metrics in wireless body area networks (WBAN). To prolong it, especially those of implanted sensors, each node must conserve its energy as much as possible. While a variety of wake-up/sleep mechanisms have been proposed, the wake-up radio potentially serves as a vehicle to introduce vulnerabilities and attacks to WBAN, eventually resulting in its malfunctions. In this paper, we propose a novel secure wake-up scheme, in which a wake-up authentication code (WAC) is employed to ensure that a BAN Node (BN) is woken up by the correct BAN Network Controller (BNC) rather than unintended users or malicious attackers. The scheme is thus particularly implemented by a two-radio architecture. We show that our scheme provides higher security while consuming less energy than the existing schemes.

Outcome of recommendations for radiographic follow-up of pneumonia on outpatient chest radiography.

PubMed

Little, Brent P; Gilman, Matthew D; Humphrey, Kathryn L; Alkasab, Tarik K; Gibbons, Fiona K; Shepard, Jo-Anne O; Wu, Carol C

2014-01-01

Follow-up chest radiographs are frequently recommended by radiologists to document the clearing of radiographically suspected pneumonia. However, the clinical utility of follow-up radiography is not well understood. The purpose of this study was to examine the incidence of important pulmonary pathology revealed during follow-up imaging of suspected pneumonia on outpatient chest radiography. Reports of 29,138 outpatient chest radiography examinations performed at an academic medical center in 2008 were searched to identify cases in which the radiologist recommended follow-up chest radiography for presumed community-acquired pneumonia (n = 618). Descriptions of index radiographic abnormalities were recorded. Reports of follow-up imaging (radiography and CT) performed during the period from January 2008 to January 2010 were reviewed to assess the outcome of the index abnormality. Clinical history, demographics, microbiology, and pathology reports were reviewed and recorded. Compliance with follow-up imaging recommendations was 76.7%. In nine of 618 cases (1.5%), a newly diagnosed malignancy corresponded to the abnormality on chest radiography initially suspected to be pneumonia. In 23 of 618 cases (3.7%), an alternative nonmalignant disease corresponded with the abnormality on chest radiography initially suspected to be pneumonia. Therefore, in 32 of 618 patients (5.2%), significant new pulmonary diagnoses were established during follow-up imaging of suspected pneumonia. Follow-up imaging of radiographically suspected pneumonia leads to a small number of new diagnoses of malignancy and important nonmalignant diseases, which may alter patient management.

Efficacy of Prophylactic use of Antibiotics to Avoid Flare up During Root Canal Treatment of Nonvital Teeth: A Randomized Clinical Trial

PubMed Central

2015-01-01

Objectives: Flare-up during root canal treatment of non vital teeth is a common clinical incident. The aim of the present study was to assess the effect of prophylactic use of antibiotics to avoid flare up during root canal treatment of the teeth having asymptomatic necrotic pulp. Materials and Methods: A randomized double blind clinical trial with parallel design was conducted on 100 subjects with asymptomatic non vital teeth. They were randomly divided into two groups. The first group (50 participants) was given two gram amoxicillin one hour before the first visit of root canal treatment; the second group (50 participants) did not receive any treatment (control group). In both groups, root canal treatment was performed in two visits. The flare up was assessed by the pain visual analogue scale and based on the swelling criteria. The data were processed and analyzed using SPSS statistical software 17. A p-value of 0.05 or less was considered statistically significant. Results: A total of 80% of participants in the experimental group had flare up while 12% of participants had flare up in the control group. Prophylactic Amoxicillin had no effect on inter-appointment flare up (p > 0.05). There was no relationship between flare up and patient’s age, gender and tooth type (p > 0.05). Conclusion: Prophylactic use of Amoxicillin in asymptomatic non vital teeth before root canal treatment had no effect on the incidence of flare-up. PMID:25954695

A concept analysis of undergraduate nursing students speaking up for patient safety in the patient care environment.

PubMed

Fagan, Anthea; Parker, Vicki; Jackson, Debra

2016-10-01

An analysis of the concept of nursing students speaking up for patient safety in the workplace. 'Speaking up' is assertive communication in clinical situations that requires action through questions or statements of opinion or information with appropriate persistence and is linked to patient safety. Previously, the concept of speaking up has focused on the registered or experienced practitioners, there is minimal discussion relating to student nurses. Analysis of the elements of students speaking up will identify the key elements that will give understanding to their position and experiences. A concept analysis. Literature included publications between 1970-2015 from, MEDLINE, CINHAL, PUBMED and SCOPUS. Search terms included patient safety AND speaking up; AND pre-registration/undergraduate nursing students, patient advocate, error reporting, organizational silence, whistleblowing and clinical placement/practicum. The Walker and Avant concept analysis model was modified and used to examine the literature. Nursing students speaking up behaviour is influenced by individual and contextual factors that differ from those influencing more experienced colleagues. Motivators and barriers to voicing concerns include moral and ethical beliefs, willingness and confidence to speak up in the workplace. Students' subordinate and often vulnerable position creates additional tensions and challenges that impact their decisions and actions. This concept analysis provides a clear definition of 'speaking up' in relation to nursing students. The analysis will facilitate understanding and operationalization of the concept applied to learning and teaching, practice and research. © 2016 John Wiley & Sons Ltd.

Strategy for NEO follow-up observations

NASA Astrophysics Data System (ADS)

Tichy, Milos; Honkova, Michaela; Ticha, Jana; Kocer, Michal

2015-03-01

The Near-Earth Objects (NEOs) belong to the most important small bodies in the solar system, having the capability of close approaches to the Earth and even possibility to collide with the Earth. In fact, it is impossible to calculate reliable orbit of an object from a single night observations. Therefore it is necessary to extend astrometry dataset by early follow-up astrometry. Follow-up observations of the newly discovered NEO candidate should be done over an arc of several hours after the discovery and should be repeated over several following nights. The basic service used for planning of the follow-up observations is the NEO Confirmation Page (NEOCP) maintained by the Minor Planet Center of the IAU. This service provides on-line tool for calculating geocentric and topocentic ephemerides and sky-plane uncertainty maps of these objects at the specific date and time. Uncertainty map is one of the most important information used for planning of follow-up observation strategy for given time, indicating also the estimated distance of the newly discovered object and including possibility of the impact. Moreover, observatories dealing with NEO follow-up regularly have prepared their special tools and systems for follow-up work. The system and strategy for the NEO follow-up observation used at the Klet Observatory are described here. Methods and techniques used at the Klet NEO follow-up CCD astrometric programme, using 1.06-m and 0.57-m telescopes, are also discussed.

Annual Trends in Follow-Up Visits for Pediatric Concussion in Emergency Departments and Physicians' Offices.

PubMed

Fridman, Liraz; Scolnik, Michal; Macpherson, Alison; Rothman, Linda; Guttmann, Astrid; Grool, Anne M; Rodriguez Duque, Daniel; Zemek, Roger L

2018-01-01

To assess whether children and youth with concussion receive follow-up visits in accordance with the recommended guidelines. We conducted a retrospective, population-based study using linked health administrative data from all concussion-related visits to emergency department and physician offices by children aged 5 through 18 years (range, 5.00-18.99) in Ontario between 2003 and 2013. We analyzed the percentage of children and youth seen for follow-up. The Mann-Kendall test for trends was used to assess a monotonic increasing trend over time in concussion follow-up visits. A total of 126 654 children and youth were evaluated for an index concussion visit. The number of children and youth assessed for concussion follow-up (N = 45 155) has increased significantly over time (P < .001). In 2003, 781 of 7126 patients (11.0%; 95% CI, 10.3-11.7) with an index visit for concussion had a follow-up assessment. By 2013, 6526 of 21 681 (30.1%; 95% CI, 29.5-30.7) patients received follow-up care. The proportion of children and youth receiving follow-up after an acute concussion has significantly increased between 2003 and 2013. Nevertheless, more than two-thirds of all patients do not seek medical follow-up or clearance as recommended by current concussion guidelines, suggesting that ongoing efforts to improve and monitor compliance with recommended guidelines by patients and physicians are important. Copyright © 2017 Elsevier Inc. All rights reserved.

Effects of different warm-up modalities on power output during the high pull.

PubMed

Barnes, Matthew John; Petterson, Ashley; Cochrane, Darryl J

2017-05-01

This study compared the effects of six warm-up modalities on peak power output (PPO) during the high-pull exercise. Nine resistance-trained males completed six trials using different warm-ups: high-pull specific (HPS), cycle, whole body vibration (WBV), cycle+HPS, WBV+HPS and a control. Intramuscular temperature (T m ) was increased by 2°C using WBV or cycling. PPO, T m and electromyography (EMG) were recorded during each trial. Two high-pulls were performed prior to and 3 min after participants completed the warm-up. The greatest increase in PPO occurred with HPS (232.8 ± 89.7 W, P < 0.001); however, this was not different to combined warm-ups (cycle+HPS 158.6 ± 121.1 W; WBV+HPS 177.3 ± 93.3 W, P = 1.00). These modalities increased PPO to a greater extent than those that did not involve HPS (all P < 0.05). HPS took the shortest time to complete, compared to the other conditions (P < 0.05). EMG did not differ from pre to post warm-up or between modalities in any of the muscles investigated. No change in T m occurred in warm-ups that did not include cycling or WBV. These results suggest that a movement-specific warm-up improves performance more than temperature-related warm-ups. Therefore, mechanisms other than increased muscle temperature and activation may be important for improving short-term PPO.

Nutrient Needs for Catch-Up Growth in Low-Birthweight Infants.

PubMed

Ziegler, Ekhard E

2015-01-01

Growth restriction among low-birthweight (LBW) infants occurs prenatally as well as postnatally. Regardless of when and how the growth restriction occurs, growth-restricted infants have the potential for catch-up growth. Catch-up growth has decidedly beneficial effects on later cognition. It also may have adverse effects on cardiovascular and metabolic health. Although the benefits for later cognition are well documented in a number of studies, growth-restricted LBW infants often do not experience catch-up growth and therefore do not enjoy its benefits. One reason is that for catch-up growth to occur, extraordinarily high protein intakes are required. Nutrient intakes have been estimated with the use of the factorial method based on the assumption that catch-up growth comprises essentially a restoration of lean body mass, with restoration of fat mass optional. The basic (no catch-up) nutritional needs of growth-restricted LBW infants are altered to a modest degree, with energy needs increased and protein needs decreased. With catch-up, however, protein needs are increased sharply. Since energy needs are only modestly increased, the protein/energy ratio of requirements is appreciably increased. The high protein needs are difficult to meet with the usual feedings for LBW infants unless special measures are taken to increase protein intakes and to increase the protein/energy ratio. Without the necessary protein intake, catch-up growth is not possible or will be delayed, which may compromise the realization of the long-term benefits on cognition. © 2015 Nestec Ltd., Vevey/S. Karger AG, Basel.

Quantitative analysis of catch-up saccades during sustained pursuit.

PubMed

de Brouwer, Sophie; Missal, Marcus; Barnes, Graham; Lefèvre, Philippe

2002-04-01

During visual tracking of a moving stimulus, primates orient their visual axis by combining two very different types of eye movements, smooth pursuit and saccades. The purpose of this paper was to investigate quantitatively the catch-up saccades occurring during sustained pursuit. We used a ramp-step-ramp paradigm to evoke catch-up saccades during sustained pursuit. In general, catch-up saccades followed the unexpected steps in position and velocity of the target. We observed catch-up saccades in the same direction as the smooth eye movement (forward saccades) as well as in the opposite direction (reverse saccades). We made a comparison of the main sequences of forward saccades, reverse saccades, and control saccades made to stationary targets. They were all three significantly different from each other and were fully compatible with the hypothesis that the smooth pursuit component is added to the saccadic component during catch-up saccades. A multiple linear regression analysis was performed on the saccadic component to find the parameters determining the amplitude of catch-up saccades. We found that both position error and retinal slip are taken into account in catch-up saccade programming to predict the future trajectory of the moving target. We also demonstrated that the saccadic system needs a minimum period of approximately 90 ms for taking into account changes in target trajectory. Finally, we reported a saturation (above 15 degrees /s) in the contribution of retinal slip to the amplitude of catch-up saccades.

Amphiphilic nanoparticles suppress droplet break-up in a concentrated emulsion flowing through a narrow constriction

PubMed Central

Gai, Ya; Kim, Minkyu; Pan, Ming; Tang, Sindy K. Y.

2017-01-01

This paper describes the break-up behavior of a concentrated emulsion comprising drops stabilized by amphiphilic silica nanoparticles flowing in a tapered microchannel. Such geometry is often used in serial droplet interrogation and sorting processes in droplet microfluidics applications. When exposed to high viscous stresses, drops can undergo break-up and compromise their physical integrity. As these drops are used as micro-reactors, such compromise leads to a loss in the accuracy of droplet-based assays. Here, we show droplet break-up is suppressed by replacing the fluoro-surfactant similar to the one commonly used in current droplet microfluidics applications with amphiphilic nanoparticles as droplet stabilizer. We identify parameters that influence the break-up of these drops and demonstrate that break-up probability increases with increasing capillary number and confinement, decreasing nanoparticle size, and is insensitive to viscosity ratio within the range tested. Practically, our results reveal two key advantages of nanoparticles with direct applications to droplet microfluidics. First, replacing surfactants with nanoparticles suppresses break-up and increases the throughput of the serial interrogation process to 3 times higher than that in surfactant system under similar flow conditions. Second, the insensitivity of break-up to droplet viscosity makes it possible to process samples having different composition and viscosities without having to change the channel and droplet geometry in order to maintain the same degree of break-up and corresponding assay accuracy. PMID:28652887

Rationale and design of the health economics evaluation registry for remote follow-up: TARIFF.

PubMed

Ricci, Renato P; D'Onofrio, Antonio; Padeletti, Luigi; Sagone, Antonio; Vicentini, Alfredo; Vincenti, Antonio; Morichelli, Loredana; Cavallaro, Ciro; Ricciardi, Giuseppe; Lombardi, Leonida; Fusco, Antonio; Rovaris, Giovanni; Silvestri, Paolo; Guidotto, Tiziana; Pollastrelli, Annalisa; Santini, Massimo

2012-11-01

The aims of the study are to develop a cost-minimization analysis from the hospital perspective and a cost-effectiveness analysis from the third payer standpoint, based on direct estimates of costs and QOL associated with remote follow-ups, using Merlin@home and Merlin.net, compared with standard ambulatory follow-ups, in the management of ICD and CRT-D recipients. Remote monitoring systems can replace ambulatory follow-ups, sparing human and economic resources, and increasing patient safety. TARIFF is a prospective, controlled, observational study aimed at measuring the direct and indirect costs and quality of life (QOL) of all participants by a 1-year economic evaluation. A detailed set of hospitalized and ambulatory healthcare costs and losses of productivity that could be directly influenced by the different means of follow-ups will be collected. The study consists of two phases, each including 100 patients, to measure the economic resources consumed during the first phase, associated with standard ambulatory follow-ups, vs. the second phase, associated with remote follow-ups. Remote monitoring systems enable caregivers to better ensure patient safety and the healthcare to limit costs. TARIFF will allow defining the economic value of remote ICD follow-ups for Italian hospitals, third payers, and patients. The TARIFF study, based on a cost-minimization analysis, directly comparing remote follow-up with standard ambulatory visits, will validate the cost effectiveness of the Merlin.net technology, and define a proper reimbursement schedule applicable for the Italian healthcare system. NCT01075516.

The acute effect of different warm-up protocols on anaerobic performance in elite youth soccer players.

PubMed

Needham, Robert A; Morse, Christopher I; Degens, Hans

2009-12-01

The purpose of the study was to investigate the acute effect of different warm-up protocols on anaerobic performance in elite youth soccer players. Twenty elite youth soccer players (mean age 17.2 +/- 1.2 years) performed 3 different warm-up protocols in a random order on nonconsecutive days. Each warm-up protocol consisted of a 5-minute low-intensity jog followed by 10 minutes of static stretching (SS), dynamic stretching (DS), or dynamic stretching followed by 8 front squats + 20% body mass (DSR). Subjects performed a countermovement jump followed by a 10- and 20-m sprint test immediately and at 3 and 6 minutes after each warm-up protocol. Vertical jump performance following DSR was better at 3 and 6 minutes than after DS, which in turn was better than after SS at 0, 3, and 6 minutes (p < 0.05). Jump performance was better at 3 minutes than immediately after, and this improvement was maintained at 6 minutes after DSR (p < 0.05). A better sprint performance was observed after DSR and DS compared with SS immediately and at 3 and 6 minutes following each warm-up protocol (p < 0.05). The results of the study suggest that a dynamic warm-up with the inclusion of resistance enhances jumping ability more than dynamic exercise alone. In addition, a dynamic warm-up produces a superior sprint and jump performance compared to a warm-up consisting of static stretching.

Warm-ups for military fitness testing: rapid evidence assessment of the literature.

PubMed

Zeno, Stacey A; Purvis, Dianna; Crawford, Cindy; Lee, Courtney; Lisman, Peter; Deuster, Patricia A

2013-07-01

Warm-up exercises are commonly used before exercise as a method to physiologically prepare for strenuous physical activity. Various warm-up exercises are often implemented but without scientific merit and, at times, may be detrimental to performance. To date, no systematic reviews have examined the effectiveness of warm-up exercises for military physical fitness test (PFT) or combat fitness test (CFT). The purpose of this rapid evidence assessment of the literature was to examine the quantity, quality, and effectiveness of warm-up exercises for PFT and identify those that might increase PFT and/or CFT scores, as reported in the literature. Literature searches of randomized controlled trials were performed across various databases from database inception to May 2011. Methodological quality of included studies was assessed using the Scottish Intercollegiate Guidelines Network (SIGN) 50 criteria for randomized controlled trial designs, and studies were individually described. Subject matter experts summarized the results applicable or generalizable to military testing. The search yielded a total of 1177 citations, with 37 fitting our inclusion criteria. Cardiovascular warm-ups increased sprint/running time, but dynamic stretching and dynamic warm-ups had the most positive outcome for the various exercise tests examined. Systematically, static stretching had no beneficial or detrimental effect on exercise performance but did improve range of movement exercises. Selected warm-up exercise may increase PFT and possibly CFT scores. Further research is needed to investigate the efficacy of dynamic stretching and dynamic warm-ups.

Nonoperative management of blunt renal trauma: Is routine early follow-up imaging necessary?

PubMed Central

Malcolm, John B; Derweesh, Ithaar H; Mehrazin, Reza; DiBlasio, Christopher J; Vance, David D; Joshi, Salil; Wake, Robert W; Gold, Robert

2008-01-01

Background There is no consensus on the role of routine follow-up imaging during nonoperative management of blunt renal trauma. We reviewed our experience with nonoperative management of blunt renal injuries in order to evaluate the utility of routine early follow-up imaging. Methods We reviewed all cases of blunt renal injury admitted for nonoperative management at our institution between 1/2002 and 1/2006. Data were compiled from chart review, and clinical outcomes were correlated with CT imaging results. Results 207 patients were identified (210 renal units). American Association for the Surgery of Trauma (AAST) grades I, II, III, IV, and V were assigned to 35 (16%), 66 (31%), 81 (39%), 26 (13%), and 2 (1%) renal units, respectively. 177 (84%) renal units underwent routine follow-up imaging 24–48 hours after admission. In three cases of grade IV renal injury, a ureteral stent was placed after serial imaging demonstrated persistent extravasation. In no other cases did follow-up imaging independently alter clinical management. There were no urologic complications among cases for which follow-up imaging was not obtained. Conclusion Routine follow-up imaging is unnecessary for blunt renal injuries of grades I-III. Grade IV renovascular injuries can be followed clinically without routine early follow-up imaging, but urine extravasation necessitates serial imaging to guide management decisions. The volume of grade V renal injuries in this study is not sufficient to support or contest the need for routine follow-up imaging. PMID:18768088

Follow-up: who does it and how do they do it?

PubMed

Chamberlain, J M; Carraccio, C L

1994-12-01

Follow-up appointments and phone contact after discharge are important components of the emergency department (ED) encounter. We surveyed ED directors at hospitals with accredited pediatric residency programs to determine mechanisms for follow-up 1) to chart progression of illness (POI), 2) for positive laboratory or x-ray results, and 3) for specific illness such as child abuse, burns, and complex wounds. One hundred thirty-five of 207 program directors responded (65%). To follow POI, 54% of EDs use the ED itself, and 59% send patients to community physicians. Of those that use community physicians, 24% do not notify the physician to expect a follow-up visit, and 27% do not send a copy of the ED chart to a physician's office. To follow POI, 20% of EDs have no formal mechanism for telephone follow-up. Sixteen percent keep no record of phone contact. For follow-up of positive laboratory tests or x-rays, results are better; only 4 and 5%, respectively, do not keep records of phone contact. Eleven percent of EDs have no mechanism for follow-up of child abuse. Mechanisms for follow-up of children seen in the ED are variable. We have identified deficiencies in the following areas: 1) lack of communication with the physician to provide follow-up, 2) lack of documentation regarding subsequent patient contacts for POI and positive test results, and 3) lack of resources to follow victims of child abuse. These deficiencies have potential implications regarding optimal patient outcome.

Supplement: Localization and broadband follow-up of the gravitational-wave transient GW150914

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

Abbott, B. P.

This Supplement provides supporting material for arXiv:1602.08492 . We briefly summarize past electromagnetic (EM) follow-up efforts as well as the organization and policy of the current EM follow-up program. Here, we compare the four probability sky maps produced for the gravitational-wave transient GW150914, and provide additional details of the EM follow-up observations that were performed in the different bands.

Optimized design for sling of stand up lift

NASA Astrophysics Data System (ADS)

Xu, Dongfang; Wang, Yue; Cui, Tengfei; Bao, Xuelian; Duan, Xingguang

2017-04-01

Stand up lift is a kind of equipment that assists those with dyskinesia of legs to stand up or move. As an important part of stand up lift, sling concerns the realization of the equipment's function and the safety of users. On the basis of ergonomics theory, this thesis will design and optimize the sling to make it safer and more comfortable and meet demands of different people.

Objectivity, Reliability, and Validity of the Bent-Knee Push-Up for College-Age Women

ERIC Educational Resources Information Center

Wood, Heather M.; Baumgartner, Ted A.

2004-01-01

The revised push-up test has been found to have good validity but it produces many zero scores for women. Maybe there should be an alternative to the revised push-up test for college-age women. The purpose of this study was to determine the objectivity, reliability, and validity for the bent-knee push-up test (executed on hands and knees) for…

Start-Up Entrepreneurs and University Students in a Co-Learning Mode: Learning Effects of a Collaborative Entrepreneurial Coaching Programme

ERIC Educational Resources Information Center

Saukkonen, Juha; Nukari, Jussi; Ballard, Sharon; Levie, Jonathan

2016-01-01

Start-up companies have been recognized as key drivers of wealth and job creation. Many students now in universities will therefore find their future employment in start-up companies, or will found them. Success in the start-up environment requires a specific set of skills. There is a growing supply of university education for new venture creation…

Supplement: Localization and broadband follow-up of the gravitational-wave transient GW150914

DOE PAGES

Abbott, B. P.

2016-07-20

This Supplement provides supporting material for arXiv:1602.08492 . We briefly summarize past electromagnetic (EM) follow-up efforts as well as the organization and policy of the current EM follow-up program. Here, we compare the four probability sky maps produced for the gravitational-wave transient GW150914, and provide additional details of the EM follow-up observations that were performed in the different bands.

Adolescent Suicide Risk Screening: The Effect of Communication about Type of Follow-Up on Adolescents' Screening Responses

ERIC Educational Resources Information Center

King, Cheryl A.; Hill, Ryan M.; Wynne, Henry A.; Cunningham, Rebecca M.

2012-01-01

This experimental study examined the effect of communication about type of screening follow-up (in-person follow-up vs. no in-person follow-up) on adolescents' responses to a self-report suicide risk screen. Participants were 245 adolescents (131 girls, 114 boys; ages 13-17; 80% White, 21.6% Black, 9.8% American Indian, 2.9% Asian) seeking medical…

Deliquification (SIC) of gas wells. Liberal District-Amoco Production Company

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

Smalley, R. Jr.

Various solutions are presented to the problem of deliquefying gas wells to achieve maximum ultimate recovery and avoid premature abandonment. Advantages and disadvantages of each method of deliquefication are discussed. The methods described include blowing up the casing, siphon strings (gas and liquids up tubing, or gas up casing-tubing annulus, and liquids up tubing), gas cycling, compression, bottomhole separators, plunger lift, and sucker rod pumping.

What Do Children Say about Tidy-Up Time? A Comparative Study of American and Taiwanese Children's Perceptions of Tidy-Up Time

ERIC Educational Resources Information Center

Izumi-Taylor, Satomi; Lin, Chia-Hui

2017-01-01

The purpose of this study was to examine the similarities and differences in American and Taiwanese children's perspectives of tidy-up time. The participants consisted of 25 American kindergarteners in the southeastern US, and 25 Taiwanese kindergarteners from central Taiwan. Children were asked to respond to five questions regarding tidy-up time.…

Cardiopulmonary Laboratory AFSC 904X0

DTIC Science & Technology

1990-10-01

SET UP POSITIVE END EXPIRATORY PRESSURE (PEEP) DEVICES 100 J321 SET UP CONTINUOUS POSITIVE AIRWAY PRESSURE ( CPAP ) DEVICES 100 J298 ASSIST PHYSICIAN IN...PRESSURE VENTILATORS 61 COMPUTERIZED PULMONARY FUNCTION ANALYZERS 61 TREADMILLS 59 HOLTER MONITOR EQUIPMENT 57 CPAP EQUIPMENT 54 PRESSURE REGULATORS 48...SUCTIONING PROCEDURES 95 J321 SET UP CONTINUOUS POSITIVE AIRWAY PRESSURE ( CPAP ) DEVICES 95 J332 SET UP VOLUME VENTILATORS 93 F148 PERFORM ARTERIAL PUNCTURES 93

A Comparative Case Study of Student Preparation for Postsecondary Education: How GEAR UP, Socioeconomic Status, and Race Influence Academic and Non-Academic Factors

ERIC Educational Resources Information Center

Lunceford, Christina J.; Sondergeld, Toni A.; Stretavski, Elizabeth L.

2017-01-01

The purpose of this study was to gain a better understanding of early preparation for postsecondary education and explore the effectiveness of Gaining Early Awareness and Readiness for Undergraduate Programs (GEAR UP). This comparative case study included 836 students from two cohorts (GEAR UP and Non GEAR UP). We compared high school attendance,…

34 CFR 75.250 - Project period can be up to 60 months.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 1 2010-07-01 2010-07-01 false Project period can be up to 60 months. 75.250 Section... Are Made Approval of Multi-Year Projects § 75.250 Project period can be up to 60 months. The Secretary may approve a project period of up to 60 months. (Authority: 20 U.S.C. 1221e-3 and 3474) [45 FR 22497...

Burden of unintended pregnancy in the United States: potential savings with increased use of long-acting reversible contraception.

PubMed

Trussell, James; Henry, Nathaniel; Hassan, Fareen; Prezioso, Alexander; Law, Amy; Filonenko, Anna

2013-02-01

This study evaluated the total costs of unintended pregnancy (UP) in the United States (US) from a third-party health care payer perspective and explored the potential role for long-acting reversible contraception (LARC) in reducing UP and resulting health care expenditure. An economic model was constructed to estimate direct costs of UP as well as the proportion of UP costs that could be attributed to imperfect contraceptive adherence. The model considered all women requiring reversible contraception in the US: the pattern of contraceptive use and the rates of UP were derived from published sources. The costs of UP in the United States and the proportion of total cost that might be avoided by improved adherence through increased use of LARC were estimated. Annual medical costs of UP in the United States were estimated to be $4.6 billion, and 53% of these were attributed to imperfect contraceptive adherence. If 10% of women aged 20-29 years switched from oral contraception to LARC, total costs would be reduced by $288 million per year. Imperfect contraceptive adherence leads to substantial UP and high, avoidable costs. Improved uptake of LARC may generate health care cost savings by reducing contraceptive non-adherence. Copyright © 2013 Elsevier Inc. All rights reserved.

Families’ Experiences of Doubling Up After Homelessness

PubMed Central

Bush, Hannah; Shinn, Marybeth

2017-01-01

This study examined experiences of doubling up among families after episodes of homelessness. Doubling up refers to two or more adults or families residing in the same housing unit, which has been an increasing trend in the United States in recent decades. Within the past 14 years, the number of households containing more than one family, related or unrelated, has more than tripled. Although doubling up is increasingly common among families at all income levels, this study seeks to understand the experiences of doubling up among families who have been homeless. Through qualitative interviews with caregivers of 29 families, we analyzed advantages and disadvantages of doubling up with the caregiver’s parent, other family, and nonfamily. Experiences were rated on a four-point scale—(1) mostly negative, (2) negative mixed, (3) positive mixed, and (4) mostly positive—and coded for various positive and negative themes. Overall, we found that doubling up was a generally negative experience for families in our sample, regardless of their relationship to their hosts. Common themes included negative effects on children, undesirable environments, interpersonal tension, and feelings of impermanence and instability. For formerly sheltered families in this study, doubling up after shelter did not resolve their period of housing instability and may be only another stop in an ongoing cycle of homelessness. PMID:29326758

Adherence to the follow-up of the newborn exposed to syphilis and factors associated with loss to follow-up.

PubMed

Feliz, Marjorie Cristiane; de Medeiros, Adeli Regina Prizybicien; Rossoni, Andrea Maciel; Tahnus, Tony; Pereira, Adriane Miro Vianna Benke; Rodrigues, Cristina

2016-01-01

All newborns exposed to syphilis in pregnancy must have outpatient follow-up. The interruption of this follow-up especially threatens those children who were not treated at birth. To describe the clinical, epidemiological, and sociodemographic characteristics of pregnant women with syphilis and their newborns, and to investigate the factors associated with the discontinuation of the follow-up. This is an observational, descriptive, analytical, and retrospective study of medical records of 254 children exposed to syphilis, who were assisted at the Congenital Infectious Clinic of the university hospital of the Universidade Federal do Paraná, between 2000 and 2010. The newborns were classified by reference according to their follow-up. Data were analyzed by means of the binary logistic regression model in order to identify the factors associated to drop out. The factors associated to the interruption of the follow-up were maternal age over 30 years, mothers with 3 or more children, and the absence of cross-infections by HIV and/or viral hepatitis. Such findings demonstrate the need to identify these families and implement strategies to promote the establishment of bonds. A greater rigor to indicate the treatment of the disease at birth is recommended, as most of them do not properly follow up.

Forward masking of dynamic acoustic intensity: effects of intensity region and end-level.

PubMed

Olsen, Kirk N; Stevens, Catherine J

2012-01-01

Overestimation of loudness change typically occurs in response to up-ramp auditory stimuli (increasing intensity) relative to down-ramps (decreasing intensity) matched on frequency, duration, and end-level. In the experiment reported, forward masking is used to investigate a sensory component of up-ramp overestimation: persistence of excitation after stimulus presentation. White-noise and synthetic vowel 3.6 s up-ramp and down-ramp maskers were presented over two regions of intensity change (40-60 dB SPL, 60-80 dB SPL). Three participants detected 10 ms 1.5 kHz pure tone signals presented at masker-offset to signal-offset delays of 10, 20, 30, 50, 90, 170 ms. Masking magnitude was significantly greater in response to up-ramps compared with down-ramps for masker-signal delays up to and including 50 ms. When controlling for an end-level recency bias (40-60 dB SPL up-ramp vs 80-60 dB SPL down-ramp), the difference in masking magnitude between up-ramps and down-ramps was not significant at each masker-signal delay. Greater sensory persistence in response to up-ramps is argued to have minimal effect on perceptual overestimation of loudness change when response biases are controlled. An explanation based on sensory adaptation is discussed.

Muscle Activity Patterns Do Not Differ Between Push-Up and Bench Press Exercises.

PubMed

Gottschall, Jinger S; Hastings, Bryce; Becker, Zachary

2018-05-29

Popular topics for upper body resistance training involve the differences between hand positions, open versus closed chain exercises, and movement variations for the novice to the advanced. We hypothesized that there will be no difference between closed (push-up) versus open (bench press) chain exercises for the primary muscle group activity nor would there be a difference between push-ups on the toes versus knees with respect to the percent contribution of each muscle. We measured surface muscle activity of 8 upper body and core muscles during a sequence of push-up and bench press variations with a normalized weight for twelve active men. Each participant completed push-ups and bench press exercises at each of three hand positions. Our results demonstrated that there were few differences between closed versus open chain exercises for the primary muscle groups with the exception of core activation. To add, in general, narrow hand positions yielded greater activation and there were no significant differences between push-ups on the toes versus knees with respect to the percent contribution for the primary muscle groups. To sum, closed chain exercises may be preferred for functional training and knee push-ups may be ideal as a novice push-up variation.

Memory-efficient table look-up optimized algorithm for context-based adaptive variable length decoding in H.264/advanced video coding

NASA Astrophysics Data System (ADS)

Wang, Jianhua; Cheng, Lianglun; Wang, Tao; Peng, Xiaodong

2016-03-01

Table look-up operation plays a very important role during the decoding processing of context-based adaptive variable length decoding (CAVLD) in H.264/advanced video coding (AVC). However, frequent table look-up operation can result in big table memory access, and then lead to high table power consumption. Aiming to solve the problem of big table memory access of current methods, and then reduce high power consumption, a memory-efficient table look-up optimized algorithm is presented for CAVLD. The contribution of this paper lies that index search technology is introduced to reduce big memory access for table look-up, and then reduce high table power consumption. Specifically, in our schemes, we use index search technology to reduce memory access by reducing the searching and matching operations for code_word on the basis of taking advantage of the internal relationship among length of zero in code_prefix, value of code_suffix and code_lengh, thus saving the power consumption of table look-up. The experimental results show that our proposed table look-up algorithm based on index search can lower about 60% memory access consumption compared with table look-up by sequential search scheme, and then save much power consumption for CAVLD in H.264/AVC.

Long-term follow-up of a randomized clinical trial comparing Beger with pylorus-preserving Whipple procedure for chronic pancreatitis.

PubMed

Müller, M W; Friess, H; Martin, D J; Hinz, U; Dahmen, R; Büchler, M W

2008-03-01

Duodenum-preserving pancreatic head resection according to Beger and the pylorus-preserving Whipple (ppWhipple) procedure were compared in patients with chronic pancreatitis (CP) in a randomized clinical trial. Perioperative data and short-term outcome have been reported previously. The present study evaluated long-term follow-up. Forty patients were enrolled originally, 20 in each group. Long-term follow-up included mortality, morbidity, pain status, occupational rehabilitation, quality of life (QoL), and endocrine and exocrine function at median follow-up of 7 and 14 years. One patient who had a ppWhipple procedure was lost to follow-up. There were five late deaths in each group. No differences were noted in pain status and exocrine pancreatic function. Loss of appetite was significantly worse in the ppWhipple group at 14 years' follow-up, but there were no other differences in QoL parameters examined. After 14 years, diabetes mellitus was present in seven of 15 patients who had the Beger procedure and 11 of 14 patients after ppWhipple resection (P = 0.128). After long-term follow-up of up to 14 years early advantages of the Beger procedure were no longer present. 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Results of Medium Seventeen Years' Follow-Up after Laparoscopic Choledochotomy for Ductal Stones.

PubMed

Quaresima, Silvia; Balla, Andrea; Guerrieri, Mario; Lezoche, Giovanni; Campagnacci, Roberto; D'Ambrosio, Giancarlo; Lezoche, Emanuele; Paganini, Alessandro M

2016-01-01

Introduction. In a previously published article the authors reported the long-term follow-up results in 138 consecutive patients with gallstones and common bile duct (CBD) stones who underwent laparoscopic transverse choledochotomy (TC) with T-tube biliary drainage and laparoscopic cholecystectomy (LC). Aim of this study is to evaluate the results at up to 23 years of follow-up in the same series. Methods. One hundred twenty-one patients are the object of the present study. Patients were evaluated by clinical visit, blood assay, and abdominal ultrasound. Symptomatic patients underwent cholangio-MRI, followed by endoscopic retrograde cholangiopancreatography (ERCP) as required. Results. Out of 121 patients, 61 elderly patients died from unrelated causes. Fourteen patients were lost to follow-up. In the 46 remaining patients, ductal stone recurrence occurred in one case (2,1%) successfully managed by ERCP with endoscopic sphincterotomy. At a mean follow-up of 17.1 years no other patients showed signs of bile stasis and no patient showed any imaging evidence of CBD stricture at the site of choledochotomy. Conclusions. Laparoscopic transverse choledochotomy with routine T-tube biliary drainage during LC has proven to be safe and effective at up to 23 years of follow-up, with no evidence of CBD stricture when the procedure is performed with a correct technique.

Genetic structure of soil population of fungus Fusarium oxysporum Schlechtend.: Fr.: Molecular reidentification of the species and genetic differentiation of isolates using polymerase chain reaction technique with universal primers (UP-PCR)

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

Bulat, S.A.; Mironenko, N.V.; Zholkevich, Yu.G.

1995-07-01

The genetic structure of three soil populations of fungus Fusarium oxysporum was analyzed using polymerase chain reaction with universal primers (UP-PCR). Distinct UP-PCR variants revealed by means of cross-dot hybridization of amplified DNA and restriction analysis of nuclear ribosomal DNA represent subspecies or sibling species of F. oxysporum. The remaining isolates of F. oxysporum showed moderate UP-PCR polymorphism characterized by numerous types, whose relatedness was analyzed by computer treatment of the UP-PCR patterns. The genetic distance trees based on the UP-PCR patterns, which were obtained with different universal primers, demonstrated similar topology. This suggests that evolutionarily important genome rearrangements correlativelymore » occur within the entire genome. Isolates representing different UP-PCR polymorphisms were encountered in all populations, being distributed asymmetrically in two of these. In general, soil populations of F. oxysporum were represented by numerous genetically isolated groups with a similar genome structure. The genetic heterogeneity of the isolates within these groups is likely to be caused by the parasexual process. The usefulness of the UP-PCR technique for population studies of F. oxysporum was demonstrated. 39 refs., 7 figs., 2 tabs.« less

Dismantling of the 904 Cell at the HAO/Sud Facility - 13466

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

Vaudey, C.E.; Crosnier, S.; Renouf, M.

2013-07-01

La Hague facility, in France, is the spent fuel recycling plant wherein a part of the fuel coming from some of the French, German, Belgian, Swiss, Dutch and Japanese nuclear reactors is reprocessed before being recycled in order to separate certain radioactive elements. The facility has been successively handled by the CEA (1962-1978), Cogema (1978-2006), and AREVA NC (since 2006). La Hague facility is composed of 3 production units: The UP2-400 production unit started to be operated in 1966 for the reprocessing of UNGG metal fuel. In 1976, following the dropout of the graphite-gas technology by EDF, an HAO workshopmore » to reprocess the fuel from the light water reactors is affiliated and then stopped in 2003. - UP2-400 is partially stopped in 2002 and then definitely the 1 January 2004 and is being dismantled - UP2-800, with the same capacity than UP3, started to be operated in 1994 and is still in operation. And UP3 - UP3 was implemented in 1990 with an annual reprocessing capacity of 800 tons of fuel and is still in operation The combined licensed capacity of UP2-800 and UP3 is 1,700 tons of used fuel. (authors)« less

Effect of follow-up period on minimal-significant dose in the atomic-bomb survivor studies.

PubMed

Cologne, John; Preston, Dale L; Grant, Eric J; Cullings, Harry M; Ozasa, Kotaro

2018-03-01

It was recently suggested that earlier reports on solid-cancer mortality and incidence in the Life Span Study of atomic-bomb survivors contain still-useful information about low-dose risk that should not be ignored, because longer follow-up may lead to attenuated estimates of low-dose risk due to longer time since exposure. Here it is demonstrated, through the use of all follow-up data and risk models stratified on period of follow-up (as opposed to sub-setting the data by follow-up period), that the appearance of risk attenuation over time may be the result of less-precise risk estimation-in particular, imprecise estimation of effect-modification parameters-in the earlier periods. Longer follow-up, in addition to allowing more-precise estimation of risk due to larger numbers of radiation-related cases, provides more-precise adjustment for background mortality or incidence and more-accurate assessment of risk modification by age at exposure and attained age. It is concluded that the latest follow-up data are most appropriate for inferring low-dose risk. Furthermore, if researchers are interested in effects of time since exposure, the most-recent follow-up data should be considered rather than the results of earlier reports.

Hemodynamic Response of the Supplementary Motor Area during Locomotor Tasks with Upright versus Horizontal Postures in Humans

PubMed Central

Obayashi, Shigeru; Nakajima, Katsumi; Hara, Yukihiro

2016-01-01

To understand cortical mechanisms related to truncal posture control during human locomotion, we investigated hemodynamic responses in the supplementary motor area (SMA) with quadrupedal and bipedal gaits using functional near-infrared spectroscopy in 10 healthy adults. The subjects performed three locomotor tasks where the degree of postural instability varied biomechanically, namely, hand-knee quadrupedal crawling (HKQuad task), upright quadrupedalism using bilateral Lofstrand crutches (UpQuad task), and typical upright bipedalism (UpBi task), on a treadmill. We measured the concentration of oxygenated hemoglobin (oxy-Hb) during the tasks. The oxy-Hb significantly decreased in the SMA during the HKQuad task, whereas it increased during the UpQuad task. No significant responses were observed during the UpBi task. Based on the degree of oxy-Hb responses, we ranked these locomotor tasks as UpQuad > UpBi > HKQuad. The order of the different tasks did not correspond with postural instability of the tasks. However, qualitative inspection of oxy-Hb time courses showed that oxy-Hb waveform patterns differed between upright posture tasks (peak-plateau-trough pattern for the UpQuad and UpBi tasks) and horizontal posture task (downhill pattern for the HKQuad task). Thus, the SMA may contribute to the control of truncal posture accompanying locomotor movements in humans. PMID:27413555

A cybernetic view on wind-up.

PubMed

Farajidavar, Aydin; Gharibzadeh, Shahriar; Towhidkhah, Farzad; Saeb, Sohrab

2006-01-01

Wind-up is described traditionally as a frequency dependent increase in the excitability of spinal cord neurons, evoked by electrical stimulation of afferent C-fibers. Different kinds of wind-up have been reported, but wind-up of Abeta fibers in hyperalgesic states has gained little attention. In this paper, we present a cybernetic view on Abeta fiber wind-up and consider the involved molecular mechanisms as feedback and feedforward processes. Furthermore, our previous hypothesis, the sprouting phenomenon, is included in this view. Considering the proposed model, wind-up in hyperalgesic states might leave out in three different ways: (1) blocking the NMDA receptors by increasing extracellular Mg2+, 2) blocking the receptors and channels that contribute to Ca2+ inward current, and 3) blocking the Abeta fibers by local anesthetics. It seems that wind-up may be inhibited more effectively by using these three blocking mechanisms simultaneously, because in this case, the feedback process (main controller), the feedforward process (trigger), and Abeta stimulation (trigger) would be inhibited concurrently. Wind up may aggravate the pain in clinical hyperalgesic situations such as post-surgical states, some neuropathic pains, fibromyalgia syndrome, and post-herpetic neuralgia. Surely, clinical studies are needed to validate the effectiveness of our abovementioned suggestions in relieving such clinical pains.

Internet of things and bariatric surgery follow-up: Comparative study of standard and IoT follow-up.

PubMed

Vilallonga, Ramon; Lecube, Albert; Fort, José Manuel; Boleko, Maria Angeles; Hidalgo, Marta; Armengol, Manel

2013-09-01

Follow-up of obese patient is difficult. There is no literature related to patient follow-up that incorporates the concept of Internet of Things (IoT), use of WiFi, Internet, or portable devices for this purpose. This prospective observational study commenced in June 2011. Patients were prospectively offered to participate in the IoT study group, in which they received a WiFi scale (Withing®, Paris) that provides instant WiFi data to the patient and surgeon. Other patients were admitted to the standard follow-up group at the outpatient clinic. A total of 33 patients were included in our study (ten in the IoT group). Twelve patients did not have WiFi at home, ten lacked of computer knowledge, and seven preferred standard for follow-up. All patients underwent different surgical procedures. There were no complications. Excess weight loss (EWL) was similar in both groups. More than 90% of patients were satisfied. In the IoT group, patients considered it valuable in saving time, and considered seeing their evolution graphics extremely motivating. IoT technology can monitor medical parameters remotely and collect data. A WiFi scale can facilitate preoperative and follow-up. Standard follow-up in a classical outpatient clinic setting with the surgeon was preferred globally.

Parents' experience of a follow-up meeting after a child's death in the Paediatric Intensive Care Unit.

PubMed

Brink, Helle L; Thomsen, Anja K; Laerkner, Eva

2017-02-01

'To identify parents' experience of a follow up meeting and to explore whether the conversation was adequate to meet the needs of parents for a follow-up after their child's death in the Paediatric Intensive Care Unit (PICU). Qualitative method utilising semi-structured interviews with six pairs of parents 2-12 weeks after the follow-up conversation. The interviews were held in the parents' homes at their request. Data were analysed using a qualitative, descriptive approach and thematic analysis. Four main themes emerged: (i) the way back to the PICU; (ii) framework; (iii) relations and (iv) closure. The parents expressed nervousness before the meeting, but were all pleased to have participated in these follow-up meetings. The parents found it meaningful that the follow-up meeting was interdisciplinary, since the parents could have answers to their questions both about treatment and care. It was important that the staff involved in the follow-up meeting were those who had been present through the hospitalisation and at the time of the child's death. Parents experienced the follow-up meeting as being a closure of the course in the PICU, regardless the length of the hospitalisation. Copyright © 2016 Elsevier Ltd. All rights reserved.

Case series: PTSD symptoms in adolescent survivors of "ethnic cleansing." Results from a 1-year follow-up study.

PubMed

Becker, D F; Weine, S M; Vojvoda, D; McGlashan, T H

1999-06-01

The authors describe the psychiatric sequelae of "ethnic cleansing" in adolescent Bosnian refugees, via a 1-year follow-up study. Ten Bosnian adolescent refugees from the war in Bosnia-Herzegovina received a baseline assessment within the first year after their resettlement and a follow-up assessment 1 year later. Evaluations included an assessment scale for posttraumatic stress disorder (PTSD) symptom severity. At baseline, 3 subjects met criteria for PTSD. At follow-up, this diagnosis persisted in none of these subjects, though 1 subject met criteria at follow-up only. For the group, mean PTSD severity scores at baseline and at follow-up were 8.9 and 4.0, respectively. At baseline, reexperiencing symptoms were present 43% of the time, avoidance symptoms were present 33% of the time, and hyperarousal symptoms were present 33% of the time; at follow-up, these proportions were 35%, 16%, and 18%, respectively. Overall, rates of PTSD symptoms diminished during the 1-year follow-up interval, suggesting that they may be transient and not representative of enduring psychopathology. This finding may reflect the relative resiliency of adolescents, as well as a variety of factors that facilitated adaptation in our particular group of adolescent refugees.

Creation of Functional Micro/Nano Systems through Top-down and Bottom-up Approaches

PubMed Central

Wong, Tak-Sing; Brough, Branden; Ho, Chih-Ming

2009-01-01

Mimicking nature’s approach in creating devices with similar functional complexity is one of the ultimate goals of scientists and engineers. The remarkable elegance of these naturally evolved structures originates from bottom-up self-assembly processes. The seamless integration of top-down fabrication and bottom-up synthesis is the challenge for achieving intricate artificial systems. In this paper, technologies necessary for guided bottom-up assembly such as molecular manipulation, molecular binding, and the self assembling of molecules will be reviewed. In addition, the current progress of synthesizing mechanical devices through top-down and bottom-up approaches will be discussed. PMID:19382535

Returning to work after cancer: know your rights

MedlinePlus

... more smoothly. Set up a meeting with your manager to work out transition issues. Set up ongoing ... in about how things are going. Tell your manager about what types of follow-up appointments you ...

76 FR 77890 - Union Pacific Railroad Company-Petition for Declaratory Order

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-14

... Avenue NW., Washington, DC 20004-2401, [email protected] (representing UP); (2) David L. Coleman, Law... negligence or fault of UP. UP's petition raises questions about what constitutes a reasonable request for...

36. HISTORIC PHOTOGRAPH SHOWING BILL KEYS CLEANING UP AFTER THE ...

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

36. HISTORIC PHOTOGRAPH SHOWING BILL KEYS CLEANING UP AFTER THE MILL RUN (NOTE SCREEN FROM MORTAR SETTING ON TABLE, STAMPS ARE HUNG UP). - Wall Street Gold Mill, Twentynine Palms, San Bernardino County, CA

Using a television documentary to prevent suicide in men and boys.

PubMed

Schlichthorst, Marisa; King, Kylie; Spittal, Matthew; Reifels, Lennart; Phelps, Andrea; Pirkis, Jane

2018-04-01

We investigated whether a documentary about masculinity and suicidality ( Man Up) could raise males' awareness of societal pressures to conform to masculine norms and influence their likelihood of connecting with their male friends and seeking help. We conducted a repeat cross-sectional survey, posting versions of the survey online before and after Man Up was screened. 1287 male respondents completed the survey; 476 completed the pre-screening survey, 811 the post-screening survey (192 had not viewed Man Up, 619 had). Those who had viewed Man Up were more likely to desire closer relationships with their male friends than those who had not, and had greater awareness of societal pressures on males, but were no more likely to seek help. Almost all respondents who saw Man Up indicated they would recommend it to others, and most said it changed the way they thought about the term 'man up'. They indicated they would be likely to undertake a number of adaptive actions following the show, and provided overwhelmingly positive feedback. Man Up appeared to effectively address factors that place males at heightened risk of suicide.

Structural and mechanistic insights into phospholipid transfer by Ups1–Mdm35 in mitochondria

PubMed Central

Watanabe, Yasunori; Tamura, Yasushi; Kawano, Shin; Endo, Toshiya

2015-01-01

Eukaryotic cells are compartmentalized into membrane-bounded organelles whose functions rely on lipid trafficking to achieve membrane-specific compositions of lipids. Here we focused on the Ups1–Mdm35 system, which mediates phosphatidic acid (PA) transfer between the outer and inner mitochondrial membranes, and determined the X-ray structures of Mdm35 and Ups1–Mdm35 with and without PA. The Ups1–Mdm35 complex constitutes a single domain that has a deep pocket and flexible Ω-loop lid. Structure-based mutational analyses revealed that a basic residue at the pocket bottom and the Ω-loop lid are important for PA extraction from the membrane following Ups1 binding. Ups1 binding to the membrane is enhanced by the dissociation of Mdm35. We also show that basic residues around the pocket entrance are important for Ups1 binding to the membrane and PA extraction. These results provide a structural basis for understanding the mechanism of PA transfer between mitochondrial membranes. PMID:26235513

Intramyocardial injection of autologous bone marrow-derived ex vivo expanded mesenchymal stem cells in acute myocardial infarction patients is feasible and safe up to 5 years of follow-up.

PubMed

Rodrigo, Sander F; van Ramshorst, Jan; Hoogslag, Georgette E; Boden, Helèn; Velders, Matthijs A; Cannegieter, Suzanne C; Roelofs, Helene; Al Younis, Imad; Dibbets-Schneider, Petra; Fibbe, Willem E; Zwaginga, Jaap Jan; Bax, Jeroen J; Schalij, Martin J; Beeres, Saskia L; Atsma, Douwe E

2013-10-01

In experimental studies, mesenchymal stem cell (MSC) transplantation in acute myocardial infarction (AMI) models has been associated with enhanced neovascularization and myogenesis. Clinical data however, are scarce. Therefore, the present study evaluates the safety and feasibility of intramyocardial MSC injection in nine patients, shortly after AMI during short-term and 5-year follow-up. Periprocedural safety analysis demonstrated one transient ischemic attack. No other adverse events related to MSC treatment were observed during 5-year follow-up. Clinical events were compared to a nonrandomized control group comprising 45 matched controls. A 5-year event-free survival after MSC-treatment was comparable to controls (89 vs. 91 %, P = 0.87). Echocardiographic imaging for evaluation of left ventricular function demonstrated improvements up to 5 years after MSC treatment. These findings were not significantly different when compared to controls. The present safety and feasibility study suggest that intramyocardial injection of MSC in patients shortly after AMI is feasible and safe up to 5-year follow-up.

Development and Testing of an Ultracapacitor Based Uninterruptible Power Supply (UPS) System

NASA Technical Reports Server (NTRS)

Eichenberg, Dennis J.

2010-01-01

The NASA Glenn Research Center (GRC) initiated the development and testing of an ultracapacitor based uninterruptible power supply (UPS) system as a means to provide backup power for the many critical NASA applications. A UPS system typically utilizes batteries for energy storage. The battery is the most vulnerable part of the UPS system, requiring regular maintenance and replacement. Battery performance is also extremely temperature dependent. Ultracapacitors are ideal for UPS systems where long life, maintenance free operation, and excellent low temperature performance is essential. State of the art symmetric ultracapacitors were used for these tests. The ultracapacitors were interconnected in an innovative configuration to minimize interconnection impedance, and to provide voltage balancing. Ultracapacitors can be charged extremely rapidly and supply high current, which are essential characteristics for an effective UPS system. Charging ultracapacitors is significantly less complex than charging batteries since there is no chemical reaction occurring while charging ultracapacitors. The report concludes that the implementation of symmetric ultracapacitors in a UPS system can provide significant improvements in power system performance and reliability.

DataUp 2.0: Improving On a Tool For Helping Researchers Archive, Manage, and Share Their Tabular Data

NASA Astrophysics Data System (ADS)

Strasser, C.; Borda, S.; Cruse, P.; Kunze, J.

2013-12-01

There are many barriers to data management and sharing among earth and environmental scientists; among the most significant are a lack of knowledge about best practices for data management, metadata standards, or appropriate data repositories for archiving and sharing data. Last year we developed an open source web application, DataUp, to help researchers overcome these barriers. DataUp helps scientists to (1) determine whether their file is CSV compatible, (2) generate metadata in a standard format, (3) retrieve an identifier to facilitate data citation, and (4) deposit their data into a repository. With funding from the NSF via a supplemental grant to the DataONE project, we are working to improve upon DataUp. Our main goal for DataUp 2.0 is to ensure organizations and repositories are able to adopt and adapt DataUp to meet their unique needs, including connecting to analytical tools, adding new metadata schema, and expanding the list of connected data repositories. DataUp is a collaborative project between the California Digital Library, DataONE, the San Diego Supercomputing Center, and Microsoft Research Connections.

Monetary reward speeds up voluntary saccades.

PubMed

Chen, Lewis L; Chen, Y Mark; Zhou, Wu; Mustain, William D

2014-01-01

Past studies have shown that reward contingency is critical for sensorimotor learning, and reward expectation speeds up saccades in animals. Whether monetary reward speeds up saccades in human remains unknown. Here we addressed this issue by employing a conditional saccade task, in which human subjects performed a series of non-reflexive, visually-guided horizontal saccades. The subjects were (or were not) financially compensated for making a saccade in response to a centrally-displayed visual congruent (or incongruent) stimulus. Reward modulation of saccadic velocities was quantified independently of the amplitude-velocity coupling. We found that reward expectation significantly sped up voluntary saccades up to 30°/s, and the reward modulation was consistent across tests. These findings suggest that monetary reward speeds up saccades in human in a fashion analogous to how juice reward sped up saccades in monkeys. We further noticed that the idiosyncratic nasal-temporal velocity asymmetry was highly consistent regardless of test order, and its magnitude was not correlated with the magnitude of reward modulation. This suggests that reward modulation and the intrinsic velocity asymmetry may be governed by separate mechanisms that regulate saccade generation.

Up-and-down designs for phase I clinical trials

PubMed Central

Liu, Suyu; Cai, Chunyan; Ning, Jing

2014-01-01

Various up-and-down designs have been proposed to improve the operating characteristics of the traditional “3+3” design, but they have been of limited use in practice. A major impediment to the adoption of the improved up-and-down designs is a lack of general guidance and a comprehensive assessment of the operating characteristics of these designs under practical clinical settings. To fill this gap, we review six up-and-down designs: the “3+3” design, accelerated titration design, biased coin design, k-in-a-row design, group up-and-down design and cumulative group up-and-down design. We conduct comprehensive simulation studies to evaluate their operating characteristics under various practical settings, and compare their performance to a theoretical optimal bound of nonparametric designs. The results show that the cumulative group up-and-down design has the best overall performance in terms of selecting the maximum tolerated dose (MTD), assigning patients to the MTD and patient safety. Its performance is generally close to the upper bound of nonparametric designs, but improvement seems possible in some cases. PMID:23856381

Bottom-up guidance in visual search for conjunctions.

PubMed

Proulx, Michael J

2007-02-01

Understanding the relative role of top-down and bottom-up guidance is crucial for models of visual search. Previous studies have addressed the role of top-down and bottom-up processes in search for a conjunction of features but with inconsistent results. Here, the author used an attentional capture method to address the role of top-down and bottom-up processes in conjunction search. The role of bottom-up processing was assayed by inclusion of an irrelevant-size singleton in a search for a conjunction of color and orientation. One object was uniquely larger on each trial, with chance probability of coinciding with the target; thus, the irrelevant feature of size was not predictive of the target's location. Participants searched more efficiently for the target when it was also the size singleton, and they searched less efficiently for the target when a nontarget was the size singleton. Although a conjunction target cannot be detected on the basis of bottom-up processing alone, participants used search strategies that relied significantly on bottom-up guidance in finding the target, resulting in interference from the irrelevant-size singleton.

On-Demand Sensor Node Wake-Up Using Solar Panels and Visible Light Communication

PubMed Central

Carrascal, Carolina; Demirkol, Ilker; Paradells, Josep

2016-01-01

To significantly reduce, or eliminate completely, the energy waste caused by the standby (idle) mode of wireless sensor nodes, we propose a novel on-demand wake-up system, which allows the nodes to be put into sleep mode unless their activation is truly necessary. Although there have been many studies proposing RF-based wake-up radio systems, in this work, we develop the first visible light communication (VLC)-based wake-up system. The developed system can extend the existing VLC systems and can be exploited to derive new application areas such as VLC tags. The system uses an off-the-shell indoor solar panel as receptor device of the wake-up signal as well as for energy harvesting purposes, through which it is able to harvest enough energy for its autonomous work. The design, implementation details and the experimental evaluation results are presented, which include flickering characterization and wake-up range evaluations. The results show that the developed system achieve reasonable wake-up distances for indoor environments, mainly where the use of VLC systems are considered. PMID:27011190

Follow-up of Temporary Implantable Nitinol Device (TIND) Implantation for the Treatment of BPH: a Systematic Review.

PubMed

Bertolo, Riccardo; Fiori, Cristian; Amparore, Daniele; Porpiglia, Francesco

2018-04-26

The purpose of the present systematic review is to offer a narrative synthesis of the available literature regarding the role of the temporary implantable nitinol device (TIND) (Medi-Tate®; Medi-Tate Ltd., Or Akiva, Israel) for the treatment of benign prostatic hyperplasia (BPH)-related lower urinary tract symptoms (LUTS), specifically focusing on the follow-up data. Current available evidences are limited in this topic. Sample size of patients available for analysis is small. Moreover, the duration of follow-up period is intermediate and longer follow-up is required. At the available 3 years follow-up, the TIND implantation is safe, effective, and well tolerated. The extended follow-up of the first and only available cohort of patients who underwent TIND for LUTS related to BPH corroborated previous literature findings. Further studies are required in order to assess the durability of TIND outcomes over a longer follow-up, to better define the indications of this approach, and to demonstrate the advantages of second-generation device over the first.

On-Demand Sensor Node Wake-Up Using Solar Panels and Visible Light Communication.

PubMed

Carrascal, Carolina; Demirkol, Ilker; Paradells, Josep

2016-03-22

To significantly reduce, or eliminate completely, the energy waste caused by the standby (idle) mode of wireless sensor nodes, we propose a novel on-demand wake-up system, which allows the nodes to be put into sleep mode unless their activation is truly necessary. Although there have been many studies proposing RF-based wake-up radio systems, in this work, we develop the first visible light communication (VLC)-based wake-up system. The developed system can extend the existing VLC systems and can be exploited to derive new application areas such as VLC tags. The system uses an off-the-shell indoor solar panel as receptor device of the wake-up signal as well as for energy harvesting purposes, through which it is able to harvest enough energy for its autonomous work. The design, implementation details and the experimental evaluation results are presented, which include flickering characterization and wake-up range evaluations. The results show that the developed system achieve reasonable wake-up distances for indoor environments, mainly where the use of VLC systems are considered.

Effects of Warm-Up and Fatigue on Knee Joint Position Sense and Jump Performance.

PubMed

Romero-Franco, N; Jiménez-Reyes, P

2017-01-01

The purpose of this study was to evaluate the effects of a warm-up and fatigue protocol on the vertical jump and knee joint position sense of sprinters. Thirty-two sprinters were randomly allocated to either a control group (CONT) or a plyometric group (PLYO) that performed a warm-up, followed by a high-intensity plyometric protocol. Absolute (AAE), relative (RAE), and variable (VAE) angular errors and vertical jump were evaluated before and after the warm-up, as well as after the plyometric protocol and again 5 min later. After the warm-up, athletes improved RAE and jump performance. After the plyometric protocol, scores on the RAE, VAE, and the vertical jump performance worsened compared to the control group and to the values obtained after the warm-up. Five minutes later, RAE and vertical jump continued to be impaired. AAE did not show significant differences. The vertical jump is improved after the warm-up, although it is deteriorated after high-intensity plyometry. Regarding knee proprioception, the lack of impairments in the AAE make unclear the effects of the plyometric exercises on knee proprioception.

Effect of the push-up exercise at different palmar width on muscle activities.

PubMed

Kim, You-Sin; Kim, Do-Yeon; Ha, Min-Seong

2016-01-01

[Purpose] The purpose of the present study was to determine the effects of changes in palmar width on the muscle activities of the shoulder and truncus muscles during push-up exercise. [Subjects] Twelve healthy adult males participated in this study as subjects. [Methods] Push-up exercises were performed with three different palmar width in narrow (50%), neutral (100%), and wide positions (150%). We measured the muscle activities of the deltoideus p. acromialis, pectoralis minor, pectoralis major, serratus anterior, biceps brachii, triceps brachii, latissimus dorsi, and infraspinatus. [Results] Pectoralis minor, triceps brachii, and infraspinatus muscle activities were greater during push-ups performed with the 50% palmar width compared with the other palmar widths. Pectoralis major muscle activity was greater during push-ups performed with the 50% and 100% palmar widths compared with the 150% palmar width. Serratus anterior muscle activity was greater during push-ups performed with the 150% palmar width compared with the other palmar widths. [Conclusion] These results are expected to serve as reference materials for push-up exercise applications in training programs for truncus muscle strengthening or rehabilitation programs for scapula patients.

Analysis of the quality of care in surgical treatment of colorectal cancer: national study. Follow-up results.

PubMed

Rodriguez-Cuellar, Elias; Nevado García, Cristina; Casanova Duran, Virginia; Romero Simó, Manuel; Duran Poveda, Manuel; Ruiz Lopez, Pedro

2014-01-01

Using the cases included in the Study on the quality of care in colorectal cancer conducted by the Spanish Association of Surgeons in 2008, we present follow-up data. Multicenter, descriptive, longitudinal and prospective study of patients operated on a scheduled basis of colorectal cancer. 35 hospitals have contributed data on 334 patients. Follow-up data: survival, recurrence and complications. Mean follow-up was 28.61±11.32 months. Follow-up by surgeon: 69.2%, tumor recurrence 23.6%, in 83.3% it was systemic; 28.2% underwent salvage surgery. Overall survival was 76.6%, disease-free survival 65.6% (26.49±11.90 months). Tumor related mortality was 12,6%. Percentage of ventral hernias was 5.8%, intestinal obstruction 3.5%. Quality and results of follow-up of patients operated on for CRC in Spain are similar to those reported in the Scientific literature. Areas for improvement: follow-up, earlier diagnosis, increase adjuvant and neoadjuvant treatments and total mesorectal excision as standard surgery for rectal cancer. Copyright © 2013 AEC. Published by Elsevier Espana. All rights reserved.

Results of a quantitative survey to explore both perceptions of the purposes of follow-up and preferences for methods of follow-up delivery among service users, primary care practitioners and specialist clinicians after cancer treatment.

PubMed

Frew, G; Smith, A; Zutshi, B; Young, N; Aggarwal, A; Jones, P; Kockelbergh, R; Richards, M; Maher, E J

2010-12-01

To ascertain perceptions of reasons for follow-up after cancer treatment among service users (patients and carers), primary care practitioners and specialist clinicians (doctors and specialist nurses) and to identify levels of preference for different models of follow-up and the effect of an individual's experience on preferred models. A national survey designed to meet the needs of each key respondent group was carried out after a structured literature review, an extensive consultation process and a pilot scheme. Respondents were asked to assess their degree of preference for 10 pre-selected indications for follow-up. Eight models of follow-up were also identified and respondents were asked to state their experience and preference for each type. The questionnaire was distributed nationally via the 34 cancer networks in England and was available both online and in hard copy (postal). The uptake for the electronic format was in the main by primary care practitioners and specialist clinicians. Service users preferred the paper (postal) format. The survey was also publicised through the primary care and patient partnership forums at a Cancer Network Development event. In total, 2928 responses were received, comprising service users (21% of the sample), primary care practitioners (32%) and specialist clinicians (47%). Eighty-six per cent of responses were received from the 10 strategic health authorities in England, with the remaining 14% from Scotland, Wales and The Isle of Man. The responses from Scotland, Wales and the Isle of Man generally occurred where they interfaced with English cancer networks or had been engaged through word of mouth by colleagues. Among all respondents the main aims of cancer follow-up were considered to be: (1) to monitor for early complications after treatment; (2) to detect recurrences early; (3) to detect late effects of treatment. The most commonly experienced method of follow-up among all respondent groups was outpatient review with a doctor. This was considered to be the most preferred follow-up option among service users (86%). The least preferred option among service users was postal follow-up (32%). Primary care practitioners and specialist clinicians were more likely than service users to have experienced alternative methods of follow-up, such as telephone follow-up, self-triggered referral and non-specialist follow-up. These models were highly rated by those who had experience of them. There was a reasonable level of consensus between service users, primary care practitioners and specialist clinicians as to the reasons for follow-up. Service users seemed to have higher expectations of follow-up, particularly in relation to detecting recurrences early. As respondents were more likely to prefer a method of follow-up delivery that they had experienced than one they had not; there could be resistance to change from established methods to new methods without adequate explanation. This suggests that the communication of new methods could be critical to their successful introduction. Copyright © 2010 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Fold-up concrete construction.

DOT National Transportation Integrated Search

1975-01-01

The fold-up method of concrete construction is a relatively new method of precasting a variety of structural shapes on a single flat surface and then folding portions up to form a three-dimensional shape. Structural members as beams, girders, columns...

Warm-up: A Psychophysiological Phenomenon.

ERIC Educational Resources Information Center

Lopez, Richard; Dausman, Cindy

1981-01-01

The effectiveness of warm-up as an aid to athletic performance is related to an interaction of both psychological and physiological factors. Benefits of warm-up include an increase in blood and muscle temperatures and an increased muscular endurance. (JN)

Rodent Control: Seal Up! Trap Up! Clean Up!

MedlinePlus

... Skip directly to site content Start of Search Controls Search Form Controls Cancel Submit Search The CDC CDC A-Z ... V W X Y Z # Start of Search Controls Search Form Controls Cancel Submit Search The CDC ...

Combat Fitness a Concept Vital to National Defense

DTIC Science & Technology

2010-06-18

Physical fitness testing has traditionally been focused on a 1.5- to 3-mile run, push-ups, sit-ups, and, in some Services pull -ups, flexibility, and...Performance 6 Shoot Physical Requirements Employ hand grenades Run under load, jump, bound, high/low crawl, climb, push, pull , squat, lunge, roll...jump, bound, high/low crawl, climb, push, pull , squat, lunge, roll, stop, start, change direction and get up/down. Navigate from one point to

40 CFR 35.4055 - What if my group can't come up with the “matching funds?”

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 1 2013-07-01 2013-07-01 false What if my group can't come up with the... Responsibilities As A Tag Recipient § 35.4055 What if my group can't come up with the “matching funds?” (a) EPA may... financial hardship to your group (for example, your local economy is depressed and coming up with in-kind...

40 CFR 35.4055 - What if my group can't come up with the “matching funds?”

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 1 2012-07-01 2012-07-01 false What if my group can't come up with the... Responsibilities As A Tag Recipient § 35.4055 What if my group can't come up with the “matching funds?” (a) EPA may... financial hardship to your group (for example, your local economy is depressed and coming up with in-kind...

40 CFR 35.4055 - What if my group can't come up with the “matching funds?”

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 1 2011-07-01 2011-07-01 false What if my group can't come up with the... Responsibilities As A Tag Recipient § 35.4055 What if my group can't come up with the “matching funds?” (a) EPA may... financial hardship to your group (for example, your local economy is depressed and coming up with in-kind...

40 CFR 35.4055 - What if my group can't come up with the “matching funds?”

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 1 2014-07-01 2014-07-01 false What if my group can't come up with the... Responsibilities As A Tag Recipient § 35.4055 What if my group can't come up with the “matching funds?” (a) EPA may... financial hardship to your group (for example, your local economy is depressed and coming up with in-kind...

40 CFR 35.4055 - What if my group can't come up with the “matching funds?”

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 1 2010-07-01 2010-07-01 false What if my group can't come up with the... Responsibilities As A Tag Recipient § 35.4055 What if my group can't come up with the “matching funds?” (a) EPA may... financial hardship to your group (for example, your local economy is depressed and coming up with in-kind...

Solar Cells Light Up Prison Cells on 'The Rock' | News | NREL

Science.gov Websites

2 » Solar Cells Light Up Prison Cells on 'The Rock' Solar Cells Light Up Prison Cells on 'The Rock ' July 23, 2012 This photo shows an island in the middle of blue sea water, with industrial buildings taking up a good deal of the island. The 1,300 solar panels on the Cellhouse building are a dark blue

A 380pW Dual Mode Optical Wake-up Receiver with Ambient Noise Cancellation.

PubMed

Lim, Wootaek; Jang, Taekwang; Lee, Inhee; Kim, Hun-Seok; Sylvester, Dennis; Blaauw, David

2016-06-01

We present a sub-nW optical wake-up receiver for wireless sensor nodes. The wake-up receiver supports dual mode operation for both ultra-low standby power and high data rates, while canceling ambient in-band noise. In 0.18µm CMOS the receiver consumes 380pW in always-on wake-up mode and 28.1µW in fast RX mode at 250kbps.

14 CFR Appendix D to Part 23 - Wheel Spin-Up and Spring-Back Loads

Code of Federal Regulations, 2014 CFR

2014-01-01

... (0.80 may be used); F Vmax=maximum vertical force on wheel (pounds)=n j W e, where W e and n j are... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Wheel Spin-Up and Spring-Back Loads D.... D Appendix D to Part 23—Wheel Spin-Up and Spring-Back Loads D23.1 Wheel spin-up loads. (a) The...

14 CFR Appendix D to Part 23 - Wheel Spin-Up and Spring-Back Loads

Code of Federal Regulations, 2013 CFR

2013-01-01

... (0.80 may be used); F Vmax=maximum vertical force on wheel (pounds)=n j W e, where W e and n j are... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Wheel Spin-Up and Spring-Back Loads D.... D Appendix D to Part 23—Wheel Spin-Up and Spring-Back Loads D23.1 Wheel spin-up loads. (a) The...

14 CFR Appendix D to Part 23 - Wheel Spin-Up and Spring-Back Loads

Code of Federal Regulations, 2011 CFR

2011-01-01

... (0.80 may be used); F Vmax=maximum vertical force on wheel (pounds)=n j W e, where W e and n j are... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Wheel Spin-Up and Spring-Back Loads D.... D Appendix D to Part 23—Wheel Spin-Up and Spring-Back Loads D23.1 Wheel spin-up loads. (a) The...

14 CFR Appendix D to Part 23 - Wheel Spin-Up and Spring-Back Loads

Code of Federal Regulations, 2010 CFR

2010-01-01

... (0.80 may be used); F Vmax=maximum vertical force on wheel (pounds)=n j W e, where W e and n j are... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Wheel Spin-Up and Spring-Back Loads D.... D Appendix D to Part 23—Wheel Spin-Up and Spring-Back Loads D23.1 Wheel spin-up loads. (a) The...

14 CFR Appendix D to Part 23 - Wheel Spin-Up and Spring-Back Loads

Code of Federal Regulations, 2012 CFR

2012-01-01

... (0.80 may be used); F Vmax=maximum vertical force on wheel (pounds)=n j W e, where W e and n j are... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Wheel Spin-Up and Spring-Back Loads D.... D Appendix D to Part 23—Wheel Spin-Up and Spring-Back Loads D23.1 Wheel spin-up loads. (a) The...

Why Do Middle School Students Sign Up for Washington's College Bound Scholarship Program? A Mixed Methods Evaluation. CEDR Working Paper. WP #2016-3

ERIC Educational Resources Information Center

Goldhaber, Dan; Long, Mark C.; Person, Ann; Rooklyn, Jordan

2016-01-01

Why individuals choose not to sign up for social programs, particularly when the costs of sign-up are low and the benefits generous, is a crucial question for policy scholars. In this paper, we show that a substantial share of qualified middle school students fail to sign up for Washington State's College Bound Scholarship program, and this…

A 380pW Dual Mode Optical Wake-up Receiver with Ambient Noise Cancellation

PubMed Central

Lim, Wootaek; Jang, Taekwang; Lee, Inhee; Kim, Hun-Seok; Sylvester, Dennis; Blaauw, David

2016-01-01

We present a sub-nW optical wake-up receiver for wireless sensor nodes. The wake-up receiver supports dual mode operation for both ultra-low standby power and high data rates, while canceling ambient in-band noise. In 0.18µm CMOS the receiver consumes 380pW in always-on wake-up mode and 28.1µW in fast RX mode at 250kbps. PMID:28392978

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

Marschman, Steven Craig

While low burn-up fuel [that characterized as having a burn-up of less than 45 gigawatt days per metric ton uranium (GWD/MTU)] has been stored for nearly three decades, the storage of high burn-up used fuels is more recent. The DOE has funded a High Burn-Up (HBU) Confirmatory Data Project to confirm the behavior of used high burn-up fuel under prototypic conditions. The Electric Power Research Institute (EPRI) is leading a project team to develop and implement the Test Plan to collect this data from a UNF dry storage system containing high burn-up fuel. As part of that project, 25 “sister”more » fuel rods have been selected, removed from assemblies, and placed in a fuel container ready for shipment to a national laboratory. This report documents that status of readiness to receive the fuel if that fuel were to be sent to Idaho National Laboratory (INL).« less

Increasing Follow-up Outcomes of At-Risk Alcohol Patients Using Motivational Interviewing.

PubMed

Wagner, Andrew J; Garbers, Rachael; Lang, Ann; Borgert, Andrew J; Fisher, Mason

2016-01-01

Our trauma division implemented a screening, brief intervention, and referral to treatment (SBIRT) program in 2009 and has maintained more than 92% screening rate for all inpatient admissions since inception. Brief interventions are proven to be more likely to effect and reinforce change if a follow-up contact is made with patients. This led to discussion regarding whether identified patients were more likely to follow up with our SBIRT wellness specialist using motivational interviewing or with our partners, exercise physiology, who use traditional interviewing techniques. We retrospectively reviewed more than 3,000 inpatient admissions in which screening for at-risk alcohol use were positive. Fifty-one percent of identified patients were referred for wellness specialist consultation with a follow-up rate of 52% compared with a follow-up rate of only 21% in the exercise physiology group. Motivational interviewing is more effective in encouraging at-risk alcohol users to participate in follow-up care.

Progress on performance assessment of ITER enhanced heat flux first wall technology after neutron irradiation

NASA Astrophysics Data System (ADS)

Hirai, T.; Bao, L.; Barabash, V.; Chappuis, Ph; Eaton, R.; Escourbiac, F.; Giqcuel, S.; Merola, M.; Mitteau, R.; Raffray, R.; Linke, J.; Loewenhoff, Th; Pintsuk, G.; Wirtz, M.; Boomstra, D.; Magielsen, A.; Chen, J.; Wang, P.; Gervash, A.; Safronov, V.

2016-02-01

ITER first wall (FW) panels are irradiated by energetic neutrons during the nuclear phase. Thus, an irradiation and high heat flux testing programme is undertaken by the ITER organization in order to evaluate the effects of neutron irradiation on the performance of enhanced heat flux (EHF) FW components. The test campaign includes neutron irradiation (up to 0.6-0.8 dpa at 200 °C-250 °C) of mock-ups that are representative of the final EHF FW panel design, followed by thermal fatigue tests (up to 4.7 MW m-2). Mock-ups were manufactured by the same manufacturing process as proposed for the series production. After a pre-irradiation thermal screening, eight mock-ups will be selected for the irradiation campaigns. This paper reports the preparatory work of HHF tests and neutron irradiation, assessment results as well as a brief description of mock-up manufacturing and inspection routes.

Exploiting Concurrent Wake-Up Transmissions Using Beat Frequencies.

PubMed

Kumberg, Timo; Schindelhauer, Christian; Reindl, Leonhard

2017-07-26

Wake-up receivers are the natural choice for wireless sensor networks because of their ultra-low power consumption and their ability to provide communications on demand. A downside of ultra-low power wake-up receivers is their low sensitivity caused by the passive demodulation of the carrier signal. In this article, we present a novel communication scheme by exploiting purposefully-interfering out-of-tune signals of two or more wireless sensor nodes, which produce the wake-up signal as the beat frequency of superposed carriers. Additionally, we introduce a communication algorithm and a flooding protocol based on this approach. Our experiments show that our approach increases the received signal strength up to 3 dB, improving communication robustness and reliability. Furthermore, we demonstrate the feasibility of our newly-developed protocols by means of an outdoor experiment and an indoor setup consisting of several nodes. The flooding algorithm achieves almost a 100% wake-up rate in less than 20 ms.

A quality by design approach to scale-up of high-shear wet granulation process.

PubMed

Pandey, Preetanshu; Badawy, Sherif

2016-01-01

High-shear wet granulation is a complex process that in turn makes scale-up a challenging task. Scale-up of high-shear wet granulation process has been studied extensively in the past with various different methodologies being proposed in the literature. This review article discusses existing scale-up principles and categorizes the various approaches into two main scale-up strategies - parameter-based and attribute-based. With the advent of quality by design (QbD) principle in drug product development process, an increased emphasis toward the latter approach may be needed to ensure product robustness. In practice, a combination of both scale-up strategies is often utilized. In a QbD paradigm, there is also a need for an increased fundamental and mechanistic understanding of the process. This can be achieved either by increased experimentation that comes at higher costs, or by using modeling techniques, that are also discussed as part of this review.

Quantifying muscle patterns and spine load during various forms of the push-up.

PubMed

Freeman, Stephanie; Karpowicz, Amy; Gray, John; McGill, Stuart

2006-03-01

This study was conducted to quantify the normalized amplitudes of the abdominal wall and back extensor musculature during a variety of push-up styles. We also sought to quantify their impact on spinal loading by calculating spinal compression and torque generation in the L4-5 area. Ten university-age participants, nine males and one female, in good to excellent condition, volunteered to participate in this study. All participants were requested to perform a maximum of 12 different push-up exercises, three trials per exercise. Surface electromyographic data (EMG) were collected bilaterally on rectus abdominis, external oblique, internal oblique, latissimus dorsi, and erector spinae muscles, and unilaterally (right side) on pectoralis major, triceps brachii, biceps brachii, and anterior deltoid muscles. Spine kinetics were obtained using an anatomically detailed model of the torso/spine. This study revealed that more dynamic push-ups (i.e., ballistic, with hand movement) required more muscle activation and higher spine load, whereas placing labile balls under the hands only resulted in modest increases in spine load. Right rectus abdominis (RA) activation was significantly higher than left RA activation during the left hand forward push-up and vice versa for the right hand forward push-up (P < 0.001). External oblique (EO) demonstrated the same switch in dominance during staggered hand push-ups (P < 0.01). The one-arm push-up resulted in the highest spine compression. Skilled participants showed greater synchronicity with peak muscle activation (plyometric type of contractions) during ballistic push-ups. These data will help guide exercise selection for individuals with differing training objectives and injury history.

Warm-up before laparoscopic surgery is not essential.

PubMed

Weston, Maree K; Stephens, Jacqueline H; Schafer, Amy; Hewett, Peter J

2014-03-01

Several recent studies have suggested that warming up prior to surgery may improve surgical performance. The purpose of this study was to investigate whether warming up prior to laparoscopic surgery improves surgical performance or reduces surgery duration. Between August 2011 and January 2012, a randomized controlled trial was conducted to compare two warm-up modalities to no warm-up. The study was conducted at a single site, with nine surgeons performing 72 laparoscopic cholecystectomies and 37 laparoscopic appendicectomies. Prior to surgery, surgeons were randomized to either laparoscopic trainer box warm-up, PlayStation 2 warm-up or no warm-up. The activity was performed within 30 min of surgery commencing. Patients provided informed consent for the surgery to be digitally recorded. Digital videodiscs (DVDs) were reviewed by an independent and blinded assessor. Data were collected on duration of surgery, level of training and perceived surgical difficulty. Surgical performance was graded using a validated scoring system. From the 109 operations performed, there were 75 usable DVDs. Overall, there were no statistical differences in the demographics of patients and surgeons in the three treatment groups, nor in the subset that had useable DVDs. There were no statistical differences in the duration of surgery or surgeon's perceived surgical difficulty. There was no statistical difference in surgical performance. This study suggests that warm-up prior to laparoscopic cholecystectomy or appendicectomy is not essential, acknowledging that there are several study limitations that preclude definitive conclusion. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

Run-up of Tsunamis in the Gulf of Mexico caused by the Chicxulub Impact Event

NASA Astrophysics Data System (ADS)

Weisz, R.; Wünnenmann, K.; Bahlburg, H.

2003-04-01

The Chicxulub impact event can be investigated on (1) local, (2) regional and in (3) global scales. Our investigations focus on the regional scale, especially on the run-up of tsunami waves on the coast around the Gulf of Mexico caused by the impact. An impact produces two types of tsunami waves: (1) the rim wave, (2) the collapse wave. Both waves propagate over long distances and reach coastal areas. Depending on the tsunami wave characteristics, they have a potentionally large influence on the coastal areas. Run-up distance and run-up height can be used as parameters for assessing this influence. To calculate these parameters, we are using a multi-material hydrocode (SALE) to simulate the generation of the tsunami wave, a non-linear shallow water approach for the propagation, and we implemented a special open boundary for considering the run-up of tsunami waves. With the help of the one-dimensional shallow water approach, we will give run-up heights and distances for the coastal area around the Gulf of Mexico. The calculations are done along several sections from the impact site towards the coast. These are a first approximation to run-up calculations for the entire coast of the Gulf of Mexico. The bathymetric data along the sections, used in the wave propagation and run-up, correspond to a linearized bathymetry of the recent Gulf of Mexico. Additionally, we will present preliminary results from our first two-dimensional experiments of propagation and run-up. These results will be compared with the one-dimensional approach.

Planning for Long-Term Follow-Up: Strategies Learned from Longitudinal Studies.

PubMed

Hill, Karl G; Woodward, Danielle; Woelfel, Tiffany; Hawkins, J David; Green, Sara

2016-10-01

Preventive interventions are often designed and tested with the immediate program period in mind, and little thought that the intervention sample might be followed up for years or even decades beyond the initial trial. However, depending on the type of intervention and the nature of the outcomes, long-term follow-up may well be appropriate. The advantages of long-term follow-up of preventive interventions are discussed and include the capacity to examine program effects across multiple later life outcomes, the ability to examine the etiological processes involved in the development of the outcomes of interest, and the ability to provide more concrete estimates of the relative benefits and costs of an intervention. In addition, researchers have identified potential methodological risks of long-term follow-up such as inflation of type 1 error through post hoc selection of outcomes, selection bias, and problems stemming from attrition over time. The present paper presents a set of seven recommendations for the design or evaluation of studies for potential long-term follow-up organized under four areas: Intervention Logic Model, Developmental Theory and Measurement Issues; Design for Retention; Dealing with Missing Data; and Unique Considerations for Intervention Studies. These recommendations include conceptual considerations in the design of a study, pragmatic concerns in the design and implementation of the data collection for long-term follow-up, as well as criteria to be considered for the evaluation of an existing intervention for potential for long-term follow-up. Concrete examples from existing intervention studies that have been followed up over the long term are provided.

Transcription factor AtTCP14 regulates embryonic growth potential during seed germination in Arabidopsis thaliana.

PubMed

Tatematsu, Kiyoshi; Nakabayashi, Kazumi; Kamiya, Yuji; Nambara, Eiji

2008-01-01

To understand the molecular mechanisms underlying regulation of seed germination, we searched enriched cis elements in the upstream regions of Arabidopsis genes whose transcript levels increased during seed germination. Using available published microarray data, we found that two cis elements, Up1 or Up2, which regulate outgrowth of Arabidopsis axillary shoots, were significantly over-represented. Classification of Up1- and Up2-containing genes by gene ontology revealed that protein synthesis-related genes, especially ribosomal protein genes, were highly over-represented. Expression analysis using a reporter gene driven by a synthetic promoter regulated by these elements showed that the Up1 is necessary and sufficient for germination-associated gene induction, whereas Up2 acts as an enhancer of Up1. Up1-mediated gene expression was suppressed by treatments that blocked germination. Up1 is almost identical to the site II motif, which is the predicted target of TCP transcription factors. Of 24 AtTCP genes, AtTCP14, which showed the highest transcript level just prior to germination, was functionally characterized to test its involvement in the regulation of seed germination. Transposon-tagged lines for AtTCP14 showed delayed germination. In addition, germination of attcp14 mutants exhibited hypersensitivity to exogenously applied abscisic acid and paclobutrazol, an inhibitor of gibberellin biosynthesis. AtTCP14 was predominantly expressed in the vascular tissues of the embryo, and affected gene expression in radicles in a non-cell-autonomous manner. Taken together, these results indicate that AtTCP14 regulates the activation of embryonic growth potential in Arabidopsis seeds.

Optimizing Bariatric Surgery Multidisciplinary Follow-up: a Focus on Patient-Centered Care.

PubMed

Aarts, Mary-Anne; Sivapalan, Nardhana; Nikzad, Seyed-Ehsan; Serodio, Kristin; Sockalingam, Sanjeev; Conn, Lesley Gotlib

2017-03-01

Failure to follow-up post-bariatric surgery has been associated with higher postoperative complications, lower percentage weight loss and poorer nutrition. This study aimed to understand the patient follow-up experience in order to optimize follow-up care within a comprehensive bariatric surgery program. Qualitative telephone interviews were conducted in patients who underwent surgery through a publically funded multidisciplinary bariatric surgery program in 2011, in Ontario, Canada. Inductive thematic analysis was used. Of the 46 patients interviewed, 76.1 % were female, mean age was 50, and 10 were lost to follow-up within 1 year postsurgery. Therapeutic continuity was the most important element of follow-up care identified by patients and was most frequently established with the dietician, as this team member was highly sought and accessible. Patients who attended regularly (1) appreciated the specialized care, (2) favoured ongoing monitoring and support, (3) were committed to the program and (4) felt their family doctor had insufficient experience/knowledge to manage their follow-up care. Of the 36 people who attended the clinic regularly, 8 were not planning to return after 2 years due to (1) perceived diminishing usefulness, (2) system issues, (3) confidence that their family physician could continue their care or (4) higher priority personal/health issues. Patients lost to follow-up stated similar barriers. Patients believe the follow-up post-bariatric surgery is essential in providing the support required to maintain their diet and health. More personalized care focusing on continuity and relationships catering to individual patient needs balanced with local healthcare resources may redefine and reduce attrition rates.

Assessing factors for loss to follow-up of HIV infected patients in Guinea-Bissau.

PubMed

Nordentoft, Pernille Bejer; Engell-Sørensen, Thomas; Jespersen, Sanne; Correia, Faustino Gomes; Medina, Candida; da Silva Té, David; Østergaard, Lars; Laursen, Alex Lund; Wejse, Christian; Hønge, Bo Langhoff

2017-04-01

The objective of this study was to ascertain vital status of patients considered lost to follow-up at an HIV clinic in Guinea-Bissau, and describe reasons for loss to follow-up (LTFU). This study was a cross-sectional sample of a prospective cohort, carried out between May 15, 2013, and January 31, 2014. Patients lost to follow-up, who lived within the area of the Bandim Health Project, a demographic surveillance site (DSS), were eligible for inclusion. Active follow-up was attempted by telephone and tracing by a field assistant. Semi-structured interviews were done face to face or by phone by a field assistant and patients were asked why they had not shown up for the scheduled appointment. Patients were included by date of HIV testing and risk factors for LTFU were assessed using Cox proportional hazard model. Among 561 patients (69.5 % HIV-1, 18.0 % HIV-2 and 12.6 % HIV-1/2) living within the DSS, 292 patients had been lost to follow-up and were, therefore, eligible for active follow-up. Vital status was ascertained in 65.9 % of eligible patients and 42.7 % were alive, while 23.2 % had died. Information on reasons for LTFU existed for 103 patients. Major reasons were moving (29.1 %), travelling (17.5 %), and transferring to other clinics (11.7 %). A large proportion of the patients at the clinic were lost to follow-up. The main reason for this was found to be the geographic mobility of the population in Guinea-Bissau.

Catch-Up Growth and Neurobehavioral Development among Full-Term, Small-for-Gestational-Age Children: A Nationwide Japanese Population-Based Study.

PubMed

Takeuchi, Akihito; Yorifuji, Takashi; Nakamura, Kazue; Tamai, Kei; Mori, Shigehiro; Nakamura, Makoto; Kageyama, Misao; Kubo, Toshihide; Ogino, Tatsuya; Kobayashi, Katsuhiro; Doi, Hiroyuki

2018-01-01

To examine the relationship between catch-up growth of full-term, small for gestational age (SGA) children and their neurobehavioral development. Data were obtained from a population-based nationwide Japanese longitudinal survey that started in 2001. Study participants were full-term children with information on height at 2 years of age (n = 32 533). Catch-up growth for SGA infants was defined as achieving a height at 2 years of age of more than -2.0 standard deviations for chronological age. Logistic regression analyses were used to estimate ORs and 95% CIs for the associations of SGA and catch-up growth status with neurobehavioral development at 2.5 and 8 years of age, adjusting for potential infant- and parent-related confounding factors. Fifteen percent of term SGA infants failed to catch up in height. At 2.5 years of age, SGA children without catch-up growth were more likely to be unable to climb stairs (OR, 10.42; 95% CI, 5.55-19.56) and unable to compose a 2-word sentence (OR, 3.58; 95% CI, 1.81-7.08) compared with children with normal growth at birth. Furthermore, SGA children without catch-up growth were at increased risk for aggressive behaviors (OR, 3.85; 95% CI, 1.19-12.47) at 8 years of age. Continuous follow-up for full-term SGA infants with failure of catch-up growth or poor postnatal growth may be beneficial for early detection and intervention for behavioral problems. Copyright © 2017 Elsevier Inc. All rights reserved.

Re-sprains during the first 3 months after initial ankle sprain are related to incomplete recovery: an observational study.

PubMed

van Middelkoop, Marienke; van Rijn, Rogier M; Verhaar, Jan A N; Koes, Bart W; Bierma-Zeinstra, Sita M A

2012-01-01

What are prognostic factors for incomplete recovery, instability, re-sprains and pain intensity 12 months after patients consult primary care practitioners for acute ankle sprains? Observational study. One hundred and two patients who consulted their general practitioner or an emergency department for an acute ankle sprain were included in the study. Possible prognostic factors were assessed at baseline and at 3 months follow-up. Outcome measures assessed at 12 months follow-up were self-reported recovery, instability, re-sprains and pain intensity. At 3 months follow-up, 65% of the participants reported instability and 24% reported one or more re-sprains. At 12 months follow-up, 55% still reported instability and more than 50% regarded themselves not completely recovered. None of the factors measured at baseline could predict the outcome at 12 months follow-up. Additionally, prognostic factors from the physical examination of the non-recovered participants at 3 months could not be identified. However, among the non-recovered participants at 3 months follow-up, re-sprains and self-reported pain at rest at 3 months were related to incomplete recovery at 12 months. A physical examination at 3 months follow-up for the non-recovered ankle sprain patient seems to have no additional value for predicting outcome at 12 months. However, for the non-recovered patients at 3 months follow-up, self-reported pain at rest and re-sprains during the first 3 months of follow-up seem to have a prognostic value for recovery at 12 months. Copyright © 2012 Australian Physiotherapy Association. Published by .. All rights reserved.

Team communication amongst clinical teachers in a formal meeting of post graduate medical training.

PubMed

Slootweg, Irene A; Scherpbier, Albert; van der Leeuw, Renée; Heineman, Maas Jan; van der Vleuten, Cees; Lombarts, Kiki M J M H

2016-03-01

The importance of team communication, or more specifically speaking up, for safeguarding quality of patient care is increasingly being endorsed in research findings. However, little is known about speaking up of clinical teachers in postgraduate medical training. In order to determine how clinical teachers demonstrate speaking up in formal teaching team meetings and what factors influence this, the authors carried out an exploratory study based on ethnographic principles. The authors selected 12 teaching teams and observed, audio recorded and analysed the data. Subsequently, during an interview, the program directors reflected on speaking up of those clinical teachers present during the meeting. Finally, the authors analysed iteratively all data, using a template analysis, based on Edmondson's behaviours of speaking up. The study was conducted from October 2013 to July 2014 and ten teams participated. During the teaching team meetings, the clinical teachers exhibited most of the behaviours of speaking up. "Sharing information" strongly resembles providing information and "talking about mistakes" occurs in a general sense and without commitment of improvement activities. "Asking questions" was often displayed by closed questions and at times several questions simultaneously. The authors identified factors that influence speaking up by clinical teachers: relational, cultural, and professional. The clinical teachers exhibit speaking up, but there is only limited awareness to discuss problems or mistakes and the discussion centred mainly on the question of blame. It is important to take into account the factors that influence speaking up, in order to stimulate open communication during the teaching team meetings.

A stakeholder-driven agenda for advancing the science and practice of scale-up and spread in health.

PubMed

Norton, Wynne E; McCannon, C Joseph; Schall, Marie W; Mittman, Brian S

2012-12-06

Although significant advances have been made in implementation science, comparatively less attention has been paid to broader scale-up and spread of effective health programs at the regional, national, or international level. To address this gap in research, practice and policy attention, representatives from key stakeholder groups launched an initiative to identify gaps and stimulate additional interest and activity in scale-up and spread of effective health programs. We describe the background and motivation for this initiative and the content, process, and outcomes of two main phases comprising the core of the initiative: a state-of-the-art conference to develop recommendations for advancing scale-up and spread and a follow-up activity to operationalize and prioritize the recommendations. The conference was held in Washington, D.C. during July 2010 and attended by 100 representatives from research, practice, policy, public health, healthcare, and international health communities; the follow-up activity was conducted remotely the following year. Conference attendees identified and prioritized five recommendations (and corresponding sub-recommendations) for advancing scale-up and spread in health: increase awareness, facilitate information exchange, develop new methods, apply new approaches for evaluation, and expand capacity. In the follow-up activity, 'develop new methods' was rated as most important recommendation; expanding capacity was rated as least important, although differences were relatively minor. Based on the results of these efforts, we discuss priority activities that are needed to advance research, practice and policy to accelerate the scale-up and spread of effective health programs.

The value of gynecologic cancer follow-up: evidence-based ignorance?

PubMed

Lajer, Henrik; Jensen, Mette B; Kilsmark, Jannie; Albæk, Jens; Svane, Danny; Mirza, Mansoor R; Geertsen, Poul F; Reerman, Diana; Hansen, Kåre; Milter, Maya C; Mogensen, Ole

2010-11-01

To explore the extent of evidence-based data and cost-utility of follow-up after primary treatment of endometrial and ovarian cancer, addressing perspectives of technology, organization, economics, and patients. Systematic literature searches according to the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions were conducted separately for each of the 4 perspectives. In addition, the organizational analysis included a nationwide questionnaire survey among all relevant hospital departments, and the operating costs were calculated. None of the identified studies supported a survival benefit from hospital-based follow-up after completion of primary treatment of endometrial or ovarian cancer. The methods for follow-up were of low technology (gynecologic examination with or without ultrasound examination). Other technologies had poor sensitivity and specificity in detecting recurrence. Small changes in applied technologies and organization lead to substantial changes in costs. Substantial differences especially in frequency and applied methods were found between departments. The literature review did not find evidence that follow-up affects the women's quality of life. The main purpose of follow-up after treatment of cancer is improved survival. Our review of the literature showed no evidence of a positive effect on survival in women followed up after primary treatment of endometrial or ovarian cancer. The conception of follow-up among physicians, patients, and their relatives therefore needs revision. Follow-up after treatment should have a clearly defined and evidence-based purpose. Based on the existing literature, this purpose should presently focus on other end points rather than early detection of relapse and improved survival. These end points could be quality of life, treatment toxicity, and economy.

Follow-up after curative treatment for colorectal cancer: longitudinal evaluation of patient initiated follow-up in the first 12 months.

PubMed

Batehup, L; Porter, K; Gage, H; Williams, P; Simmonds, P; Lowson, E; Dodson, L; Davies, N J; Wagland, R; Winter, J D; Richardson, A; Turner, A; Corner, J L

2017-07-01

To compare patient-triggered follow-up (PTFU) for curatively treated colorectal cancer against traditional outpatient follow-up (OPFU). Questionnaires were mailed at four time points over one-year post-treatment to two prospectively-recruited cohorts: A, patients entering follow-up and receiving OPFU pre-implementation of PTFU; B, patients entering follow-up (FU) and receiving either OPFU (B1) or PTFU (B2) post-implementation of PTFU. Bi-variate tests were used to compare patient characteristics and outcomes eight months after entering follow-up (generic and cancer-specific quality of life (QoL), satisfaction). Regression analysis explored associations between follow-up model and outcomes. Resource implications and costs of models were compared. Patients in Cohort B1 were significantly more likely to have received chemotherapy (p < 0.001), radiotherapy (p < 0.05), and reported poorer QoL (p = 0.001). Having a longstanding co-morbid condition was the most important determinant of QoL (p < 0.001); model of care was not significant. Patients were satisfied with their follow-up care regardless of model. Health service costs were higher in PTFU over the first year CONCLUSIONS: PTFU is acceptable to patients with colorectal cancer and can be considered to be a realistic alternative to OPFU for clinically suitable patients. The initial costs are higher due to provision of a self-management (SM) programme and remote surveillance. Further research is needed to establish long-term outcomes and costs.

Aerosol characterisation at the FEBUKO upwind station Goldlauter (II): Detailed organic chemical characterisation

NASA Astrophysics Data System (ADS)

Müller, K.; van Pinxteren, D.; Plewka, A.; Svrcina, B.; Kramberger, H.; Hofmann, D.; Bächmann, K.; Herrmann, H.

An extensive set of gaseous and particulate organic compounds was quantified before an orographic cloud passage at the upwind site of the research region in Thüringer Wald. Samples were collected with two different time resolutions, 2 h for gaseous species and spray absorber samples and the whole cloud event duration to determine the concentrations of ketones, aldehydes, monocarboxylic acids, dicarboxylic acids (DCA), hydrocarbons, biogenic sugars and alcohols in both the gas and particle phase. The measurement of different groups of organic compounds delivered size-segregated concentrations at the upwind site of a cloud experiment. The size distribution of DCA showed a peak in the mass-rich impactor stage 3 (0.42-1.2 μm). The concentrations of DCA from the filters, the impactor foils as well as the spray absorber samples decreased with increasing C-number. The time resolved measurements revealed an increasing mixing ratio from night time to midday for carboxylic and DCA, and related carbonyl compounds. The biogenic compounds xylitol (up to 103 ng m -3), levoglucosan (up to 62 ng m -3) and pinonaldehyde (up to 34 ng m -3) were the compounds found in highest concentrations in the particle phase beside the oxalate (up to 104 ng m -3). The organic trace gases with the highest mixing ratios identified were formaldehyde (up to 1.47 ppbv), acetaldehyde (up to 0.84 ppbv) and acetone (up to 0.65 ppbv), acetic acid (up to 0.43 ppbv) and formic acid (up to 0.41 ppbv).

The Mediating Role of Autonomy and Relatedness on Maternal and Child Outcomes.

PubMed

Guo, Xiamei; Slesnick, Natasha

2018-02-01

The current study examined the mediating role of both mother and child interactive behaviors, which granted or undermined autonomy and relatedness, on the bidirectional and longitudinal association between maternal depressive symptoms and child internalizing behaviors, as well as the association between maternal substance use and child externalizing behaviors. Child's sex and mother's drug of choice were explored as potential moderators of the mediation relationship. Data were collected from 183 dyads including treatment-seeking substance using mothers and their children (95 males, aged between 8 and 16 years old). Structural equation modeling analysis showed girls' internalizing and externalizing behaviors at the 3-month follow-up were negatively associated with the same behaviors at the 12-month follow-up through increased relatedness undermining behaviors from their mothers at the 6-month follow-up. Among mothers with opioids as their drug of choice (DOC), children's externalizing behaviors at the 3-month follow-up were positively associated with mothers' substance use at the 12-month follow-up through the elevated levels of mothers' relatedness undermining behaviors at the 6-month follow-up. Among mothers with alcohol as their DOC, maternal depressive symptoms at the 3-month follow-up were positively related to children's internalizing behaviors at the 12-month follow-up through reduced relatedness undermining behaviors exhibited by mothers at the 6-month follow-up. To our knowledge, this is one of the first studies to attempt to unravel these longitudinal and bidirectional influences as well as the moderated mediation pathways among families with a substance using mothers.

MRI follow-up after concordant, histologically benign diagnosis of breast lesions sampled by MRI-guided biopsy.

PubMed

Li, Jie; Dershaw, D David; Lee, Carol H; Kaplan, Jennifer; Morris, Elizabeth A

2009-09-01

Follow-up MRI can be useful to confirm a benign diagnosis after MRI-guided breast biopsy. This retrospective study was undertaken to evaluate appropriate timing and imaging interpretation for the initial follow-up MRI when a benign, concordant histology is obtained using MRI-guided breast biopsy. Retrospective review was performed of 177 lesions visualized only by MRI in 172 women who underwent 9-gauge, vacuum-assisted core biopsy and marker placement with imaging-concordant benign histology. All underwent follow-up MRI within 12 months. Timing of the follow-up study, change in size, results of second biopsy if performed, and distance of localizing marker to the lesion on the follow-up study were recorded. At initial follow-up, 155 lesions were decreased or gone, 14 lesions were stable, and eight were enlarged. Seventeen (9.6%, 17/177) lesions underwent a second biopsy, including six enlarging, 10 stable, and one decreasing. Of these, four were malignant. Enlargement was seen in two carcinomas at 6 and 12 months. Two carcinomas, one stable at 2 months and another stable at 3 and 11 months, were rebiopsied because of suspicion of a missed lesion in the former and worrisome mammographic and sonographic changes in the latter. The distance of the marker from the lesion on follow-up did not correlate with biopsy accuracy. Follow-up MRI did not detect missed cancers because of lesion enlargement before 6 months after biopsy; two of four missed cancers were stable. The localizing marker can deploy away from the target despite successful sampling.

Planning for Long-Term Follow-up: Strategies Learned from Longitudinal Studies

PubMed Central

Hill, Karl G.; Woodward, Danielle; Woelfel, Tiffany; Hawkins, J. David; Green, Sara

2017-01-01

Preventive interventions are often designed and tested with the immediate program period in mind, and little thought that the intervention sample might be followed up for years, or even decades beyond the initial trial. However, depending on the type of intervention and the nature of the outcomes, long-term follow-up may well be appropriate. The advantages of long-term follow-up of preventive interventions are discussed, and include the capacity to examine program effects across multiple later life outcomes, the ability to examine the etiological processes involved in the development of the outcomes of interest and the ability to provide more concrete estimates of the relative benefits and costs of an intervention. In addition, researchers have identified potential methodological risks of long-term follow-up such as inflation of type 1 error through post-hoc selection of outcomes, selection bias and problems stemming from attrition over time. The present paper presents a set of seven recommendations for the design or evaluation of studies for potential long-term follow-up organized under four areas: Intervention Logic Model, Developmental Theory and Measurement Issues; Design for Retention; Dealing with Missing Data; and Unique Considerations for Intervention Studies. These recommendations include conceptual considerations in the design of a study, pragmatic concerns in the design and implementation of the data collection for long-term follow-up, as well as criteria to be considered for the evaluation of an existing intervention for potential for long-term follow-up. Concrete examples from existing intervention studies that have been followed up over the long-term are provided. PMID:26453453

Electronic Detection of Delayed Test Result Follow-Up in Patients with Hypothyroidism.

PubMed

Meyer, Ashley N D; Murphy, Daniel R; Al-Mutairi, Aymer; Sittig, Dean F; Wei, Li; Russo, Elise; Singh, Hardeep

2017-07-01

Delays in following up abnormal test results are a common problem in outpatient settings. Surveillance systems that use trigger tools to identify delayed follow-up can help reduce missed opportunities in care. To develop and test an electronic health record (EHR)-based trigger algorithm to identify instances of delayed follow-up of abnormal thyroid-stimulating hormone (TSH) results in patients being treated for hypothyroidism. We developed an algorithm using structured EHR data to identify patients with hypothyroidism who had delayed follow-up (>60 days) after an abnormal TSH. We then retrospectively applied the algorithm to a large EHR data warehouse within the Department of Veterans Affairs (VA), on patient records from two large VA networks for the period from January 1, 2011, to December 31, 2011. Identified records were reviewed to confirm the presence of delays in follow-up. During the study period, 645,555 patients were seen in the outpatient setting within the two networks. Of 293,554 patients with at least one TSH test result, the trigger identified 1250 patients on treatment for hypothyroidism with elevated TSH. Of these patients, 271 were flagged as potentially having delayed follow-up of their test result. Chart reviews confirmed delays in 163 of the 271 flagged patients (PPV = 60.1%). An automated trigger algorithm applied to records in a large EHR data warehouse identified patients with hypothyroidism with potential delays in thyroid function test results follow-up. Future prospective application of the TSH trigger algorithm can be used by clinical teams as a surveillance and quality improvement technique to monitor and improve follow-up.

Handling an Asthma Flare-Up

MedlinePlus

... Videos for Educators Search English Español Handling an Asthma Flare-Up KidsHealth / For Kids / Handling an Asthma ... español Cómo controlar las crisis asmáticas What's an Asthma Flare-Up? If you have asthma , you probably ...

7. CLOSEUP VIEW OF WASHED UP 12' x 12' DAM ...

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

7. CLOSE-UP VIEW OF WASHED UP 12' x 12' DAM SUPPORT TIMBERS, THREE BEARS LAKE, LOOKING NORTHEAST FROM SOUTH SIDE OF LAKE - Three Bears Lake & Dams, North of Marias Pass, East Glacier Park, Glacier County, MT

Should the surgeon or the general practitioner (GP) follow up patients after surgery for colon cancer? A randomized controlled trial protocol focusing on quality of life, cost-effectiveness and serious clinical events.

PubMed

Augestad, Knut M; Vonen, Barthold; Aspevik, Ranveig; Nestvold, Torunn; Ringberg, Unni; Johnsen, Roar; Norum, Jan; Lindsetmo, Rolv-Ole

2008-06-25

All patients who undergo surgery for colon cancer are followed up according to the guidelines of the Norwegian Gastrointestinal Cancer Group (NGICG). These guidelines state that the aims of follow-up after surgery are to perform quality assessment, provide support and improve survival. In Norway, most of these patients are followed up in a hospital setting. We describe a multi-centre randomized controlled trial to test whether these patients can be followed up by their general practitioner (GP) without altering quality of life, cost effectiveness and/or the incidence of serious clinical events. Patients undergoing surgery for colon cancer with histological grade Dukes's Stage A, B or C and below 75 years of age are eligible for inclusion. They will be randomized after surgery to follow-up at the surgical outpatient clinic (control group) or follow-up by the district GP (intervention group). Both study arms comply with the national NGICG guidelines. The primary endpoints will be quality of life (QoL) (measured by the EORTC QLQ C-30 and the EQ-5D instruments), serious clinical events (SCEs), and costs. The follow-up period will be two years after surgery, and quality of life will be measured every three months. SCEs and costs will be estimated prospectively. The sample size was 170 patients. There is an ongoing debate on the best method of follow-up for patients with CRC. Due to a wide range of follow-up programmes and paucity of randomized trials, it is impossible to draw conclusions about the best combination and frequency of clinic (or family practice) visits, blood tests, endoscopic procedures and radiological examinations that maximize the clinical outcome, quality of life and costs. Most studies on follow-up of CRC patients have been performed in a hospital outpatient setting. We hypothesize that postoperative follow-up of colon cancer patients (according to national guidelines) by GPs will not have any impact on patients' quality of life. Furthermore, we hypothesize that there will be no increase in SCEs and that the incremental cost-effectiveness ratio will improve. This trial has been registered at ClinicalTrials.gov. The trial registration number is: NCT00572143.

Effective strategies for scaling up evidence-based practices in primary care: a systematic review.

PubMed

Ben Charif, Ali; Zomahoun, Hervé Tchala Vignon; LeBlanc, Annie; Langlois, Léa; Wolfenden, Luke; Yoong, Sze Lin; Williams, Christopher M; Lépine, Roxanne; Légaré, France

2017-11-22

While an extensive array of existing evidence-based practices (EBPs) have the potential to improve patient outcomes, little is known about how to implement EBPs on a larger scale. Therefore, we sought to identify effective strategies for scaling up EBPs in primary care. We conducted a systematic review with the following inclusion criteria: (i) study design: randomized and non-randomized controlled trials, before-and-after (with/without control), and interrupted time series; (ii) participants: primary care-related units (e.g., clinical sites, patients); (iii) intervention: any strategy used to scale up an EBP; (iv) comparator: no restrictions; and (v) outcomes: no restrictions. We searched MEDLINE, Embase, PsycINFO, Web of Science, CINAHL, and the Cochrane Library from database inception to August 2016 and consulted clinical trial registries and gray literature. Two reviewers independently selected eligible studies, then extracted and analyzed data following the Cochrane methodology. We extracted components of scaling-up strategies and classified them into five categories: infrastructure, policy/regulation, financial, human resources-related, and patient involvement. We extracted scaling-up process outcomes, such as coverage, and provider/patient outcomes. We validated data extraction with study authors. We included 14 studies. They were published since 2003 and primarily conducted in low-/middle-income countries (n = 11). Most were funded by governmental organizations (n = 8). The clinical area most represented was infectious diseases (HIV, tuberculosis, and malaria, n = 8), followed by newborn/child care (n = 4), depression (n = 1), and preventing seniors' falls (n = 1). Study designs were mostly before-and-after (without control, n = 8). The most frequently targeted unit of scaling up was the clinical site (n = 11). The component of a scaling-up strategy most frequently mentioned was human resource-related (n = 12). All studies reported patient/provider outcomes. Three studies reported scaling-up coverage, but no study quantitatively reported achieving a coverage of 80% in combination with a favorable impact. We found few studies assessing strategies for scaling up EBPs in primary care settings. It is uncertain whether any strategies were effective as most studies focused more on patient/provider outcomes and less on scaling-up process outcomes. Minimal consensus on the metrics of scaling up are needed for assessing the scaling up of EBPs in primary care. This review is registered as PROSPERO CRD42016041461 .

Feelings of Hopelessness in Midlife and Cognitive Health in Later Life: A Prospective Population-Based Cohort Study.

PubMed

Håkansson, Krister; Soininen, Hilkka; Winblad, Bengt; Kivipelto, Miia

2015-01-01

Several studies have found depression and depressive feelings to be associated with subsequent dementia. As dementias typically have a long preclinical development phase, it has been difficult to determine whether depression and depressive feelings reflect a concurrent underlying dementia disease, rather than playing a causative role. Our aim was to investigate hopelessness, one dimension of depressive feelings, and evaluate the likelihood of a prodromal versus a causative role of hopelessness feelings in dementia development. We invited a random sample of 2000 survivors from a representative population in Eastern Finland, originally investigated in midlife between 1972 and 1987, for re-examination an average of 21 years later. The age of the 1449 persons who accepted the invitation was between 39 and 64 years (mean 50.4 years) in midlife and between 65 and 80 (mean 71.3) at follow-up. To measure feelings of hopelessness in midlife and at follow-up, the participants indicated their level of agreement to two statements about their own possible future. We used logistic regression to investigate the association between the combined scores from these two items and cognitive health at follow-up, while adjusting for several health and life-style variables from midlife and for apolipoprotein E4 (ApoE4) status, depression and hopelessness feelings at follow-up. We compared the associations with late-life cognitive health when feelings of hopelessness were either measured in midlife or at the follow-up. In addition we analyzed the changes in hopelessness scores from midlife to follow-up in participants who were either cognitively healthy or impaired at follow-up. We found higher levels of hopelessness in midlife, but not at follow-up, to be associated with cognitive impairment at follow-up; the adjusted odds ratio for each step of the five-level hopelessness scale was 1.30 (95% confidence interval 1.11-1.51) for any cognitive impairment and 1.37 (1.05-1.78) for Alzheimer's disease. These associations remained significant also after the final adjustments for depressive feelings and for hopelessness at follow-up. The individual changes in hopelessness scores between midlife and follow-up were not systematically related to cognitive health at the follow-up. Our results suggest that feelings of hopelessness already in midlife may have long-term implications for cognitive health and increase the risk of Alzheimer's disease in later life.

Endoscopic or surgical step-up approach for infected necrotising pancreatitis: a multicentre randomised trial.

PubMed

van Brunschot, Sandra; van Grinsven, Janneke; van Santvoort, Hjalmar C; Bakker, Olaf J; Besselink, Marc G; Boermeester, Marja A; Bollen, Thomas L; Bosscha, Koop; Bouwense, Stefan A; Bruno, Marco J; Cappendijk, Vincent C; Consten, Esther C; Dejong, Cornelis H; van Eijck, Casper H; Erkelens, Willemien G; van Goor, Harry; van Grevenstein, Wilhelmina M U; Haveman, Jan-Willem; Hofker, Sijbrand H; Jansen, Jeroen M; Laméris, Johan S; van Lienden, Krijn P; Meijssen, Maarten A; Mulder, Chris J; Nieuwenhuijs, Vincent B; Poley, Jan-Werner; Quispel, Rutger; de Ridder, Rogier J; Römkens, Tessa E; Scheepers, Joris J; Schepers, Nicolien J; Schwartz, Matthijs P; Seerden, Tom; Spanier, B W Marcel; Straathof, Jan Willem A; Strijker, Marin; Timmer, Robin; Venneman, Niels G; Vleggaar, Frank P; Voermans, Rogier P; Witteman, Ben J; Gooszen, Hein G; Dijkgraaf, Marcel G; Fockens, Paul

2018-01-06

Infected necrotising pancreatitis is a potentially lethal disease and an indication for invasive intervention. The surgical step-up approach is the standard treatment. A promising alternative is the endoscopic step-up approach. We compared both approaches to see whether the endoscopic step-up approach was superior to the surgical step-up approach in terms of clinical and economic outcomes. In this multicentre, randomised, superiority trial, we recruited adult patients with infected necrotising pancreatitis and an indication for invasive intervention from 19 hospitals in the Netherlands. Patients were randomly assigned to either the endoscopic or the surgical step-up approach. The endoscopic approach consisted of endoscopic ultrasound-guided transluminal drainage followed, if necessary, by endoscopic necrosectomy. The surgical approach consisted of percutaneous catheter drainage followed, if necessary, by video-assisted retroperitoneal debridement. The primary endpoint was a composite of major complications or death during 6-month follow-up. Analyses were by intention to treat. This trial is registered with the ISRCTN registry, number ISRCTN09186711. Between Sept 20, 2011, and Jan 29, 2015, we screened 418 patients with pancreatic or extrapancreatic necrosis, of which 98 patients were enrolled and randomly assigned to the endoscopic step-up approach (n=51) or the surgical step-up approach (n=47). The primary endpoint occurred in 22 (43%) of 51 patients in the endoscopy group and in 21 (45%) of 47 patients in the surgery group (risk ratio [RR] 0·97, 95% CI 0·62-1·51; p=0·88). Mortality did not differ between groups (nine [18%] patients in the endoscopy group vs six [13%] patients in the surgery group; RR 1·38, 95% CI 0·53-3·59, p=0·50), nor did any of the major complications included in the primary endpoint. In patients with infected necrotising pancreatitis, the endoscopic step-up approach was not superior to the surgical step-up approach in reducing major complications or death. The rate of pancreatic fistulas and length of hospital stay were lower in the endoscopy group. The outcome of this trial will probably result in a shift to the endoscopic step-up approach as treatment preference. The Dutch Digestive Disease Foundation, Fonds NutsOhra, and the Netherlands Organization for Health Research and Development. Copyright © 2018 Elsevier Ltd. All rights reserved.

Long-term follow-up results of stepwise radical endoscopic resection for Barrett's esophagus with early neoplasia.

PubMed

Belghazi, Kamar; van Vilsteren, Frederike G I; Weusten, Bas L A M; Meijer, Sybren L; Bergman, Jacques J G H M; Pouw, Roos E

2018-01-01

Stepwise radical endoscopic resection (SRER) has shown to be effective in eradicating Barrett's esophagus (BE) and its associated dysplasia. The aim of this study was to assess the long-term durability after successful SRER for early Barrett's neoplasia. Patients treated with SRER for BE ≤5 cm with high-grade dysplasia (HGD) or early cancer (EC) and who had reached complete eradication of intestinal metaplasia (CE-IM) and neoplasia (CE-neo) were included. Primary outcomes were recurrence of neoplasia (HGD/EC), recurrence of dysplasia (indefinite for dysplasia included), and recurrence of endoscopically visible BE. Secondary outcomes were buried Barrett's glands, IM in biopsy specimens obtained distal to a normal-appearing neo-squamocolumnar junction (neo-SCJ), need for retreatment, and sustained CE-IM and CE-neo at the last follow-up endoscopy. Seventy-three patients were included (64 men; mean age, 66 years; median BE, C2M3). Median follow-up was 76 months. Recurrence of neoplasia was observed in 1 patient (T1bN0M0) after 129 months of follow-up and was treated with curative surgery (annual incidence of .22% per patient-year of follow-up). In 4 patients, recurrence of dysplasia was found (.87% per patient-year of follow-up). Twelve patients had recurrent endoscopically visible BE after a median follow-up of 22 months (2.6% per patient-year of follow-up), mostly small islands or tongues. Five patients had a single finding of buried Barrett's glands (1.1% per patient-year of follow-up), and 27 patients (5.9% per patient-year of follow-up) showed IM in biopsy specimens just distal to the neo-SCJ, which was not reproduced in 56%. Retreatment was performed in 9 patients. CE-IM and CE-neo (excluding IM in the neo-SCJ) at the last follow-up endoscopy was seen in 95% and 97% of patients, respectively. This study presents the longest published follow-up data on SRER to date. The 6-year outcomes show that successful SRER is a durable treatment for BE ≤5 cm with HGD/EC. Copyright © 2018 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Assessing the Effectiveness of Ramp-Up During Sonar Operations Using Exposure Models.

PubMed

von Benda-Beckmann, Alexander M; Wensveen, Paul J; Kvadsheim, Petter H; Lam, Frans-Peter A; Miller, Patrick J O; Tyack, Peter L; Ainslie, Michael A

2016-01-01

Ramp-up procedures are used to mitigate the impact of sound on marine mammals. Sound exposure models combined with observations of marine mammals responding to sound can be used to assess the effectiveness of ramp-up procedures. We found that ramp-up procedures before full-level sonar operations can reduce the risk of hearing threshold shifts with marine mammals, but their effectiveness depends strongly on the responsiveness of the animals. In this paper, we investigated the effect of sonar parameters (source level, pulse-repetition time, ship speed) on sound exposure by using a simple analytical model and highlight the mechanisms that limit the effectiveness of ramp-up procedures.

On lower bounds for possible blow-up solutions to the periodic Navier-Stokes equation

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

Cortissoz, Jean C., E-mail: jcortiss@uniandes.edu.co; Montero, Julio A., E-mail: ja.montero907@uniandes.edu.co; Pinilla, Carlos E., E-mail: ce.pinilla108@uniandes.edu.co

2014-03-15

We show a new lower bound on the H{sup .3/2} (T{sup 3}) norm of a possible blow-up solution to the Navier-Stokes equation, and also comment on the extension of this result to the whole space. This estimate can be seen as a natural limiting result for Leray's blow-up estimates in L{sup p}(R{sup 3}), 3 < p < ∞. We also show a lower bound on the blow-up rate of a possible blow-up solution of the Navier-Stokes equation in H{sup .5/2} (T{sup 3}), and give the corresponding extension to the case of the whole space.

The Development of the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders: A Case Study

PubMed Central

Boisseau, Christina L.; Farchione, Todd J.; Fairholme, Christopher P.; Ellard, Kristen K.; Barlow, David H.

2013-01-01

A detailed description of treatment utilizing the Unified Protocol (UP), a transdiagnostic emotion-focused cognitive-behavioral treatment, is presented using a clinical case example treated during the most current phase of an ongoing randomized controlled trial of the UP. The implementation of the UP in its current, modular version is illustrated. A working case conceptualization is presented from the perspective of the UP drawing from theory and research that underlies current transdiagnostic approaches to treatment and consistent with recent dimensional classification proposals (Brown & Barlow, in press). Treatment is illustrated module-by-module describing how the principles of the UP were applied in the presented case. PMID:23997572

What happens during vocal warm-up?

PubMed

Elliot, N; Sundberg, J; Gramming, P

1995-03-01

Most singers prefer to warm up their voices before performing. Although the subjective effect is often considerable, the underlying physiological effects are largely unknown. Because warm-up tends to increase blood flow in muscles, it seems likely that vocal warm-up might induce decreased viscosity in the vocal folds. According to the theory of vocal-fold vibration, such a decrease should lead to a lower phonation threshold pressure. In this investigation the effect of vocal warm-up on the phonation threshold pressure was examined in a group of male and female singers. The effect varied considerably between subjects, presumably because the vocal-fold viscosity was not a dominating factor for the phonation-threshold pressure.

A Newton-Krylov solver for fast spin-up of online ocean tracers

NASA Astrophysics Data System (ADS)

Lindsay, Keith

2017-01-01

We present a Newton-Krylov based solver to efficiently spin up tracers in an online ocean model. We demonstrate that the solver converges, that tracer simulations initialized with the solution from the solver have small drift, and that the solver takes orders of magnitude less computational time than the brute force spin-up approach. To demonstrate the application of the solver, we use it to efficiently spin up the tracer ideal age with respect to the circulation from different time intervals in a long physics run. We then evaluate how the spun-up ideal age tracer depends on the duration of the physics run, i.e., on how equilibrated the circulation is.