Sample records for va form 10

  1. 78 FR 39832 - Proposed Information Collection Activity: Proposed Collection; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-02

    ... techniques or the use of other forms of information technology. Titles: a. Application for Health Benefits, VA Form 10-10EZ. b. Health Benefits Renewal Form, VA Form 10-10EZR. c. VA Form 10-10HS. OMB Control... determine the Veteran's eligibility for medical benefits. b. Veterans currently enrolled in VA health care...

  2. 48 CFR 853.215-70 - VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ..., Application for Furnishing Nursing Home Care to Beneficiaries of VA. 853.215-70 Section 853.215-70 Federal... 853.215-70 VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA. VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA, will be used for...

  3. 48 CFR 853.215-70 - VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ..., Application for Furnishing Nursing Home Care to Beneficiaries of VA. 853.215-70 Section 853.215-70 Federal... 853.215-70 VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA. VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA, will be used for...

  4. 48 CFR 853.215-70 - VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ..., Application for Furnishing Nursing Home Care to Beneficiaries of VA. 853.215-70 Section 853.215-70 Federal... 853.215-70 VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA. VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA, will be used for...

  5. 48 CFR 853.215-70 - VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., Application for Furnishing Nursing Home Care to Beneficiaries of VA. 853.215-70 Section 853.215-70 Federal... 853.215-70 VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA. VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA, will be used for...

  6. 48 CFR 853.215-70 - VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ..., Application for Furnishing Nursing Home Care to Beneficiaries of VA. 853.215-70 Section 853.215-70 Federal... 853.215-70 VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA. VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA, will be used for...

  7. 76 FR 27386 - Agency Information Collection (Cooperative Studies Program (CSP): Site Survey and Meeting...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-11

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-New (VA Form 10-0511)] Agency Information.... 2900-New (VA Form 10-0511).'' SUPPLEMENTARY INFORMATION: Titles: a. Cooperative Studies Program (CSP) Site Survey, VA Form 10-0511. b. Cooperative Studies Program (CSP) Meeting Evaluation, VA Form 10...

  8. 77 FR 30593 - Agency Information Collection (Applications and Appraisals for Employment for Title 38 Positions...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-23

    ... Optometrists, Chiropractors, VA Form 10-2850--7,450 hours. b. Application for Nurses and Nurse Anesthetists, VA... Optometrists, Chiropractors, VA Form 10-2850--30 minutes. b. Application for Nurses and Nurse Anesthetists, VA..., Podiatrists and Optometrists, Chiropractors, VA Form 10-2850--14,900. b. Application for Nurses and Nurse...

  9. 48 CFR 853.236-70 - VA Form 10-6298, Architect-Engineer Fee Proposal.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false VA Form 10-6298, Architect-Engineer Fee Proposal. 853.236-70 Section 853.236-70 Federal Acquisition Regulations System DEPARTMENT OF...-Engineer Fee Proposal. VA Form 10-6298, Architect-Engineer Fee Proposal, shall be used as prescribed in 836...

  10. 48 CFR 853.236-70 - VA Form 10-6298, Architect-Engineer Fee Proposal.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false VA Form 10-6298, Architect-Engineer Fee Proposal. 853.236-70 Section 853.236-70 Federal Acquisition Regulations System DEPARTMENT OF...-Engineer Fee Proposal. VA Form 10-6298, Architect-Engineer Fee Proposal, shall be used as prescribed in 836...

  11. 77 FR 15190 - Proposed Information Collection Activity; Comment Request: Applications and Appraisals for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-14

    ... Physicians, Dentists, Podiatrists and Optometrists, Chiropractors, VA Form 10-2850--7,450 hours. b.... Application for Physicians, Dentists, Podiatrists and Optometrists, Chiropractors, VA Form 10-2850--30 minutes... Respondents a. Application for Physicians, Dentists, Podiatrists and Optometrists, Chiropractors, VA Form 10...

  12. 78 FR 50143 - Agency Information Collection (Application for CHAMPVA Benefits) Activities Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-16

    ...,402 hours. c. VA Form 10-7959c--6,728 hours. d. VA Form 10-7959d--467 hours. e. VA Form 10-7959e--1500...,000. Dated: August 13, 2013. By direction of the Secretary. Crystal Rennie, VA Clearance Officer, U.S. Department of Veterans Affairs. [FR Doc. 2013-19914 Filed 8-15-13; 8:45 am] BILLING CODE 8320-01-P ...

  13. 75 FR 9276 - Proposed Information Collection (Application for CHAMPVA Benefits); Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-01

    ... Form 10-7959a--37,336 hours. c. VA Form 10-7959c--13,456 hours. d. VA Form 10-7959d--467 hours. e. VA...) 273-9381. SUPPLEMENTARY INFORMATION: Under the PRA of 1995 (Pub. L. 104-13; 44 U.S.C. 3501-21...

  14. 38 CFR 58.17 - VA Form 10-0144A-Statement of Assurance of Compliance with Equal Opportunity Laws.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false VA Form 10-0144A-Statement of Assurance of Compliance with Equal Opportunity Laws. 58.17 Section 58.17 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) FORMS § 58.17 VA Form 10-0144A—Statement of Assurance of Compliance with Equal...

  15. 78 FR 34709 - Proposed Information Collection (Application for CHAMPVA Benefits); Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-10

    ...-5870 or Fax (202) 495-5397. SUPPLEMENTARY INFORMATION: Under the PRA of 1995 (Pub. L. 104-13; 44 U.S.C...,402 hours. c. VA Form 10-7959c--6,728 hours. d. VA Form 10-7959d--467 hours. e. VA Form 10-7959e--1500... Technology, U.S. Department of Veterans Affairs. [FR Doc. 2013-13693 Filed 6-7-13; 8:45 am] BILLING CODE 8320...

  16. 75 FR 15495 - Agency Information Collection (Application for Furnishing Long-Term Care Services to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-29

    ... (Application for Furnishing Long- Term Care Services to Beneficiaries of Veterans Affairs, and Residential Care... Furnishing Long-Term Care Services to Beneficiaries of Veterans Affairs, VA Form 10-1170. b. Residential Care... agencies wishing to provide long term care to veterans receiving VA benefits. b. VA Form 10-2407 is an...

  17. 38 CFR 58.12 - VA Forms 10-10EZ and 10-10EZR-Application for Health Benefits and Renewal Form.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false VA Forms 10-10EZ and 10-10EZR-Application for Health Benefits and Renewal Form. 58.12 Section 58.12 Pensions, Bonuses, and...—Application for Health Benefits and Renewal Form. ER29AP09.145 ER29AP09.146 ER29AP09.147 ER29AP09.148 ER29AP09...

  18. 38 CFR 58.12 - VA Forms 10-10EZ and 10-10EZR-Application for Health Benefits and Renewal Form.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false VA Forms 10-10EZ and 10-10EZR-Application for Health Benefits and Renewal Form. 58.12 Section 58.12 Pensions, Bonuses, and...—Application for Health Benefits and Renewal Form. ER29AP09.145 ER29AP09.146 ER29AP09.147 ER29AP09.148 ER29AP09...

  19. 38 CFR 58.12 - VA Forms 10-10EZ and 10-10EZR-Application for Health Benefits and Renewal Form.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false VA Forms 10-10EZ and 10-10EZR-Application for Health Benefits and Renewal Form. 58.12 Section 58.12 Pensions, Bonuses, and...—Application for Health Benefits and Renewal Form. ER29AP09.145 ER29AP09.146 ER29AP09.147 ER29AP09.148 ER29AP09...

  20. 38 CFR 58.12 - VA Forms 10-10EZ and 10-10EZR-Application for Health Benefits and Renewal Form.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false VA Forms 10-10EZ and 10-10EZR-Application for Health Benefits and Renewal Form. 58.12 Section 58.12 Pensions, Bonuses, and...—Application for Health Benefits and Renewal Form. ER29AP09.145 ER29AP09.146 ER29AP09.147 ER29AP09.148 ER29AP09...

  1. 76 FR 35950 - Agency Information Collection Activity (Living Will and Durable Power of Attorney for Health Care...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-20

    ... (Living Will and Durable Power of Attorney for Health Care) Under OMB Review AGENCY: Department of... INFORMATION Title: Living Will and Durable Power of Attorney for Health Care, VA Form 10-0137. OMB Control... admitted to a VA medical facility complete VA Form 10-0137 to appoint a health care agent to make decision...

  2. 76 FR 9637 - Proposed Information Collection (Veteran Suicide Prevention Online Quantitative Surveys) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-18

    ... Collection (Veteran Suicide Prevention Online Quantitative Surveys) Activity: Comment Request AGENCY... techniques or the use of other forms of information technology. Titles a. Veterans Online Survey, VA Form 10-0513: b. Veterans Family Online Survey, VA Form 10-0513a. c. Veterans Primary Care Provider Online...

  3. 76 FR 27384 - Agency Information Collection Activity (Veteran Suicide Prevention Online Quantitative Surveys...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-11

    ... Collection Activity (Veteran Suicide Prevention Online Quantitative Surveys) Under OMB Review AGENCY... techniques or the use of other forms of information technology. Titles a. Veterans Online Survey, VA Form 10-0513. b. Veterans Family Online Survey, VA Form 10-0513a. c. Veterans Primary Care Provider Online...

  4. 77 FR 51850 - Agency Information Collection: Emergency Submission for OMB Review (PACT: Clinical Innovation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-27

    ..., et al., 1993), VA Form 10-0532g. i. The Brief COPE (Carver, 1997), VA Form 10-0532h. j. Depression... PCM on depression and anxiety relative to usual care. This data collection's model has been designed...

  5. 78 FR 57001 - Proposed Collection of Information; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-16

    .... Customer Modality Administrative Survey, VA Form 10-0151. b. VA Form Letter 10-491 & HEC Online Survey, 10... processes. The goal of the Customer Modality Survey is to implement a survey process that allows the organization to be proactive in caring for Veterans prior to them receiving services. DATES: Written comments...

  6. 48 CFR 853.300 - Scope of subpart.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Scope of subpart. 853.300 Section 853.300 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS CLAUSES AND FORMS.... VA forms may also be available on the Web at http://www.va.gov/vaforms/. ...

  7. 75 FR 32539 - Agency Information Collection (Dental Patient Satisfaction Survey) Activities Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-08

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-New (VA Form 10-0503)] Agency Information Collection (Dental Patient Satisfaction Survey) Activities Under OMB Review AGENCY: Veterans Health...).'' Title: Survey of Healthcare Experiences, Dental Patient Satisfaction Survey, VA Form 10-0503. OMB...

  8. 75 FR 62636 - Proposed Information Collection (Veterans Health Benefits Handbook Satisfaction Survey) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-12

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-New (VA Form 10-0507)] Proposed Information Collection (Veterans Health Benefits Handbook Satisfaction Survey) Activity: Comment Request AGENCY: Veterans... information technology. Title: Veterans Health Benefits Handbook Satisfaction Survey, VA Form 10-0507. OMB...

  9. 76 FR 625 - Proposed Information Collection (Veterans Health Benefits Handbook Satisfaction Survey) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-05

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900--New (VA Form 10-0507)] Proposed Information Collection (Veterans Health Benefits Handbook Satisfaction Survey) Activity: Comment Request AGENCY: Veterans...).'' SUPPLEMENTARY INFORMATION: Title: Veterans Health Benefits Handbook Satisfaction Survey, VA Form 10-0507. OMB...

  10. 75 FR 52627 - Disenrollment Procedures

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-27

    ... program that has been discontinued. It also amends the regulation to reflect current VA practice and to... conform with current VA practice, which does not disenroll veterans based on their failure to file VA Form 10-10EZ. Current practice is reflected in current paragraph (d)(3)(iv). Removing paragraph (d)(5)(iii...

  11. 78 FR 53506 - Proposed Information Collection (Care Coordination Home Telehealth (CCHT) Patient Satisfaction...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-29

    ... Coordination Home Telehealth (CCHT) Patient Satisfaction Survey, VA Form 10-0481); Activity: Comment Request... required to obtain patient perspective on satisfaction with the CCHT program and messaging devices. DATES.... Titles: Care Coordination Home Telehealth (CCHT) Patient Satisfaction Survey, VA Form 10-0481. OMB...

  12. 75 FR 45206 - Proposed Information Collection (Claim, Authorization and Invoice for Prosthetic Items and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-02

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0188] Proposed Information Collection (Claim... Control No. 2900-0188'' in any correspondence. During the comment period, comments may be viewed online... Structural Alterations, VA Form 10-0103. b. Application for Adaptive Equipment Motor Vehicle, VA Form 10...

  13. 78 FR 35099 - Proposed Information Collection Activity: [Claim, Authorization and Invoice for Prosthetic Items...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-11

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0188] Proposed Information Collection... . Please refer to ``OMB Control No. 2900-0188'' in any correspondence. During the comment period, comments... Alterations, VA Form 10-0103. (c) Application for Adaptive Equipment Motor Vehicle, VA Form 10- 1394. (d...

  14. 38 CFR 58.13 - VA Form 10-10SH-State Home Program Application for Veteran Care Medical Certification.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false VA Form 10-10SH-State Home Program Application for Veteran Care Medical Certification. 58.13 Section 58.13 Pensions, Bonuses... Home Program Application for Veteran Care Medical Certification. ER29AP09.150 ER29AP09.151 ER29AP09.152...

  15. 38 CFR 59.100 - Payment of grant award.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... engineering inspection approved by VA, must obtain VA approval of the final equipment list submitted by the... the internet Web site provided in § 59.170). The equipment list and the completed VA Form 10-0388-13...

  16. 38 CFR 59.100 - Payment of grant award.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... engineering inspection approved by VA, must obtain VA approval of the final equipment list submitted by the... the internet Web site provided in § 59.170). The equipment list and the completed VA Form 10-0388-13...

  17. 76 FR 33029 - Agency Information Collection (Disability Benefits Questionnaires-Group 1) Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-07

    ...) Disability Benefits Questionnaire, VA Form 21-0960C-2. c. Peripheral Nerve Conditions (Not Including Diabetic Sensory- Motor Peripheral Neuropathy) Disability Benefits Questionnaire, VA Form 21-0960C-10. d. Persian...

  18. 75 FR 48412 - Proposed Information Collection (Six-Month Post-Exit Focus Interview of Former VHA Employees...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-10

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-New (VA Form 10-0487)] Proposed Information Collection (Six-Month Post-Exit Focus Interview of Former VHA Employees) Activities; Under OMB Review AGENCY...).'' SUPPLEMENTARY INFORMATION: Title: Six-Month Post-Exit Focus Interview of Former VHA Employees, VA Form 10-0487...

  19. 76 FR 70831 - Proposed Information Collection (Survey of Veteran Enrollees (Quality and Efficiency of VA Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-15

    ... of Veteran Enrollees (Quality and Efficiency of VA Health Care)) Activity; Comment Request AGENCY... of Veteran Enrollees (Quality and Efficiency of VA Health Care), VA Form 10-21088. OMB Control Number... will be used to collect data that is necessary to promote quality and efficient delivery of health care...

  20. 77 FR 3841 - Proposed Information Collection (Survey of Veteran Enrollees (Quality and Efficiency of VA Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-25

    ... of Veteran Enrollees (Quality and Efficiency of VA Health Care)) Activities Under OMB Review AGENCY... of Veteran Enrollees (Quality and Efficiency of VA Health Care), VA Form 10-21088. OMB Control Number... will be used to collect data that is necessary to promote quality and efficient delivery of health care...

  1. 77 FR 74280 - Proposed Information Collection (Learner's Perception (LP) Survey); Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-13

    ... (Learner's Perception (LP) Survey); Comment Request AGENCY: Veterans Health Administration, Department of... techniques or the use of other forms of information technology. Title: Learner's Perception (LP) Survey, VA... collection. Abstract: VA Form 10-0439 will be use to obtain health care trainees perception of their clinical...

  2. 75 FR 9490 - Proposed Information Collection (Ethics Consultation Feedback Tool (ECFT)) Activity: Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-02

    ... Collection (Ethics Consultation Feedback Tool (ECFT)) Activity: Comment Request AGENCY: Veterans Health... notice. This notice solicits comments for information needed to improve the process of ethics.... Title: Ethics Consultation Feedback Tool (ECFT), VA Form 10-0502. OMB Control Number: 2900-New (VA Form...

  3. 76 FR 71623 - Agency Information Collection (Spinal Cord Injury Patient Care Survey) Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-18

    ... Collection (Spinal Cord Injury Patient Care Survey) Under OMB Review AGENCY: Veterans Benefits Administration... INFORMATION: Title: Spinal Cord Injury Patient Care Survey, VA Form 10-0515. OMB Control Number: OMB Control... 10-0515 will be used to determine spinal cord patients' satisfaction with VA rehabilitation and...

  4. 78 FR 63139 - Designee for Patient Personal Property

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-23

    ... Benefits. However, VA Form 10-10EZ does not include a space for a veteran to designate someone to receive... information on several key elements of the designation process. We propose to divide it into several smaller... that are derived from gratuitous benefits under laws administered by VA. It further states that the...

  5. 75 FR 16912 - Proposed Information Collection (Dental Patient Satisfaction Survey) Activity: Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-02

    ... Collection (Dental Patient Satisfaction Survey) Activity: Comment Request AGENCY: Veterans Health... notice. This notice solicits comments for information needed to measure patients' satisfaction with VA's.... Title: Survey of Healthcare Experiences, Dental Patient Satisfaction Survey, VA Form 10-0503. OMB...

  6. 48 CFR 853.300 - Scope of subpart.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 5 2013-10-01 2013-10-01 false Scope of subpart. 853.300 Section 853.300 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS CLAUSES AND FORMS FORMS Illustration of Forms 853.300 Scope of subpart. VA Forms will not be illustrated in this VAAR...

  7. 48 CFR 853.300 - Scope of subpart.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false Scope of subpart. 853.300 Section 853.300 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS CLAUSES AND FORMS FORMS Illustration of Forms 853.300 Scope of subpart. VA Forms will not be illustrated in this VAAR...

  8. 77 FR 64387 - Agency Information Collection (Request for and Authorization To Release Medical Records or Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-19

    ... Protected Health Information to Nationwide Health Information Network, VA Form 10-0485. OMB Control Number... electronically exchange protected health information between VA and approved Nationwide Health Information... for and Authorization To Release Medical Records or Health Information) Activities Under OMB Review...

  9. 78 FR 49335 - Agency Information Collection (Ethics Consultation Feedback Tool (ECFT)) Activity Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-13

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0750] Agency Information Collection (Ethics...-0750''. SUPPLEMENTARY INFORMATION: Title: Ethics Consultation Feedback Tool (ECFT), VA Form 10-10065... experience during the Ethics Consultation Service. VA will be used the data to improve the process of ethics...

  10. 78 FR 38810 - Proposed Information Collection (Application for Furnishing Long-Term Care Service to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-27

    ... (Application for Furnishing Long- Term Care Service to Beneficiaries of Veterans Affairs, and Residential Care.... 2900-0616.'' SUPPLEMENTARY INFORMATION: Title: Residential Care Home Program--Sponsor Application, VA... collection. Abstract: VA Form 10-2407 is an application used by a residential care facility or home that...

  11. Vascular access in patients receiving hemodialysis in Libya.

    PubMed

    Alashek, Wiam A; McIntyre, Christopher W; Taal, Maarten W

    2012-01-01

    A native arteriovenous fistula (AVF) represents the optimal form of Vascular Access (VA) for patients receiving hemodialysis (HD). In Libya there are several barriers to AVF creation including lack of adequate preparation for dialysis and surgical services. We aimed to conduct the first comprehensive study of VA utilisation in HD patients in Libya. A prospective observational study included all adult patients receiving HD treatment in 25 HD facilities in Libya from May 2009 to Nov 2011. Researchers gathered data regarding VA through interviews with staff and patients as well as medical records. Patients with definitive VA were re-interviewed after 1 year. At baseline the majority of patients (91.9%; n=1573) were using permanent VA in the form of AVF or arteriovenous graft. Patients with permanent VA were more likely to be male and less likely to be diabetic than those with CVCs. Most patients had commenced HD using a temporary CVC (91.8%). VA-related complications were: thrombosis (46.7%), aneurysm (22.6%), infection (11.5%) and haemorrhage (10.2%). Incident VA thrombosis was reported by 14.7% in 1 year. Independent risk factors for incident thrombosis were female gender and diabetes. Hospitalisation for VA related complications was reported by 31.4%. Few patients in Libya initiate HD with definitive VA, but most achieve it thereafter. Improved dialysis preparation and increased provision of surgical services are required to increase the proportion of patients initiating HD with definitive VA and should be a priority in rebuilding health services in Libya after the recent conflict.

  12. 77 FR 23322 - Proposed Information Collection (Report of General Information) Activity: Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-18

    ... Information. d. VA Form 21-0820c, Report of Defense Finance and Accounting Service (DFAS). e. VA Form 21-0820d.... VA Form 21-0820c, Report of Defense Finance and Accounting Service (DFAS)--2,500. e. VA Form 21-0820d... Nursing Home Information--30,000. d. VA Form 21-0820c, Report of Defense Finance and Accounting Service...

  13. 78 FR 6404 - Agency Information Collection (Survey of Chronic Gastrointestinal Illness in Persian Gulf...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-30

    ...: Approximately 25 percent military troops who were deployed in the first Persian Gulf War returned with... of Chronic Gastrointestinal Illness in Persian Gulf Veterans) Activities Under OMB Review AGENCY.... Survey of Chronic Gastrointestinal Illness in Persian Gulf Veterans, VA Form 10-21092a. b. VA Research...

  14. 78 FR 6849 - Agency Information Collection (Verification of VA Benefits) Activity Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-31

    ... (Verification of VA Benefits) Activity Under OMB Review AGENCY: Veterans Benefits Administration, Department of... ``OMB Control No. 2900-0406.'' SUPPLEMENTARY INFORMATION: Title: Verification of VA Benefits, VA Form 26... eliminate unlimited versions of lender- designed forms. The form also informs the lender whether or not the...

  15. 77 FR 50546 - Agency Information Collection: (PACT Patient Experiences Survey); Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-21

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-New (VA Form 10-0536)] Agency Information... 20420, (202) 632-7479, Fax (202) 632-7583 or email: [email protected] . Please refer to ``OMB Control... Form 10-0536. OMB Control Number: 2900--New. Type of Review: New data collection. Abstract: The data...

  16. 76 FR 40453 - Agency Information Collection (Application for VA Education Benefits) Activity Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-08

    ... (Application for VA Education Benefits) Activity Under OMB Review AGENCY: Veterans Benefits Administration... Education Benefits, VA Form 22-1990. b. Application for Family Member to Use Transferred Benefits, VA Form 22-1990E. [[Page 40454

  17. 76 FR 27381 - Proposed Information Collection (Notice of Waiver of VA Compensation or Pension To Receive...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-11

    ... of Waiver of VA Compensation or Pension To Receive Military Pay and Allowances) Activity; Comment... Pension to Receive Military Pay and Allowances, VA Form 21-8951 and VA Form 21-8951-2. OMB Control Number... to waive VA disability benefits in order to receive active or inactive duty training pay are required...

  18. 76 FR 16478 - Proposed Information Collection (Disability Benefits Questionnaires-Group 2) Activity: Comment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-23

    ... Conditions (Vascular Diseases including Varicose Veins) Disability Benefits Questionnaire, VA Form 21-0960A-2. b. Hypertension Disability Benefits Questionnaire, VA Form 21- 0960A-3. c. Non-ischemic Heart Disease (including Arrhythmias and Surgery) Disability Benefits Questionnaire, VA Form 21-0960A-4. d...

  19. 76 FR 35950 - Agency Information Collection (Disability Benefits Questionnaires-Group 3) Activity Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-20

    ... Collection (Disability Benefits Questionnaires--Group 3) Activity Under OMB Review AGENCY: Veterans Benefits... Questionnaire, VA Form 21-0960C-5. b. Headaches (Including Migraine Headaches), Disability Benefits Questionnaire, VA Form 21-0960C-8. c. Multiple Sclerosis (MS), Disability Benefits Questionnaire, VA Form 21...

  20. 77 FR 22068 - Proposed Information Collection (Financial Status Report) Activity: Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-12

    ... (Financial Status Report) Activity: Comment Request AGENCY: Office of Management, Department of Veterans... techniques or the use of other forms of information technology. Title: Financial Status Report, VA Form 5655...: Claimants complete VA Form 5655 to report their financial status. VA uses the data collected to determine...

  1. 76 FR 34812 - Proposed Information Collection (Joint Application for Comprehensive Assistance and Support...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-14

    ... Application for Comprehensive Assistance and Support Services for Family Caregivers); Comment Request AGENCY... and their caregivers' eligibility to participate in the Family Caregivers Program. DATES: Written... Assistance and Support Services for Family Caregivers, VA Form 10-10-10CG. OMB Control Number: 2900-0768...

  2. 77 FR 50547 - Agency Information Collection: Emergency Submission for OMB Review (PACT: Clinical Innovation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-21

    ... 10-0532h. j. Depression and Anxiety Stress Scales (DASS-21; Lovibond & Lovibond, 1995), VA Form 10... care and (2) to assess the impact of PCM on depression and anxiety relative to usual care. This data...

  3. 77 FR 39346 - Proposed Information Collection (Statement of Accredited Representative in Appealed Case, VA Form...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-02

    ... in Appealed Case, VA Form 646. OMB Control Number: 2900-0042. Type of Review: Extension of a... (Statement of Accredited Representative in Appealed Case, VA Form 646) Activity: Comment Request AGENCY: The Board of Veterans' Appeals (BVA), Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Board of...

  4. 75 FR 78806 - Agency Information Collection (Create Payment Request for the VA Funding Fee Payment System (VA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-16

    ... Payment Request for the VA Funding Fee Payment System (VA FFPS); a Computer Generated Funding Fee Receipt.... 2900-0474.'' SUPPLEMENTARY INFORMATION: Title: Create Payment Request for the VA Funding Fee Payment System (VA FFPS); a Computer Generated Funding Fee Receipt, VA Form 26-8986. OMB Control Number: 2900...

  5. 78 FR 59771 - Proposed Information Collection (Create Payment Request for the VA Funding Fee Payment System (VA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-27

    ... Payment Request for the VA Funding Fee Payment System (VA FFPS); a Computer Generated Funding Fee Receipt.... Title: Create Payment Request for the VA Funding Fee Payment System (VA FFPS); A Computer Generated Funding Fee Receipt, VA Form 26-8986. OMB Control Number: 2900-0474. Type of Review: Revision of a...

  6. 76 FR 27379 - Proposed Information Collection (Supplement to VA Forms 21-526, 21-534, and 21-535 (For...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-11

    ... information technology. Title: Supplement to VA Forms 21-526, 21-534, and 21-535 (For Philippine Claims), VA... residence, proof of service, and whether the applicant was a member of pro-Japanese, pro-German, or anti...

  7. Characterizing Disease Burden and Progression of Geographic Atrophy Secondary to Age-Related Macular Degeneration.

    PubMed

    Chakravarthy, Usha; Bailey, Clare C; Johnston, Robert L; McKibbin, Martin; Khan, Rehna S; Mahmood, Sajjad; Downey, Louise; Dhingra, Narendra; Brand, Christopher; Brittain, Christopher J; Willis, Jeffrey R; Rabhi, Sarah; Muthutantri, Anushini; Cantrell, Ronald A

    2018-06-01

    To understand levels of disease burden and progression in a real-world setting among patients from the United Kingdom with bilateral geographic atrophy (GA) secondary to age-related macular degeneration (AMD). Retrospective cohort analysis of a multicenter electronic medical record (EMR) database. Patients who were aged ≥50 years with bilateral GA and no history of choroidal neovascularization (CNV) and who attended 1 of 10 clinical sites using the EMR. A deidentified data set was constructed from the records held at the 10 sites. An algorithm was used to extract cases with a GA diagnosis, of which 1901 had bilateral GA and form the basis of this report. A sample of records randomly selected from each center was used to validate disease definitions. Progression to blindness (visual acuity [VA] <20 letters or Snellen 3/60 in the better-seeing eye), driving ineligibility (VA ≤70 letters or Snellen 6/12 in the better-seeing eye), progression to CNV, loss of 10 or more letters, and mean change in VA over time. At first record of GA, 7.1% had a VA in the better-seeing eye equal to or lower than the cutoff for blindness registration and 71.1% had a VA that would have rendered them ineligible to drive. Over time, 16% became legally blind (median time to outcome, 6.2 years) and 66.7% became ineligible to drive (median time to outcome, 1.6 years). In the worse-seeing eye, 40.1% lost ≥10 letters in 2.4 years. Among patients with baseline and 24-month VA measurements, mean VA decline was 6.1 letters in the worse-seeing eye (n = 413) and 12.4 letters in the better-seeing eye (n = 414). The rate of progression to CNV in either eye was 7.4% per patient-year. At initial diagnosis, based on VA in the better-seeing eye, a high proportion of patients with bilateral GA were ineligible to drive and approximately 7% were eligible for UK blindness registration. The subsequent reduction in VA that occurred in the better-seeing eye would render a further two-thirds ineligible to drive. These findings emphasize the severity of the visual disability associated with GA secondary to AMD. Copyright © 2018 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  8. 76 FR 72243 - Proposed Information Collection (Operation Enduring Freedom/Operation Iraqi Freedom Veterans...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-22

    ... (Operation Enduring Freedom/ Operation Iraqi Freedom Veterans Health Needs Assessment) Activity; Comment...: Operation Enduring Freedom/Operation Iraqi Freedom Veterans Health Needs Assessment, VA Form 10-21091. OMB... 10-21091 is used to gather input from returning war zone veterans to identify their needs, concerns...

  9. 76 FR 28851 - Proposed Information Collection (Application for Extended Care Services); Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-18

    ... (Application for Extended Care Services); Comment Request AGENCY: Veterans Health Administration, Department of... solicits comments on information needed to determine eligibility for extended care benefits. DATES: Written...: Application for Extended Care Services, VA Form 10-10EC. OMB Control Number: 2900-0629. Type of Review...

  10. 78 FR 46423 - Proposed Information Collection (Application for Reimbursement of National Test Fee) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-31

    ... (Application for Reimbursement of National Test Fee) Activity; Comment Request AGENCY: Veterans Benefits.... Title: Application for Reimbursement of National Test Fee, VA Form 22-0810. OMB Control Number: 2900..., and eligible dependents complete VA Form 22-0810 to request reimbursement of national test fees. VA...

  11. 75 FR 62187 - Proposed Information Collection (Application for Reimbursement of National Test Fee) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-07

    ... (Application for Reimbursement of National Test Fee) Activity: Comment Request AGENCY: Veterans Benefits.... Title: Application for Reimbursement of National Test Fee, VA Form 22-0810. OMB Control Number: 2900..., and eligible dependents complete VA Form 22-0810 to request reimbursement of national test fees. VA...

  12. 77 FR 70210 - Agency Information Collection (Veteran's Application for Compensation and/or Pension): Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-23

    ...'s Application for Compensation and/or Pension): Activity Under OMB Review AGENCY: Veterans Benefits... Application for Compensation and/or Pension, VA Form 21-526. b. Veteran's Supplemental Claim Application, VA.../or pension benefits. b. Veterans who previously filed a claim using VA Form 21-526, and who wish to...

  13. 76 FR 78739 - Agency Information Collection (Regulation on Application for Fisher Houses and Other Temporary...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-19

    ... (Regulation on Application for Fisher Houses and Other Temporary Lodging and VHA Fisher House Application... INFORMATION: Title: Regulation on Application for Fisher Houses and Other Temporary Lodging and VHA Fisher House Application, VA Forms 10-0408 and 10-0408a. OMB Control Number: 2900-0630. Type of Review...

  14. 38 CFR 39.122 - Inspections, audits, and reports.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...-16-10) Forms Award of Grant § 39.122 Inspections, audits, and reports. Pt. 40 (a) A State will allow... Single Audit Act of 1984 (see part 41 of this chapter). (b) A State will make an annual report on VA Form... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Inspections, audits, and...

  15. 75 FR 78807 - Agency Information Collection (Application for Reimbursement of National Test Fee) Activity Under...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-16

    ... (Application for Reimbursement of National Test Fee) Activity Under OMB Review AGENCY: Veterans Benefits... Reimbursement of National Test Fee, VA Form 22-0810. OMB Control Number: 2900-0706. Type of Review: Extension of... complete VA Form 22-0810 to request reimbursement of national test fees. VA will use the data collected to...

  16. Method of making compound semiconductor films and making related electronic devices

    DOEpatents

    Basol, Bulent M.; Kapur, Vijay K.; Halani, Arvind T.; Leidholm, Craig R.; Roe, Robert A.

    1999-01-01

    A method of forming a compound film includes the steps of preparing a source material, depositing the source material on a base to form a precursor film, and heating the precursor film in a suitable atmosphere to form a film. The source material includes Group IB-IIIA alloy-containing particles having at least one Group IB-IIIA alloy phase, with Group IB-IIIA alloys constituting greater than about 50 molar percent of the Group IB elements and greater than about 50 molar percent of the Group IIIA elements in the source material. The film, then, includes a Group IB-IIIA-VIA compound. The molar ratio of Group IB to Group IIIA elements in the source material may be greater than about 0.80 and less than about 1.0, or substantially greater than 1.0, in which case this ratio in the compound film may be reduced to greater than about 0.80 and less than about 1.0. The source material may be prepared as an ink from particles in powder form. The alloy phase may include a dopant. Compound films including a Group IIB-IVA-VA compound or a Group IB-VA-VIA compound may be substituted using appropriate substitutions in the method. The method, also, is applicable to fabrication of solar cells and other electronic devices.

  17. Renal Replacement Therapy and Incremental Hemodialysis for Veterans with Advanced Chronic Kidney Disease

    PubMed Central

    Kalantar-Zadeh, Kamyar; Crowley, Susan T.; Beddhu, Srinivasan; Chen, Joline LT; Daugirdas, John T; Goldfarb, David S.; Jin, Anna; Kovesdy, Csaba P.; Leehey, David J.; Moradi, Hamid; Navaneethan, Sankar D; Norris, Keith C; Obi, Yoshitsugu; O’Hare, Ann; Shafi, Tariq; Streja, Elani; Unruh, Mark L.; Vachharajani, Tushar; Weisbord, Steven; Rhee, Connie M.

    2017-01-01

    Each year approximately 13,000 Veterans transition to maintenance dialysis, mostly in the traditional form of thrice-weekly hemodialysis from the start. Among >6,000 dialysis units nationwide, there are currently approximately 70 Veterans Affairs (VA) dialysis centers. Given this number of VA dialysis centers and their limited capacity, only 10% of all incident dialysis Veterans initiate treatment in a VA center. Evidence suggests that, among Veterans, receipt of care within the VA system is associated with favorable outcomes, potentially due to enhanced access to healthcare resources. Data from the United States Renal Data System Special Study Center “Transition-of-Care-in-CKD” suggest that Veterans who receive dialysis in a VA unit exhibit greater survival compared to non-VA centers. Substantial financial expenditures arise from the high volume of outsourced care and higher dialysis reimbursement paid by the VA than by Medicare to outsourced providers. Given the exceedingly high mortality and abrupt decline in residual kidney function (RKF) in the first dialysis year, it is possible that incremental transition to dialysis through an initial twice-weekly hemodialysis regimen preserves RKF, prolongs vascular access longevity, improves patients’ quality of life, and is a more patient-centered approach and consistent with “personalized” dialysis. Broad implementation of incremental dialysis may also result in more Veterans receiving care within a VA dialysis unit. Controlled trials are urgently needed to examine safety and efficacy of incremental hemodialysis in Veterans and other populations, and the administrative and health care as well as provider structure within the VA system would facilitate the performance of such trials. PMID:28421638

  18. 78 FR 44624 - Proposed Information Collection (Conduct the Point-of-Care Research Questionnaire); Activities...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-24

    ... data collected on VA Form 10-10069 will be used as a grant to evaluate patient and provider attitudes... innovation program by assessing the perceptions and attitudes of patients; and (2) produce guidelines for VHA...

  19. 76 FR 63355 - Proposed Information Collection (Regulation on Application for Fisher Houses and Other Temporary...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-12

    ... (Regulation on Application for Fisher Houses and Other Temporary Lodging and VHA Fisher House Application... information technology. Title: Regulation on Application for Fisher Houses and Other Temporary Lodging and VHA Fisher House Application, VA Forms 10-0408 and 10-0408a. OMB Control Number: 2900-0630. Type of Review...

  20. 76 FR 24570 - Proposed Information Collection (Application for VA Education Benefits) Activity; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-02

    ... (Application for VA Education Benefits) Activity; Comment Request AGENCY: Veterans Benefits Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Veterans Benefits Administration (VBA... Under the Montgomery GI Bill, VA Form 22-1990E. c. Application for VA Education Benefits Under the...

  1. 75 FR 9277 - Proposed Information Collection (VA National Rehabilitation Special Events, Event Registration...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-01

    ... Clinic Application, VA Form 0928--53 hours. f. National Veterans Creative Arts Festival Application, VA... Games, National Veterans Golden Age Games, National Veterans Creative Arts Festival, National Veterans...

  2. 75 FR 25321 - Agency Information Collection (VA National Rehabilitation Special Events, Event Registration...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-07

    ... Clinic Application, VA Form 0928a series. f. National Veterans Creative Arts Festival Application, VA... Veterans Creative Arts Festival, National Veterans TEE Tournament, National Disabled Veterans Winter Sports...

  3. 48 CFR 852.219-71 - VA mentor-protégé program.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false VA mentor-protégÃ....219-71 VA mentor-protégé program. As prescribed in 819.7115(a), insert the following clause: VA Mentor-Protégé Program (DEC 2009) (a) Large businesses are encouraged to participate in the VA Mentor-Protégé...

  4. 75 FR 7651 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-22

    ... Administration Leadership and Workforce Development--VA'' (161VA10A2). DATES: Comments on this new system of.... Description of Proposed Systems of Records Veterans Health Administration Leadership and Workforce Development... Affairs. 161VA10A2 SYSTEM NAME: Veterans Health Administration Leadership and Workforce Development--VA...

  5. 48 CFR 852.219-9 - VA Small business subcontracting plan minimum requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false VA Small business... Provisions and Clauses 852.219-9 VA Small business subcontracting plan minimum requirements. As prescribed in subpart 819.709, insert the following clause: VA Small Business Subcontracting Plan Minimum Requirements...

  6. 48 CFR 852.219-9 - VA Small business subcontracting plan minimum requirements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 5 2013-10-01 2013-10-01 false VA Small business... Provisions and Clauses 852.219-9 VA Small business subcontracting plan minimum requirements. As prescribed in subpart 819.709, insert the following clause: VA Small Business Subcontracting Plan Minimum Requirements...

  7. 48 CFR 852.219-9 - VA Small business subcontracting plan minimum requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false VA Small business... Provisions and Clauses 852.219-9 VA Small business subcontracting plan minimum requirements. As prescribed in subpart 819.709, insert the following clause: VA Small Business Subcontracting Plan Minimum Requirements...

  8. 48 CFR 852.219-9 - VA Small business subcontracting plan minimum requirements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 5 2012-10-01 2012-10-01 false VA Small business... Provisions and Clauses 852.219-9 VA Small business subcontracting plan minimum requirements. As prescribed in subpart 819.709, insert the following clause: VA Small Business Subcontracting Plan Minimum Requirements...

  9. 48 CFR 852.219-9 - VA Small business subcontracting plan minimum requirements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false VA Small business... Provisions and Clauses 852.219-9 VA Small business subcontracting plan minimum requirements. As prescribed in subpart 819.709, insert the following clause: VA Small Business Subcontracting Plan Minimum Requirements...

  10. 76 FR 24568 - Proposed Information Collection (Supplemental Physical Examination Report); Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-02

    ... (Supplemental Physical Examination Report); Comment Request AGENCY: Veterans Benefits Administration, Department... techniques or the use of other forms of information technology. Titles: a. Supplemental Physical Examination Report, VA Form 29-8146. b. Attending Physician's Statement, VA Form 29-8158. c. Supplemental Physical...

  11. 77 FR 69549 - Proposed Information Collection (Compensation and Pension Examination Program (CPEP) Veterans...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-19

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0774] Proposed Information Collection (Compensation and Pension Examination Program (CPEP) Veterans Satisfaction Survey) Activity: Comment Request...: Compensation and Pension Examination Program (CPEP) Veterans Satisfaction Survey, VA Form 10-0480. [[Page 69550...

  12. 76 FR 8846 - Proposed Information Collection (Disability Benefits Questionnaires-Group 1) Activity: Comment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-15

    ... Lymphatic Conditions, Including Leukemia Disability Benefits Questionnaire, VA Form 21-0960B-2. b..., VA Form 21-0960M-14. k. Tumors and Neoplasms (Except Prostate Cancer and Leukemias) Disability...

  13. 76 FR 61149 - Agency Information Collection (Disability Benefits Questionnaires-Group 4) Activity Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-03

    ...-Related Illness, Chronic Fatigue Syndrome, or Tuberculosis) Disability Benefits Questionnaire, VA Form 21...) Disability Benefits Questionnaire, VA Form 21- 0960-J-4. Respiratory Conditions (other than Tuberculosis and...

  14. Comparison of the Air Force Officer Qualifying Test Form T and Form S: Initial Item- and Subtest-Level Analyses

    DTIC Science & Technology

    2017-03-15

    61 BC .17 .91 .54 BC .28 .86 .60 AI .23 .77 .45 AI .07 .78 .50 T2 N = 5,199; S2 N = 8,164 5 Subtest-Level Analyses Descriptive ...GS) to .90 (IC) for Form S2. The reliability for both Forms S1 and S2 was .83. The highest item-total correlations for both Forms T1 and S1 were...The lowest item-total correlations for T1 and S1 occurred for VA (T1, .37; S1, .27). VA also had the lowest correlation for T2 and S2; VA (T2, .37

  15. 75 FR 33897 - Agency Request for Emergency Approval of an Information Collection

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-15

    ... Leukemias Disability Benefits Questionnaire, VA Form 21-0960B. c. Parkinson's Disease Disability Benefits...: Hairy cell leukemia and other chronic B-cell leukemias, Parkinson's disease, and ischemic heart disease... Form 21-0960B--500. c. Parkinson's Disease Disability Benefits Questionnaire, VA Form 21-0960C--1,250...

  16. 76 FR 45008 - Proposed Information Collection (Disability Benefits Questionnaires-Group 4) Activity: Comment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-27

    ... Tuberculosis Disability Benefits Questionnaire, VA Form 21-0960-I-3. k. Systemic Lupus Erytematous (SLE) and... Conditions (other than Tuberculosis and Sleep Apnea) Disability Benefits Questionnaire, VA Form 21-0960-L-1...

  17. 78 FR 18425 - Proposed Information Collection VA Police Officer Pre-Employment Screening Checklist); Comment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-26

    ... enhance the quality, utility, and clarity of the information to be collected; and (4) ways to minimize the... approved collection. Abstract: VA personnel complete VA Form 0120 to document pre- employment history and...

  18. 77 FR 74278 - Proposed Information Collection (Internet Student CPR Web Registration Application); Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-13

    ... (Internet Student CPR Web Registration Application); Comment Request AGENCY: Veterans Health Administration... web registration application. DATES: Written comments and recommendations on the proposed collection.... Title: Internet Student CPR Web Registration Application, VA Form 10-0468. OMB Control Number: 2900-0746...

  19. 78 FR 24469 - Proposed Information Collection (Ethics Consultation Feedback Tool (ECFT)) Activity; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-25

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0750] Proposed Information Collection (Ethics... ethics consultation service. DATES: Written comments and recommendations on the proposed collection of... information technology. Title: Ethics Consultation Feedback Tool (ECFT), VA Form 10-0502. OMB Control Number...

  20. 75 FR 2595 - Proposed Information Collection (Care Coordination Home Telehealth (CCHT) Activity: Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-15

    ... (Care Coordination Home Telehealth (CCHT) Activity: Comment Request AGENCY: Veterans Health.... Title: Care Coordination Home Telehealth (CCHT) Patient Satisfaction Survey, VA Form 10-0481. OMB... program will receive survey questions through a messaging device located in their home. Patients can...

  1. 75 FR 15495 - Agency Information Collection (Compensation and Pension Examination Program (CPEP)) Activities...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-29

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-New (CPEP)] Agency Information Collection (Compensation and Pension Examination Program (CPEP)) Activities under OMB Review AGENCY: Veterans Health...: Compensation and Pension Examination Program (CPEP) Veterans Satisfaction Survey, VA Form 10-0480. Type of...

  2. 75 FR 2594 - Proposed Information Collection (Compensation and Pension Examination Program (CPEP) Veterans...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-15

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-New (CPEP)] Proposed Information Collection (Compensation and Pension Examination Program (CPEP) Veterans Satisfaction Survey) Activity: Comment Request... Program (CPEP) Veterans Satisfaction Survey, VA Form 10-0480. OMB Control Number: 2900-New (CPEP). Type of...

  3. Characterization of the interaction between the heavy and light chains of bovine factor Va.

    PubMed

    Walker, F J

    1992-10-05

    Bovine factor Va has been previously been shown to consist of heavy (M(r) = 94,000) and light chains (M(r) = 81,000), that interact in a manner dependent upon the presence of either calcium or manganese ions. In an attempt to understand the mechanism of subunit interaction we have studied the effects of temperature and ions on factor Va stability. The rates of formation of factor Va from isolated chains and dissociation were temperature-dependent with an energy of activation of 6.2 and 1.3 kcal mol-1, respectively. The yield of factor Va from isolated chains was inversely related to the amount of time the chains were incubated at 4 degrees C. Incubation of individual chains revealed that the heavy chain is cold-labile, an effect that is reversible. Manganese ion was observed to prevent the conversion to the inactive form. High salt tends to stabilize the two-chain structure of factor Va, but is inhibitory to its formation from isolated chains. High concentrations of either manganese or calcium ions also inhibited reconstitution of activity. The light chain, in particular, was sensitive to the presence of manganese or calcium ion. Heavy chain that had been cleaved by activated protein C had a weakened interaction with the light chain, and the resulting complex had no procoagulant activity. Cooling of the heavy chain to 4 degrees C enhanced its intrinsic fluorescence. Manganese ion prevented some of this enhancement. The heavy chain fluorescence returned to the room temperature value with a half-life of approximately 10 min. In the presence of manganese ion relaxation was accelerated. The intrinsic fluorescence of activated protein C-cleaved heavy chain was not increased when the temperature was decreased. These data suggest that the heavy chain can exist in two forms. Elevated temperature converts it to a form that can bind ions and have a productive interaction with the light chain. However, conditions that prevent the heavy chain from combining with the light chain also stabilize the two subunit structure, suggesting that the high affinity of the complex is due to conformational changes that occur after chain interaction.

  4. The hyperferremic mouse model for the evaluation of the effectiveness of VA-MENGOC-BC against Neisseria meningitidis B clinical isolates.

    PubMed

    Sifontes, S; Infante, J F; Pérez, P; Caro, E; Sierra, G; Campa, C

    1997-01-01

    VA-MENGOC-BC is a vaccine against B and C serogroups of Neisseria meningitidis. Its effectiveness at population level has been shown after the application of the vaccine in Cuba, Brazil, Argentina and Colombia. In vitro assays are not always able to reproduce the microorganism-host relationships and this makes it necessary to compile and standardize results obtained in animal models to extrapolate them with a greater degree of safety for humans. We evaluated the effectiveness of VA-MENGOC-BC against Neisseria meningitidis group B isolates from clinically ill patients in Latin America (Argentina, B not typeable: P1; Chile, not typed; Colombia, B4:P1.15 and Cuba B4:P1.15) using Balb/cJ mice treated with iron to make them susceptible to Neisseria meningitidis. The lethal median dose of each strain and of two others that were not included in challenge assays (Brazil: P1.15 and Argentina, B2b:P1.10) were determined. Results were 2.68 x 10(6), 3.16 x 10(7), 1.98 x 10(8), 1.28 x 10(9), 6.42 x 10(6) and 3.88 x 10(7) colony forming units (CFU), respectively. Non-immunized animals and mice treated with one and two doses of VA-MENGOC-BC were challenged with 10(3)-(10) CFU. Protection ranged from 30 to 100% with one dose and was equal to or higher than 70% with the two-dose immunization schedule. A significant protection could not be observed against the Colombian isolate from the lethality point of view, but the mean time of survival lengthened in immunized animals in relation to the controls. The applied inoculum of this strain was much higher (505 x LD50) than the remaining ones. The protection conferred was evident; nevertheless, more data are needed to determine how relevant the results are to humans.

  5. 76 FR 44086 - Agency Information Collection (Notice of Waiver of VA Compensation or Pension To Receive Military...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-22

    ... of Waiver of VA Compensation or Pension To Receive Military Pay and Allowances) Activity Under OMB....'' SUPPLEMENTARY INFORMATION: Title: Notice of Waiver of VA Compensation or Pension to Receive Military Pay and... order to receive active or inactive duty training pay are required to complete VA Forms 21-8951 and 21...

  6. 77 FR 50548 - Agency Information Collection: (PACT Clinical Innovation Study: Engaging Caregivers in the Care...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-21

    ... Collection: (PACT Clinical Innovation Study: Engaging Caregivers in the Care of Veterans With Dementia... announces that the Department of Veterans Affairs (VA), will submit to the Office of Management and Budget... Form 10-0537). SUPPLEMENTARY INFORMATION: Title: PACT Clinical Innovation Study: Engaging Caregivers in...

  7. 75 FR 27601 - Proposed Collection; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-17

    ... effect trades with or for U.S. institutional investors through a U.S. registered broker-dealer, provided... other forms of information technology. Consideration will be given to comments and suggestions submitted... Green Way, Alexandria, VA 22312 or send an e- mail to: [email protected] . Dated: May 10, 2010...

  8. 38 CFR 12.3 - Deceased veteran's cases.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... beneficiary at a field facility, as defined in § 12.0(b), a survey and inventory of the funds and effects of... occurred during hospitalization, a complete inventory (VA Form 10-2687, Inventory of Funds and Effects... death of incompetent veterans after November 30, 1959, the inventory will be completed to show...

  9. 75 FR 26345 - Agency Information Collection (Ethics Consultation Feedback Tool (ECFT)) New Enrollee Survey...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-11

    ... Collection (Ethics Consultation Feedback Tool (ECFT)) New Enrollee Survey) Activity Under OMB Review AGENCY...).'' SUPPLEMENTARY INFORMATION: Title: Ethics Consultation Feedback Tool (ECFT), VA Form 10-0502. OMB Control Number... collect data from patients and family members about their experience during the Ethics Consultation...

  10. 75 FR 15496 - Agency Information Collection (Care Coordination Home Telehealth (CCHT)) Activity Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-29

    ... (Care Coordination Home Telehealth (CCHT)) Activity Under OMB Review AGENCY: Veterans Health... INFORMATION: Title: Care Coordination Home Telehealth (CCHT) Patient Satisfaction Survey, VA Form 10-0481. OMB... program will receive survey questions through a messaging device located in their home. Patients can...

  11. 78 FR 76193 - Agency Information Collection (Care Coordination Home Telehealth (CCHT) Patient Satisfaction...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-16

    ... Coordination Home Telehealth (CCHT) Patient Satisfaction Survey) Activities Under OMB Review AGENCY: Veterans... patient perspective on satisfaction with the CCHT program and messaging devices. DATES: Comments must be...: Care Coordination Home Telehealth (CCHT) Patient Satisfaction Survey, VA Form 10-0481. Type of Review...

  12. 77 FR 3844 - Proposed Information Collection (Dependents' Application for VA Educational Benefits) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-25

    ... use of other forms of information technology. Title: Dependents' Application for VA Educational... (Dependents' Application for VA Educational Benefits) Activity; Comment Request AGENCY: Veterans Benefits...' Educational Assistance and Fry Scholarship benefits. DATES: Written comments and recommendations on the...

  13. 75 FR 77956 - Agency Information Collection (Annual Certification of Veteran Status and Veteran-Relatives...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-14

    ... Certification of Veteran Status and Veteran- Relatives, VA Form 20-0344. OMB Control Number: 2900-0654. Type of..., conflict of interest, improper influence etc. by VA and non-VA employees. An agency may not conduct or...

  14. Polyblends of LDPE with EVA

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

    Deanin, R.D.; Hou, T.J.A.

    1993-12-31

    Melt processability of LDPE was improved by blending with EVA copolymers containing 10-28% VA. Softening of modules was controlled primarily by overall VA content of the blends. Tensile necking was converted to smooth rubbery elongation by adding larger amounts of VA. Transparency was produced by adding EVA containing 10% VA and then stretching the polyblend film. These parameters give the film manufacturer wide control over processability and properties.

  15. Volatile anesthetic rescue therapy in children with acute asthma: innovative but costly or just costly?.

    PubMed

    Char, Danton S; Ibsen, Laura M; Ramamoorthy, Chandra; Bratton, Susan L

    2013-05-01

    To describe volatile anesthesia (VA) use for pediatric asthma, including complications and outcomes. Retrospective cohort study. Children's hospitals contributing to the Pediatric Health Information System between 2004-2008. Children 2-18 years old with a primary diagnosis code for asthma supported with mechanical ventilation. Those treated with VA were compared to those not treated with VA or extracorporeal membrane oxygenation. Hospital VA use was grouped as none, <5%, 5-10% and >10% among intubated children. One thousand five hundred and fifty-eight patients received mechanical ventilation at 40 hospitals for asthma: 47 (3%) received VA treatment at 11 (28%) hospitals. Those receiving a VA were significantly less likely to receive inhaled b-agonists, ipratropium bromide, and heliox, but more likely to receive neuromuscular blocking agents than patients treated without VA. Length of mechanical ventilation, hospital stay (length of stay [LOS]) and charges were significantly greater for those treated with VA. Aspiration was more common but death and air leak did not differ. Patients at hospitals with VA use >10% were significantly less likely to receive inhaled b agonist, ipratropium bromide, methylxanthines, and heliox, but more likely to receive systemic b agonist, neuromuscular blocking agents compared to those treated at hospitals not using VA. LOS, duration of ventilation, and hospital charges were significantly greater for patients treated at centers with high VA use. Mortality does not differ between centers that use VA or not. Patients treated at centers with high VA use had significantly increased hospital charges and increased LOS.

  16. 78 FR 36642 - Proposed Information Collection (VA Loan Electronic Reporting Interface (VALERI) System) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-18

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0021] Proposed Information Collection (VA Loan Electronic Reporting Interface (VALERI) System) Activity: Comment Request AGENCY: Veterans... techniques or the use of other forms of information technology. Title: VA Loan Electronic Reporting Interface...

  17. 77 FR 22069 - Proposed Information Collection (Notice of Lapse-Government Life Insurance); Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-12

    ... of Lapse--Government Life Insurance); Comment Request AGENCY: Veterans Benefits Administration... determine claimants' eligibility to reinstate lapsed Government Life Insurance policy. DATES: Written.... Notice of Lapse--Government Life Insurance, VA Form 29-389. b. Application for Reinstatement, VA Form 29...

  18. 78 FR 35661 - Proposed Information Collection (Disability Benefits Questionnaires) Activity: Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-13

    ... (Disability Benefits Questionnaires) Activity: Comment Request AGENCY: Veterans Benefits Administration.... Ischemic Heart Disease (IHD) Disability Benefits Questionnaire, VA Form 21-0960a-1. b. Hairy Cell and Other B-Cell Leukemias Disability Benefits Questionnaire, VA Form 21-0960b-1. c. Parkinson's Disease...

  19. Assessment of free and cued recall in Alzheimer's disease and vascular and frontotemporal dementia with 24-item Grober and Buschke test.

    PubMed

    Cerciello, Milena; Isella, Valeria; Proserpi, Alice; Papagno, Costanza

    2017-01-01

    Alzheimer's disease (AD), vascular dementia (VaD) and frontotemporal dementia (FTD) are the most common forms of dementia. It is well known that memory deficits in AD are different from those in VaD and FTD, especially with respect to cued recall. The aim of this clinical study was to compare the memory performance in 15 AD, 10 VaD and 9 FTD patients and 20 normal controls by means of a 24-item Grober-Buschke test [8]. The patients' groups were comparable in terms of severity of dementia. We considered free and total recall (free plus cued) both in immediate and delayed recall and computed an Index of Sensitivity to Cueing (ISC) [8] for immediate and delayed trials. We assessed whether cued recall predicted the subsequent free recall across our patients' groups. We found that AD patients recalled fewer items from the beginning and were less sensitive to cueing supporting the hypothesis that memory disorders in AD depend on encoding and storage deficit. In immediate recall VaD and FTD showed a similar memory performance and a stronger sensitivity to cueing than AD, suggesting that memory disorders in these patients are due to a difficulty in spontaneously implementing efficient retrieval strategies. However, we found a lower ISC in the delayed recall compared to the immediate trials in VaD than FTD due to a higher forgetting in VaD.

  20. 76 FR 67557 - Proposed Information Collection (Survey of Veteran Enrollees' Health and Reliance Upon VA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-01

    ... of Veteran Enrollees' Health and Reliance Upon VA) Activity: Comment Request AGENCY: Veterans Health... enrollees' health status and reliance on VA's health care services. DATES: Written comments and... of automated collection techniques or the use of other forms of information technology. Title: Survey...

  1. 78 FR 17777 - Proposed Information Collection (Application for Furnishing Long-Term Care Service to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-22

    ... (Application for Furnishing Long- Term Care Service to Beneficiaries of Veterans Affairs, and Residential Care... qualification to provide care to Veteran patients. DATES: Written comments and recommendations on the proposed.... Application for Furnishing Long-Term Care Services to Beneficiaries of Veterans Affairs, VA Form 10-1170. b...

  2. 77 FR 3844 - Agency Information Collection (Architect-Engineer Fee Proposal) Activity Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-25

    ... (Architect--Engineer Fee Proposal) Activity Under OMB Review AGENCY: Veterans Health Administration...) of 1995 (44 U.S.C. 3501-21), this notice announces that the Veterans Health Administration... the scope and complexity of the project. VA Form 10-6298 is used to obtain such proposal and...

  3. 76 FR 40454 - Proposed Information Collection (VSO Access to VHA Electronic Health Records) Activity; Comment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-08

    ... Access to VHA Electronic Health Records) Activity; Comment Request AGENCY: Veterans Health Administration... Access to VHA Electronic Health Records, VA Form 10- 0400. OMB Control Number: 2900-0710. Type of Review... were granted power of attorney by veterans who have medical information recorded in VHA electronic...

  4. 77 FR 50551 - Agency Information Collection: Emergency Submission for OMB Review (PACT VISN20 Health Care...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-21

    ... Collection: Emergency Submission for OMB Review (PACT VISN20 Health Care Experiences of Patients With.... 2900-New (VA Form 10-0535). SUPPLEMENTARY INFORMATION: Title: PACT VISN20 Health Care Experiences of...: Veterans Health Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: In compliance with...

  5. 77 FR 27542 - Agency Information Collection Activities (Bereaved Family Member Satisfaction Survey) Under OMB...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-10

    ... Activities (Bereaved Family Member Satisfaction Survey) Under OMB Review AGENCY: Veterans Health...: Bereaved Family Member Satisfaction Survey, VA Form 10- 21081(NR). OMB Control Number: 2900-0701. Type of...) will be use to survey family members of deceased veterans on their satisfaction with the quality care...

  6. 75 FR 62635 - Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-12

    ... Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program) Activity: Comment Request... determine patients' satisfaction with services provided by or through the Michael E. DeBakey Home Care...: Patient Satisfaction Survey Michael E. DeBakey Home Care Program, VA Form 10-0476. OMB Control Number...

  7. 77 FR 69550 - Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-19

    ... (Patient Satisfaction Survey Michael E. DeBakey Home Care Program) Activity: Comment Request AGENCY... information needed to determine patients' satisfaction with services provided by or through the Michael E...: Patient Satisfaction Survey Michael E. DeBakey Home Care Program, VA Form 10-0476. OMB Control Number...

  8. Venturing into ventricular arrhythmia storm: a systematic review and meta-analysis.

    PubMed

    Nayyar, Sachin; Ganesan, Anand N; Brooks, Anthony G; Sullivan, Thomas; Roberts-Thomson, Kurt C; Sanders, Prashanthan

    2013-02-01

    Ablation has substantial evidence base in the management of ventricular arrhythmia (VA). It can be a 'lifesaving' procedure in the acute setting of VA storm. Current reports on ablation in VA storm are in the form of small series and have relative small representation in a large observational series. The purpose of this study was to systematically synthesize the available literature to appreciate the efficacy and safety of ablation in the setting of VA storm. The medical electronic databases through 31 January 2012 were searched. Ventricular arrhythmia storm was defined as recurrent (≥ 3 episodes or defibrillator therapies in 24 h) or incessant (continuous >12 h) VA. Studies reporting data on VA storm patients at the individual or study level were included. A total of 471 VA storm patients from 39 publications were collated for the analysis. All VAs were successfully ablated in 72% [95% confidence interval (CI) 71-89%] and 9% (95% CI: 3-10%) had a failed procedure. Procedure-related mortality occurred in three patients (0.6%). Only 6% patients had a recurrence of VA storm. The recurrence of VA was significantly higher after ablation for arrhythmic storm of monomorphic ventricular tachycardia (VT) relative to ventricular fibrillation or polymorphic VT with underlying cardiomyopathy (odds ratio 3.76; 95% CI: 1.65-8.57; P = 0.002). During the follow-up (61 ± 37 weeks), 17% of patients died (heart failure 62%, arrhythmias 23%, and non-cardiac 15%) with 55% deaths occurring within 12 weeks of intervention. The odds of death were four times higher after a failed procedure compared with those with a successful procedure (95% CI: 2.04-8.01, P < 0.001). Ventricular arrhythmia storm ablation has high-acute success rates, with a low rate of recurrent storms. Heart failure is the dominant cause of death in the long term. Failure of the acute procedure carries a high mortality.

  9. 76 FR 56504 - Proposed Information Collection (Claim for Disability Insurance Benefits, Government Life...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-13

    ... for Disability Insurance Benefits, Government Life Insurance) Activity: Comment Request. AGENCY... for Disability Insurance Benefits, Government Life Insurance, VA Form 29-357. OMB Control Number: 2900... VA Form 29-357 to file a claim for disability insurance on National Service Life Insurance and United...

  10. 76 FR 71624 - Agency Information Collection (Claim for Disability Insurance Benefits, Government Life Insurance...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-18

    ... for Disability Insurance Benefits, Government Life Insurance) Activity Under OMB Review AGENCY... INFORMATION: Title: Claim for Disability Insurance Benefits, Government Life Insurance, VA Form 29-357. OMB...: Policyholders complete VA Form 29-357 to file a claim for disability insurance on National Service Life...

  11. 78 FR 40551 - Agency Information Collection (Monthly Certification of Flight Training) Activity Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-05

    ... Certification of Flight Training) Activity Under OMB Review AGENCY: Veterans Benefits Administration, Department...-0162.'' SUPPLEMENTARY INFORMATION: Title: Monthly Certification of Flight Training, VA Form 22-6553c... or pursuing approved vocational flight training. VA Form 22-6553c serves as a report of flight...

  12. 77 FR 2351 - Agency Information Collection (Application for Work-Study Allowance): Activity Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-17

    ... (Application for Work-Study Allowance): Activity Under OMB Review AGENCY: Veterans Benefits Administration... ``OMB Control No. 2900-0209.'' SUPPLEMENTARY INFORMATION: Titles a. Application for Work-Study Allowance, VA Form 22-8691. b. Student Work-Study Agreement (Advance Payment), VA Form 22-8692. c. Extended...

  13. 75 FR 76081 - Agency Information Collection (Disability Benefits Questionnaires) Activity Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-07

    ... Leukemias Disability Benefits Questionnaire, VA Form 21-0960b-1. c. Parkinson's Disease Disability Benefits...-cell Leukemias, Parkinson's and Ischemic Heart diseases. Veterans have the option of providing the.... Parkinson's Disease Disability Benefits Questionnaire, VA Form 21-0960c-1--5,000. Dated: December 1, 2010...

  14. 75 FR 52066 - Proposed Information Collection (Application for Supplemental Service Disabled Veterans Insurance...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-24

    ... (Application for Supplemental Service Disabled Veterans Insurance) Activity: Comment Request AGENCY: Veterans... Disabled Veterans Insurance (SRH), VA Form 29-0188 and 29-0189, and Application for Supplemental Service Disabled Veterans (RH) Life Insurance, VA Form 29- 0190. OMB Control Number: 2900-0539. Type of Review...

  15. 75 FR 68037 - Proposed Information Collection (Application for Supplemental Service Disabled Veterans Insurance...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-04

    ... (Application for Supplemental Service Disabled Veterans Insurance) Activity: Comment Request AGENCY: Veterans...: Application for Supplemental Service Disabled Veterans Insurance (SRH), VA Form 29-0188 and 29-0189, and Application for Supplemental Service Disabled Veterans (RH) Life Insurance, VA Form 29- 0190. OMB Control...

  16. 75 FR 2593 - Proposed Information Collection (Service-Disabled Veterans Insurance-Waiver of Premiums); Comment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-15

    ... (Service-Disabled Veterans Insurance--Waiver of Premiums); Comment Request AGENCY: Veterans Benefits... information technology. Title: Service-Disabled Veterans Insurance--Waiver of Premiums, VA Form 29-0812. OMB...: Claimants who become totally disabled complete VA Form 29-0812 to apply for a waiver of their Service...

  17. 78 FR 36830 - Proposed Information Collection (Application for Supplemental Service Disabled Veterans Insurance...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-19

    ... (Application for Supplemental Service Disabled Veterans Insurance) Activity: Comment Request AGENCY: Veterans... Disabled Veterans Insurance (SRH), VA Form 29-0188 and 29-0189, and Application for Supplemental Service Disabled Veterans (RH) Life Insurance, VA Form 29- 0190. OMB Control Number: 2900-0539. Type of Review...

  18. 76 FR 44091 - Proposed Information Collection (Child Care Subsidy) Activity: Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-22

    ... techniques or the use of other forms of information technology. Titles a. Child Care Subsidy Application Form... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0717] Proposed Information Collection (Child... solicits comments on information needed to determine VA employees' eligibility to participate in VA's child...

  19. Rehabilitation and Prosthetic Services

    MedlinePlus

    ... VA Learning University (VALU) SimLearn Libraries (VALNET) VA Software Documentation Library (VDL) About VHA Learn about VHA Forms & ... & Sensory Aids Service (PSAS) Our Mission The mission of the Prosthetic & ...

  20. 75 FR 77958 - Agency Information Collection (Statement of Dependency of Parent(s)) Activity Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-14

    ... (Statement of Dependency of Parent(s)) Activity Under OMB Review AGENCY: Veterans Benefits Administration...: Statement of Dependency of Parent(s), VA Form 21-509. OMB Control Number: 2900-0089. Type of Review... VA Form 21-509 to report income and dependency information. Surviving parents of deceased veterans...

  1. 78 FR 59099 - Agency Information Collection (Disability Benefits Questionnaires) Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-25

    .... Hairy Cell and Other B-Cell Leukemias Disability Benefits Questionnaire, VA Form 21-0960b-1. c... exposure: Hairy Cell and Other Chronic B-cell Leukemias, Parkinson's and Ischemic Heart diseases. Veterans...-1--13,750. b. Hairy Cell and Other B-Cell Leukemias Disability Benefits Questionnaire, VA Form 21...

  2. 32 CFR 105.10 - SARC and SAPR VA procedures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... CIVILIAN SEXUAL ASSAULT PREVENTION AND RESPONSE PROGRAM PROCEDURES § 105.10 SARC and SAPR VA procedures. (a) SARC procedures. The SARC shall: (1) Serve as the single point of contact to coordinate sexual assault response when a sexual assault is reported. All SARCs shall be authorized to perform VA duties in...

  3. 32 CFR 105.10 - SARC and SAPR VA procedures.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... CIVILIAN SEXUAL ASSAULT PREVENTION AND RESPONSE PROGRAM PROCEDURES § 105.10 SARC and SAPR VA procedures. (a) SARC procedures. The SARC shall: (1) Serve as the single point of contact to coordinate sexual assault response when a sexual assault is reported. All SARCs shall be authorized to perform VA duties in...

  4. 75 FR 54445 - Proposed Information Collection (Follow-Up Study of a National Cohort of Gulf War and Gulf Era...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-07

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-New (VA Form 10-0488)] Proposed Information Collection (Follow-Up Study of a National Cohort of Gulf War and Gulf Era Veterans) Activity: Comment Request AGENCY: Veterans Health Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The...

  5. 75 FR 54965 - Proposed Information Collection (Follow-Up Study of a National Cohort of Gulf War and Gulf Era...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-09

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-New (VA Form 10-0488)] Proposed Information Collection (Follow-Up Study of a National Cohort of Gulf War and Gulf Era Veterans) Activity: Comment Request AGENCY: Veterans Health Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The...

  6. 78 FR 6851 - Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-31

    ... (Patient Satisfaction Survey Michael E. DeBakey Home Care Program) Activity: Comment Request AGENCY... Satisfaction Survey Michael E. DeBakey Home Care Program, VA Form 10-0476. OMB Control Number: 2900-0775. Type... gather feedback from patients regarding their satisfaction with the quality of services/care provided by...

  7. Vascular access infection: survival or mortality.

    PubMed

    Hirotani, Sachiko; Kai, Kotaro; Iwatoh, Kazuhiro; Sannomiya, Akihito; Nakajima, Ichiro; Fuchinoue, Shohei

    2015-11-01

    We conducted an analysis on 11 cases of death after AVG infection that occurred between 1996 and 2013, and compared their information with those of 23 cases of generalized infection due to arteriovenous graft (AVG) infection during the same period who survived. The cause of death was sepsis in all 11 patients. The initial C-reactive protein (CRP) was 10.2-39.8 (28 in average) and the duration from onset of fever to vascular access (VA) hemostasis/removal procedure was 6-9 days (6.4 days in average) in the 11 cases of death. Blood culture revealed a high frequency of methicillin-resistant staphylococcus aureus (MRSA) in 7 of the 11 cases of death. In contrast, in 23 survivors with VA infection and generalized infection, the CRP at the initial visit was 3.2-15.8 (5.6 in average) and the duration from onset of the fever to VA hemostasis/removal procedure was 0-5 days (2.6 days in average), and blood culture revealed a high frequency of methicillin-sensitive staphylococcus aureus (MSSA). Among the cases of death, although VA infection in the upper extremity itself resolved after removing the artificial vessel, they died without an improvement of sepsis. The reason why the sepsis did not resolve is that infectious foci were secondarily formed in other areas than the upper extremity because the start of treatment for VA infection was delayed. Treatment for VA infection should be started as early as possible after onset to avoid the formation of secondary infectious foci in other areas.

  8. 46 CFR 7.45 - Cape Henlopen, DE to Cape Charles, VA.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Cape Henlopen, DE to Cape Charles, VA. 7.45 Section 7.45 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC BOUNDARY LINES Atlantic Coast § 7.45 Cape Henlopen, DE to Cape Charles, VA. (a) A line drawn from the easternmost...

  9. 48 CFR 819.7113 - Reports.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 5 2013-10-01 2013-10-01 false Reports. 819.7113 Section... SMALL BUSINESS PROGRAMS VA Mentor-Protégé Program 819.7113 Reports. (a) Mentor and protégé entities shall submit to VA's OSDBU bi-annual reports on progress under the Mentor-Protégé Agreement. VA will...

  10. 48 CFR 819.7113 - Reports.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 5 2012-10-01 2012-10-01 false Reports. 819.7113 Section... SMALL BUSINESS PROGRAMS VA Mentor-Protégé Program 819.7113 Reports. (a) Mentor and protégé entities shall submit to VA's OSDBU bi-annual reports on progress under the Mentor-Protégé Agreement. VA will...

  11. 48 CFR 819.7113 - Reports.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Reports. 819.7113 Section... SMALL BUSINESS PROGRAMS VA Mentor-Protégé Program 819.7113 Reports. (a) Mentor and protégé entities shall submit to VA's OSDBU bi-annual reports on progress under the Mentor-Protégé Agreement. VA will...

  12. 78 FR 61002 - Agency Information Collection (Statement of Dependency of Parent(s)) Activity Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-02

    ... (Statement of Dependency of Parent(s)) Activity Under OMB Review AGENCY: Veterans Benefits Administration... INFORMATION: Title: Statement of Dependency of Parent(s), VA Form 21-509. OMB Control Number: 2900-0089. Type...) for support complete VA Form 21-509 to report income and dependency information. Surviving parents of...

  13. 77 FR 38396 - Agency Information Collection (Notice of Lapse-Government Life Insurance) Activities Under OMB...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-27

    ... of Lapse--Government Life Insurance) Activities Under OMB Review AGENCY: Veterans Benefits...--Government Life Insurance, VA Form 29-389. b. Application for Reinstatement, VA Form 29-389-1. OMB Control...-389 and 29-389-1 are used to inform claimants that their government life insurance has lapsed or will...

  14. 76 FR 44089 - Agency Information Collection (Offer To Purchase and Contract of Sale) Activity Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-22

    ... Purchase and Contract of Sale) Activity Under OMB Review AGENCY: Veterans Benefits Administration... Management and Budget (OMB) for review and comment. The PRA submission describes the nature of the... Purchase and Contract of Sale, VA Form 26-6705. b. Credit Statement of Prospective Purchaser, VA Form 26...

  15. On SYM theory and all order bulk singularity structures of BPS strings in type II theory

    NASA Astrophysics Data System (ADS)

    Hatefi, Ehsan

    2018-06-01

    The complete forms of the S-matrix elements of a transverse scalar field, two world volume gauge fields, and a Potential Cn-1 Ramond-Ramond (RR) form field are investigated. In order to find an infinite number of t , s , (t + s + u)-channel bulk singularity structures of this particular mixed open-closed amplitude, we employ all the conformal field theory techniques to , exploring all the entire correlation functions and all order α‧ contact interactions to these supersymmetric Yang-Mills (SYM) couplings. Singularity and contact term comparisons with the other symmetric analysis, and are also carried out in detail. Various couplings from pull-Back of branes, Myers terms and several generalized Bianchi identities should be taken into account to be able to reconstruct all order α‧ bulk singularities of type IIB (IIA) superstring theory. Finally, we make a comment on how to derive without any ambiguity all order α‧ contact terms of this S-matrix which carry momentum of RR in transverse directions.

  16. Separation of large mammalian ventricular myosin differing in ATPase activity.

    PubMed

    Rupp, Heinz; Maisch, Bernhard

    2007-01-01

    To investigate a possible heterogeneity of human ventricular myosin, papillary muscles of patients with valvular dysfunction were examined using a modified native gel electrophoresis. Myosin was separated into 2 components termed VA and VB, whereby the VA to VB proportion appeared to depend on the ventricular load. The proportion of the faster migrating band VA was correlated (P<0.05) with end-diastolic pressure and the aortic pressure-cardiac index product. The regression based on these variables accounted for 67% of the variation in VA (R2=0.67). The VA proportion was, however, not significantly correlated with cardiac norepinephrine concentration. The ATPase activity of the 2 components of myosin was assessed from the Ca3(PO4)2 precipitation by incubating the gel in the presence of ATP and CaCl2. The ATPase activity of VA was 60% of that of VB. The VA and VB forms were observed also in the cat (31.4% VA), dog (32.1% VA), pig (28.5% VA), wild pig (33.7% VA), and roe deer (30.5% VA). VA and VB were not detected in the rat exhibiting the 3 isoforms V1, V2, and V3, rabbit (100% V3), and hare (86% V1). The data demonstrate a heterogeneity of large mammalian ventricular myosin, whereby an increased cardiac load appeared to be associated with a higher myosin VA proportion that exhibited a reduced ATPase activity.

  17. 77 FR 64388 - Agency Information Collection (Former POW Medical History), VA Form 10-0048 Activities Under OMB...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-19

    ... INFORMATION CONTACT: Crystal Rennie, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420, (202) 632-7492, fax (202) 632-7583 or email crystal[email protected] Response: One time. Estimated Number of Respondents: 75. Dated: October 15, 2012. By direction of the...

  18. Injury-related gaining momentum as external causes of deaths in Ethiopian health and demographic surveillance sites: evidence from verbal autopsy study

    PubMed Central

    Gelaye, Kassahun Alemu; Tessema, Fasil; Tariku, Befikadu; Abera, Semaw Ferede; Gebru, Alemseged Aregay; Assefa, Nega; Zelalem, Desalew; Dedefo, Melkamu; Kondal, Mekdes; Kote, Mesfin; Sisay, Mitike Molla; Mekonnen, Wubegzier; Terefe, Mamo Wubshet; Biks, Gashaw Andargie; Eshetu, Firehywot; Abera, Mulumebet; Fekadu, Yoseph; Hailu, Gessessew Bugssa; Tilahun, Etsehiwot; Lakew, Yihunie

    2018-01-01

    ABSTRACT Background: In Ethiopia, though all kinds of mortality due to external causes are an important component of overall mortality often not counted or documented on an individual basis. Objective: The aim of this study was to describe the patterns of mortality from external causes using verbal autopsy (VA) method at the Ethiopian HDSS Network sites. Methods: All deaths at Ethiopian HDSS sites were routinely registered and followed up with VA interviews. The VA forms comprised deaths up to 28 days, between four weeks and 14 years and 15 years and above. The cause of a death was ascertained based on an interview with next of families or other caregivers using a standardized questionnaire that draws information on signs, symptoms, medical history and circumstances preceding death after 45 days mourning period. Two physician assigned probable causes of death as underlying, immediate and contributing factors independently using information in VA forms based on the WHO ICD-10 and VA code system. Disagreed cases sent to third physician for independent review and diagnosis. The final cause of death considered when two of the three physicians assigned underlying cause of death; otherwise, labeled as undetermined. Results: In the period from 2009 to 2013, a total of 9719 deaths were registered. Of the total deaths, 623 (6.4%) were from external causes. Of these, accidental drowning and submersion, 136 (21.8%), accidental fall, 113 (18.1%) and transport-related accidents, 112 (18.0%) were the topmost three leading external causes of deaths. About 436 (70.0%) of deaths were from the age group above 15 years old. Drowning and submersion and transport-related accidents were high in age group between 5 and 14 years old. Conclusion: In this study, external causes of death are significant public health problems and require attention as one of prior health agenda. PMID:29471744

  19. 46 CFR 7.55 - Cape Henry, VA to Cape Fear, NC.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Cape Henry, VA to Cape Fear, NC. 7.55 Section 7.55 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC BOUNDARY LINES Atlantic Coast § 7.55 Cape Henry, VA to Cape Fear, NC. (a) A line drawn from Rudee Inlet Jetty Light “2” to...

  20. Recovery of Ventriculo-Atrial Conduction after Adrenaline in Patients Implanted with Pacemakers.

    PubMed

    Cismaru, Gabriel; Gusetu, Gabriel; Muresan, Lucian; Rosu, Radu; Andronache, Marius; Matuz, Roxana; Puiu, Mihai; Mester, Petru; Miclaus, Maria; Pop, Dana; Mircea, Petru Adrian; Zdrenghea, Dumitru

    2015-07-01

    Ventriculo-atrial (VA) conduction can have negative consequences for patients with implanted pacemakers and defibrillators. There is concern whether impaired VA conduction could recover during stressful situations. Although the influence of isoproterenol and atropine are well established, the effect of adrenaline has not been studied systematically. The objective of this study was to determine if adrenaline can facilitate recovery of VA conduction in patients implanted with pacemakers. A prospective study was conducted on 61 consecutive patients during a 4-month period (April-July 2014). The presence of VA conduction was assessed during the pacemaker implantation procedure. In case of an impaired VA conduction, adrenaline infusio was used as a stress surrogate to test conduction recovery. The indications for pacemaker implantation were: sinus node dysfunction in 18 patients, atrioventricular (AV) block in 40 patients, binodal dysfunction (sinus node+ AV node) in two patients and other (carotid sinus syndrome) in one patient. In the basal state, 15/61 (24.6%) presented spontaneous VA conduction and 46/61 (75.4%) had no VA conduction. After administration of adrenaline, there was VA conduction recovery in 5/46 (10.9%) patients. Adrenaline infusion produced recovery of VA conduction in 10.9% of patients with absent VA conduction in a basal state. Recovery of VA conduction during physiological or pathological stresses could be responsible for the pacemaker syndrome, PMT episodes, or certain implantable cardiac defibrillator detection issues. © 2015 Wiley Periodicals, Inc.

  1. Lower Respiratory Tract Infection and Short-Term Outcome in Patients With Acute Respiratory Distress Syndrome.

    PubMed

    Zampieri, Fernando G; Póvoa, Pedro; Salluh, Jorge I; Rodriguez, Alejandro; Valade, Sandrine; Andrade Gomes, José; Reignier, Jean; Molinos, Elena; Almirall, Jordi; Boussekey, Nicolas; Socias, Lorenzo; Ramirez, Paula; Viana, William N; Rouzé, Anahita; Nseir, Saad; Martin-Loeches, Ignacio

    2018-01-01

    To assess whether ventilator-associated lower respiratory tract infections (VA-LRTIs) are associated with mortality in critically ill patients with acute respiratory distress syndrome (ARDS). Post hoc analysis of prospective cohort study including mechanically ventilated patients from a multicenter prospective observational study (TAVeM study); VA-LRTI was defined as either ventilator-associated tracheobronchitis (VAT) or ventilator-associated pneumonia (VAP) based on clinical criteria and microbiological confirmation. Association between intensive care unit (ICU) mortality in patients having ARDS with and without VA-LRTI was assessed through logistic regression controlling for relevant confounders. Association between VA-LRTI and duration of mechanical ventilation and ICU stay was assessed through competing risk analysis. Contribution of VA-LRTI to a mortality model over time was assessed through sequential random forest models. The cohort included 2960 patients of which 524 fulfilled criteria for ARDS; 21% had VA-LRTI (VAT = 10.3% and VAP = 10.7%). After controlling for illness severity and baseline health status, we could not find an association between VA-LRTI and ICU mortality (odds ratio: 1.07; 95% confidence interval: 0.62-1.83; P = .796); VA-LRTI was also not associated with prolonged ICU length of stay or duration of mechanical ventilation. The relative contribution of VA-LRTI to the random forest mortality model remained constant during time. The attributable VA-LRTI mortality for ARDS was higher than the attributable mortality for VA-LRTI alone. After controlling for relevant confounders, we could not find an association between occurrence of VA-LRTI and ICU mortality in patients with ARDS.

  2. Summary Report of Depleted Uranium (DU) Survey Actions at Nevada Test and Training Range (NTTR), Airspace Region 63B, Active Target Complex 10 (63-10)

    DTIC Science & Technology

    2016-09-15

    currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE (DD-MM-YYYY) 15 Sep 2016 2. REPORT TYPE...Consultative Letter 3. DATES COVERED (From – To) Feb – Jun 2013 4. TITLE AND SUBTITLE Summary Report of Depleted Uranium (DU) Survey Actions at...USAF RADIOISOTOPE COMMITTEE SECRETARIAT ATTN: DR. RAMACHANDRA BHAT 7700 ARLINGTON BLVD, STE 5151 FALLS CHURCH, VA 22042-5151

  3. Applied Innovative Technologies for Characterization of Nitrocellulose and Nitroglycerin Contaminated Buildings and Soils

    DTIC Science & Technology

    2008-07-01

    analyses of the NG test group samples are summarized in Table 4- 8 along with results for the lab reference method, STL (SW- 846 ) Method 8330. The results for...Drive, Suite 17D08,Alexandria,VA,22350-3605 8 . PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10...Standard Form 298 (Rev. 8 -98) Prescribed by ANSI Std Z39-18 i COST & PERFORMANCE REPORT Project: ER-0130 TABLE OF CONTENTS Page 1.0 EXECUTIVE

  4. Assessment of Service Members Knowledge and Trust of the Department of Veterans Affairs

    DTIC Science & Technology

    2015-06-12

    www.va.gov/health/aboutVHA.asp. 24 Veterans Benefits Administration, “About VBA ,” last updated December 18, 2014, accessed May 10, 2015, http...Department of Veterans Affairs, 2014. Veterans Benefits Administration. “About VBA .” Last updated December 18, 2014. Accessed May 10, 2015. http...OIF Operation Iraqi Freedom VA Department of Veterans Affairs VA OIG Department of Veterans Affairs Office of Inspector General VBA Veterans Benefits

  5. Long-term effect of surface light scattering and glistenings of intraocular lenses on visual function.

    PubMed

    Hayashi, Ken; Hirata, Akira; Yoshida, Motoaki; Yoshimura, Koichi; Hayashi, Hideyuki

    2012-08-01

    To investigate the long-term effect of surface light scattering and glistenings of various intraocular lenses (IOLs) on visual function and optical aberrations after cataract surgery. Case-control study. Thirty-five eyes that underwent implantation of a hydrophobic acrylic, silicone, or polymethyl methacrylate (PMMA) IOL more than 10 years ago were recruited. The scattering light intensity of the surface and internal matrix of the optic was measured using Scheimpflug photography. Visual acuity (VA) was measured using VA charts, and contrast VA and that with glare (glare VA) were examined using a contrast sensitivity tester. Ocular higher-order aberrations (HOAs) were measured using a Hartmann-Shack aberrometer. Mean scattering light intensity of the surface and internal matrix of the optic was significantly higher in the acrylic group than in the silicone and PMMA groups (P < .0001). Mean uncorrected VA, photopic and mesopic contrast VA and glare VA, and HOAs did not differ significantly among groups, although mean corrected VA in the acrylic group was significantly better than that in the other groups (P = .0023). Scattering light intensity of the surface and internal matrix did not correlate with VA, contrast VA, or glare VA, and did not correlate with ocular and internal optic HOAs in the acrylic group. At more than 10 years postoperatively, visual function, including contrast sensitivity, and ocular HOAs were comparable among eyes that received acrylic, silicone, and PMMA IOLs. Surface scattering and glistenings with the acrylic IOLs were not significantly correlated with visual function and optical aberrations. Copyright © 2012 Elsevier Inc. All rights reserved.

  6. Different responses of vanillic acid, a phenolic compound, in HTC cells: cytotoxicity, antiproliferative activity, and protection from DNA-induced damage.

    PubMed

    Almeida, I V; Cavalcante, F M L; Vicentini, V E P

    2016-12-19

    The consumption of healthy and natural foods has increased over the last few years, primarily because these foods are rich in substances with biological properties of interest, such as exerting anticancer effects and decreasing oxidative stress in living tissues. These foods support adequate nutrition, maintain health, and improve quality of life. Vanillic acid (VA) is a phenolic compound used widely in the food industry as a flavoring, preservative, and food additive. VA can be found in various cereals, whole grains, fruits, herbs, green tea, juices, beers, and wines and possesses antioxidant, hepatoprotective, cardioprotective, and antiapoptotic activities. Studying the cytotoxicity as well as the mutagenic and antimutagenic effects of different concentrations of VA in Rattus norvegicus hepatoma cells (HTC) can identify new cellular activities of this substance. Concentrations up to 100 µM VA are not cytotoxic to HTC cells in a MTT [3-(4,5-dimethilthiazol-2-yl)-2,5-diphenil tetrazolium bromide] assay after 96-h exposure; therefore, VA does not compromise mitochondrial activity. Similarly, concentrations up to 500 µM do not compromise plasma membrane integrity. VA at 10 and 50 µM showed no mutagenic/clastogenic effects, as no significant micronuclei induction was observed. VA 10 µM presented no antiproliferative activity and reduced the cytotoxicity induced by benzo[a]pyrene. The antimutagenic activity of 10 µM VA was observed by the simultaneous, pre-, and post-treatments, as the phenolic compound significantly reduced the frequency of micronuclei induced by the mutagen. These results indicate that VA exerts different responses in HTC cells. Low concentrations present no cytotoxic, mutagenic, or antiproliferative effects and protect cells from DNA damage.

  7. Neutron Absorbing Alloys

    DOEpatents

    Zhong, Yuanzhen , Parikh, Hemant; Smith, Terry E.

    2002-05-28

    A process for making homogeneous copolymers of vinylpyrrolidone (VP) and vinyl acetate (VA) which form clear aqueous solutions and have high cloud points. The process involves precharging VP and VA monomers in a predetermined ratio, and then feeding VP and VA at a predetermined rate, the ratio of the components in the initial charge and the feeding rates for the monomer being selected in accordance with the reactivity rates of the monomers towards copolymerization as opposed to homopolymerization.

  8. 10 CFR 434.701 - General.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Refrigeration Institute, 4301 North Fairfax Drive, Suite 425, Arlington, VA 22203 434.403.1. RS-16 ARI Standard.... Air-Conditioning and Refrigeration Institute, 4301 North Fairfax Drive, Suite 425, Arlington, VA 22203...-Conditioning and Refrigeration Institute, 4301 North Fairfax Drive, Suite 425, Arlington, VA 22203 434.403.1...

  9. 10 CFR 434.701 - General.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Refrigeration Institute, 4301 North Fairfax Drive, Suite 425, Arlington, VA 22203 434.403.1. RS-16 ARI Standard.... Air-Conditioning and Refrigeration Institute, 4301 North Fairfax Drive, Suite 425, Arlington, VA 22203...-Conditioning and Refrigeration Institute, 4301 North Fairfax Drive, Suite 425, Arlington, VA 22203 434.403.1...

  10. 10 CFR 434.701 - General.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Refrigeration Institute, 4301 North Fairfax Drive, Suite 425, Arlington, VA 22203 434.403.1. RS-16 ARI Standard.... Air-Conditioning and Refrigeration Institute, 4301 North Fairfax Drive, Suite 425, Arlington, VA 22203...-Conditioning and Refrigeration Institute, 4301 North Fairfax Drive, Suite 425, Arlington, VA 22203 434.403.1...

  11. 10 CFR 434.701 - General.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Refrigeration Institute, 4301 North Fairfax Drive, Suite 425, Arlington, VA 22203 434.403.1. RS-16 ARI Standard.... Air-Conditioning and Refrigeration Institute, 4301 North Fairfax Drive, Suite 425, Arlington, VA 22203...-Conditioning and Refrigeration Institute, 4301 North Fairfax Drive, Suite 425, Arlington, VA 22203 434.403.1...

  12. 10 CFR 434.701 - General.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Refrigeration Institute, 4301 North Fairfax Drive, Suite 425, Arlington, VA 22203 434.403.1. RS-16 ARI Standard.... Air-Conditioning and Refrigeration Institute, 4301 North Fairfax Drive, Suite 425, Arlington, VA 22203...-Conditioning and Refrigeration Institute, 4301 North Fairfax Drive, Suite 425, Arlington, VA 22203 434.403.1...

  13. 10. Close view of the Tshaped chimney stack on the ...

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

    10. Close view of the T-shaped chimney stack on the north gable end, from around the central point of the west facade looking north northeast (note difference in lighting between VA-183-9 & 10) - Kiskiack, Naval Mine Depot, State Route 238 vicinity, Yorktown, York County, VA

  14. 48 CFR 870.112 - Telecommunications equipment.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Telecommunications... DEPARTMENT SUPPLEMENTARY REGULATIONS SPECIAL PROCUREMENT CONTROLS Controls 870.112 Telecommunications... specifications for telecommunications equipment, as defined in VA manual MP-6, Part VIII (available at any VA...

  15. 48 CFR 870.112 - Telecommunications equipment.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Telecommunications... DEPARTMENT SUPPLEMENTARY REGULATIONS SPECIAL PROCUREMENT CONTROLS Controls 870.112 Telecommunications... specifications for telecommunications equipment, as defined in VA manual MP-6, Part VIII (available at any VA...

  16. Introducing vibro-acupuncture: a psychophysical study.

    PubMed

    Wang, Kelun; Larsen, Dennis Boye; Jensen, Tanja Kim; Liu, Tiejun; Liu, Zhuxuan; Arendt-Nielsen, Lars

    2016-10-01

    To potentially enhance the effects of conventional acupuncture, a novel acu-vibrator (prototype) has been developed to perform vibro-acupuncture (VA). The aim of this psychophysical study was to investigate the subjective sensations of VA compared with conventional manual acupuncture (MA) and non-penetrating sham acupuncture (SA). 30 young healthy volunteers (21 men and 9 women) received VA, MA, and SA at LI4 and LI10 in a randomised, single-blind, placebo-controlled, cross-over manner. After 25 min of treatment, the Massachusetts General Hospital (MGH) acupuncture sensation scale (MASS), McGill pain questionnaire (MPQ), and numerical rating scale (NRS; 0-10) were employed followed by the acupuncture credibility and indication scale. Adverse events were investigated after treatment. Data were analysed using Friedman's test for repeated measures on ranks and post hoc Wilcoxon signed-rank tests with Bonferroni correction. The MASS scores were significantly higher during MA and VA compared with SA at both LI4 and LI10 (p<0.017). Treatment with VA evoked significantly higher vibration sensations compared with MA and SA (p<0.005). Treatment with SA yielded significantly lower NRS and MPQ scores compared with MA and VA (p<0.001) with no difference between MA and VA (p>0.05). Blinding of participants was achieved for SA and MA; however, VA was correctly identified in 29 of 30 subjects due to the characteristic vibrational stimulation. No serious adverse events were recorded for any of the treatments. Subjective sensations were influenced by treatment mode, with MA and VA yielding higher stimulation responses compared with SA. VA evoked specific vibrational sensations beyond MA, which might have specific effects in various disorders. 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/.

  17. 48 CFR 852.219-10 - VA Notice of total service-disabled veteran-owned small business set-aside.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...-disabled veteran-owned small business set-aside. 852.219-10 Section 852.219-10 Federal Acquisition... CLAUSES Texts of Provisions and Clauses 852.219-10 VA Notice of total service-disabled veteran-owned small...-Disabled Veteran-Owned Small Business Set-Aside (DEC 2009) (a) Definition. For the Department of Veterans...

  18. 48 CFR 852.219-10 - VA Notice of total service-disabled veteran-owned small business set-aside.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...-disabled veteran-owned small business set-aside. 852.219-10 Section 852.219-10 Federal Acquisition... CLAUSES Texts of Provisions and Clauses 852.219-10 VA Notice of total service-disabled veteran-owned small...-Disabled Veteran-Owned Small Business Set-Aside (DEC 2009) (a) Definition. For the Department of Veterans...

  19. 48 CFR 852.219-10 - VA Notice of total service-disabled veteran-owned small business set-aside.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...-disabled veteran-owned small business set-aside. 852.219-10 Section 852.219-10 Federal Acquisition... CLAUSES Texts of Provisions and Clauses 852.219-10 VA Notice of total service-disabled veteran-owned small...-Disabled Veteran-Owned Small Business Set-Aside (DEC 2009) (a) Definition. For the Department of Veterans...

  20. 48 CFR 852.219-10 - VA Notice of total service-disabled veteran-owned small business set-aside.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...-disabled veteran-owned small business set-aside. 852.219-10 Section 852.219-10 Federal Acquisition... CLAUSES Texts of Provisions and Clauses 852.219-10 VA Notice of total service-disabled veteran-owned small...-Disabled Veteran-Owned Small Business Set-Aside (DEC 2009) (a) Definition. For the Department of Veterans...

  1. 48 CFR 852.219-10 - VA Notice of total service-disabled veteran-owned small business set-aside.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...-disabled veteran-owned small business set-aside. 852.219-10 Section 852.219-10 Federal Acquisition... CLAUSES Texts of Provisions and Clauses 852.219-10 VA Notice of total service-disabled veteran-owned small...-Disabled Veteran-Owned Small Business Set-Aside (DEC 2009) (a) Definition. For the Department of Veterans...

  2. Bio-production of Baccatin III, an Important Precursor of Paclitaxel by a Cost-Effective Approach.

    PubMed

    Lin, Shu-Ling; Wei, Tao; Lin, Jun-Fang; Guo, Li-Qiong; Wu, Guang-Pei; Wei, Jun-Bin; Huang, Jia-Jun; Ouyang, Ping-Lan

    2018-07-01

    Natural production of anti-cancer drug taxol from Taxus has proved to be environmentally unsustainable and economically unfeasible. Currently, bioengineering the biosynthetic pathway of taxol is an attractive alternative production approach. 10-deacetylbaccatin III-10-O-acetyl transferase (DBAT) was previously characterized as an acyltransferase, using 10-deacetylbaccatin III (10-DAB) and acetyl CoA as natural substrates, to form baccatin III in the taxol biosynthesis. Here, we report that other than the natural acetyl CoA (Ac-CoA) substrate, DBAT can also utilize vinyl acetate (VA), which is commercially available at very low cost, acylate quickly and irreversibly, as acetyl donor in the acyl transfer reaction to produce baccatin III. Furthermore, mutants were prepared via a semi-rational design in this work. A double mutant, I43S/D390R was constructed to combine the positive effects of the different single mutations on catalytic activity, and its catalytic efficiency towards 10-DAB and VA was successfully improved by 3.30-fold, compared to that of wild-type DBAT, while 2.99-fold higher than the catalytic efficiency of WT DBAT towards 10-DAB and Ac-CoA. These findings can provide a promising economically and environmentally friendly method for exploring novel acyl donors to engineer natural product pathways.

  3. Effect of daily consumption of ß-cryptoxanthin-rich tangerines and ß-carotene-rich sweet potatoes on vitamin A and carotenoid concentrations in plasma and breast milk of Bangladeshi women with low vitamin A status

    USDA-ARS?s Scientific Manuscript database

    Background: The potential of ß-cryptoxanthin-rich foods to form vitamin A (VA) in humans is not well understood. Objective: To measure the effects of consuming ß-cryptoxanthin (CX) and ß-carotene-rich (BC) foods on breast milk and plasma VA and carotenoids in VA deficient lactating women. Design: Su...

  4. 77 FR 20887 - Proposed Information Collection (National Acquisition Center Customer Response Survey) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-06

    ... information needed to measure customer satisfaction with delivered products and services. DATES: Written... (National Acquisition Center Customer Response Survey) Activity; Comment Request AGENCY: Office of...: Department of Veterans Affairs (VA) National Acquisition Center Customer Response Survey, VA Form 0863. OMB...

  5. 76 FR 33417 - Agency Information Collection (Disability Benefits Questionnaires-Group 2) Activity Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-08

    .... Non-ischemic Heart Disease (including Arrhythmias and Surgery, Disability Benefits Questionnaire, VA.... Arteries and Veins Conditions (Vascular Diseases including Varicose Veins) Disability Benefits... g. Skin Diseases Disability Benefits Questionnaire, VA Form 21- 0960F-2. h. Amputations Disability...

  6. 77 FR 27859 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-11

    ... Veterans Affairs. ACTION: Notice of New System of Records ``Virtual Lifetime Electronic Record (VLER)-VA... ``Virtual Lifetime Electronic Record (VLER)-VA'' (168VA10P2). DATES: Comments on this new system of records... Virtual Lifetime Electronic Record (VLER) is an overarching program being developed by the Department of...

  7. Estimating 10-year cardiovascular disease risk in Asian patients with schizophrenia.

    PubMed

    Rekhi, Gurpreet; Khyne, Toe Toe; Lee, Jimmy

    This study aims to describe the cardiovascular risk profile of Asian patients with schizophrenia. Data was extracted from the databases of 139 patients with schizophrenia and 206 controls from two previous studies conducted at the Institute for Mental Health (IMH), Singapore. Their medical and smoking histories were obtained, and anthropometric parameters measured. Framingham risk score (FRS) calculator using body mass index was used to compute the 10-year cardiovascular disease risk (FRS BMI ) and the vascular age (VA BMI ) for each participant. Data on fasting lipids were available for 80 patients and all the controls; hence the FRS for lipids (FRS lipids ) and VA (VA lipids ) were also computed. The difference between VA and actual age was computed as VA diff . The 10-year CVD risk and VA diff based on lipids as well as BMI were significantly higher for patients compared to controls (all p<0.01). There was a strong correlation between FRS lipids and FRS BMI (r=0.97, p<0.001). Significantly higher numbers of patients than controls were smokers and obese; and reported having dyslipidaemia. We found a high risk of CVD in patients with schizophrenia as compared to controls; and conclude that patients with schizophrenia need regular physical health monitoring, especially for cardiovascular risk factors. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Serratia ureilytica sp. nov., a novel urea-utilizing species.

    PubMed

    Bhadra, Bhaskar; Roy, Pradosh; Chakraborty, Ranadhir

    2005-09-01

    A Gram-negative, rod-shaped, urea-dissolving and non-spore-forming bacterium, designated strain NiVa 51(T), was isolated from water of the River Torsa in Hasimara, Jalpaiguri district, West Bengal, India. On the basis of 16S rRNA gene sequence similarity, strain NiVa 51(T) was shown to belong to the gamma-Proteobacteria and to be related to Serratia marcescens subsp. sakuensis (98.35%) and S. marcescens subsp. marcescens (98.30%); however, strain NiVa 51(T) exhibited only 43.7% similarity to S. marcescens by DNA-DNA hybridization. The G+C content of the genomic DNA of the isolate was 60 mol%. Both biochemical characteristics and fatty acid analysis data supported the affiliation of strain NiVa 51(T) to the genus Serratia. Furthermore, strain NiVa 51(T) was found to utilize urea as nitrogen source. The results of DNA-DNA hybridization as well as physiological and biochemical tests allowed genotypic and phenotypic differentiation of strain NiVa 51(T) from recognized Serratia species. Strain NiVa 51(T) therefore represents a novel species, for which the name Serratia ureilytica sp. nov. is proposed, with type strain NiVa 51(T) (=LMG 22860(T)=CCUG 50595(T)).

  9. Quality Of End-Of-Life Care Is Higher In The VA Compared To Care Paid For By Traditional Medicare.

    PubMed

    Gidwani-Marszowski, Risha; Needleman, Jack; Mor, Vincent; Faricy-Anderson, Katherine; Boothroyd, Derek B; Hsin, Gary; Wagner, Todd H; Lorenz, Karl A; Patel, Manali I; Joyce, Vilija R; Murrell, Samantha S; Ramchandran, Kavitha; Asch, Steven M

    2018-01-01

    Congressional and Veterans Affairs (VA) leaders have recommended the VA become more of a purchaser than a provider of health care. Fee-for-service Medicare provides an example of how purchased care differs from the VA's directly provided care. Using established indicators of overly intensive end-of-life care, we compared the quality of care provided through the two systems to veterans dying of cancer in fiscal years 2010-14. The Medicare-reliant veterans were significantly more likely to receive high-intensity care, in the form of chemotherapy, hospital stays, admission to the intensive care unit, more days spent in the hospital, and death in the hospital. However, they were significantly less likely than VA-reliant patients to have multiple emergency department visits. Higher-intensity end-of-life care may be driven by financial incentives present in fee-for-service Medicare but not in the VA's integrated system. To avoid putting VA-reliant veterans at risk of receiving lower-quality care, VA care-purchasing programs should develop coordination and quality monitoring programs to guard against overly intensive end-of-life care.

  10. 75 FR 13208 - Proposed Information Collection (IRIS) Activity; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-18

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0619] Proposed Information Collection (IRIS... submitted to VA through the Inquiry Routing and Information System (IRIS). DATES: Written comments and... (IRIS), VA Form 0873. OMB Control Number: 2900-0619. Type of Review: Extension of a currently approved...

  11. 76 FR 60774 - Discontinuance of Form CO in Registration Practices

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-30

    ....e., Form TX for nondramatic literary works, Form PA for works of the performing arts, Form VA for works of visual art, Form SR for sound recordings, and Form SE for serials). Additionally, the proposed...

  12. 77 FR 38398 - Agency Information Collection (National Acquisition Center Customer Response Survey) Activities...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-27

    ... Acquisition Center Customer Response Survey) Activities Under OMB Review AGENCY: Office of Acquisition and... INFORMATION: Title: Department of Veterans Affairs (VA) National Acquisition Center Customer Response Survey... collection. Abstract: VA Form 0863 will be used to collect customer's feedback and suggestions on delivered...

  13. Health and Health Care Access of Rural Women Veterans: Findings From the National Survey of Women Veterans.

    PubMed

    Cordasco, Kristina M; Mengeling, Michelle A; Yano, Elizabeth M; Washington, Donna L

    2016-09-01

    Disparities in health and health care access between rural and urban Americans are well documented. There is evidence that these disparities are mirrored within the US veteran population. However, there are few studies assessing this issue among women veterans (WVs). Using the 2008-2009 National Survey of Women Veterans, a population-based cross-sectional national telephone survey, we examined rural WVs' health and health care access compared to urban WVs. We measured health using the Medical Outcomes Study Short-Form (SF-12); access using measures of regular source of care (RSOC), health care utilization, and unmet needs; and barriers to getting needed care. Rural WVs have significantly worse physical health functioning compared to urban WVs (mean physical component score of 43.6 for rural WVs versus 47.2 for urban WVs; P = .007). Rural WVs were more likely to have a VA RSOC (16.4% versus 10.6%; P = .009) and use VA health care (21.7% versus 12.9%; P < .001), and had fewer non-VA health care visits compared with urban WVs (mean 4.2 versus 5.9; P = .021). They had similar overall numbers of health care visits (mean 5.8 versus 7.1; P = .11 ). Access barriers were affordability for rural WVs and work release time for urban WVs. Rural WVs additionally reported that transportation was a major factor affecting health care decisions. Our findings demonstrate VA's crucial role in addressing disparities in health and health care access for rural WVs. As VA continues to strive to optimally meet the needs of all WVs, innovative care models need to account for their high health care needs and persistent barriers to care. © 2016 National Rural Health Association.

  14. Quantity and Quality of Vision Using Tinted Filters in Patients with Low Vision Due to Diabetic Retinopathy.

    PubMed

    Sadeghpour, Naser; Alishiri, Ali Agha; Ajudani, Reza; Khosravi, Mohammad Hossein; Amiri, Mohammad Aghazadeh; Sadeghpour, Omid

    2015-01-01

    To investigate the effect of tinted filters on visual acuity (VA), contrast sensitivity and patient satisfaction in diabetic retinopathy associated with low vision. In a prospective study, 51 patients with diabetic retinopathy and low vision were assessed. We chose a simple random sampling method and used the patient's files for data collection. LogMAR notations were applied for assessing VA and a contrast sensitivity chart (CSV-1000) was employed for measuring contrast sensitivity. First, measurements were performed without tinted filters and then using them. Appropriate lenses were given to the patients for 2 days, and they were questioned about their satisfaction using them in different places. A total of 20 male and 31 female patients with mean age of 57.3 years participated in the study. With a 527 ± 10 nm filter, mean VA improved significantly (P ≤ 0.05). Using the 527 ± 10 nm and 511 ± 10 nm filters, mean contrast sensitivity was improved significantly at 3 and 6 cycles/degree frequencies (P < 0.05). The effect of other filters on VA and contrast sensitivity was not significant. Patient satisfaction rate was generally high. Tinted filters are able to rehabilitate low-vision patients due to diabetic retinopathy. The 527 ± 10 and 511 ± 10 nm wavelength filters improved contrast sensitivity and the 527 ± 10 nm filter improved VA to some extent. Further investigations are recommended to assess the effect of these filters in patients with other causes of low-vision.

  15. 30 CFR 57.22234 - Actions at 1.0 percent methane (I-A, I-B, III, V-A, and V-B mines).

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ....22234 Actions at 1.0 percent methane (I-A, I-B, III, V-A, and V-B mines). (a) If methane reaches 1.0... methane reaches 1.0 percent at a main exhaust fan, electrical power underground shall be deenergized..., and all persons shall be withdrawn from the mine. (c) If methane reaches 1.0 percent at a work place...

  16. Trends in Timing of Dialysis Initiation within Versus Outside the Department of Veterans Affairs.

    PubMed

    Yu, Margaret K; O'Hare, Ann M; Batten, Adam; Sulc, Christine A; Neely, Emily L; Liu, Chuan-Fen; Hebert, Paul L

    2015-08-07

    The secular trend toward dialysis initiation at progressively higher levels of eGFR is not well understood. This study compared temporal trends in eGFR at dialysis initiation within versus outside the Department of Veterans Affairs (VA)-the largest non-fee-for-service health system in the United States. The study used linked data from the US Renal Data System, VA, and Medicare to compare temporal trends in eGFR at dialysis initiation between 2000 and 2009 (n=971,543). Veterans who initiated dialysis within the VA were compared with three groups who initiated dialysis outside the VA: (1) veterans whose dialysis was paid for by the VA, (2) veterans whose dialysis was not paid for by the VA, and (3) nonveterans. Logistic regression was used to estimate average predicted probabilities of dialysis initiation at an eGFR≥10 ml/min per 1.73 m(2). The adjusted probability of starting dialysis at an eGFR≥10 ml/min per 1.73 m(2) increased over time for all groups but was lower for veterans who started dialysis within the VA (0.31; 95% confidence interval [95% CI], 0.30 to 0.32) than for those starting outside the VA, including veterans whose dialysis was (0.36; 95% CI, 0.35 to 0.38) and was not (0.40; 95% CI, 0.40 to 0.40) paid for by the VA and nonveterans (0.39; 95% CI, 0.39 to 0.39). Differences in eGFR at initiation within versus outside the VA were most pronounced among older patients (P for interaction <0.001) and those with a higher risk of 1-year mortality (P for interaction <0.001). Temporal trends in eGFR at dialysis initiation within the VA mirrored those in the wider United States dialysis population, but eGFR at initiation was consistently lowest among those who initiated within the VA. Differences in eGFR at initiation within versus outside the VA were especially pronounced in older patients and those with higher 1-year mortality risk. Copyright © 2015 by the American Society of Nephrology.

  17. Trends in Timing of Dialysis Initiation within Versus Outside the Department of Veterans Affairs

    PubMed Central

    O’Hare, Ann M.; Batten, Adam; Sulc, Christine A.; Neely, Emily L.; Liu, Chuan-Fen; Hebert, Paul L.

    2015-01-01

    Background and objectives The secular trend toward dialysis initiation at progressively higher levels of eGFR is not well understood. This study compared temporal trends in eGFR at dialysis initiation within versus outside the Department of Veterans Affairs (VA)—the largest non–fee-for-service health system in the United States. Design, setting, participants, & measurements The study used linked data from the US Renal Data System, VA, and Medicare to compare temporal trends in eGFR at dialysis initiation between 2000 and 2009 (n=971,543). Veterans who initiated dialysis within the VA were compared with three groups who initiated dialysis outside the VA: (1) veterans whose dialysis was paid for by the VA, (2) veterans whose dialysis was not paid for by the VA, and (3) nonveterans. Logistic regression was used to estimate average predicted probabilities of dialysis initiation at an eGFR≥10 ml/min per 1.73 m2. Results The adjusted probability of starting dialysis at an eGFR≥10 ml/min per 1.73 m2 increased over time for all groups but was lower for veterans who started dialysis within the VA (0.31; 95% confidence interval [95% CI], 0.30 to 0.32) than for those starting outside the VA, including veterans whose dialysis was (0.36; 95% CI, 0.35 to 0.38) and was not (0.40; 95% CI, 0.40 to 0.40) paid for by the VA and nonveterans (0.39; 95% CI, 0.39 to 0.39). Differences in eGFR at initiation within versus outside the VA were most pronounced among older patients (P for interaction <0.001) and those with a higher risk of 1-year mortality (P for interaction <0.001). Conclusions Temporal trends in eGFR at dialysis initiation within the VA mirrored those in the wider United States dialysis population, but eGFR at initiation was consistently lowest among those who initiated within the VA. Differences in eGFR at initiation within versus outside the VA were especially pronounced in older patients and those with higher 1-year mortality risk. PMID:26206891

  18. 103. Catalog HHistory 1, C.C.C., 58 Landscaping, Negative No. 870 ...

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

    103. Catalog H-History 1, C.C.C., 58 Landscaping, Negative No. 870 10 ca. 1936 PROPAGATION AND PLANTING. ROOTED PLANTS TRANSPLANTED FROM HOT BEDS TO CANS TO SHADED BEDS IN PREPARATION FOR PLANTING ON ROAD SLOPES. NURSERY AT NORTH ENTRANCE. - Skyline Drive, From Front Royal, VA to Rockfish Gap, VA , Luray, Page County, VA

  19. WC Nanocrystals Grown on Vertically Aligned Carbon Nanotubes: An Efficient and Stable Electrocatalyst for Hydrogen Evolution Reaction.

    PubMed

    Fan, Xiujun; Zhou, Haiqing; Guo, Xia

    2015-05-26

    Single nanocrystalline tungsten carbide (WC) was first synthesized on the tips of vertically aligned carbon nanotubes (VA-CNTs) with a hot filament chemical vapor deposition (HF-CVD) method through the directly reaction of tungsten metal with carbon source. The VA-CNTs with preservation of vertical structure integrity and alignment play an important role to support the nanocrystalline WC growth. With the high crystallinity, small size, and uniform distribution of WC particles on the carbon support, the formed WC-CNTs material exhibited an excellent catalytic activity for hydrogen evolution reaction (HER), giving a η10 (the overpotential for driving a current of 10 mA cm(-2)) of 145 mV, onset potential of 15 mV, exchange current density@ 300 mV of 117.6 mV and Tafel slope values of 72 mV dec(-1) in acid solution, and η10 of 137 mV, onset potential of 16 mV, exchange current density@ 300 mV of 33.1 mV and Tafel slope values of 106 mV dec(-1) in alkaline media, respectively. Electrochemical stability test further confirms the long-term operation of the catalyst in both acidic and alkaline media.

  20. The subatlantic triangle: gateway to early localization of the atlantoaxial vertebral artery.

    PubMed

    Tayebi Meybodi, Ali; Gandhi, Sirin; Preul, Mark C; Lawton, Michael T

    2018-04-27

    OBJECTIVE Exposure of the vertebral artery (VA) between C-1 and C-2 vertebrae (atlantoaxial VA) may be necessary in a variety of pathologies of the craniovertebral junction. Current methods to expose this segment of the VA entail sharp dissection of muscles close to the internal jugular vein and the spinal accessory nerve. The present study assesses the technique of exposing the atlantoaxial VA through a newly defined muscular triangle at the craniovertebral junction. METHODS Five cadaveric heads were prepared for surgical simulation in prone position, turned 30°-45° toward the side of exposure. The atlantoaxial VA was exposed through the subatlantic triangle after reflecting the sternocleidomastoid and splenius capitis muscles inferiorly. The subatlantic triangle was formed by 3 groups of muscles: 1) the levator scapulae and splenius cervicis muscles inferiorly and laterally, 2) the longissimus capitis muscle inferiorly and medially, and 3) the inferior oblique capitis superiorly. The lengths of the VA exposed through the triangle before and after unroofing the C-2 transverse foramen were measured. RESULTS The subatlantic triangle consistently provided access to the whole length of atlantoaxial VA. The average length of the VA exposed via the subatlantic triangle was 19.5 mm. This average increased to 31.5 mm after the VA was released at the C-2 transverse foramen. CONCLUSIONS The subatlantic triangle provides a simple and straightforward pathway to expose the atlantoaxial VA. The proposed method may be useful during posterior approaches to the craniovertebral junction should early exposure and control of the atlantoaxial VA become necessary.

  1. Visual impairment in adult people with moderate, severe, and profound intellectual disability.

    PubMed

    Warburg, M

    2001-10-01

    To assess visual impairment in adults with intellectual disability after de-institutionalisation. The county has a population of 385 483 persons of 18 years and older; 961 were moderately, severely or profoundly intellectually impaired (ID), 837 of them (87 %) participated in the investigation. Visual acuity, VA: Østerberg picture charts and reduced copies for near vision could be used in 71% of the patients. Teller preferential looking procedure was applied to people who were unable to cooperate with the picture charts. When examined with picture wall chart VA 0.3-> or =0.10) was found in 10.8%, severe low vision in 1.2% (VA <0.10-> or =0.05), and blindness (VA<0.05) in 3.8%. Poor near vision (<0.3) was present in 19%. Those assessed with Teller acuity cards had poorer vision than the others. It is possible that the low values of assessment with Teller cards represent a combination of gnostic and resolution deficiencies, which means that the results of grating VA and recognition VA are non-comparable. Ophthalmic disorders: The most widespread medical condition was cerebral visual impairment, the most frequent eye disorders were optic atrophy, high myopia, cataract, and keratoconus. Refraction: Refraction was assessed in 710 persons (85%), the most prevalent cause of visual impairment was uncorrected ametropia. Hypermetropia of >+1.50 was found in 151 of 710 subjects (21%), and spectacles were used by 106 (15%); myopia <-1.0 was present in 213 individuals (30%), 95 persons (13%) had lenses <-1.0. Resettled adult people with intellectual disability have a high prevalence of treatable visual impairment. A structured scheme of referral to optometric and ophthalmological care is essential if these people are to be given the care to which they are entitled.

  2. Use of a "Super-child" Approach to Assess the Vitamin A Equivalence of Moringa oleifera Leaves, Develop a Compartmental Model for Vitamin A Kinetics, and Estimate Vitamin A Total Body Stores in Young Mexican Children.

    PubMed

    Lopez-Teros, Veronica; Ford, Jennifer Lynn; Green, Michael H; Tang, Guangwen; Grusak, Michael A; Quihui-Cota, Luis; Muzhingi, Tawanda; Paz-Cassini, Mariela; Astiazaran-Garcia, Humberto

    2017-12-01

    Background: Worldwide, an estimated 250 million children <5 y old are vitamin A (VA) deficient. In Mexico, despite ongoing efforts to reduce VA deficiency, it remains an important public health problem; thus, food-based interventions that increase the availability and consumption of provitamin A-rich foods should be considered. Objective: The objectives were to assess the VA equivalence of 2 H-labeled Moringa oleifera (MO) leaves and to estimate both total body stores (TBS) of VA and plasma retinol kinetics in young Mexican children. Methods: β-Carotene was intrinsically labeled by growing MO plants in a 2 H 2 O nutrient solution. Fifteen well-nourished children (17-35 mo old) consumed puréed MO leaves (1 mg β-carotene) and a reference dose of [ 13 C 10 ]retinyl acetate (1 mg) in oil. Blood (2 samples/child) was collected 10 times (2 or 3 children each time) over 35 d. The bioefficacy of MO leaves was calculated from areas under the composite "super-child" plasma isotope response curves, and MO VA equivalence was estimated through the use of these values; a compartmental model was developed to predict VA TBS and retinol kinetics through the use of composite plasma [ 13 C 10 ]retinol data. TBS were also estimated with isotope dilution. Results: The relative bioefficacy of β-carotene retinol activity equivalents from MO was 28%; VA equivalence was 3.3:1 by weight (0.56 μmol retinol:1 μmol β-carotene). Kinetics of plasma retinol indicate more rapid plasma appearance and turnover and more extensive recycling in these children than are observed in adults. Model-predicted mean TBS (823 μmol) was similar to values predicted using a retinol isotope dilution equation applied to data from 3 to 6 d after dosing (mean ± SD: 832 ± 176 μmol; n = 7). Conclusions: The super-child approach can be used to estimate population carotenoid bioefficacy and VA equivalence, VA status, and parameters of retinol metabolism from a composite data set. Our results provide initial estimates of retinol kinetics in well-nourished young children with adequate VA stores and demonstrate that MO leaves may be an important source of VA. © 2017 American Society for Nutrition.

  3. 75 FR 53378 - Agency Information Collection (Request to Employer for Employment Information in Connection With...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-31

    ... to Employer for Employment Information in Connection With Claim for Disability Benefits) Activities... through http://www.Regulations.gov or to VA's OMB Desk Officer, OMB Human Resources and Housing Branch... Connection with Claim for Disability Benefits, VA Form Letter 29-459. OMB Control Number: 2900-0066. Type of...

  4. 76 FR 40451 - Agency Information Collection (Veterans Mortgage Life Insurance-Change of Address Statement...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-08

    ... Mortgage Life Insurance-- Change of Address Statement) Activity Under OMB Review AGENCY: Veterans Benefits... Mortgage Life Insurance--Change of Address Statement, VA Form 29-0563. OMB Control Number: 2900-0503. Type... Mortgage Life Insurance when an address change for the veteran is received. VA uses the data collected to...

  5. Red palm oil as an intervention food to prevent vitamin A deficiency.

    USDA-ARS?s Scientific Manuscript database

    Vitamin A deficiency (VAD) is an important cause of blindness. Red palm oil (RPO) is the richest food source of VA-forming carotenoids. We evaluated RPO carotenoid concentration and bioavailability, and used this data to estimate the amount of RPO needed to meet VA requirements. Amounts ranged fr...

  6. 78 FR 59773 - Proposed Information Collection (VA Request for Determination of Reasonable Value) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-27

    ... Request for Determination of Reasonable Value) Activity: Comment Request AGENCY: Veterans Benefits... to determine the reasonable value of properties for guaranteed or direct home loans. DATES: Written... Reasonable Value, VA Form 26-1805 and 26-1805-1. OMB Control Number: 2900-0045. Type of Review: Revision of a...

  7. 75 FR 61249 - Proposed Information Collection (VA Request for Determination of Reasonable Value) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-04

    ... Request for Determination of Reasonable Value) Activity: Comment Request AGENCY: Veterans Benefits... information needed to determine the reasonable value of properties for guaranteed or direct home loans. DATES... Request for Determination of Reasonable Value, VA Form 26-1805 and 26-1805-1. OMB Control Number: 2900...

  8. 75 FR 61858 - Proposed Information Collection (VA Request for Determination of Reasonable Value) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-06

    ... Request for Determination of Reasonable Value) Activity: Comment Request AGENCY: Veterans Benefits... to determine the reasonable value of properties for guaranteed or direct home loans. DATES: Written... Reasonable Value, VA Form 26-1805 and 26-1805-1. OMB Control Number: 2900-0045. Type of Review: Extension of...

  9. 77 FR 35114 - Agency Information Collection (NCA PreNeed Burial Planning) Activity Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-12

    ...Need Burial Planning) Activity Under OMB Review AGENCY: National Cemetery Administration, Department of... PreNeed Burial Planning, VA Form 40-10007. OMB Control Number: 2900--New. Type of Review: New... members, and their eligible family members with planning for burial in a VA national cemetery. This...

  10. 76 FR 60134 - Proposed Information Collection (Monthly Statement of Wages Paid to Trainee) Activity; Comment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-28

    ... on-the-job training or apprenticeship program. DATES: Written comments and recommendations on the...: Extension of a currently approved collection. Abstract: Employers providing on-job or apprenticeship training to veterans complete VA Form 28-1917 to report each veteran's wages during the preceding month. VA...

  11. Vascular determinants of cholinergic deficits in Alzheimer disease and vascular dementia.

    PubMed

    Román, Gustavo C; Kalaria, Raj N

    2006-12-01

    Alzheimer's disease (AD) and vascular dementia (VaD) are widely accepted as the most common forms of dementia. Cerebrovascular lesions frequently coexist with AD, creating an overlap in the clinical and pathological features of VaD and AD. This review assembles evidence for a role for cholinergic mechanisms in the pathogenesis of VaD, as has been established for AD. We first consider the anatomy and vascularization of the basal forebrain cholinergic neuronal system, emphasizing its susceptibility to the effects of arterial hypertension, sustained hypoperfusion, and ischemic cerebrovascular disease. The impact of aging and consequences of disruption of the cholinergic system in cognition and in control of cerebral blood flow are further discussed. We also summarize preclinical and clinical evidence supporting cholinergic deficits and the use of cholinesterase inhibitors in patients with VaD. We postulate that vascular pathology likely plays a common role in initiating cholinergic neuronal abnormalities in VaD and AD.

  12. Plutonium working group report on environmental, safety and health vulnerabilities associated with the department`s plutonium storage. Volume II, Appendix B, Part 9: Oak Ridge site site team report

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

    NONE

    1994-09-01

    This report provides the input to and results of the Department of Energy (DOE) - Oak Ridge Operations (ORO) DOE Plutonium Environment, Safety and Health (ES & H) Vulnerability Assessment (VA) self-assessment performed by the Site Assessment Team (SAT) for the Oak Ridge National Laboratory (ORNL or X-10) and the Oak Ridge Y-12 Plant (Y-12) sites that are managed by Martin Marietta Energy Systems, Inc. (MMES). As initiated (March 15, 1994) by the Secretary of Energy, the objective of the VA is to identify and rank-order DOE-ES&H vulnerabilities associated for the purpose of decision making on the interim safe managementmore » and ultimate disposition of fissile materials. This assessment is directed at plutonium and other co-located transuranics in various forms.« less

  13. Short-term exposure to air pollutants increases the risk of ST elevation myocardial infarction and of infarct-related ventricular arrhythmias and mortality.

    PubMed

    Bañeras, Jordi; Ferreira-González, Ignacio; Marsal, Josep Ramon; Barrabés, José A; Ribera, Aida; Lidón, Rosa Maria; Domingo, Enric; Martí, Gerard; García-Dorado, David

    2018-01-01

    The relation between STEMI and air pollution (AP) is scant. We aimed to investigate the short term association between AP and the incidence of STEMI, and STEMI-related ventricular arrhythmias (VA) and mortality. The study was carried out in the area of Barcelona from January 2010 to December 2011. Daily STEMI rates and incidence of STEMI-related VA and mortality were obtained prospectively. The corresponding daily levels of the main pollutants were recorded as well as the atmospheric variables. Three cohorts were defined in order to minimize exposure bias. The magnitude of association was estimated using a time-series design and was adjusted according to atmospheric variables. The daily rate of hospital admissions for STEMI was associated with increases in PM 2.5, PM 10, lead and NO2 concentrations. VA incidence and mortality were associated with increases in PM 2.5 and PM 10 concentrations. In the most specific cohort, BCN (Barcelona) Attended & Resident, STEMI incidence was associated with increases in PM 2.5 (1.009% per 10μg/m 3 ) and PM 10 concentrations (1.005% per 10μg/m 3 ). VA was associated with increases in PM 2.5 (1.021%) and PM 10 (1.015%) and mortality was associated with increases in PM 2.5 (1.083%) and PM 10 (1.045%). Short-term exposure to high levels of PM 2.5 and PM 10 is associated with increased daily STEMI admissions and STEMI-related VA and mortality. Exposure to high levels of lead and NO2 is associated with increased daily STEMI admissions, and NO2 with higher mortality in STEMI patients. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  14. The Incubator Process: Implementation Experience for a Proposed Follow-On to the MOUT ACTD

    DTIC Science & Technology

    2002-09-01

    program are as follows. a. Workshop I Date and Location . 8-9 January 2001; IDA – Alexandria, VA Participants. 10 warfighter SMEs with MOUT...Date and Location . 10-12 January 2000; IDA – Alexandria, VA Participants. 10 warfighter SMEs (same as participated in Workshop I) Observers. 13...24 5. Location and Movement Status of Red Entities............................................... 25 6. Sniper

  15. 78 FR 76412 - Agency Information Collection (Application for Reimbursement of National Test Fee) Activity Under...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-17

    ... (Application for Reimbursement of National Test Fee) Activity Under OMB Review AGENCY: Veterans Benefits... National Test Fee, VA Form 22-0810. OMB Control Number: 2900-0706. Type of Review: Revision of a currently... to request reimbursement of national test fees. VA will use the data collected to determine the...

  16. 75 FR 78808 - Agency Information Collection (VA Request for Determination of Reasonable Value) Activity Under...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-16

    ... Request for Determination of Reasonable Value) Activity Under OMB Review AGENCY: Veterans Benefits... Determination of Reasonable Value VA Form 26- 1805 and 26-1805-1. OMB Control Number: 2900-0045. Type of Review... alterations does not exceed the reasonable value; or if the loan is for repair, alteration, or improvements of...

  17. 78 FR 6850 - Agency Information Collection (Monthly Record of Training and Wages) Activities Under OMB

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-31

    ... collection of information through www.Regulations.gov or to VA's OMB Desk Officer, OMB Human Resources and... Management and Budget (OMB) for review and comment. The PRA submission describes the nature of the... collection. Abstract: On-the-job training establishments and trainers in certain special programs use VA Form...

  18. 75 FR 56662 - Agency Information Collection (Request for Nursing Home Information in Connection With Claim for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-16

    ... for Nursing Home Information in Connection With Claim for Aid and Attendance) Activity Under OMB... INFORMATION: Title: Request for Nursing Home Information in Connection with Claim for Aid and Attendance, VA... collection. Abstract: The data collected on VA Form 21-0779 is used to determine veterans residing in nursing...

  19. MyRIP interaction with MyoVa on secretory granules is controlled by the cAMP-PKA pathway.

    PubMed

    Brozzi, Flora; Lajus, Sophie; Diraison, Frederique; Rajatileka, Shavanthi; Hayward, Katy; Regazzi, Romano; Molnár, Elek; Váradi, Anikó

    2012-11-01

    Myosin- and Rab-interacting protein (MyRIP), which belongs to the protein kinase A (PKA)-anchoring family, is implicated in hormone secretion. However, its mechanism of action is not fully elucidated. Here we investigate the role of MyRIP in myosin Va (MyoVa)-dependent secretory granule (SG) transport and secretion in pancreatic beta cells. These cells solely express the brain isoform of MyoVa (BR-MyoVa), which is a key motor protein in SG transport. In vitro pull-down, coimmunoprecipitation, and colocalization studies revealed that MyRIP does not interact with BR-MyoVa in glucose-stimulated pancreatic beta cells, suggesting that, contrary to previous notions, MyRIP does not link this motor protein to SGs. Glucose-stimulated insulin secretion is augmented by incretin hormones, which increase cAMP levels and leads to MyRIP phosphorylation, its interaction with BR-MyoVa, and phosphorylation of the BR-MyoVa receptor rabphilin-3A (Rph-3A). Rph-3A phosphorylation on Ser-234 was inhibited by small interfering RNA knockdown of MyRIP, which also reduced cAMP-mediated hormone secretion. Demonstrating the importance of this phosphorylation, nonphosphorylatable and phosphomimic Rph-3A mutants significantly altered hormone release when PKA was activated. These data suggest that MyRIP only forms a functional protein complex with BR-MyoVa on SGs when cAMP is elevated and under this condition facilitates phosphorylation of SG-associated proteins, which in turn can enhance secretion.

  20. 76 FR 43386 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-20

    ...The Privacy Act of 1974 (5 U.S.C. 552(e)(4)) requires that all agencies publish in the Federal Register a notice of the existence and character of their systems of records. Notice is hereby given that the Department of Veterans Affairs (VA) is establishing a new system of records entitled ``Ethics Consultation Web-based Database (ECWeb)-VA'' (152VA10E).

  1. Verbal autopsy: current practices and challenges.

    PubMed Central

    Soleman, Nadia; Chandramohan, Daniel; Shibuya, Kenji

    2006-01-01

    Cause-of-death data derived from verbal autopsy (VA) are increasingly used for health planning, priority setting, monitoring and evaluation in countries with incomplete or no vital registration systems. In some regions of the world it is the only method available to obtain estimates on the distribution of causes of death. Currently, the VA method is routinely used at over 35 sites, mainly in Africa and Asia. In this paper, we present an overview of the VA process and the results of a review of VA tools and operating procedures used at demographic surveillance sites and sample vital registration systems. We asked for information from 36 field sites about field-operating procedures and reviewed 18 verbal autopsy questionnaires and 10 cause-of-death lists used in 13 countries. The format and content of VA questionnaires, field-operating procedures, cause-of-death lists and the procedures to derive causes of death from VA process varied substantially among sites. We discuss the consequences of using varied methods and conclude that the VA tools and procedures must be standardized and reliable in order to make accurate national and international comparisons of VA data. We also highlight further steps needed in the development of a standard VA process. PMID:16583084

  2. Determination of the electrical resistivity of vertically aligned carbon nanotubes by scanning probe microscopy

    NASA Astrophysics Data System (ADS)

    Ageev, O. A.; Il'in, O. I.; Rubashkina, M. V.; Smirnov, V. A.; Fedotov, A. A.; Tsukanova, O. G.

    2015-07-01

    Techniques are developed to determine the resistance per unit length and the electrical resistivity of vertically aligned carbon nanotubes (VA CNTs) using atomic force microscopy (AFM) and scanning tunneling microscopy (STM). These techniques are used to study the resistance of VA CNTs. The resistance of an individual VA CNT calculated with the AFM-based technique is shown to be higher than the resistance of VA CNTs determined by the STM-based technique by a factor of 200, which is related to the influence of the resistance of the contact of an AFM probe to VA CNTs. The resistance per unit length and the electrical resistivity of an individual VA CNT 118 ± 39 nm in diameter and 2.23 ± 0.37 μm in height that are determined by the STM-based technique are 19.28 ± 3.08 kΩ/μm and 8.32 ± 3.18 × 10-4 Ω m, respectively. The STM-based technique developed to determine the resistance per unit length and the electrical resistivity of VA CNTs can be used to diagnose the electrical parameters of VA CNTs and to create VA CNT-based nanoelectronic elements.

  3. Association between air pollutants and dementia risk in the elderly.

    PubMed

    Wu, Yun-Chun; Lin, Yuan-Chien; Yu, Hwa-Lung; Chen, Jen-Hau; Chen, Ta-Fu; Sun, Yu; Wen, Li-Li; Yip, Ping-Keung; Chu, Yi-Min; Chen, Yen-Ching

    2015-06-01

    The aging rate in Taiwan is the second highest in the world. As the population ages quickly, the prevalence of dementia increases rapidly. There are some studies that have explored the association between air pollution and cognitive decline, but the association between air pollution and dementia has not been directly evaluated. This was a case-control study comprising 249 Alzheimer's disease (AD) patients, 125 vascular dementia (VaD) patients, and 497 controls from three teaching hospitals in northern Taiwan from 2007 to 2010. Data of particulate matter <10 μm in diameter (PM10) and ozone were obtained from the Taiwan Environmental Protection Administration for 12 and 14 years, respectively. Blood samples were collected to determine the apolipoprotein E (APOE) ɛ4 haplotype. Bayesian maximum entropy was used to estimate the individual exposure level of air pollutants, which was then tertiled for analysis. Conditional logistic regression models were used to estimate adjusted odds ratios (AORs) and 95% confidence intervals between the association of PM10 and ozone exposure with AD and VaD risk. The highest tertile of PM10 (≥49.23 μg/m(3)) or ozone (≥21.56 ppb) exposure was associated with increased AD risk (highest vs. lowest tertile of PM10: AOR = 4.17; highest vs. lowest tertile of ozone: AOR = 2.00). Similar finding was observed for VaD. The association with AD and VaD risk remained for the highest tertile PM10 exposure after stratification by APOE ɛ4 status and gender. Long-term exposure to the highest tertile of PM10 or ozone was significantly associated with an increased risk of AD and VaD.

  4. 30 CFR 57.22234 - Actions at 1.0 percent methane (I-A, I-B, III, V-A, and V-B mines).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Actions at 1.0 percent methane (I-A, I-B, III...-UNDERGROUND METAL AND NONMETAL MINES Safety Standards for Methane in Metal and Nonmetal Mines Ventilation § 57.22234 Actions at 1.0 percent methane (I-A, I-B, III, V-A, and V-B mines). (a) If methane reaches 1.0...

  5. Increases in the prevalence of reduced visual acuity and myopia in Chinese children in Guangzhou over the past 20 years.

    PubMed

    Xiang, F; He, M; Zeng, Y; Mai, J; Rose, K A; Morgan, I G

    2013-12-01

    To estimate the prevalence of myopia based on reduced unaided visual acuity (VA) in Chinese school children over the past 20 years. Guangzhou school health authorities have measured VA on Grade 1-12 students from 1988 to 2007 annually, using a LogMAR tumbling E chart. VA is reported as Snellen categories: normal (VA ≥ 6/6), mildly reduced (6/9 < VA <6/6), moderately reduced (6/18 < VA ≤ 6/9), and severely reduced VA (VA ≤ 6/18). In 1988, over 80% of children in Grade 1 (age 6 years) and about 30% in Grade 12 (age 17 years) had normal unaided VA. By 2007, this dropped to only 60% in Grade 1 and about 10% in Grade 12. Conversely, the prevalence of moderately and severely reduced unaided VA increased from 6.2% in Grade 1 and 62.5% in Grade 12 in 1988 to 14.5% in Grade 1 and 84.11% in Grade 12 in 2007. This rate was unchanged from 2003 to 2007 at both the Grade 1 and Grade 12 levels. In Guangzhou, the prevalence of reduced unaided VA has increased markedly in the past 20 years, but has stabilized in the past few years. This increase may result from environmental changes, such as increased schooling intensity and urbanization.

  6. The effect of membrane composition on the hemostatic balance.

    PubMed

    Smirnov, M D; Ford, D A; Esmon, C T; Esmon, N L

    1999-03-23

    The phospholipid composition requirements for optimal prothrombin activation and factor Va inactivation by activated protein C (APC) anticoagulant were examined. Vesicles composed of phosphatidylethanolamine (PE) and phosphatidylcholine (PC) supported factor Va inactivation relatively well. However, optimal factor Va inactivation still required relatively high concentrations of phosphatidylserine (PS). In addition, at a fixed concentration of phospholipid, PS, and APC, vesicles devoid of PE never attained a rate of factor Va inactivation achievable with vesicles containing PE. Polyunsaturation of any vesicle component also contributed significantly to APC inactivation of factor Va. Thus, PE makes an important contribution to factor Va inactivation that cannot be mimicked by PS. In the absence of polyunsaturation in the other membrane constituents, this contribution was dependent upon the presence of both the PE headgroup per se and unsaturation of the 1,2 fatty acids. Although PE did not affect prothrombin activation rates at optimal PS concentrations, PE reduced the requirement for PS approximately 10-fold. The Km(app) for prothrombin and the Kd(app) for factor Xa-factor Va decreased as a function of increasing PS concentration, reaching optimal values at 10-15% PS in the absence of PE but only 1% PS in the presence of PE. Fatty acid polyunsaturation had minimal effects. A lupus anticoagulant immunoglobulin was more inhibitory to both prothrombinase and factor Va inactivation in the presence of PE. The degree of inhibition of APC was significantly greater and much more dependent on the phospholipid composition than that of prothrombinase. Thus, subtle changes in the phospholipid composition of cells may control procoagulant and anticoagulant reactions differentially under both normal and pathological conditions.

  7. Effects of intra-aortic balloon pump on cerebral blood flow during peripheral venoarterial extracorporeal membrane oxygenation support

    PubMed Central

    2014-01-01

    Background The addition of an intra-aortic balloon pump (IABP) during peripheral venoarterial extracorporeal membrane oxygenation (VA ECMO) support has been shown to improve coronary bypass graft flows and cardiac function in refractory cardiogenic shock after cardiac surgery. The purpose of this study was to evaluate the impact of additional IABP support on the cerebral blood flow (CBF) in patients with peripheral VA ECMO following cardiac procedures. Methods Twelve patients (mean age 60.40 ± 9.80 years) received VA ECMO combined with IABP support for postcardiotomy cardiogenic shock after coronary artery bypass grafting. The mean CBF in the bilateral middle cerebral arteries was measured with and without IABP counterpulsation by transcranial Doppler. The patients provided their control values. The mean CBF data were divided into two groups (pulsatile pressure greater than 10 mmHg, P group; pulsatile pressure less than 10 mmHg, N group) based on whether the patients experienced cardiac stun. The mean cerebral blood flow in VA ECMO (IABP turned off) alone and VA ECMO with IABP support were compared using the paired t test. Results All of the patients were successfully weaned from VA ECMO, and eight patients survived to discharge. The addition of IABP to VA ECMO did not change the mean CBF (251.47 ± 79.28 ml/min vs. 251.30 ± 79.47 ml/min, P = 0.96). The mean CBF was higher in VA ECMO alone than in VA ECMO combined with IABP support in the N group (257.68 ± 97.21 ml/min vs. 239.47 ± 95.60, P = 0.00). The addition of IABP to VA ECMO support increased the mean CBF values significantly compared with VA ECMO alone (261.68 ± 82.45 ml/min vs. 244.43 ± 45.85 ml/min, P = 0.00) in the P group. Conclusion These results demonstrate that an IABP significantly changes the CBF during peripheral VA ECMO, depending on the antegrade blood flow by spontaneous cardiac function. The addition of an IABP to VA ECMO support decreased the CBF during cardiac stun, and it increased CBF without cardiac stun. PMID:24766774

  8. All-distance visual acuity and contrast visual acuity in eyes with a refractive multifocal intraocular lens with minimal added power.

    PubMed

    Hayashi, Ken; Yoshida, Motoaki; Hayashi, Hideyuki

    2009-03-01

    To compare visual acuity (VA) from far to near distances, photopic and mesopic contrast VA, and contrast VA in the presence of a glare source (glare VA), between eyes with a new refractive multifocal intraocular lens (IOL) with added power of only +3.0 diopters and those with a monofocal IOL. Comparative, nonrandomized, interventional study. Forty-four eyes of 22 patients who were scheduled for implantation of a refractive multifocal IOL (Hoya SFX MV1; Tokyo, Japan) and 44 eyes of 22 patients scheduled for implantation of a monofocal IOL. All patients underwent phacoemulsification with bilateral implantation of either multifocal or monofocal IOLs. At approximately 3 months after surgery, monocular and binocular VA from far to near distances was measured using the all-distance vision tester (Kowa AS-15; Tokyo, Japan), whereas photopic and mesopic contrast VA and glare VA were examined using the Contrast Sensitivity Accurate Tester (Menicon CAT-2000, Nagoya, Japan). Pupillary diameter and the degree of IOL decentration and tilt were correlated with VA at all distances. Mean VA in both the multifocal and monofocal IOL groups decreased gradually from far to near distances. When comparing the 2 groups, however, both uncorrected and best distance-corrected intermediate VA at 0.5 m and near VA at 0.3 m in the multifocal IOL group were significantly better than those in the monofocal IOL group (P

  9. Authorities and Mechanisms for Purchased Care at the Department of Veterans Affairs

    PubMed Central

    Greenberg, Michael D.; Batka, Caroline; Buttorff, Christine; Dunigan, Molly; Lovejoy, Susan L.; McGovern, Geoffrey; Pace, Nicholas M.; Pillemer, Francesca; Williams, Kayla M.; Apaydin, Eric; Aranibar, Clara; Buenaventura, Maya; Carter, Phillip; Cherney, Samantha; Davis, Lynn E.; Donohue, Amy Grace; Geyer, Lily; Hemler, Joslyn; Roshan, Parisa; Skrabala, Lauren; Simmons, Stephen; Thompson, Joseph; Welch, Jonathan; Hosek, Susan D.; Farmer, Carrie M.

    2016-01-01

    Abstract The Veterans Access, Choice, and Accountability Act of 2014 addressed the need for access to timely, high-quality health care for veterans. Section 201 of the legislation called for an independent assessment of various aspects of veterans' health care. The RAND Corporation was tasked with an assessment of the authorities and mechanisms by which the Department of Veterans Affairs (VA) pays for health care services from non-VA providers. Purchased care accounted for 10 percent, or around $5.6 billion, of VA's health care budget in fiscal year 2014, and the amount of care purchased from outside VA is growing rapidly. VA purchases non-VA care through an array of programs, each with different payment processes and eligibility requirements for veterans and outside providers. A review and analysis of statutes, regulations, legislation, and literature on VA purchased care, along with interviews with expert stakeholders, a survey of VA medical facilities, and an evaluation of local-level policy documents revealed that VA's purchased care system is complex and decentralized. Inconsistencies in procedures, unclear goals, and a lack of cohesive strategy for purchased care could have ramifications for veterans' access to care. Adding to the complexity of VA's purchased care system is a lack of systematic data collection on access to and quality of care provided through VA's purchased care programs. The analysis also explored concepts of “episodes of care” and their implications for purchased care by VA. PMID:28083425

  10. 48 CFR 852.219-11 - VA notice of total veteran-owned small business set-aside.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false VA notice of total veteran-owned small business set-aside. 852.219-11 Section 852.219-11 Federal Acquisition Regulations System... owned by one or more veterans; (ii) The management and daily business operations of which are controlled...

  11. High-Bandwidth Tactical-Network Data Analysis in a High-Performance-Computing (HPC) Environment: Packet-Level Analysis

    DTIC Science & Technology

    2015-09-01

    with a collection of information if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS . 1...UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS (ES) Technical and Project Engineering, LLC QED Systems, LLC Alexandria, VA...AND ADDRESS (ES) US Army Research Laboratory ATTN: RDRL-CIH-C Aberdeen Proving Ground, MD 21005 10. SPONSOR/MONITOR’S ACRONYM(S) 11. SPONSOR

  12. Computation of Laminar and Turbulent Flow in 90-Degree Square-Duct and Pipe Bends Using the Navier-Stokes Equations

    DTIC Science & Technology

    1982-04-01

    R.M. and Warming, R.F.: An Implicit Finite - Difference Algorithm for Hyperbolic Systems in Conservation Law Form. Journal of Computational Physics...Quincy Street C-40) Arlington, VA 22217 D 82 05-.10 I0, S4CURITY CLASSIFICATION OF THIS ’E(Wha, Doae Entotwed) Slength scale. Six different flow cases...forces upstream have produced a non-zero velocity gradient normal to the plane of curvature. Fluid with above (/below) average nioiiiei.tuili migrates

  13. Space Separatism: Degree of Differentiation

    DTIC Science & Technology

    2014-12-01

    Separate Service” (Norfolk, VA: Joint Forces Staff College, 6 September 2002); MAJ William S. Moncrief , “Building a United States Space Force,” Army Space...unclassified b. ABSTRACT unclassified c . THIS PAGE unclassified Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 November–December 2014 Air...FY14_Green_Book.pdf. 32. Story, “Separate Space Force,” 2–5. 33. Moncrief , “Building a United States Space Force,” 34–38. 34. DODD 3100.10, Space Policy, 3. 35. Lt

  14. Self-Learning Among Army Noncommissioned Officers: Experiences, Attitudes, and Preferred Strategies

    DTIC Science & Technology

    2012-09-01

    Sciences, ATTN: DAPE-ARI-ZXM, 6000 6th Street (Bldg. 1464 / Mail Stop 5610), Ft. Belvoir, VA 22060-5610. FINAL DISPOSITION: Destroy this Research...6000 6th Street (Building 1464 / Mail Stop 5610) Fort Belvoir, VA 22060-5610 8. PERFORMING ORGANIZATION REPORT NUMBER Research Report... Street (Building 1464 / Mail Stop 5610) Fort Belvoir, VA 22060-5610 10. MONITOR ACRONYM ARI 11. MONITOR REPORT NUMBER Research Report 1961

  15. Beta-Cryptoxanthin- and alpha-carotene-rich foods have greater apparent bioavailability than beta-carotene-rich foods in Western diets

    USDA-ARS?s Scientific Manuscript database

    Background: Beta-carotene (BC), beta-cryptoxanthin (CX) and alpha-carotene (AC) are common carotenoids that form vitamin A (VA). Conversion ratios for VA formation have been set at 12:1 for BC- and 24:1 for CX- and AC-rich foods, respectively. These conversion ratios are based on chemical structure...

  16. Reducing Short-Wavelength Blue Light in Dry Eye Patients with Unstable Tear Film Improves Performance on Tests of Visual Acuity.

    PubMed

    Kaido, Minako; Toda, Ikuko; Oobayashi, Tomoo; Kawashima, Motoko; Katada, Yusaku; Tsubota, Kazuo

    2016-01-01

    To investigate whether suppression of blue light can improve visual function in patients with short tear break up time (BUT) dry eye (DE). Twenty-two patients with short BUT DE (10 men, 12 women; mean age, 32.4 ± 6.4 years; age range, 23-43 years) and 18 healthy controls (10 men, 8 women; mean age, 30.1 ± 7.4 years; age range, 20-49 years) underwent functional visual acuity (VA) examinations with and without wearing eyeglasses with 50% blue light blocked lenses. The functional VA parameters were starting VA, functional VA, and visual maintenance ratio. The baseline mean values (logarithm of the minimum angle of resolution, logMAR) of functional VA and the visual maintenance ratio were significantly worse in the DE patients than in the controls (P < 0.05), while no significant difference was observed in the baseline starting VA (P > 0.05). The DE patients had significant improvement in mean functional VA and visual maintenance ratio while wearing the glasses (P < 0.05), while there were no significant changes with and without the glasses in the control group (P > 0.05). Protecting the eyes from short-wavelength blue light may help to ameliorate visual impairment associated with tear instability in patients with DE. This finding represents a new concept, which is that the blue light exposure might be harmful to visual function in patients with short BUT DE.

  17. Reducing Short-Wavelength Blue Light in Dry Eye Patients with Unstable Tear Film Improves Performance on Tests of Visual Acuity

    PubMed Central

    Kaido, Minako

    2016-01-01

    Purpose To investigate whether suppression of blue light can improve visual function in patients with short tear break up time (BUT) dry eye (DE). Methods Twenty-two patients with short BUT DE (10 men, 12 women; mean age, 32.4 ± 6.4 years; age range, 23–43 years) and 18 healthy controls (10 men, 8 women; mean age, 30.1 ± 7.4 years; age range, 20–49 years) underwent functional visual acuity (VA) examinations with and without wearing eyeglasses with 50% blue light blocked lenses. The functional VA parameters were starting VA, functional VA, and visual maintenance ratio. Results The baseline mean values (logarithm of the minimum angle of resolution, logMAR) of functional VA and the visual maintenance ratio were significantly worse in the DE patients than in the controls (P < 0.05), while no significant difference was observed in the baseline starting VA (P > 0.05). The DE patients had significant improvement in mean functional VA and visual maintenance ratio while wearing the glasses (P < 0.05), while there were no significant changes with and without the glasses in the control group (P > 0.05), Conclusions Protecting the eyes from short-wavelength blue light may help to ameliorate visual impairment associated with tear instability in patients with DE. This finding represents a new concept, which is that the blue light exposure might be harmful to visual function in patients with short BUT DE. PMID:27045760

  18. Mortality of Department of Veterans Affairs patients undergoing coronary revascularization in private sector hospitals.

    PubMed

    Vaughan-Sarrazin, Mary S; Wakefield, Bonnie; Rosenthal, Gary E

    2007-10-01

    A limitation of studies comparing outcomes of Veterans Affairs (VA) and private sector hospitals is uncertainty about the methods of accounting for risk factors in VA populations. This study estimates whether use of VA services is a marker for increased risk by comparing outcomes of VA users and other patients undergoing coronary revascularization in private sector hospitals. Males 67 years and older undergoing coronary artery bypass graft (CABG; n=687,936) surgery or percutaneous coronary intervention (PCI; n=664,124) during 1996-2002 were identified from Medicare administrative data. Patients using VA services during the 2 years preceding the Medicare admission were identified using VA administrative files. Thirty-, 90-, and 365-day mortality were compared in patients who did and did not use VA services, adjusting for demographic and clinical risk factors using generalized estimating equations and propensity score analysis. Adjusted mortality after CABG was higher (p<.001) in VA users compared with nonusers at 30, 90, and 365 days: odds ratio (OR)=1.07 (95 percent confidence interval [CI], 1.03-1.11), 1.07 (95 percent CI, 1.04-1.10), and 1.09 (95 percent CI, 1.06-1.12), respectively. For PCI, mortality at 30 and 90 days was similar (p>.05) for VA users and nonusers, but was higher at 365 days (OR=1.09; 95 percent CI, 1.06-1.12). The increased risk of death in VA users was limited to patients with service-connected disabilities or low incomes. Odds of death for VA users were slightly lower using samples matched by propensity scores. A small difference in risk-adjusted outcomes for VA users and nonusers undergoing revascularization in private sector hospitals was found. This difference reflects unmeasured severity in VA users undergoing revascularization in private sector hospitals.

  19. 38 CFR 1.904 - Form of payment.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Claims for Money Or Property § 1.904 Form of payment. Claims may be paid in the form of money or, when a contractual basis exists, VA may demand the return of specific property or the performance of specific...

  20. Three-dimensional Imaging of High-resolution Computer Tomography of Singers' Larynges-A Pilot Study.

    PubMed

    Vorik, Alexandra; Unteregger, Fabian; Zwicky, Salome; Schiwowa, Julia; Potthast, Silke; Storck, Claudio

    2017-01-01

    Biplanar imaging technique is not sufficient for an exact visualization and evaluation of the laryngeal biomechanics during speaking or singing. The aim of this pilot study was to test a 3D-visualization software MIMICS (Materialize Interactive Medical Image Control System, Materialize, Leuven, Belgium) for visualizing laryngeal cartilages and resonance space of living humans during singing based on high-resolution computed tomography (HRCT) and analyzing the biomechanics thereof. This is a prospective pilot study. A total of 10 professional female singers (five sopranos and five altos) was scanned with HRCT in three singing positions fundamental frequency (ƒo), first octave (ƒo+1 8va) and second octave (ƒo+2 8va). All relevant laryngeal structures and resonance space could be 3D visualized. Superimposing the different HRCT scans showed an inward rotation and rocking of the arytenoid cartilages from ƒo+1 8va to ƒo+2 8va and a backward tilting of the cricoid cartilage from ƒo+1 8va to ƒo+2 8va. Moreover, we could demonstrate a vocal fold elongation of 13% from ƒo to ƒo+1 8va and an additional elongation from ƒo+1 8va to ƒo+2 8va of 10% in type A cricothyroid joints (CTJ) A and 4% in CTJ's type B/C. There were no significant differences between sopranos and altos in all parameters (length of the glottis, subglottic diameter, distance between anterior commissure and cervical spine, and CTJ distribution). This noninvasive 3D-visualization technique with MIMICS allows the anatomical structures and landmarks of the larynx to be analyzed. We believe that this pilot study will serve as a basis for further biomechanical studies on speakers' and singers' larynges. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  1. Construction of an infectious cDNA clone of avian hepatitis E virus (avian HEV) recovered from a clinically healthy chicken in the United States and characterization of its pathogenicity in specific-pathogen-free chickens.

    PubMed

    Kwon, Hyuk Moo; LeRoith, Tanya; Pudupakam, R S; Pierson, F William; Huang, Yao-Wei; Dryman, Barbara A; Meng, Xiang-Jin

    2011-01-27

    A genetically distinct strain of avian hepatitis E virus (avian HEV-VA strain) was isolated from a healthy chicken in Virginia, and thus it is important to characterize and compare its pathogenicity with the prototype strain (avian HEV-prototype) isolated from a diseased chicken. Here we first constructed an infectious clone of the avian HEV-VA strain. Capped RNA transcripts from the avian HEV-VA clone were replication-competent after transfection of LMH chicken liver cells. Chickens inoculated intrahepatically with RNA transcripts of avian HEV-VA clone developed active infection as evidenced by fecal virus shedding, viremia, and seroconversion. To characterize the pathogenicity, RNA transcripts of both avian HEV-VA and avian HEV-prototype clones were intrahepatically inoculated into the livers of chickens. Avian HEV RNA was detected in feces, serum and bile samples from 10/10 avian HEV-VA-inoculated and 9/9 avian HEV-prototype-inoculated chickens although seroconversion occurred only in some chickens during the experimental period. The histopathological lesion scores were lower for avian HEV-VA group than avian HEV-prototype group in the liver at 3 and 5 weeks post-inoculation (wpi) and in the spleen at 3 wpi, although the differences were not statistically significant. The liver/body weight ratio, indicative of liver enlargement, of both avian HEV-VA and avian HEV-prototype groups were significantly higher than that of the control group at 5 wpi. Overall, the avian HEV-VA strain still induces histological liver lesions even though it was isolated from a healthy chicken. The results also showed that intrahepatic inoculation of chickens with RNA transcripts of avian HEV infectious clone may serve as an alternative for live virus in animal pathogenicity studies. Copyright © 2010 Elsevier B.V. All rights reserved.

  2. Comparison of rates of potentially inappropriate medication use according to the Zhan criteria for VA versus private sector medicare HMOs.

    PubMed

    Barnett, Mitchell J; Perry, Paul J; Langstaff, Jodi D; Kaboli, Peter J

    2006-06-01

    Inappropriate prescribing in the elderly is common, but rates across different health care systems and the impact of formulary restrictions are not well described. To determine if rates of inappropriate medication use in the elderly differ between the Veterans Affairs (VA) health care system and the private sector Medicare health maintenance organization (HMO) patients. A cross-sectional study design compared administrative pharmacy claims from 10 distinct geographic regions in the United States in the VA health care system and 10 analogous regions for patients enrolled in Medicare HMOs. The cohorts included 123,633 VA and 157,517 Medicare HMO patients aged 65 years and older. Inappropriate medication use was identified using the Zhan modification of the Beers criteria, which categorizes 33 potentially inappropriate drugs into 3 major classifications: "always avoid," "rarely appropriate," and "some indications." Comparisons between the VA health care system and the private sector Medicare HMO were performed for overall differences and stratified by gender and age. The drug formulary status of the Zhan-criteria drugs was known for the VA health system but not for the Medicare HMO patients. Compared with private sector patients, VA patients were less likely to receive any inappropriate medication (21% vs. 29%, P <0.001), and in each classification: always avoid (2% vs. 5%, P <0.001), rarely appropriate (8% vs. 13%, P<0.001), and some indications (15% vs. 17%, P <0.001). The rate of inappropriate drug use was lower in the VA compared with the private sector for males (21% vs. 24%, P <0.001) and females (28% vs. 32%, P <0.001). Differences were consistent when stratified by age. Compared with private sector Medicare HMOs, elderly VA patients were less likely to receive medications defined by the Zhan criteria as potentially inappropriate. A restrictive formulary that excludes 12 of the 33 Zhan criteria drugs may be a factor in the reduction of undesired prescribing patterns in elderly populations.

  3. Meta-analysis comparing same-day versus delayed vitrectomy clinical outcomes for intravitreal retained lens fragments after age-related cataract surgery

    PubMed Central

    Vanner, Elizabeth A; Stewart, Michael W

    2014-01-01

    Purpose/design We aimed to perform a systematic review and meta-analysis comparing the risk difference of clinical outcomes for same-day (SD) vs delayed (DEL) pars plana vitrectomy (PPV). Methods We searched MEDLINE (English; January 1, 1985 to July 16, 2013) and article reference lists, for patients with crystalline retained lens fragments and discussion of SD-PPV vs DEL-PPV. For the meta-analysis, articles needed the number of patients receiving SD-PPV and DEL-PPV, and the number, in each group, who experienced one or more of the outcomes: not good visual acuity (VA) (<20/40), bad VA (≤20/200), retinal detachment, increased intraocular pressure/glaucoma, intraocular infection/inflammation, cystoid macular edema, and corneal edema. Results Of 304 articles identified, 23 provided data for the meta-analysis. Results were mixed, indicating 1) neither vitrectomy time produced better outcomes in all studies (not good VA risk difference =10.3% [positive numbers favored SD-PPV; negative numbers favored DEL-PPV], 95% confidence interval [CI] = [−0.4% to 21.0%], P=0.059; and bad VA risk difference =−0.3%, 95% CI = [−10.7% to 10.1%], P=0.953); 2) better outcomes with immediate SD-PPV compared with all DEL-PPV (not good VA risk difference =16.2%, 95% CI = [0.8% to 31.5%], P=0.039; and bad VA risk difference =8.5%; 95% CI = [0.8% to 16.2%], P=0.030); and 3) immediate SD-PPV and prompt DEL-PPV (3 to 14 days after cataract surgery) had no significant differences and so may produce similar outcomes (not good VA risk differences range = [−19.9% to 6.5%], 95% CI = [−59.9% to 36.4%]; and bad VA risk differences range = [−6.9% to 7.4%], 95% CI = [−33.1% to 31.8%]). Conclusion Perhaps SD-PPV should be limited to facilities at which a vitreoretinal surgeon is immediately available. Otherwise, these results support referring a patient with retained lens fragments promptly to a vitreoretinal surgeon but do not support interfacility transport for SD-PPV. PMID:25429196

  4. Granular Formation during Apoptosis in Blastocystis sp. Exposed to Metronidazole (MTZ)

    PubMed Central

    Suresh, Kumar; Tan, Tian Chye

    2016-01-01

    The role and function of the granular life cycle stage in Blastocystis sp, remains uncertain despite suggestions being made that the granules are metabolic, reproductive and lipid in nature. This present study aims to understand granular formation by triggering apoptosis in Blastocystis sp. by treating them with metronidazole (MTZ). Blastocystis sp.cultures of 4 sub-types namely 1, 2, 3 and 5 when treated with 0.01 and 0.0001 mg/ml of metronidazole (MTZ) respectively showed many of the parasites to be both viable and apoptotic (VA). Treated subtype 3 isolates exhibited the highest number of granular forms i.e. 88% (p<0.001) (0.0001 mg/ml) and 69% (p<0.01) (0.01 mg/ml) respectively at the 72 h in in vitro culture compared to other subtypes. These VA forms showed distinct granules using acridine orange (AO) and 4’,6-diamino-2-phenylindole (DAPI) staining with a mean per cell ranging from 5 in ST 5 to as high as 16 in ST 3. These forms showed intact mitochondria in both viable apoptotic (VA) and viable non-apoptotic (VNA) cells with a pattern of accumulation of lipid droplets corresponding to viable cells. Granular VA forms looked ultra-structurally different with prominent presence of mitochondria-like organelle (MLO) and a changed mitochondrial trans-membrane potential with thicker membrane and a highly convoluted inner membrane than the less dense non-viable apoptotic (NVA) cells. This suggests that granular formation during apoptosis is a self-regulatory mechanism to produce higher number of viable cells in response to treatment. This study directs the need to search novel chemotherapeutic approaches by incorporating these findings when developing drugs against the emerging Blastocystis sp. infections. PMID:27471855

  5. Use of the Blue Button Online Tool for Sharing Health Information: Qualitative Interviews With Patients and Providers.

    PubMed

    Klein, Dawn M; Fix, Gemmae M; Hogan, Timothy P; Simon, Steven R; Nazi, Kim M; Turvey, Carolyn L

    2015-08-18

    Information sharing between providers is critical for care coordination, especially in health systems such as the United States Department of Veterans Affairs (VA), where many patients also receive care from other health care organizations. Patients can facilitate this sharing by using the Blue Button, an online tool that promotes patients' ability to view, print, and download their health records. The aim of this study was to characterize (1) patients' use of Blue Button, an online information-sharing tool in VA's patient portal, My HealtheVet, (2) information-sharing practices between VA and non-VA providers, and (3) how providers and patients use a printed Blue Button report during a clinical visit. Semistructured qualitative interviews were conducted with 34 VA patients, 10 VA providers, and 9 non-VA providers. Interviews focused on patients' use of Blue Button, information-sharing practices between VA and non-VA providers, and how patients and providers use a printed Blue Button report during a clinical visit. Qualitative themes were identified through iterative rounds of coding starting with an a priori schema based on technology adoption theory. Information sharing between VA and non-VA providers relied primarily on the patient. Patients most commonly used Blue Button to access and share VA laboratory results. Providers recognized the need for improved information sharing, valued the Blue Button printout, and expressed interest in a way to share information electronically across settings. Consumer-oriented technologies such as Blue Button can facilitate patients sharing health information with providers in other health care systems; however, more education is needed to inform patients of this use to facilitate care coordination. Additional research is needed to explore how personal health record documents, such as Blue Button reports, can be easily shared and incorporated into the clinical workflow of providers.

  6. "Where's My Choice?" An Examination of Veteran and Provider Experiences With Hepatitis C Treatment Through the Veteran Affairs Choice Program.

    PubMed

    Tsai, Jack; Yakovchenko, Vera; Jones, Natalie; Skolnik, Avy; Noska, Amanda; Gifford, Allen L; McInnes, D Keith

    2017-07-01

    The Department of Veterans Affairs (VA) is the country's largest provider for chronic hepatitis C virus (HCV) infection. The VA created the Choice Program, which allows eligible veterans to seek care from community providers, who are reimbursed by the VA. This study aimed to examine perspectives and experiences with the VA Choice Program among veteran patients and their HCV providers. Qualitative study based on semistructured interviews with veteran patients and VA providers. Interview transcripts were analyzed using rapid assessment procedures based in grounded theory. A total of 38 veterans and 10 VA providers involved in HCV treatment across 3 VA medical centers were interviewed. Veterans and providers were asked open-ended questions about their experiences with HCV treatment in the VA and through the Choice Program, including barriers and facilitators to treatment access and completion. Four themes were identified: (1) there were difficulties in enrollment, ongoing support, and billing with third-party administrators; (2) veterans experienced a lack of choice in location of treatment; (3) fragmented care led to coordination challenges between VA and community providers; and (4) VA providers expressed reservations about sending veterans to community providers. The Choice Program has the potential to increase veteran access to HCV treatment, but veterans and VA providers have described substantial problems in the initial years of the program. Enhancing care coordination, incorporating shared decision-making, and establishing a wide network of community providers may be important areas for further development in designing community-based specialist services for needy veterans.

  7. An overview of patient safety climate in the VA.

    PubMed

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

    2008-08-01

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

  8. Controlled Crystal Grain Growth in Mixed Cation-Halide Perovskite by Evaporated Solvent Vapor Recycling Method for High Efficiency Solar Cells.

    PubMed

    Numata, Youhei; Kogo, Atsushi; Udagawa, Yosuke; Kunugita, Hideyuki; Ema, Kazuhiro; Sanehira, Yoshitaka; Miyasaka, Tsutomu

    2017-06-07

    We developed a new and simple solvent vapor-assisted thermal annealing (VA) procedure which can reduce grain boundaries in a perovskite film for fabricating highly efficient perovskite solar cells (PSCs). By recycling of solvent molecules evaporated from an as-prepared perovskite film as a VA vapor source, named the pot-roast VA (PR-VA) method, finely controlled and reproducible device fabrication was achieved for formamidinium (FA) and methylammonium (MA) mixed cation-halide perovskite (FAPbI 3 ) 0.85 (MAPbBr 3 ) 0.15 . The mixed perovskite was crystallized on a low-temperature prepared brookite TiO 2 mesoporous scaffold. When exposed to very dilute solvent vapor, small grains in the perovskite film gradually unified into large grains, resulting in grain boundaries which were highly reduced and improvement of photovoltaic performance in PSC. PR-VA-treated large grain perovskite absorbers exhibited stable photocurrent-voltage performance with high fill factor and suppressed hysteresis, achieving the best conversion efficiency of 18.5% for a 5 × 5 mm 2 device and 15.2% for a 1.0 × 1.0 cm 2 device.

  9. Formation of a tyrosine adduct involved in lignin degradation by Trametopsis cervina lignin peroxidase: a novel peroxidase activation mechanism.

    PubMed

    Miki, Yuta; Pogni, Rebecca; Acebes, Sandra; Lucas, Fátima; Fernández-Fueyo, Elena; Baratto, Maria Camilla; Fernández, María I; de los Ríos, Vivian; Ruiz-Dueñas, Francisco J; Sinicropi, Adalgisa; Basosi, Riccardo; Hammel, Kenneth E; Guallar, Victor; Martínez, Angel T

    2013-06-15

    LiP (lignin peroxidase) from Trametopsis cervina has an exposed catalytic tyrosine residue (Tyr181) instead of the tryptophan conserved in other lignin-degrading peroxidases. Pristine LiP showed a lag period in VA (veratryl alcohol) oxidation. However, VA-LiP (LiP after treatment with H2O2 and VA) lacked this lag, and H2O2-LiP (H2O2-treated LiP) was inactive. MS analyses revealed that VA-LiP includes one VA molecule covalently bound to the side chain of Tyr181, whereas H2O2-LiP contains a hydroxylated Tyr181. No adduct is formed in the Y171N variant. Molecular docking showed that VA binding is favoured by sandwich π stacking with Tyr181 and Phe89. EPR spectroscopy after peroxide activation of the pre-treated LiPs showed protein radicals other than the tyrosine radical found in pristine LiP, which were assigned to a tyrosine-VA adduct radical in VA-LiP and a dihydroxyphenyalanine radical in H2O2-LiP. Both radicals are able to oxidize large low-redox-potential substrates, but H2O2-LiP is unable to oxidize high-redox-potential substrates. Transient-state kinetics showed that the tyrosine-VA adduct strongly promotes (>100-fold) substrate oxidation by compound II, the rate-limiting step in catalysis. The novel activation mechanism is involved in ligninolysis, as demonstrated using lignin model substrates. The present paper is the first report on autocatalytic modification, resulting in functional alteration, among class II peroxidases.

  10. 11. INTERIOR VIEW OF 8FOOT HIGH SPEED WIND TUNNEL. SAME ...

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

    11. INTERIOR VIEW OF 8-FOOT HIGH SPEED WIND TUNNEL. SAME CAMERA POSITION AS VA-118-B-10 LOOKING IN THE OPPOSITE DIRECTION. - NASA Langley Research Center, 8-Foot High Speed Wind Tunnel, 641 Thornell Avenue, Hampton, Hampton, VA

  11. Dissecting Vertebral Artery Aneurysm Presenting Regrowth After Stent-Assisted Coil Embolization in Acute Stage.

    PubMed

    Hijikata, Takamichi; Baba, Eiichi; Shirokane, Kazutaka; Tsuchiya, Atsushi; Nomura, Motohiro

    2018-06-01

    For a case of dissecting vertebral artery aneurysm (DVAA) in a dominant vertebral artery (VA) or posterior inferior cerebellar artery (PICA)-involving lesion, stent-assisted coil embolization (SACE) is an effective technique to preserve blood flow of the VA. A 41-year-old man presented with subarachnoid hemorrhage. Angiography demonstrated DVAA on the left VA just distal to the PICA, and the right VA was thinner than the left. For this case, SACE was performed to preserve the left VA and PICA. On the 10th day, angiography showed recurrence of the dissection. The dissected portion had thickened and extended to both distal and proximal sides involving the PICA origin and proximal portion to the PICA. A second endovascular embolization was performed and the recurrent dissecting aneurysm was embolized including the main VA cavity. In cases of DVAA, there is a possibility of recurrence after SACE, if a dissecting cavity remains unembolized. Therefore, total embolization is necessary under close observation from multiple angles, including the down-the-barrel view.

  12. The role of vision in academic school performance.

    PubMed

    Dirani, Mohamed; Zhang, Xiaoe; Goh, Liang Ke; Young, Terri L; Lee, Paul; Saw, Seang Mei

    2010-01-01

    To determine whether presenting distance visual acuity is related to subsequent academic school performance in Singaporean children between 9 to 10 years of age. Singapore children (n = 1143 children) were examined during their visits at ages 9 to 10 years (grades 3 to 4) as part of the Singapore Cohort Study of the Risk Factors for Myopia (SCORM) longitudinal study. Each child underwent an annual comprehensive eye examination, including the assessment of presenting logarithm of the minimum angle of resolution (LogMAR) distance visual acuity (VA). The individual marks of a nation-wide standard examination in grade 4 were used as the outcome measure for academic school performance. Children with any known eye disease, (such as media opacities) were excluded from the analysis. The mean presenting distance VA of the better eye was 0.10 and 0.08 when the children were in grades 3 and 4, respectively. There was a statistically significant difference for mean presenting VA with 9 and 10 year old boys scoring better (0.08 and 0.07) compared to girls (0.12 and 0.09) for the same ages, (p = 0.001 and p = 0.007), respectively. After adjusting for gender, ethnicity, school, reading, intelligence quotient and father's education, no significant relationships were found between average examination marks at the end of grade 4 and presenting VA obtained (better eye and worst eye) in grade 3 (p = 0.38 and p = 0.98) and 4 (p = 0.27 and p = 0.16). In our sample of Singaporean children without ocular disease, distance VA did not play a significant role in predicting academic school performance.

  13. Visual Acuity and Contrast Sensitivity Development in Children: Sweep Visually Evoked Potential and Psychophysics.

    PubMed

    Almoqbel, Fahad M; Irving, Elizabeth L; Leat, Susan J

    2017-08-01

    The purpose of this study was to investigate the development of visual acuity (VA) and contrast sensitivity in children as measured with objective (sweep visually evoked potential) and subjective, psychophysical techniques, including signal detection theory (SDT), which attempts to control for differences in criterion or behavior between adults and children. Furthermore, this study examines the possibility of applying SDT methods with children. Visual acuity and contrast thresholds were measured in 12 children 6 to 7 years old, 10 children 8 to 9 years old, 10 children 10 to 12 years old, and 16 adults. For sweep visually evoked potential measurements, spatial frequency was swept from 1 to 40 cpd to measure VA, and contrast of sine-wave gratings (1 or 8 cpd) was swept from 0.33 to 30% to measure contrast thresholds. For psychophysical measurements, VA and contrast thresholds (1 or 8 cpd) were measured using a temporal two-alternative forced-choice staircase procedure and also with a yes-no SDT procedure. Optotype (logMAR [log of the minimum angle of resolution]) VA was also measured. The results of the various procedures were in agreement showing that there are age-related changes in threshold values and logMAR VA after the age of 6 years and that these visual functions do not become adult-like until the age of 8 to 9 years at the earliest. It was also found that children can participate in SDT procedures and do show differences in criterion compared with adults in psychophysical testing. These findings confirm a slightly later development of VA and contrast sensitivity (8 years or older) and indicate the importance of using SDT or forced-choice procedures in any developmental study to attempt to overcome the effect of criterion in children.

  14. Isolation and characterization of a 17-kDa FKBP-type peptidyl-prolyl cis/trans isomerase from Vibrio anguillarum.

    PubMed

    Jo, Geon-A; Lee, Jong Min; No, Gyuyou; Kang, Dong Seop; Kim, So-Hyun; Ahn, Sun-Hee; Kong, In-Soo

    2015-06-01

    Peptidyl-prolyl cis/trans isomerase (PPIase) catalyzes the isomerization of peptide bonds to achieve conformational changes in native folded proteins. An FKBP-type PPIase with an approximate molecular weight of 17kDa was isolated from Vibrio anguillarum O1 and named VaFKBP17. To investigate its biochemical properties, the ppi gene from V. anguillarum O1 was isolated and overexpressed in Escherichia coli. A protease-coupled assay for isomerization activity, using Succinyl-Ala-Phe-Pro-Phe-p nitroanilide as substrate, indicated that the activity of VaFKBP17 was highest at low temperature (5°C) and alkaline conditions (pH 10). The immunosuppressant FK506 inhibited the isomerization activity of VaFKBP17. The chaperone activity of VaFKBP17 was assessed using a citrate synthase thermal aggregation activity assay. To evaluate its ability to catalyze protein refolding, the effect of VaFKBP17 on inclusion bodies was investigated during a dilution process. In this assay, VaFKBP17 was able to assist protein refolding. These results provide evidence that VaFKBP17 possesses chaperone-like activity. The structural homology of VaFKBP17 relative to other known bacterial FKBPs was also examined. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Commission on the National Guard and Reserves: Strengthening America’s Defenses in the New Security Environment

    DTIC Science & Technology

    2007-03-01

    Guard would reduce its ability to respond effectively to state missions.10 Governor Ruth Ann Minner of Delaware testified before the Commission that the...2118 and 2216 Rayburn House Office Building, Washington DC June 15, 2006 9:00 a.m. • The Honorable Ruth Ann Minner, Governor of Delaware and Lead...2006 Arlington, VA Mr. Terrell Parker October 27, 2006 Arlington, VA Lieutenant Colonel Angel Perez October 27, 2006 Arlington, VA Ms. Sallie Shaffer

  16. Comprehensive Synchronization Elimination for Java (PREPRINT)

    DTIC Science & Technology

    2003-01-01

    e : % thread-local % reentrant % enclosed Figure...0.2 0.4 0.6 0.8 1.0 1.2 1.4 1.6 ca ss ow ar y ja va c ja va cu p ja va do c jg l jle x pi zz a ar ra y in st an td b jlo go pl as m a sl ic e Figure 6...1998. [DR98] P. Diniz and M. Rinard. Lock Coarsening: Eliminating Lock Overhead in Automatically Parallelized Object-based Programs. In Journal

  17. 78 FR 63311 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-23

    ... the media on request.] Additional information includes Social Security Number, VA Employee...) to effect delivery of salary payments to VA employees. 10. Transfer payroll information to the Social Security Administration in order to credit quarterly posting for social security. 11. Relevant information...

  18. Environmental Assessment: Proposed Construction of Army and Air Force Exchange Service Shopping Center Offutt Air Force Base, Nebraska

    DTIC Science & Technology

    2005-05-01

    402) 342-0949 MAPA Email: mapa @mapacog.org www.mapacog.org In the MAl> A Region: 1-800-827-6866 A Council of Governments July 22, 2004... MAPA Project Review Committee with the iqfprmation requested on the enclosed E.O. 12372 Review Process Form for the f11.?P9l;!et;l project. Completing...advance ior your cooperation. ~a /f:u6JbVA All~e A, Ramsey Adtinistrative Services Director i .. 07/27/2004 10:17 FAX 4022940790 MAPA E.O. 12372

  19. Vitamin A Status of Women and Children in Yaoundé and Douala, Cameroon, is Unchanged One Year after Initiation of a National Vitamin A Oil Fortification Program

    PubMed Central

    Engle-Stone, Reina; Nankap, Martin; Ndjebayi, Alex; Gimou, Marie-Madeleine; Friedman, Avital; Haskell, Marjorie J.; Tarini, Ann; Brown, Kenneth H.

    2017-01-01

    Vitamin A (VA) fortification of cooking oil is considered a cost-effective strategy for increasing VA status, but few large-scale programs have been evaluated. We conducted representative surveys in Yaoundé and Douala, Cameroon, 2 years before and 1 year after the introduction of a mandatory national program to fortify cooking oil with VA. In each survey, 10 different households were selected within each of the same 30 clusters (n = ~300). Malaria infection and plasma indicators of inflammation and VA (retinol-binding protein, pRBP) status were assessed among women aged 15–49 years and children aged 12–59 months, and casual breast milk samples were collected for VA and fat measurements. Refined oil intake was measured by a food frequency questionnaire, and VA was measured in household oil samples post-fortification. Pre-fortification, low inflammation-adjusted pRBP was common among children (33% <0.83 µmol/L), but not women (2% <0.78 µmol/L). Refined cooking oil was consumed by >80% of participants in the past week. Post-fortification, only 44% of oil samples were fortified, but fortified samples contained VA concentrations close to the target values. Controlling for age, inflammation, and other covariates, there was no difference in the mean pRBP, mean breast milk VA, prevalence of low pRBP, or prevalence of low milk VA between the pre- and post-fortification surveys. The frequency of refined oil intake was not associated with VA status indicators post-fortification. In sum, after a year of cooking oil fortification with VA, we did not detect evidence of increased plasma RBP or milk VA among urban women and preschool children, possibly because less than half of the refined oil was fortified. The enforcement of norms should be strengthened, and the program should be evaluated in other regions where the prevalence of VA deficiency was greater pre-fortification. PMID:28531099

  20. Orally Disintegrating Tablets Containing Melt Extruded Amorphous Solid Dispersion of Tacrolimus for Dissolution Enhancement.

    PubMed

    Ponnammal, Poovizhi; Kanaujia, Parijat; Yani, Yin; Ng, Wai Kiong; Tan, Reginald B H

    2018-03-16

    In order to improve the aqueous solubility and dissolution of Tacrolimus (TAC), amorphous solid dispersions of TAC were prepared by hot melt extrusion with three hydrophilic polymers, Polyvinylpyrrolidone vinyl acetate (PVP VA64), Soluplus ® and Hydroxypropyl Cellulose (HPC), at a drug loading of 10% w / w . Molecular modeling was used to determine the miscibility of the drug with the carrier polymers by calculating the Hansen Solubility Parameters. Powder X-ray diffraction and differential scanning calorimetry (DSC) studies of powdered solid dispersions revealed the conversion of crystalline TAC to amorphous form. Fourier transform Infrared (FTIR) spectroscopy results indicated formation of hydrogen bond between TAC and polymers leading to stabilization of TAC in amorphous form. The extrudates were found to be stable under accelerated storage conditions for 3 months with no re-crystallization, indicating that hot melt extrusion is suitable for producing stable amorphous solid dispersions of TAC in PVP VA64, Soluplus ® and HPC. Stable solid dispersions of amorphous TAC exhibited higher dissolution rate, with the solid dispersions releasing more than 80% drug in 15 min compared to the crystalline drug giving 5% drug release in two hours. These stable solid dispersions were incorporated into orally-disintegrating tablets in which the solid dispersion retained its solubility, dissolution and stability advantage.

  1. Orally Disintegrating Tablets Containing Melt Extruded Amorphous Solid Dispersion of Tacrolimus for Dissolution Enhancement

    PubMed Central

    Ponnammal, Poovizhi; Kanaujia, Parijat; Ng, Wai Kiong; Tan, Reginald B. H.

    2018-01-01

    In order to improve the aqueous solubility and dissolution of Tacrolimus (TAC), amorphous solid dispersions of TAC were prepared by hot melt extrusion with three hydrophilic polymers, Polyvinylpyrrolidone vinyl acetate (PVP VA64), Soluplus® and Hydroxypropyl Cellulose (HPC), at a drug loading of 10% w/w. Molecular modeling was used to determine the miscibility of the drug with the carrier polymers by calculating the Hansen Solubility Parameters. Powder X-ray diffraction and differential scanning calorimetry (DSC) studies of powdered solid dispersions revealed the conversion of crystalline TAC to amorphous form. Fourier transform Infrared (FTIR) spectroscopy results indicated formation of hydrogen bond between TAC and polymers leading to stabilization of TAC in amorphous form. The extrudates were found to be stable under accelerated storage conditions for 3 months with no re-crystallization, indicating that hot melt extrusion is suitable for producing stable amorphous solid dispersions of TAC in PVP VA64, Soluplus® and HPC. Stable solid dispersions of amorphous TAC exhibited higher dissolution rate, with the solid dispersions releasing more than 80% drug in 15 min compared to the crystalline drug giving 5% drug release in two hours. These stable solid dispersions were incorporated into orally-disintegrating tablets in which the solid dispersion retained its solubility, dissolution and stability advantage. PMID:29547585

  2. Prevalence of Visual Impairment and Refractive Errors in Children of South Sinai, Egypt.

    PubMed

    Yamamah, Gamal Abdel Naser; Talaat Abdel Alim, Ahmed Ahmed; Mostafa, Yehia Salah El Din; Ahmed, Rania Ahmed Abdel Salam; Mohammed, Asmaa Mahmoud; Mahmoud, Asmaa Mohammed

    2015-01-01

    To assess the prevalence and causes of visual impairment in children of South Sinai, and to evaluate outcomes of rehabilitation programs. Population-based, cross-sectional analysis of 2070 healthy school children screened for visual impairment from 2009 through 2010 in cities of South Sinai and their surrounding Bedouin settlements. Visual acuity (VA) was tested using Snellen charts followed by cycloplegic autorefractometry for cases with presenting VA ≤ 6/9. Appropriate eyeglasses were prescribed and VA re-evaluated. This study included 1047 boys and 1023 girls, mean age 10.7 ± 3.1 years. Visual impairment (uncorrected VA ≤ 6/9) was detected in 29.4% of children, while 2.0% had moderate-severe visual impairment (uncorrected VA ≤ 6/24). There were statistically significant differences in prevalence of visual impairment between the studied cities (p < 0.05), with the highest prevalence in Abu Redis. Prevalence of visual impairment was significantly higher among girls (p < 0.05) and those with positive consanguinity (p < 0.05). Bedouin children showed significantly lower prevalences of visual impairment. Only age was a reliable predictor of visual impairment (odds ratio 0.94, p < 0.0001). Ophthalmic examination revealed other disorders, e.g. dry eye (4.74%), squint (2.37%), exophthalmos (1.58%) and ptosis (0.79%). VA significantly improved in children who received spectacles (p < 0.001). A total of 29.4% of South Sinai children had some form of visual impairment, 90.32% of which comprised refractive errors (mainly astigmatism) which were significantly corrected with eyeglasses. VA screening and correction of refractive errors are of the utmost importance for ensuring better visual outcomes and improved school performance.

  3. Betulinic acid, a natural PDE inhibitor restores hippocampal cAMP/cGMP and BDNF, improve cerebral blood flow and recover memory deficits in permanent BCCAO induced vascular dementia in rats.

    PubMed

    Kaundal, Madhu; Zameer, Saima; Najmi, Abul Kalam; Parvez, Suhel; Akhtar, Mohd

    2018-08-05

    Vascular dementia (VaD) is the second most common form of senile dementia, embraces memory deficits, neuroinflammation, executive function damage, mood and behavioral changes and abnormal cerebral blood flow. The purpose of the study was to explore the therapeutic potential of betulinic acid in bilateral common carotid artery occlusion (BCCAO) induced VaD in experimental rats. VaD was induced by BCCAO in rats and betulinic acid (10 and 15 mg/kg/day po) was administered 1 week after surgery. The cerebral blood pressure of the animal was recorded before and after the treatment using Laser Doppler flow meter. Object recognition task for non-spatial, Morris water maze for spatial and locomotor activity was performed to evaluate behavioral changes in rats. At the end of the study, animals were decapitated and hippocampus was separated to perform biochemical, neuroinflammatory and second messengers cAMP/cGMP analysis. Histology was done to study the brain pathophysiology. BCCAO surgery was able to significantly impaired memory in rats as observed behavioral and biochemical parameters. Moreover, BA demonstrated a neuroprotective effect in a dose-dependent manner. BA was able to re-establish cerebral blood flow, restore behavioral parameters and showed significant improvements in the as cAMP,cGMP and BDNF levels, restrain the oxidative stress and inflammatory parameters. In histopathology, betulinic acid treated groups showed a decrease in microgliosis and less pathological abnormalities comparable to diseased rat's brain. The observed effect might be attributed to the neuroprotective potential of betulinic acid and its ability to restore cognitive impairment and hippocampal neurochemistry in VaD. Copyright © 2018 Elsevier B.V. All rights reserved.

  4. Bond-based linear indices in QSAR: computational discovery of novel anti-trichomonal compounds

    NASA Astrophysics Data System (ADS)

    Marrero-Ponce, Yovani; Meneses-Marcel, Alfredo; Rivera-Borroto, Oscar M.; García-Domenech, Ramón; De Julián-Ortiz, Jesus Vicente; Montero, Alina; Escario, José Antonio; Barrio, Alicia Gómez; Pereira, David Montero; Nogal, Juan José; Grau, Ricardo; Torrens, Francisco; Vogel, Christian; Arán, Vicente J.

    2008-08-01

    Trichomonas vaginalis ( Tv) is the causative agent of the most common, non-viral, sexually transmitted disease in women and men worldwide. Since 1959, metronidazole (MTZ) has been the drug of choice in the systemic treatment of trichomoniasis. However, resistance to MTZ in some patients and the great cost associated with the development of new trichomonacidals make necessary the development of computational methods that shorten the drug discovery pipeline. Toward this end, bond-based linear indices, new TOMOCOMD-CARDD molecular descriptors, and linear discriminant analysis were used to discover novel trichomonacidal chemicals. The obtained models, using non-stochastic and stochastic indices, are able to classify correctly 89.01% (87.50%) and 82.42% (84.38%) of the chemicals in the training (test) sets, respectively. These results validate the models for their use in the ligand-based virtual screening. In addition, they show large Matthews' correlation coefficients ( C) of 0.78 (0.71) and 0.65 (0.65) for the training (test) sets, correspondingly. The result of predictions on the 10% full-out cross-validation test also evidences the robustness of the obtained models. Later, both models are applied to the virtual screening of 12 compounds already proved against Tv. As a result, they correctly classify 10 out of 12 (83.33%) and 9 out of 12 (75.00%) of the chemicals, respectively; which is the most important criterion for validating the models. Besides, these classification functions are applied to a library of seven chemicals in order to find novel antitrichomonal agents. These compounds are synthesized and tested for in vitro activity against Tv. As a result, experimental observations approached to theoretical predictions, since it was obtained a correct classification of 85.71% (6 out of 7) of the chemicals. Moreover, out of the seven compounds that are screened, synthesized and biologically assayed, six compounds (VA7-34, VA7-35, VA7-37, VA7-38, VA7-68, VA7-70) show pronounced cytocidal activity at the concentration of 100 μg/ml at 24 h (48 h) within the range of 98.66%-100% (99.40%-100%), while only two molecules (chemicals VA7-37 and VA7-38) show high cytocidal activity at the concentration of 10 μg/ml at 24 h (48 h): 98.38% (94.23%) and 97.59% (98.10%), correspondingly. The LDA-assisted QSAR models presented here could significantly reduce the number of synthesized and tested compounds and could increase the chance of finding new chemical entities with anti-trichomonal activity.

  5. Bond-based linear indices in QSAR: computational discovery of novel anti-trichomonal compounds.

    PubMed

    Marrero-Ponce, Yovani; Meneses-Marcel, Alfredo; Rivera-Borroto, Oscar M; García-Domenech, Ramón; De Julián-Ortiz, Jesus Vicente; Montero, Alina; Escario, José Antonio; Barrio, Alicia Gómez; Pereira, David Montero; Nogal, Juan José; Grau, Ricardo; Torrens, Francisco; Vogel, Christian; Arán, Vicente J

    2008-08-01

    Trichomonas vaginalis (Tv) is the causative agent of the most common, non-viral, sexually transmitted disease in women and men worldwide. Since 1959, metronidazole (MTZ) has been the drug of choice in the systemic treatment of trichomoniasis. However, resistance to MTZ in some patients and the great cost associated with the development of new trichomonacidals make necessary the development of computational methods that shorten the drug discovery pipeline. Toward this end, bond-based linear indices, new TOMOCOMD-CARDD molecular descriptors, and linear discriminant analysis were used to discover novel trichomonacidal chemicals. The obtained models, using non-stochastic and stochastic indices, are able to classify correctly 89.01% (87.50%) and 82.42% (84.38%) of the chemicals in the training (test) sets, respectively. These results validate the models for their use in the ligand-based virtual screening. In addition, they show large Matthews' correlation coefficients (C) of 0.78 (0.71) and 0.65 (0.65) for the training (test) sets, correspondingly. The result of predictions on the 10% full-out cross-validation test also evidences the robustness of the obtained models. Later, both models are applied to the virtual screening of 12 compounds already proved against Tv. As a result, they correctly classify 10 out of 12 (83.33%) and 9 out of 12 (75.00%) of the chemicals, respectively; which is the most important criterion for validating the models. Besides, these classification functions are applied to a library of seven chemicals in order to find novel antitrichomonal agents. These compounds are synthesized and tested for in vitro activity against Tv. As a result, experimental observations approached to theoretical predictions, since it was obtained a correct classification of 85.71% (6 out of 7) of the chemicals. Moreover, out of the seven compounds that are screened, synthesized and biologically assayed, six compounds (VA7-34, VA7-35, VA7-37, VA7-38, VA7-68, VA7-70) show pronounced cytocidal activity at the concentration of 100 mug/ml at 24 h (48 h) within the range of 98.66%-100% (99.40%-100%), while only two molecules (chemicals VA7-37 and VA7-38) show high cytocidal activity at the concentration of 10 mug/ml at 24 h (48 h): 98.38% (94.23%) and 97.59% (98.10%), correspondingly. The LDA-assisted QSAR models presented here could significantly reduce the number of synthesized and tested compounds and could increase the chance of finding new chemical entities with anti-trichomonal activity.

  6. Malaria epidemiology in the Pakaanóva (Wari') Indians, Brazilian Amazon.

    PubMed

    Sá, D Ribeiro; Souza-Santos, R; Escobar, A L; Coimbra, C E A

    2005-04-01

    This paper reports the results of a longitudinal study of malaria incidence (1998-2002) among the Pakaanóva (Wari') Indians, Brazilian southwest Amazon region, based on data routinely gathered by Brazilian National Health Foundation outposts network in conjunction with the Indian health service. Malaria is present yearlong in the Pakaanóva. Statistically significant differences between seasons or months were not noticed. A total of 1933 cases of malaria were diagnosed in the Pakaanóva during this period. The P. vivax / P. falciparum ratio was 3.4. P. vivax accounted for 76.5% of the cases. Infections with P. malariae were not recorded. Incidence rates did not differ by sex. Most malaria cases were reported in children < 10 years old (45%). About one fourth of all cases were diagnosed on women 10-40 years old. An entomological survey carried out at two Pakaanóva villages yielded a total of 3.232 specimens of anophelines. Anopheles darlingi predominated (94.4%). Most specimens were captured outdoors and peak activity hours were noted at early evening and just before sunrise. It was observed that Pakaanóva cultural practices may facilitate outdoor exposure of individuals of both sexes and all age groups during peak hours of mosquito activities (e.g., coming to the river early in the morning for bathing or to draw water, fishing, engaging in hunting camps, etc). In a context in which anophelines are ubiquitous and predominantly exophilic, and humans of both sexes and all ages are prone to outdoor activities during peak mosquito activity hours, malaria is likely to remain endemic in the Pakaanóva, thus requiring the development of alternative control strategies that are culturally and ecologically sensitive.

  7. Valerenic Acid Protects Against Physical and Psychological Stress by Reducing the Turnover of Serotonin and Norepinephrine in Mouse Hippocampus-Amygdala Region

    PubMed Central

    Jung, Hyo Young; Yoo, Dae Young; Nam, Sung Min; Kim, Jong Whi; Choi, Jung Hoon; Yoo, Miyoung; Lee, Sanghee; Yoon, Yeo Sung

    2015-01-01

    Abstract In a previous study, we demonstrated that a Valeriana officinalis extract could attenuate increases in serum corticosterone levels in a mouse model of physical and psychological stress. In addition, our results showed that the extract could modulate serotonin (5-HT) and norepinephrine (NE) turnover in the hippocampus and amygdala region. In this study, we intended to investigate the effects of valerenic acid (VA), the main component of V. officinalis extract, on corticosterone levels in serum in normal mice and monoamine turnover in hippocampus-amygdala homogenates in a mouse model of physical and psychological stress. To determine the minimum dose of VA for antianxiety effect, eight-week-old ICR mice were orally administered VA (0.2, 0.5, and 1.0 mg/kg/0.3 mL) once daily for 3 weeks to probe for immobility time and serum corticosterone levels. At a VA dose of 0.5 and 1.0 mg/kg, animals showed a decrease in the duration of immobility time and serum corticosterone levels. To confirm the antianxiety effect of VA, eight-week-old ICR mice received VA at a dose of 0.5 mg/kg, orally, once daily for 3 weeks, before being subjected to physical or psychological stress for 3 days, in a specially designed communication box, followed by estimation of levels of monoamines and their metabolites in the hippocampus-amygdala region. In conclusion, VA administration at 0.5 mg/kg can mitigate the physical and psychological stress response by decreasing the turnover of 5-HT to 5-hydroxyindoleacetic acid and NE to 3-methoxy-4-hydroxyphenylethyleneglycol sulfate in the hippocampus and amygdala. PMID:26177123

  8. Intelligent walkers for the elderly: performance and safety testing of VA-PAMAID robotic walker.

    PubMed

    Rentschler, Andrew J; Cooper, Rory A; Blasch, Bruce; Boninger, Michael L

    2003-01-01

    A walker that could help navigate and avoid collisions with obstacles could help reduce health costs and increase the quality of care and independence of thousands of people. This study evaluated the safety and performance of the Veterans Affairs Personal Adaptive Mobility Aid (VA-PAMAID). We performed engineering tests on the VA-PAMAID to determine safety factors, including stability, energy consumption, fatigue life, and sensor and control malfunctions. The VA-PAMAID traveled 10.9 km on a full charge and avoided obstacles while traveling at a speed of up to 1.2 m/s. No failures occurred during static stability, climatic, or fatigue testing. Some problems were encountered during obstacle climbing and sensor and control testing. The VA-PAMAID has good range, has adequate reaction time, and is structurally sound. Clinical trials are planned to compare the device to other low-technical adaptive mobility devices.

  9. Study of adhesion of vertically aligned carbon nanotubes to a substrate by atomic-force microscopy

    NASA Astrophysics Data System (ADS)

    Ageev, O. A.; Blinov, Yu. F.; Il'ina, M. V.; Il'in, O. I.; Smirnov, V. A.; Tsukanova, O. G.

    2016-02-01

    The adhesion to a substrate of vertically aligned carbon nanotubes (VA CNT) produced by plasmaenhanced chemical vapor deposition has been experimentally studied by atomic-force microscopy in the current spectroscopy mode. The longitudinal deformation of VA CNT by applying an external electric field has been simulated. Based on the results, a technique of determining VA CNT adhesion to a substrate has been developed that is used to measure the adhesion strength of connecting VA CNT to a substrate. The adhesion to a substrate of VA CNT 70-120 nm in diameter varies from 0.55 to 1.19 mJ/m2, and the adhesion force from 92.5 to 226.1 nN. When applying a mechanical load, the adhesion strength of the connecting VA CNT to a substrate is 714.1 ± 138.4 MPa, and the corresponding detachment force increases from 1.93 to 10.33 μN with an increase in the VA CNT diameter. As an external electric field is applied, the adhesion strength is almost doubled and is 1.43 ± 0.29 GPa, and the corresponding detachment force is changed from 3.83 to 20.02 μN. The results can be used in the design of technological processes of formation of emission structures, VA CNT-based elements for vacuum microelectronics and micro- and nanosystem engineering, and also the methods of probe nanodiagnostics of VA CNT.

  10. Predictors of visual outcomes in patients with neovascular age-related macular degeneration treated with anti-vascular endothelial growth factor therapy: post hoc analysis of the VIEW studies.

    PubMed

    Lanzetta, Paolo; Cruess, Alan F; Cohen, Salomon Y; Slakter, Jason S; Katz, Todd; Sowade, Olaf; Zeitz, Oliver; Ahlers, Christiane; Mitchell, Paul

    2018-04-16

    Identify predictors for response to anti-vascular endothelial growth factor (VEGF) therapy in patients with neovascular (wet) age-related macular degeneration (nAMD). Retrospective, post hoc analysis of VIEW 1/2. Patients were randomized 1:1:1:1 to 0.5 mg intravitreal aflibercept (IVT-AFL) injection every 4 weeks (0.5q4); 2 mg IVT-AFL every 4 weeks (2q4); 2 mg IVT-AFL every 8 weeks (2q8) after an initial three injections at weeks 0, 4 and 8 or 0.5 mg intravitreal ranibizumab every 4 weeks (0.5q4). 1815 patients [IVT-AFL 2q4 (n = 613); IVT-AFL 2q8 (n = 607); ranibizumab 0.5q4 (n = 595)] were included. Baseline demographics/characteristics were evenly balanced. Younger age (49-69 years), lower visual acuity (VA) [10.0-≤45.0 Early Treatment Diabetic Retinopathy Study (ETDRS) letters] and smaller choroidal neovascularization (CNV) size [0.0-≤3.1 disc areas (DA)] at baseline were associated with the most vision gain (≥15 letters) over 52 weeks (all nominal p < 0.0001).Younger age, higher baseline VA (>64.0-≤83.0 letters) and smaller CNV size were associated with a VA ≥20/40 at week 52. Predominantly classic CNV at baseline (nominal p = 0.0007), older age (≥90 years), lower baseline VA (10.0-≤ 45.0 ETDRS letters) and larger CNV size (>10.1-≤32.6 DA) were all associated with a VA ≤20/200 at week 52 (all nominal p < 0.0001). Along with treatment (nominal p < 0.0001), lower VA (p = 0.0166) and smaller central retinal thickness (both nominal p = 0.0190) were predictors for dry retina development. Younger age, lower VA and smaller CNV size at baseline were all associated with greater vision gains over 52 weeks while younger age, higher VA and smaller CNV size at treatment start were more likely to achieve best-corrected VA 20/40 or better after a year's treatment, suggesting the benefit of early anti-VEGF treatment. © 2018 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  11. 17. Photocopy of photograph (original in the Langley Research Center ...

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

    17. Photocopy of photograph (original in the Langley Research Center Archives, Hampton, VA LaRC) (L86-10,257) DETAIL VIEW OF EXTERIOR OF COOLING TOWER FOR 8- FOOT HIGH SPEED WIND TUNNEL. - NASA Langley Research Center, 8-Foot High Speed Wind Tunnel, 641 Thornell Avenue, Hampton, Hampton, VA

  12. 38 CFR 21.7576 - Entitlement charges.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) Correspondence training; (3) Cooperative training; or (4) Apprenticeship or other on-job training. (Authority: 10... other on-job training, VA will make a charge against entitlement— (i) On the basis of total elapsed time... assistance allowance while undergoing apprenticeship or other on-job training, VA will make a charge against...

  13. The Role of Vision in Academic School Performance

    PubMed Central

    Dirani, Mohamed; Zhang, Xiaoe; Goh, Liang Ke; Young, Terri L.; Lee, Paul; Saw, Seang Mei

    2014-01-01

    Purpose To determine whether presenting distance visual acuity is related to subsequent academic school performance in Singaporean children between 9 to 10 years of age. Methods Singapore children (n = 1143 children) were examined during their visits at ages 9 to 10 years (grades 3 to 4) as part of the Singapore Cohort Study of the Risk Factors for Myopia (SCORM) longitudinal study. Each child underwent an annual comprehensive eye examination, including the assessment of presenting logarithm of the minimum angle of resolution (LogMAR) distance visual acuity (VA). The individual marks of a nation-wide standard examination in grade 4 were used as the outcome measure for academic school performance. Children with any known eye disease, (such as media opacities) were excluded from the analysis. Results The mean presenting distance VA of the better eye was 0.10 and 0.08 when the children were in grades 3 and 4, respectively. There was a statistically significant difference for mean presenting VA with 9 and 10 year old boys scoring better (0.08 and 0.07) compared to girls (0.12 and 0.09) for the same ages, (p = 0.001 and p = 0.007), respectively. After adjusting for gender, ethnicity, school, reading, intelligence quotient and father’s education, no significant relationships were found between average examination marks at the end of grade 4 and presenting VA obtained (better eye and worst eye) in grade 3 (p = 0.38 and p = 0.98) and 4 (p = 0.27 and p = 0.16). Conclusion In our sample of Singaporean children without ocular disease, distance VA did not play a significant role in predicting academic school performance. PMID:20100096

  14. Duplicate Federal Payments for Dual Enrollees in Medicare Advantage Plans and the Veterans Affairs Health Care System

    PubMed Central

    Trivedi, Amal N.; Grebla, Regina C.; Jiang, Lan; Yoon, Jean; Mor, Vincent; Kizer, Kenneth W.

    2013-01-01

    Context Some veterans are eligible to enroll simultaneously in a Medicare Advantage (MA) plan and the Veterans Affairs health care system (VA). This scenario produces the potential for redundant federal spending because MA plans would receive payments to insure veterans who receive care from the VA, another taxpayer-funded health plan. Objective To quantify the prevalence of dual enrollment in VA and MA, the concurrent use of health services in each setting, and the estimated costs of VA care provided to MA enrollees. Design Retrospective analysis of 1 245 657 veterans simultaneously enrolled in the VA and an MA plan between 2004–2009. Main Outcome Measures Use of health services and inflation-adjusted estimated VA health care costs. Results Among individuals who were eligible to enroll in the VA and in an MA plan, the number of persons dually enrolled increased from 485 651 in 2004 to 924 792 in 2009. In 2009, 8.3% of the MA population was enrolled in the VA and 5.0% of MA beneficiaries were VA users. The estimated VA health care costs for MA enrollees totaled $13.0 billion over 6 years, increasing from $1.3 billion in 2004 to $3.2 billion in 2009. Among dual enrollees, 10% exclusively used the VA for outpatient and acute inpatient services, 35% exclusively used the MA plan, 50% used both the VA and MA, and 4% received no services during the calendar year. The VA financed 44% of all outpatient visits (n=21 353 841), 15% of all acute medical and surgical admissions (n=177 663), and 18% of all acute medical and surgical inpatient days (n=1 106 284) for this dually enrolled population. In 2009, the VA billed private insurers $52.3 million to reimburse care provided to MA enrollees and collected $9.4 million (18% of the billed amount; 0.3% of the total cost of care). Conclusions The federal government spends a substantial and increasing amount of potentially duplicative funds in 2 separate managed care programs for the care of same individuals. PMID:22735360

  15. Baseline predictors for one-year visual outcomes with ranibizumab or bevacizumab for neovascular age-related macular degeneration.

    PubMed

    Ying, Gui-shuang; Huang, Jiayan; Maguire, Maureen G; Jaffe, Glenn J; Grunwald, Juan E; Toth, Cynthia; Daniel, Ebenezer; Klein, Michael; Pieramici, Dante; Wells, John; Martin, Daniel F

    2013-01-01

    To determine the baseline predictors of visual acuity (VA) outcomes 1 year after treatment with ranibizumab or bevacizumab for neovascular age-related macular degeneration (AMD). Cohort study within the Comparison of Age-related Macular Degeneration Treatments Trials (CATT). A total of 1105 participants with neovascular AMD, baseline VA 20/25 to 20/320, and VA measured at 1 year. Participants were randomly assigned to ranibizumab or bevacizumab on a monthly or as-needed schedule. Masked readers evaluated fundus morphology and features on optical coherence tomography (OCT). Visual acuity was measured using electronic VA testing. Independent predictors were identified using regression techniques. The VA score, VA score change from baseline, and ≥3-line gain at 1 year. At 1 year, the mean VA score was 68 letters, mean improvement from baseline was 7 letters, and 28% of participants gained ≥3 lines. Older age, larger area of choroidal neovascularization (CNV), and elevation of retinal pigment epithelium (RPE) were associated with worse VA (all P<0.005), less gain in VA (all P<0.02), and a lower proportion gaining ≥3 lines (all P<0.04). Better baseline VA was associated with better VA at 1 year, less gain in VA, and a lower proportion gaining ≥3 lines (all P<0.0001). Predominantly or minimally classic lesions were associated with worse VA than occult lesions (66 vs. 69 letters; P=0.0003). Retinal angiomatous proliferans (RAP) lesions were associated with more gain in VA (10 vs. 7 letters; P=0.03) and a higher proportion gaining ≥3 lines (odds ratio, 1.9; 95% confidence interval, 1.2-3.1). Geographic atrophy (GA) was associated with worse VA (64 vs. 68 letters; P=0.02). Eyes with total foveal thickness in the second quartile (325-425 μm) had the best VA (P=0.01) and were most likely to gain ≥3 lines (P=0.004). Predictors did not vary by treatment group. For all treatment groups, older age, better baseline VA, larger CNV area, predominantly or minimally classic lesion, absence of RAP lesion, presence of GA, greater total fovea thickness, and RPE elevation on optical coherence tomography were independently associated with less improvement in VA at 1 year. The author(s) have no proprietary or commercial interest in any materials discussed in this article. Copyright © 2013 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  16. An Overview of Patient Safety Climate in the VA

    PubMed Central

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

    2008-01-01

    Objective To assess variation in safety climate across VA hospitals nationally. Study Setting Data were collected from employees at 30 VA hospitals over a 6-month period using the Patient Safety Climate in Healthcare Organizations survey. Study Design We sampled 100 percent of senior managers and physicians and a random 10 percent of other employees. At 10 randomly selected hospitals, we sampled an additional 100 percent of employees working in units with intrinsically higher hazards (high-hazard units [HHUs]). Data Collection Data were collected using an anonymous survey design. Principal Findings We received 4,547 responses (49 percent response rate). The percent problematic response—lower percent reflecting higher levels of patient safety climate—ranged from 12.0–23.7 percent across hospitals (mean=17.5 percent). Differences in safety climate emerged by management level, clinician status, and workgroup. Supervisors and front-line staff reported lower levels of safety climate than senior managers; clinician responses reflected lower levels of safety climate than those of nonclinicians; and responses of employees in HHUs reflected lower levels of safety climate than those of workers in other areas. Conclusions This is the first systematic study of patient safety climate in VA hospitals. Findings indicate an overall positive safety climate across the VA, but there is room for improvement. PMID:18355257

  17. Use of DHCP to provide essential information for care and management of HIV patients.

    PubMed

    Pfeil, C N; Ivey, J L; Hoffman, J D; Kuhn, I M

    1991-01-01

    The Department of Veterans' Affairs (VA) has reported over 10,000 Acquired Immune Deficiency Syndrome (AIDS) cases since the beginning of the epidemic. These cases were distributed throughout 152 of the VA's network of 172 medical centers and outpatient clinics. This network of health care facilities presents a unique opportunity to provide computer based information systems for clinical care and resource monitoring for these patients. The VA further facilitates such a venture through its commitment to the Decentralized Hospital Computer Program (DHCP). This paper describes a new application within DHCP known as the VA's HIV Registry. This project addresses the need to support clinical information as well as the added need to manage the resources necessary to care for HIV patients.

  18. Home Photovoltaic System Design in Pangkalpinang City

    NASA Astrophysics Data System (ADS)

    Sunanda, Wahri

    2018-02-01

    This research aims to obtain the design of home photovoltaic systems in Pangkalpinang and the opportunity of economic savings. The system consists of photovoltaic with batteries. Based on electricity consumption of several houses with installed power of 1300 VA and 2200 VA in Pangkalpinang for one year, the daily load of photovoltaic system is varied to 40%, 30% and 20% of the average value of the daily home electricity consumption. The investment costs, the cost of replacement parts and the cost of electricity consumption accrued to PLN during lifetime of systems (25 years) are also calculated. The result provided that there are no economic saving opportunities for photovoltaic systems with batteries at home with installed power of 1300 VA and 2200 VA in Pangkalpinang. The most economical is the photovoltaic system with the daily load of 20% of the average value of the daily home electricity consumption. The configuration of photovoltaic system for 1300 VA home consists of 10 modules of 200 wattpeak and 4 batteries 150 AH, 12 Volt while photovoltaic system for 2200 VA home consists of 15 modules of 200 wattpeak and 6 batteries 150 AH,12Volt.

  19. Timely access to mental health care among women veterans.

    PubMed

    Brunner, Julian; Schweizer, C Amanda; Canelo, Ismelda A; Leung, Lucinda B; Strauss, Jennifer L; Yano, Elizabeth M

    2018-04-05

    Using survey data on (N = 419) patients at Department of Veterans Affairs (VA) clinics we analyzed women veterans' reports of timely access to VA mental health care. We evaluated problems that patients might face in obtaining care, and examined subjective ratings of VA care as a function of timely access to mental health care. We found that 59% of participants reported "always" getting an appointment for mental health care as soon as needed. In adjusted analyses, two problems were negatively associated with timely access to mental health care: (a) medical appointments that interfere with other activities, and (b) difficulty getting questions answered between visits. Average subjective ratings of VA ranged from 8.2-8.6 out of 10, and 93% of participants would recommend VA care. Subjective ratings of VA were higher among women who reported timely access to mental health care. Findings suggest that overall experience of care is associated with timely access to mental health care, and that such access may be amenable to improvements related to clinic hours or mechanisms for answering patient questions between visits. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  20. deltaNp63 Has a Role in Maintaining Epithelial Integrity in Airway Epithelium

    PubMed Central

    Arason, Ari Jon; Jonsdottir, Hulda R.; Halldorsson, Skarphedinn; Benediktsdottir, Berglind Eva; Bergthorsson, Jon Thor; Ingthorsson, Saevar; Baldursson, Olafur; Sinha, Satrajit; Gudjonsson, Thorarinn; Magnusson, Magnus K.

    2014-01-01

    The upper airways are lined with a pseudostratified bronchial epithelium that forms a barrier against unwanted substances in breathing air. The transcription factor p63, which is important for stratification of skin epithelium, has been shown to be expressed in basal cells of the lungs and its ΔN isoform is recognized as a key player in squamous cell lung cancer. However, the role of p63 in formation and maintenance of bronchial epithelia is largely unknown. The objective of the current study was to determine the expression pattern of the ΔN and TA isoforms of p63 and the role of p63 in the development and maintenance of pseudostratified lung epithelium in situ and in culture. We used a human bronchial epithelial cell line with basal cell characteristics (VA10) to model bronchial epithelium in an air-liquid interface culture (ALI) and performed a lentiviral-based silencing of p63 to characterize the functional and phenotypic consequences of p63 loss. We demonstrate that ΔNp63 is the major isoform in the human lung and its expression was exclusively found in the basal cells lining the basement membrane of the bronchial epithelium. Knockdown of p63 affected proliferation and migration of VA10 cells and facilitated cellular senescence. Expression of p63 is critical for epithelial repair as demonstrated by wound healing assays. Importantly, generation of pseudostratified VA10 epithelium in the ALI setup depended on p63 expression and goblet cell differentiation, which can be induced by IL-13 stimulation, was abolished by the p63 knockdown. After knockdown of p63 in primary bronchial epithelial cells they did not proliferate and showed marked senescence. We conclude that these results strongly implicate p63 in the formation and maintenance of differentiated pseudostratified bronchial epithelium. PMID:24533135

  1. Shall we stay, or shall we switch? Continued anti-VEGF therapy versus early switch to dexamethasone implant in refractory diabetic macular edema.

    PubMed

    Busch, Catharina; Zur, Dinah; Fraser-Bell, Samantha; Laíns, Inês; Santos, Ana Rita; Lupidi, Marco; Cagini, Carlo; Gabrielle, Pierre-Henry; Couturier, Aude; Mané-Tauty, Valérie; Giancipoli, Ermete; Ricci, Giuseppe D'Amico; Cebeci, Zafer; Rodríguez-Valdés, Patricio J; Chaikitmongkol, Voraporn; Amphornphruet, Atchara; Hindi, Isaac; Agrawal, Kushal; Chhablani, Jay; Loewenstein, Anat; Iglicki, Matias; Rehak, Matus

    2018-05-05

    To compare functional and anatomical outcomes of continued anti-vascular endothelial growth factor (VEGF) therapy versus dexamethasone (DEX) implant in eyes with refractory diabetic macular edema (DME) after three initial anti-VEGF injections in a real-world setting. To be included in this retrospective multicenter, case-control study, eyes were required: (1) to present with early refractory DME, as defined by visual acuity (VA) gain ≤ 5 letters or reduction in central subfield thickness (CST) ≤ 20%, after a loading phase of anti-VEGF therapy (three monthly injections) and (2) to treat further with (a) anti-VEGF therapy or (b) DEX implant. Main outcome measures were change in visual acuity (VA) and central subfield thickness (CST) at 12 months. Due to imbalanced baseline characteristics, a matched anti-VEGF group was formed by only keeping eyes with similar baseline characteristics as those in the DEX group. A total of 110 eyes from 105 patients were included (anti-VEGF group: 72 eyes, DEX group: 38 eyes). Mean change in VA at 12 months was - 0.4 ± 10.8 letters (anti-VEGF group), and + 6.1 ± 10.6 letters (DEX group) (P = 0.004). Over the same period, mean change in CST was + 18.3 ± 145.9 µm (anti-VEGF group) and - 92.8 ± 173.6 µm (DEX group) (P < 0.001). Eyes in the DEX group were more likely to gain ≥ 10 letters (OR 3.71, 95% CI 1.19-11.61, P = 0.024) at month 12. In a real-world setting, eyes with DME considered refractory to anti-VEGF therapy after three monthly injections which were switched to DEX implant and had better visual and anatomical outcomes at 12 months than those that continued treatment with anti-VEGF therapy.

  2. deltaNp63 has a role in maintaining epithelial integrity in airway epithelium.

    PubMed

    Arason, Ari Jon; Jonsdottir, Hulda R; Halldorsson, Skarphedinn; Benediktsdottir, Berglind Eva; Bergthorsson, Jon Thor; Ingthorsson, Saevar; Baldursson, Olafur; Sinha, Satrajit; Gudjonsson, Thorarinn; Magnusson, Magnus K

    2014-01-01

    The upper airways are lined with a pseudostratified bronchial epithelium that forms a barrier against unwanted substances in breathing air. The transcription factor p63, which is important for stratification of skin epithelium, has been shown to be expressed in basal cells of the lungs and its ΔN isoform is recognized as a key player in squamous cell lung cancer. However, the role of p63 in formation and maintenance of bronchial epithelia is largely unknown. The objective of the current study was to determine the expression pattern of the ΔN and TA isoforms of p63 and the role of p63 in the development and maintenance of pseudostratified lung epithelium in situ and in culture. We used a human bronchial epithelial cell line with basal cell characteristics (VA10) to model bronchial epithelium in an air-liquid interface culture (ALI) and performed a lentiviral-based silencing of p63 to characterize the functional and phenotypic consequences of p63 loss. We demonstrate that ΔNp63 is the major isoform in the human lung and its expression was exclusively found in the basal cells lining the basement membrane of the bronchial epithelium. Knockdown of p63 affected proliferation and migration of VA10 cells and facilitated cellular senescence. Expression of p63 is critical for epithelial repair as demonstrated by wound healing assays. Importantly, generation of pseudostratified VA10 epithelium in the ALI setup depended on p63 expression and goblet cell differentiation, which can be induced by IL-13 stimulation, was abolished by the p63 knockdown. After knockdown of p63 in primary bronchial epithelial cells they did not proliferate and showed marked senescence. We conclude that these results strongly implicate p63 in the formation and maintenance of differentiated pseudostratified bronchial epithelium.

  3. Aflibercept, Bevacizumab, or Ranibizumab for Diabetic Macular Edema: Two-Year Results from a Comparative Effectiveness Randomized Clinical Trial.

    PubMed

    Wells, John A; Glassman, Adam R; Ayala, Allison R; Jampol, Lee M; Bressler, Neil M; Bressler, Susan B; Brucker, Alexander J; Ferris, Frederick L; Hampton, G Robert; Jhaveri, Chirag; Melia, Michele; Beck, Roy W

    2016-06-01

    To provide 2-year results comparing anti-vascular endothelial growth factor (VEGF) agents for center-involved diabetic macular edema (DME) using a standardized follow-up and retreatment regimen. Randomized clinical trial. Six hundred sixty participants with visual acuity (VA) impairment from DME. Randomization to 2.0-mg aflibercept, 1.25-mg repackaged (compounded) bevacizumab, or 0.3-mg ranibizumab intravitreous injections performed up to monthly using a protocol-specific follow-up and retreatment regimen. Focal/grid laser photocoagulation was added after 6 months if DME persisted. Visits occurred every 4 weeks during year 1 and were extended up to every 4 months thereafter when VA and macular thickness were stable. Change in VA, adverse events, and retreatment frequency. Median numbers of injections were 5, 6, and 6 in year 2 and 15, 16, and 15 over 2 years in the aflibercept, bevacizumab, and ranibizumab groups, respectively (global P = 0.08). Focal/grid laser photocoagulation was administered in 41%, 64%, and 52%, respectively (aflibercept vs. bevacizumab, P < 0.001; aflibercept vs. ranibizumab, P = 0.04; bevacizumab vs. ranibizumab, P = 0.01). At 2 years, mean VA improved by 12.8, 10.0, and 12.3 letters, respectively. Treatment group differences varied by baseline VA (P = 0.02 for interaction). With worse baseline VA (20/50 to 20/320), mean improvement was 18.1, 13.3, and 16.1 letters, respectively (aflibercept vs. bevacizumab, P = 0.02; aflibercept vs. ranibizumab, P = 0.18; ranibizumab vs. bevacizumab, P = 0.18). With better baseline VA (20/32 to 20/40), mean improvement was 7.8, 6.8, and 8.6 letters, respectively (P > 0.10, for pairwise comparisons). Anti-Platelet Trialists' Collaboration (APTC) events occurred in 5% with aflibercept, 8% with bevacizumab, and 12% with ranibizumab (global P = 0.047; aflibercept vs. bevacizumab, P = 0.34; aflibercept vs. ranibizumab, P = 0.047; ranibizumab vs. bevacizumab, P = 0.20; global P = 0.09 adjusted for potential confounders). All 3 anti-VEGF groups showed VA improvement from baseline to 2 years with a decreased number of injections in year 2. Visual acuity outcomes were similar for eyes with better baseline VA. Among eyes with worse baseline VA, aflibercept had superior 2-year VA outcomes compared with bevacizumab, but superiority of aflibercept over ranibizumab, noted at 1 year, was no longer identified. Higher APTC event rates with ranibizumab over 2 years warrants continued evaluation in future trials. Copyright © 2016 American Academy of Ophthalmology. All rights reserved.

  4. An Overview of the Technical Basis of HENRE 2.0 Models

    DTIC Science & Technology

    2015-08-01

    Defense Threat Reduction Agency 8725 John J . Kingman Road, MS-6201 Fort Belvoir, VA 22060-6201...Agency 8725 John J . Kingman Road, Mail Stop 6201 Fort Belvoir, VA 22060-6201 DTRA J9NTSN DTRA-TR-15-070 DISTRIBUTION A. Approved for public release...10–19 joule ( J ) erg 1 × 10–7 joule ( J ) kiloton (kT) (TNT equivalent) 4.184 × 1012 joule ( J ) British thermal unit (Btu) (thermochemical) 1.054 350

  5. Ventilation/perfusion ratios measured by multiple inert gas elimination during experimental cardiopulmonary resuscitation.

    PubMed

    Hartmann, E K; Duenges, B; Boehme, S; Szczyrba, M; Liu, T; Klein, K U; Baumgardner, J E; Markstaller, K; David, M

    2014-09-01

    During cardiopulmonary resuscitation (CPR) the ventilation/perfusion distribution (VA /Q) within the lung is difficult to assess. This experimental study examines the capability of multiple inert gas elimination (MIGET) to determine VA /Q under CPR conditions in a pig model. Twenty-one anaesthetised pigs were randomised to three fractions of inspired oxygen (1.0, 0.7 or 0.21). VA/ Q by micropore membrane inlet mass spectrometry-derived MIGET was determined at baseline and during CPR following induction of ventricular fibrillation. Haemodynamics, blood gases, ventilation distribution by electrical impedance tomography and return of spontaneous circulation were assessed. Intergroup differences were analysed by non-parametric testing. MIGET measurements were feasible in all animals with an excellent correlation of measured and predicted arterial oxygen partial pressure (R(2)  = 0.96, n = 21 for baseline; R(2)  = 0.82, n = 21 for CPR). CPR induces a significant shift from normal VA /Q ratios to the high VA /Q range. Electrical impedance tomography indicates a dorsal to ventral shift of the ventilation distribution. Diverging pulmonary shunt fractions induced by the three inspired oxygen levels considerably increased during CPR and were traceable by MIGET, while 100% oxygen most negatively influenced the VA /Q. Return of spontaneous circulation were achieved in 52% of the animals. VA /Q assessment by MIGET is feasible during CPR and provides a novel tool for experimental purposes. Changes in VA /Q caused by different oxygen fractions are traceable during CPR. Beyond pulmonary perfusion deficits, these data imply an influence of the inspired oxygen level on VA /Q. Higher oxygen levels significantly increase shunt fractions and impair the normal VA /Q ratio. © 2014 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  6. Effects of inspired CO2, hyperventilation, and time on VA/Q inequality in the dog

    NASA Technical Reports Server (NTRS)

    Tsukimoto, K.; Arcos, J. P.; Schaffartzik, W.; Wagner, P. D.; West, J. B.

    1992-01-01

    In a recent study by Tsukimoto et al. (J. Appl. Physiol. 68: 2488-2493, 1990), CO2 inhalation appeared to reduce the size of the high ventilation-perfusion ratio (VA/Q) mode commonly observed in anesthetized mechanically air-ventilated dogs. In that study, large tidal volumes (VT) were used during CO2 inhalation to preserve normocapnia. To separate the influences of CO2 and high VT on the VA/Q distribution in the present study, we examined the effect of inspired CO2 on the high VA/Q mode using eight mechanically ventilated dogs (4 given CO2, 4 controls). The VA/Q distribution was measured first with normal VT and then with increased VT. In the CO2 group at high VT, data were collected before, during, and after CO2 inhalation. With normal VT, there was no difference in the size of the high VA/Q mode between groups [10.5 +/- 3.5% (SE) of ventilation in the CO2 group, 11.8 +/- 5.2% in the control group]. Unexpectedly, the size of the high VA/Q mode decreased similarly in both groups over time, independently of the inspired PCO2, at a rate similar to the fall in cardiac output over time. The reduction in the high VA/Q mode together with a simultaneous increase in alveolar dead space (estimated by the difference between inert gas dead space and Fowler dead space) suggests that poorly perfused high VA/Q areas became unperfused over time. A possible mechanism is that elevated alveolar pressure and decreased cardiac output eliminate blood flow from corner vessels in nondependent high VA/Q regions.

  7. Electronic Health Records: DOD and VA Should Remove Barriers and Improve Efforts to Meet Their Common System Needs

    DTIC Science & Technology

    2011-02-01

    and develop joint information technology (IT) capabilities for the James A. Lovell Federal Health Care Center ( FHCC ). In light of these efforts...Center to form the James A. Lovell Federal Health Care Center ( FHCC ) has prompted the departments to work toward implementing electronic health...information needs for the FHCC . To do this, GAO analyzed departmental reviews and other documentation and interviewed DOD and VA officials. What

  8. The importance of binder moisture content in Metformin HCL high-dose formulations prepared by moist aqueous granulation (MAG).

    PubMed

    Takasaki, Hiroshi; Yonemochi, Etsuo; Ito, Masanori; Wada, Koichi; Terada, Katsuhide

    2015-01-01

    The aim of this study was to evaluate binders to improve the flowability of granulates and compactibility of Metformin HCL (Met) using the moist aqueous granulation (MAG) process. The effect of the binder moisture content on granulate and tablet quality was also evaluated. Vinylpyrrolidone-vinyl acetate copolymer (Kollidon VA64 fine: VA64), polyvidone (Povidone K12: PVP), hydroxypropyl cellulose (HPC SSL SF: HPC) and hydroxypropyl methylcellulose (Methocel E5 LV: HPMC) were evaluated as binders. These granulates, except for HPMC, had a lower yield pressure than Met active pharmaceutical ingredient (API). HPMC Met was not sufficiently granulated with low water volume. No problems were observed with the VA64 Met granulates during the tableting process. However, HPC Met granulates had a bowl-forming tendency, and PVP Met granulates had the tendency to stick during the tableting process. These bowl-forming and sticking tendencies may have been due to the low moisture absorbency of HPC and the high volume of bound water of PVP, respectively. VA64 Met granulates had the highest ambient moisture content (bulk water, bound water) and moisture absorbency. It was concluded that the type of binder used for the Met MAG process has an impact on granulate flow and compactibility, as well as moisture absorbency and maintenance of moisture balance.

  9. The importance of binder moisture content in Metformin HCL high-dose formulations prepared by moist aqueous granulation (MAG)

    PubMed Central

    Takasaki, Hiroshi; Yonemochi, Etsuo; Ito, Masanori; Wada, Koichi; Terada, Katsuhide

    2015-01-01

    The aim of this study was to evaluate binders to improve the flowability of granulates and compactibility of Metformin HCL (Met) using the moist aqueous granulation (MAG) process. The effect of the binder moisture content on granulate and tablet quality was also evaluated. Vinylpyrrolidone–vinyl acetate copolymer (Kollidon VA64 fine: VA64), polyvidone (Povidone K12: PVP), hydroxypropyl cellulose (HPC SSL SF: HPC) and hydroxypropyl methylcellulose (Methocel E5 LV: HPMC) were evaluated as binders. These granulates, except for HPMC, had a lower yield pressure than Met active pharmaceutical ingredient (API). HPMC Met was not sufficiently granulated with low water volume. No problems were observed with the VA64 Met granulates during the tableting process. However, HPC Met granulates had a bowl-forming tendency, and PVP Met granulates had the tendency to stick during the tableting process. These bowl-forming and sticking tendencies may have been due to the low moisture absorbency of HPC and the high volume of bound water of PVP, respectively. VA64 Met granulates had the highest ambient moisture content (bulk water, bound water) and moisture absorbency. It was concluded that the type of binder used for the Met MAG process has an impact on granulate flow and compactibility, as well as moisture absorbency and maintenance of moisture balance. PMID:26779418

  10. Reliability of visual acuity measurements taken with a notebook and a tablet computer in participants who were illiterate to Roman characters.

    PubMed

    Ruamviboonsuk, Paisan; Sudsakorn, Napitchareeya; Somkijrungroj, Thanapong; Engkagul, Chayanee; Tiensuwan, Montip

    2012-03-01

    Electronic measurement of visual acuity (VA) has been proposed and adopted as a method of determining VA scores in clinical research. Characters (optotypes) are displayed on a monitor screen and the examinee selects a match and inputs his choice to another electronic device. Unfortunately, the optotypes, called Sloan letters, in the standard protocol are 10 Roman characters. This limits their practicabilityfor measuring VA of patients who are illiterate to these characters. The authors introduced a method of displaying the Sloan letters one by one on a notebook and all 10 Sloan letters on a tablet computer screen. The former is for testing the patients whereas the latter is for them to input their responses by tapping on a letter that matches the one on the notebook screen. To assess test-retest reliability of VA scores determined with this method. Participants without ocular abnormality were recruited to have their right eyes measured with the same VA measurement method twice, one week apart. Those who were illiterate to Roman characters were enrolled for the aforementioned method for measuring their VA (Tablet group). A 15-inch display notebook computer and a 9-inch display tablet computer (iPad) communicated via a local wireless data network provided by a Wi-Fi router. Those who understood Roman characters were enrolled to have measurements with a 17-inch desktop computer and an infrared wireless keyboard (Keyboard group). Both methods used the same protocols and software for VA measurements. Reliability of VA scores obtained from each group was assessed by the confidence interval (CI) of the difference of the scores from the test and retest. The t test was used to analyze differences in mean VA scores between the test and retest in each group with p < 0.05 determined as statistically significant. There were 49 and 50 participants in the Tablet and Keyboard group respectively. The 95% CI of the difference between the scores from the test and retest in each group was 2 letters. Approximately 95% of participants in each group had an absolute difference of the scores between the test and retest of 7 letters. The mean of VA scores from the first test was significantly different from that of the second test in the Keyboard group (one-letter difference, p = 0.049); there was no significant difference between these scores in the Tablet group (0.1-letter difference, p = 0.86). Tablet computers may be used to assist patients who are illiterate to Roman characters in having their VA measured with the standard electronic protocol. This preliminary study suggested that the proposed method should be useful for reliable measuring VA outcome in multicenter international clinical trials without encountering a language barrier

  11. Enhanced repellency of binary mixtures of Zanthoxylum armatum seed oil, vanillin, and their aerosols to mosquitoes under laboratory and field conditions.

    PubMed

    Kwon, Hyung Wook; Kim, Soon-Il; Chang, Kyu-Sik; Clark, J Marshall; Ahn, Young-Joon

    2011-01-01

    The repellency of Zanthoxylum armatum seed oil (ZA-SO), alone or in combination with vanillin (VA), its six major constituents, and another four major previously known Zanthoxylum piperitum fruit oil constituents, as well as aerosol products containing 5 or 10% ZA-SO and 5% VA, was evaluated against female Aedes aegypti in laboratory and field studies. Results were then compared with those of N,N-diethyl-3-methylbenzamide (DEET) as a standard. Hand in cage laboratory tests showed that 0.2, 0.1, and 0.05 mg/cm2 ZA-SO resulted in > 92% protection through 30-min postexposure and was not significantly different than 0.05 mg/cm2 DEET. Skin treated with linalool and limonene (from Z. armatum) provided > 80% repellency to female Ae. aegypti at 10-min exposure, whereas cuminaldehyde, citronellal, geranyl acetate, and cuminyl alcohol (from Zanthoxylum piperitum) provided > 90% protection during this same time period. Only cuminaldehyde and citronellal provided complete protection comparable to DEET at 10-min postexposure. After that time, repellency of all plant constituents to mosquitoes was considerably decreased (< approximately 65%). An increase in repellency and duration of effectiveness was produced by a binary 1:4 mixture of ZA-SO and VA (0.05:0.2 mg/cm2) that was significantly more effective than 0.05 mg/cm2 DEET through 90 min. In field tests, an aerosol formulation containing 5 or 10% ZA-SO plus 5% VA gave 100% repellency at 60-min postexposure. Although these formulations were equal to the level of protection afforded by 10% DEET, repellency to the binary ZA-SO aerosol formulations at 90 min was significantly less effective than DEET. However, mixtures formulated from ZA-SO and VA merit further study as potential repellents for protection of humans and domestic animals from biting and nuisance caused by mosquitoes.

  12. Risk and Determinants of Dementia in Patients with Mild Cognitive Impairment and Brain Subcortical Vascular Changes: A Study of Clinical, Neuroimaging, and Biological Markers—The VMCI-Tuscany Study: Rationale, Design, and Methodology

    PubMed Central

    Poggesi, Anna; Salvadori, Emilia; Pantoni, Leonardo; Pracucci, Giovanni; Cesari, Francesca; Chiti, Alberto; Ciolli, Laura; Cosottini, Mirco; Del Bene, Alessandra; De Stefano, Nicola; Diciotti, Stefano; Dotti, Maria Teresa; Ginestroni, Andrea; Giusti, Betti; Gori, Anna Maria; Nannucci, Serena; Orlandi, Giovanni; Pescini, Francesca; Valenti, Raffaella; Abbate, Rosanna; Federico, Antonio; Mascalchi, Mario; Murri, Luigi; Inzitari, Domenico

    2012-01-01

    Dementia is one of the most disabling conditions. Alzheimer's disease and vascular dementia (VaD) are the most frequent causes. Subcortical VaD is consequent to deep-brain small vessel disease (SVD) and is the most frequent form of VaD. Its pathological hallmarks are ischemic white matter changes and lacunar infarcts. Degenerative and vascular changes often coexist, but mechanisms of interaction are incompletely understood. The term mild cognitive impairment defines a transitional state between normal ageing and dementia. Pre-dementia stages of VaD are also acknowledged (vascular mild cognitive impairment, VMCI). Progression relates mostly to the subcortical VaD type, but determinants of such transition are unknown. Variability of phenotypic expression is not fully explained by severity grade of lesions, as depicted by conventional MRI that is not sensitive to microstructural and metabolic alterations. Advanced neuroimaging techniques seem able to achieve this. Beside hypoperfusion, blood-brain-barrier dysfunction has been also demonstrated in subcortical VaD. The aim of the Vascular Mild Cognitive Impairment Tuscany Study is to expand knowledge about determinants of transition from mild cognitive impairment to dementia in patients with cerebral SVD. This paper summarizes the main aims and methodological aspects of this multicenter, ongoing, observational study enrolling patients affected by VMCI with SVD. PMID:22550606

  13. Novel wine yeast with mutations in YAP1 that produce less acetic acid during fermentation.

    PubMed

    Cordente, Antonio G; Cordero-Bueso, Gustavo; Pretorius, Isak S; Curtin, Christopher D

    2013-02-01

    Acetic acid, a byproduct formed during yeast alcoholic fermentation, is the main component of volatile acidity (VA). When present in high concentrations in wine, acetic acid imparts an undesirable 'vinegary' character that results in a significant reduction in quality and sales. Previously, it has been shown that saké yeast strains resistant to the antifungal cerulenin produce significantly lower levels of VA. In this study, we used a classical mutagenesis method to isolate a series of cerulenin-resistant strains, derived from a commercial diploid wine yeast. Four of the selected strains showed a consistent low-VA production phenotype after small-scale fermentation of different white and red grape musts. Specific mutations in YAP1, a gene encoding a transcription factor required for oxidative stress tolerance, were found in three of the four low-VA strains. When integrated into the genome of a haploid wine strain, the mutated YAP1 alleles partially reproduced the low-VA production phenotype of the diploid cerulenin-resistant strains, suggesting that YAP1 might play a role in (regulating) acetic acid production during fermentation. This study offers prospects for the development of low-VA wine yeast starter strains that could assist winemakers in their effort to consistently produce wine to definable quality specifications. © 2012 Federation of European Microbiological Societies. Published by Blackwell Publishing Ltd. All rights reserved.

  14. 78 FR 69175 - Proposed Information Collection (Financial Statement); Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-18

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0047] Proposed Information Collection (Financial Statement); Comment Request AGENCY: Veterans Benefits Administration, Department of Veterans... use of other forms of information technology. Title: Financial Statement, VA Form 26-6807. OMB Control...

  15. 46 CFR 2.10-20 - General requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... the U.S. Treasury. Payment may also be made by credit card or wire transfer. (c) All payments must be...) For payment by credit card, U.S. Coast Guard Finance Center (OGR), 1430A Kristina Way, Chesapeake, VA... by credit card, U.S. Coast Guard Finance Center (OGR), 1430A Kristina Way, Chesapeake, VA 23326. (ii...

  16. 75 FR 1120 - Agency Information Collection (Health-Care Use Survey for Enduring Freedom and Operation Iraqi...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-08

    ... (Health-Care Use Survey for Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) Veterans) Activity...-New (10-0478).'' SUPPLEMENTARY INFORMATION: Title: Health-Care Use Survey for Enduring Freedom and... VA health care; (2) document unique barriers to VA care for women and men; and (3) provide reliable...

  17. The Formal Representation of Administrative and Operational Relationships within Defense Organizational Constructs

    DTIC Science & Technology

    2006-06-01

    of the 10th International Command and Control Research and Technology Symposium; Ritz - Carlton Hotel , McLean, VA; 13-16 June 2005. See: http...International Command and Control Research and Technology Symposium; Ritz - Carlton Hotel , McLean, VA; 13-16 June 2005. http://www.dodccrp.org/events/2005

  18. 38 CFR 21.4215 - Decision of Director of VA Regional Processing Office of jurisdiction.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Administration of Educational Assistance Programs Schools § 21.4215 Decision of Director of VA Regional... subject of the Committee on Educational Allowances proceedings. (Authority: 10 U.S.C. 16136(b); 38 U.S.C..., including— (i) The recommendations of the Committee on Educational Allowances; (ii) The hearing transcript...

  19. 38 CFR 21.4215 - Decision of Director of VA Regional Processing Office of jurisdiction.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Administration of Educational Assistance Programs Schools § 21.4215 Decision of Director of VA Regional... subject of the Committee on Educational Allowances proceedings. (Authority: 10 U.S.C. 16136(b); 38 U.S.C..., including— (i) The recommendations of the Committee on Educational Allowances; (ii) The hearing transcript...

  20. Biosynthesis of actinorhodin and related antibiotics: discovery of alternative routes for quinone formation encoded in the act gene cluster.

    PubMed

    Okamoto, Susumu; Taguchi, Takaaki; Ochi, Kozo; Ichinose, Koji

    2009-02-27

    All known benzoisochromanequinone (BIQ) biosynthetic gene clusters carry a set of genes encoding a two-component monooxygenase homologous to the ActVA-ORF5/ActVB system for actinorhodin biosynthesis in Streptomyces coelicolor A3(2). Here, we conducted molecular genetic and biochemical studies of this enzyme system. Inactivation of actVA-ORF5 yielded a shunt product, actinoperylone (ACPL), apparently derived from 6-deoxy-dihydrokalafungin. Similarly, deletion of actVB resulted in accumulation of ACPL, indicating a critical role for the monooxygenase system in C-6 oxygenation, a biosynthetic step common to all BIQ biosyntheses. Furthermore, in vitro, we showed a quinone-forming activity of the ActVA-ORF5/ActVB system in addition to that of a known C-6 monooxygenase, ActVA-ORF6, by using emodinanthrone as a model substrate. Our results demonstrate that the act gene cluster encodes two alternative routes for quinone formation by C-6 oxygenation in BIQ biosynthesis.

  1. Improved oral bioavailability of probucol by dry media-milling.

    PubMed

    Li, Jia; Yang, Yan; Zhao, Meihui; Xu, Hui; Ma, Junyuan; Wang, Shaoning

    2017-09-01

    The polymer/probucol co-milled mixtures were prepared to improve drug dissolution rate and oral bioavailability. Probucol, a BCS II drug, was co-milled together with Copovidone (Kollidon VA64, VA64), Soluplus, or MCC using the dry media-milling process with planetary ball-milling equipment. The properties of the milled mixtures including morphology, crystal form, vitro drug dissolution and in vivo oral bioavailability in rats were evaluated. Probucol existed as an amorphous in the matrix of the co-milled mixtures containing VA64, which helped to enhance drug dissolution. The ternary mixture composed of VA64, RH40, and probucol showed increased dissolution rates in both sink and non-sink conditions. It also had a higher oral bioavailability compared to the reference formulation. Dry-media milling of binary or ternary mixtures composed of drug, polymer and surfactant possibly have wide applications to improve dissolution rate and oral bioavailability of water-insoluble drugs. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Employment status, employment functioning, and barriers to employment among VA primary care patients.

    PubMed

    Zivin, Kara; Yosef, Matheos; Levine, Debra S; Abraham, Kristen M; Miller, Erin M; Henry, Jennifer; Nelson, C Beau; Pfeiffer, Paul N; Sripada, Rebecca K; Harrod, Molly; Valenstein, Marcia

    2016-03-15

    Prior research found lower employment rates among working-aged patients who use the VA than among non-Veterans or Veterans who do not use the VA, with the lowest reported employment rates among VA patients with mental disorders. This study assessed employment status, employment functioning, and barriers to employment among VA patients treated in primary care settings, and examined how depression and anxiety were associated with these outcomes. The sample included 287 VA patients treated in primary care in a large Midwestern VA Medical Center. Bivariate and multivariable analyses were conducted examining associations between socio-demographic and clinical predictors of six employment domains, including: employment status, job search self-efficacy, work performance, concerns about job loss among employed Veterans, and employment barriers and likelihood of job seeking among not employed Veterans. 54% of respondents were employed, 36% were not employed, and 10% were economically inactive. In adjusted analyses, participants with depression or anxiety (43%) were less likely to be employed, had lower job search self-efficacy, had lower levels of work performance, and reported more employment barriers. Depression and anxiety were not associated with perceived likelihood of job loss among employed or likelihood of job seeking among not employed. Single VA primary care clinic; cross-sectional study. Employment rates are low among working-aged VA primary care patients, particularly those with mental health conditions. Offering primary care interventions to patients that address mental health issues, job search self-efficacy, and work performance may be important in improving health, work, and economic outcomes. Published by Elsevier B.V.

  3. Time- and concentration-dependent increases in cell proliferation in rats and mice administered vinyl acetate in drinking water.

    PubMed

    Valentine, Rudolph; Bamberger, J R; Szostek, B; Frame, S R; Hansen, J F; Bogdanffy, M S

    2002-06-01

    Chronic administration of vinyl acetate (VA) in drinking water to rats and mice has produced upper digestive tract neoplasms. These tumors were believed to arise from the intracellular metabolism of VA by carboxylesterases to cytotoxic and genotoxic compounds. We hypothesized that prolonged VA exposure at high concentrations would induce cytotoxicity and a restorative cell proliferation (CP). These endpoints were measured in F-344 rats and BDF1 mice administered drinking water containing 0, 1000, 5000, 10,000, or 24,000 ppm VA for 92 days. On test days, Days 1, 8, 29, and 92, upper digestive tract histopathology and oral cavity CP (pulsed 5-bromodeoxyuridine [BrdU] to measure S-phase DNA synthesis) were evaluated. Analysis of test solutions showed that VA spontaneously hydrolyzed, slowly releasing acetic acid and thereby lowering pH. Statistically significant, concentration-related increases in CP occurred in basal cells of the mandibular oral cavity mucosa of mice at 10,000 and 24,000 ppm but only after 92 days. CP increases were approximately 2.4- and 3.4-fold above controls and were considered to be toxicologically significant. Some statistically significant increases in CP were also measured in the oral cavity mucosa of rats; however, these changes were considered to be of equivocal biological relevance. No histopathological evidence of mucosal injury was seen in either species. The absence of cytotoxicity in the upper digestive tract mucosa suggests that the increased CP at high administered VA concentrations may be due to a mitogenic response, ostensibly from the loss of cell growth controls in oral cavity mucosa.

  4. Inter-rater reliability and review of the VA unresolved narratives.

    PubMed Central

    Eagon, J. C.; Hurdle, J. F.; Lincoln, M. J.

    1996-01-01

    To better understand how VA clinicians use medical vocabulary in every day practice, we set out to characterize terms generated in the Problem List module of the VA's DHCP system that were not mapped to terms in the controlled-vocabulary lexicon of DHCP. When entered terms fail to match those in the lexicon, a note is sent to a central repository. When our study started, the volume in that repository had reached 16,783 terms. We wished to characterize the potential reasons why these terms failed to match terms in the lexicon. After examining two small samples of randomly selected terms, we used group consensus to develop a set of rating criteria and a rating form. To be sure that the results of multiple reviewers could be confidently compared, we analyzed the inter-rater agreement of our rating process. Two rates used this form to rate the same 400 terms. We found that modifiers and numeric data were common and consistent reasons for failure to match, while others such as use of synonyms and absence of the concept from the lexicon were common but less consistently selected. PMID:8947642

  5. Inter-rater reliability and review of the VA unresolved narratives.

    PubMed

    Eagon, J C; Hurdle, J F; Lincoln, M J

    1996-01-01

    To better understand how VA clinicians use medical vocabulary in every day practice, we set out to characterize terms generated in the Problem List module of the VA's DHCP system that were not mapped to terms in the controlled-vocabulary lexicon of DHCP. When entered terms fail to match those in the lexicon, a note is sent to a central repository. When our study started, the volume in that repository had reached 16,783 terms. We wished to characterize the potential reasons why these terms failed to match terms in the lexicon. After examining two small samples of randomly selected terms, we used group consensus to develop a set of rating criteria and a rating form. To be sure that the results of multiple reviewers could be confidently compared, we analyzed the inter-rater agreement of our rating process. Two rates used this form to rate the same 400 terms. We found that modifiers and numeric data were common and consistent reasons for failure to match, while others such as use of synonyms and absence of the concept from the lexicon were common but less consistently selected.

  6. Effects of the KiVa antibullying program on cyberbullying and cybervictimization frequency among Finnish youth.

    PubMed

    Williford, Anne; Elledge, L Christian; Boulton, Aaron J; DePaolis, Kathryn J; Little, Todd D; Salmivalli, Christina

    2013-01-01

    Cyberbullying among school-aged children has received increased attention in recent literature. However, no empirical evidence currently exists on whether existing school-based antibullying programs are effective in targeting the unique aspects of cyberbullying. To address this important gap, the present study investigates the unique effects of the KiVa Antibullying Program on the frequency of cyberbullying and cybervictimization among elementary and middle school youth. Using data from a group randomized controlled trial, multilevel ordinal regression analyses were used to examine differences in the frequencies of cyberbullying and cybervictimization between intervention (N = 9,914) and control students (N = 8,498). The effects of age and gender on frequencies of cyber behaviors were also assessed across conditions. Results revealed a significant intervention effect on the frequency of cybervictimization; KiVa students reported lower frequencies of cybervictimization at posttest than students in a control condition. The effect of condition on the perpetration of cyberbullying was moderated by age. When student age was below the sample mean, KiVa students reported lower frequencies of cyberbullying than students in the control condition. We also found evidence of classroom level variation in cyberbullying and cybervictimization, suggesting cyberbullying is in part a classroom-level phenomenon. KiVa appears to be an efficacious program to address cyber forms of bullying and victimization. We discuss several unique aspects of KiVa that may account for the significant intervention effects. Results suggest that KiVa is an intervention option for schools concerned with reducing cyberbullying behavior and its deleterious effects on children's adjustment.

  7. Use of DHCP to provide essential information for care and management of HIV patients.

    PubMed Central

    Pfeil, C. N.; Ivey, J. L.; Hoffman, J. D.; Kuhn, I. M.

    1991-01-01

    The Department of Veterans' Affairs (VA) has reported over 10,000 Acquired Immune Deficiency Syndrome (AIDS) cases since the beginning of the epidemic. These cases were distributed throughout 152 of the VA's network of 172 medical centers and outpatient clinics. This network of health care facilities presents a unique opportunity to provide computer based information systems for clinical care and resource monitoring for these patients. The VA further facilitates such a venture through its commitment to the Decentralized Hospital Computer Program (DHCP). This paper describes a new application within DHCP known as the VA's HIV Registry. This project addresses the need to support clinical information as well as the added need to manage the resources necessary to care for HIV patients. PMID:1807575

  8. Use of the Blue Button Online Tool for Sharing Health Information: Qualitative Interviews With Patients and Providers

    PubMed Central

    Fix, Gemmae M; Hogan, Timothy P; Simon, Steven R; Nazi, Kim M; Turvey, Carolyn L

    2015-01-01

    Background Information sharing between providers is critical for care coordination, especially in health systems such as the United States Department of Veterans Affairs (VA), where many patients also receive care from other health care organizations. Patients can facilitate this sharing by using the Blue Button, an online tool that promotes patients’ ability to view, print, and download their health records. Objective The aim of this study was to characterize (1) patients’ use of Blue Button, an online information-sharing tool in VA’s patient portal, My HealtheVet, (2) information-sharing practices between VA and non-VA providers, and (3) how providers and patients use a printed Blue Button report during a clinical visit. Methods Semistructured qualitative interviews were conducted with 34 VA patients, 10 VA providers, and 9 non-VA providers. Interviews focused on patients’ use of Blue Button, information-sharing practices between VA and non-VA providers, and how patients and providers use a printed Blue Button report during a clinical visit. Qualitative themes were identified through iterative rounds of coding starting with an a priori schema based on technology adoption theory. Results Information sharing between VA and non-VA providers relied primarily on the patient. Patients most commonly used Blue Button to access and share VA laboratory results. Providers recognized the need for improved information sharing, valued the Blue Button printout, and expressed interest in a way to share information electronically across settings. Conclusions Consumer-oriented technologies such as Blue Button can facilitate patients sharing health information with providers in other health care systems; however, more education is needed to inform patients of this use to facilitate care coordination. Additional research is needed to explore how personal health record documents, such as Blue Button reports, can be easily shared and incorporated into the clinical workflow of providers. PMID:26286139

  9. 76 FR 27386 - Proposed Information Collection (Employment Questionnaire) Activity; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-11

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0079] Proposed Information Collection (Employment Questionnaire) Activity; Comment Request AGENCY: Veterans Benefits Administration, Department of... use of other forms of information technology. Title: Employment Questionnaire, VA Forms 21-4140 and 21...

  10. 78 FR 46422 - Proposed Information Collection (Status of Dependents Questionnaire) Activity: Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-31

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0500] Proposed Information Collection (Status of Dependents Questionnaire) Activity: Comment Request AGENCY: Veterans Benefits Administration... use of other forms of information technology. Title: Status of Dependents Questionnaire, VA Form 21...

  11. 75 FR 62636 - Proposed Information Collection (Status of Dependents Questionnaire) Activity: Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-12

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0500] Proposed Information Collection (Status of Dependents Questionnaire) Activity: Comment Request AGENCY: Veterans Benefits Administration... use of other forms of information technology. Title: Status of Dependents Questionnaire, VA Form 21...

  12. 37 CFR 201.3 - Fees for registration, recordation, and related services, special services, and services...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...) Registration of a claim in a group of contributions to periodicals (Form GR/CP), published photographs, or... updates thereto or group registration of published photographs 35 Forms GR/CP, PA, SR, VA and SE (paper...

  13. 37 CFR 201.3 - Fees for registration, recordation, and related services, special services, and services...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...) Registration of a claim in a group of contributions to periodicals (Form GR/CP), published photographs, or... updates thereto or group registration of published photographs 35 Forms GR/CP, PA, SR, VA and SE (paper...

  14. 77 FR 64385 - Proposed Information Collection (Loan Analysis) Activity: Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-19

    ... forms of information technology. Title: Loan Analysis, VA Form 26-6393. OMB Control Number: 2900-0523... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0523] Proposed Information Collection (Loan Analysis) Activity: Comment Request AGENCY: Veterans Benefits Administration, Department of Veterans...

  15. National Dam Safety Program. Lake Monocan Dam (ID VA-12502), James River Basin, Allen Creek. Nelson County, Virginia. Phase I Inspection Report.

    DTIC Science & Technology

    1980-04-01

    P 114 June 1978 Mr. W. Douglas Wright *Wiley and Wilson, Inc. 2310 Langhorne Road ’ :5 1973 Lvnchburg, Virginia 24505 & LSON, INC. LYNCHF.U1G. VA. Dv...CLASSIFICATION OF THIS P Dat Entered)’ " ’ READ INSTRUCTIO)NS REPORT DOCUMENTATION PAGE BEFORE COMPLETING FORM . REPORT NUMBER - 12. GOVT ACCESSION...OBSOLETE Unclassified -SECUnclassified OI P nd SECURITY CLASSIFICATION OF THIS PAGE (Wfen Dis Entered) SECURITY CLASSIFICATION OF INIS PAOE(Whe Data

  16. 30 CFR 57.22605 - Blasting from the surface (V-A mines).

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Standards for Methane in Metal and Nonmetal Mines Explosives § 57.22605 Blasting from the surface (V-A mines). (a) All development and production blasting shall be initiated from the surface after all persons are... methane in the mine is less than 1.0 percent, persons may enter the mine, and all places blasted shall be...

  17. 30 CFR 57.22605 - Blasting from the surface (V-A mines).

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Standards for Methane in Metal and Nonmetal Mines Explosives § 57.22605 Blasting from the surface (V-A mines). (a) All development and production blasting shall be initiated from the surface after all persons are... methane in the mine is less than 1.0 percent, persons may enter the mine, and all places blasted shall be...

  18. 30 CFR 57.22605 - Blasting from the surface (V-A mines).

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Standards for Methane in Metal and Nonmetal Mines Explosives § 57.22605 Blasting from the surface (V-A mines). (a) All development and production blasting shall be initiated from the surface after all persons are... methane in the mine is less than 1.0 percent, persons may enter the mine, and all places blasted shall be...

  19. 30 CFR 57.22605 - Blasting from the surface (V-A mines).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Standards for Methane in Metal and Nonmetal Mines Explosives § 57.22605 Blasting from the surface (V-A mines). (a) All development and production blasting shall be initiated from the surface after all persons are... methane in the mine is less than 1.0 percent, persons may enter the mine, and all places blasted shall be...

  20. 30 CFR 57.22605 - Blasting from the surface (V-A mines).

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Standards for Methane in Metal and Nonmetal Mines Explosives § 57.22605 Blasting from the surface (V-A mines). (a) All development and production blasting shall be initiated from the surface after all persons are... methane in the mine is less than 1.0 percent, persons may enter the mine, and all places blasted shall be...

  1. Harbors.

    DTIC Science & Technology

    1981-07-01

    CONTRACT OR GRANT NUMBER(e) Naval Facilities Engineering Command 200 Stovall Street r Alexandria, VA 22332 (Code 0453) s. PERFORMING ORGANIZATION NAME...AND ADDRESS 10. PROGRAM ELEMENT. PROJECT. TASK • Naval Facilities Engineering Command AREA & WORK UNIT NUMBERS < 200 Stovall Street Engineering and...Design Alexandria, VA 22332 It. CONTROLLING OFFICE NAME AND ADDRESS 12. REPORT DATE ~ Naval Facilities Engineering Command (Code10432) July 1981 200

  2. Cf-252 Characterization Documents

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

    Feldman, Alexander

    2014-03-14

    Six documents were written by Vance and Associates under contract to the Off-Site Source Recovery Project of Los Alamos National Laboratory. These Six documents provided the basis for characterization of Californium-252 sealed sources and for the packaging and manifesting of this material for disposal at the Waste Isolation Pilot Project. The Six documents are: 1. VA-OSR-10, Development of radionuclide distributions for Cf-252 sealed sources. 2. VA-OSR-11, Uncertainty analysis for Cf-252 sealed sources. 3. VA-OSR-12, To determine the radionuclides in the waste drums containing Cf-252 sealed source waste that are required to be reported under the requirements of the WIPP WACmore » and the TRAMPAC. 4. VA-OSR-13, Development of the spreadsheet for the radiological calculations for the characterization of Cf-252 sources. 5. VA-OSR-14, Relative importance of neutron-induced fission in Cf-252 sources. 6. VA-OSR-15, Determine upper bound of decay product inventories from a drum of Cf-252 sources. These six documents provide the technical basis for the characterization of Cf-252 sources and will be part of the AK documentation required for submittal to the Central Characterization Project (CCP) of WIPP.« less

  3. Maximal Voluntary Activation of the Elbow Flexors Is under Predicted by Transcranial Magnetic Stimulation Compared to Motor Point Stimulation Prior to and Following Muscle Fatigue

    PubMed Central

    Cadigan, Edward W. J.; Collins, Brandon W.; Philpott, Devin T. G.; Kippenhuck, Garreth; Brenton, Mitchell; Button, Duane C.

    2017-01-01

    Transcranial magnetic (TMS) and motor point stimulation have been used to determine voluntary activation (VA). However, very few studies have directly compared the two stimulation techniques for assessing VA of the elbow flexors. The purpose of this study was to compare TMS and motor point stimulation for assessing VA in non-fatigued and fatigued elbow flexors. Participants performed a fatigue protocol that included twelve, 15 s isometric elbow flexor contractions. Participants completed a set of isometric elbow flexion contractions at 100, 75, 50, and 25% of maximum voluntary contraction (MVC) prior to and following fatigue contractions 3, 6, 9, and 12 and 5 and 10 min post-fatigue. Force and EMG of the bicep and triceps brachii were measured for each contraction. Force responses to TMS and motor point stimulation and EMG responses to TMS (motor evoked potentials, MEPs) and Erb's point stimulation (maximal M-waves, Mmax) were also recorded. VA was estimated using the equation: VA% = (1−SITforce/PTforce) × 100. The resting twitch was measured directly for motor point stimulation and estimated for both motor point stimulation and TMS by extrapolation of the linear regression between the superimposed twitch force and voluntary force. MVC force, potentiated twitch force and VA significantly (p < 0.05) decreased throughout the elbow flexor fatigue protocol and partially recovered 10 min post fatigue. VA was significantly (p < 0.05) underestimated when using TMS compared to motor point stimulation in non-fatigued and fatigued elbow flexors. Motor point stimulation compared to TMS superimposed twitch forces were significantly (p < 0.05) higher at 50% MVC but similar at 75 and 100% MVC. The linear relationship between TMS superimposed twitch force and voluntary force significantly (p < 0.05) decreased with fatigue. There was no change in triceps/biceps electromyography, biceps/triceps MEP amplitudes, or bicep MEP amplitudes throughout the fatigue protocol at 100% MVC. In conclusion, motor point stimulation as opposed to TMS led to a higher estimation of VA in non-fatigued and fatigued elbow flexors. The decreased linear relationship between TMS superimposed twitch force and voluntary force led to an underestimation of the estimated resting twitch force and thus, a reduced VA. PMID:28979211

  4. Maximal Voluntary Activation of the Elbow Flexors Is under Predicted by Transcranial Magnetic Stimulation Compared to Motor Point Stimulation Prior to and Following Muscle Fatigue.

    PubMed

    Cadigan, Edward W J; Collins, Brandon W; Philpott, Devin T G; Kippenhuck, Garreth; Brenton, Mitchell; Button, Duane C

    2017-01-01

    Transcranial magnetic (TMS) and motor point stimulation have been used to determine voluntary activation (VA). However, very few studies have directly compared the two stimulation techniques for assessing VA of the elbow flexors. The purpose of this study was to compare TMS and motor point stimulation for assessing VA in non-fatigued and fatigued elbow flexors. Participants performed a fatigue protocol that included twelve, 15 s isometric elbow flexor contractions. Participants completed a set of isometric elbow flexion contractions at 100, 75, 50, and 25% of maximum voluntary contraction (MVC) prior to and following fatigue contractions 3, 6, 9, and 12 and 5 and 10 min post-fatigue. Force and EMG of the bicep and triceps brachii were measured for each contraction. Force responses to TMS and motor point stimulation and EMG responses to TMS (motor evoked potentials, MEPs) and Erb's point stimulation (maximal M-waves, M max ) were also recorded. VA was estimated using the equation: VA% = (1- SITforce / PTforce ) × 100. The resting twitch was measured directly for motor point stimulation and estimated for both motor point stimulation and TMS by extrapolation of the linear regression between the superimposed twitch force and voluntary force. MVC force, potentiated twitch force and VA significantly ( p < 0.05) decreased throughout the elbow flexor fatigue protocol and partially recovered 10 min post fatigue. VA was significantly ( p < 0.05) underestimated when using TMS compared to motor point stimulation in non-fatigued and fatigued elbow flexors. Motor point stimulation compared to TMS superimposed twitch forces were significantly ( p < 0.05) higher at 50% MVC but similar at 75 and 100% MVC. The linear relationship between TMS superimposed twitch force and voluntary force significantly ( p < 0.05) decreased with fatigue. There was no change in triceps/biceps electromyography, biceps/triceps MEP amplitudes, or bicep MEP amplitudes throughout the fatigue protocol at 100% MVC. In conclusion, motor point stimulation as opposed to TMS led to a higher estimation of VA in non-fatigued and fatigued elbow flexors. The decreased linear relationship between TMS superimposed twitch force and voluntary force led to an underestimation of the estimated resting twitch force and thus, a reduced VA.

  5. Identification of QTL and Qualitative Trait Loci for Agronomic Traits Using SNP Markers in the Adzuki Bean.

    PubMed

    Li, Yuan; Yang, Kai; Yang, Wei; Chu, Liwei; Chen, Chunhai; Zhao, Bo; Li, Yisong; Jian, Jianbo; Yin, Zhichao; Wang, Tianqi; Wan, Ping

    2017-01-01

    The adzuki bean ( Vigna angularis ) is an important grain legume. Fine mapping of quantitative trait loci (QTL) and qualitative trait genes plays an important role in gene cloning, molecular-marker-assisted selection (MAS), and trait improvement. However, the genetic control of agronomic traits in the adzuki bean remains poorly understood. Single-nucleotide polymorphisms (SNPs) are invaluable in the construction of high-density genetic maps. We mapped 26 agronomic QTLs and five qualitative trait genes related to pigmentation using 1,571 polymorphic SNP markers from the adzuki bean genome via restriction-site-associated DNA sequencing of 150 members of an F 2 population derived from a cross between cultivated and wild adzuki beans. We mapped 11 QTLs for flowering time and pod maturity on chromosomes 4, 7, and 10. Six 100-seed weight (SD100WT) QTLs were detected. Two major flowering time QTLs were located on chromosome 4, firstly VaFld4.1 (PEVs 71.3%), co-segregating with SNP marker s690-144110, and VaFld4.2 (PEVs 67.6%) at a 0.974 cM genetic distance from the SNP marker s165-116310. Three QTLs for seed number per pod ( Snp3.1, Snp3.2 , and Snp4.1 ) were mapped on chromosomes 3 and 4. One QTL VaSdt4.1 of seed thickness (SDT) and three QTLs for branch number on the main stem were detected on chromosome 4. QTLs for maximum leaf width (LFMW) and stem internode length were mapped to chromosomes 2 and 9, respectively. Trait genes controlling the color of the seed coat, pod, stem and flower were mapped to chromosomes 3 and 1. Three candidate genes, VaAGL, VaPhyE , and VaAP2 , were identified for flowering time and pod maturity. VaAGL encodes an agamous-like MADS-box protein of 379 amino acids. VaPhyE encodes a phytochrome E protein of 1,121 amino acids. Four phytochrome genes ( VaPhyA1, VaPhyA2, VaPhyB , and VaPhyE ) were identified in the adzuki bean genome. We found candidate genes VaAP2/ERF.81 and VaAP2/ERF.82 of SD100WT, VaAP2-s4 of SDT, and VaAP2/ERF.86 of LFMW. A candidate gene VaUGT related to black seed coat color was identified. These mapped QTL and qualitative trait genes provide information helpful for future adzuki bean candidate gene cloning and MAS breeding to improve cultivars with desirable growth periods, yields, and seed coat color types.

  6. 76 FR 24571 - Proposed Information Collection (Veterans Mortgage Life Insurance Inquiry); Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-02

    ... (Veterans Mortgage Life Insurance Inquiry); Comment Request AGENCY: Veterans Benefits Administration... maintain Veterans Mortgage Life Insurance accounts. DATES: Written comments and recommendations on the... use of other forms of information technology. Title: Veterans Mortgage Life Insurance Inquiry, VA Form...

  7. 76 FR 8848 - Proposed Information Collection (Financial Statement); Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-15

    ... (Financial Statement); Comment Request AGENCY: Veterans Benefits Administration, Department of Veterans... use of other forms of information technology. Title: Financial Statement, VA Form 26-6807. OMB Control... creditworthiness requirements. The data is also used to determine a borrower's financial condition in connection...

  8. 75 FR 77906 - Agency Information Collection Activities: Proposed Collection; Comments Requested: Drug...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-14

    ..., Human Resources Division, Drug Enforcement Administration, 8701 Morrissette Drive, Springfield, VA 22152... collection: Form number: DEA Form 341. Component: Human Resources Division, Drug Enforcement Administration... Administration (DEA), will be submitting the following information collection request to the Office of Management...

  9. 76 FR 15054 - Proposed Information Collection (Supporting Statement Regarding Marriage); Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-18

    ... (Supporting Statement Regarding Marriage); Comment Request AGENCY: Veterans Benefits Administration... eligibility for benefits based on a common law marriage. DATES: Written comments and recommendations on the... use of other forms of information technology. Title: Supporting Statement Regarding Marriage, VA Form...

  10. Graph theoretical analysis of EEG effective connectivity in vascular dementia patients during a visual oddball task.

    PubMed

    Wang, Chao; Xu, Jin; Zhao, Songzhen; Lou, Wutao

    2016-01-01

    The study was dedicated to investigating the change in information processing in brain networks of vascular dementia (VaD) patients during the process of decision making. EEG was recorded from 18 VaD patients and 19 healthy controls when subjects were performing a visual oddball task. The whole task was divided into several stages by using global field power analysis. In the stage related to the decision-making process, graph theoretical analysis was applied to the binary directed network derived from EEG signals at nine electrodes in the frontal, central, and parietal regions in δ (0.5-3.5Hz), θ (4-7Hz), α1 (8-10Hz), α2 (11-13Hz), and β (14-30Hz) frequency bands based on directed transfer function. A weakened outgoing information flow, a decrease in out-degree, and an increase in in-degree were found in the parietal region in VaD patients, compared to healthy controls. In VaD patients, the parietal region may also lose its hub status in brain networks. In addition, the clustering coefficient was significantly lower in VaD patients. Impairment might be present in the parietal region or its connections with other regions, and it may serve as one of the causes for cognitive decline in VaD patients. The brain networks of VaD patients were significantly altered toward random networks. The present study extended our understanding of VaD from the perspective of brain functional networks, and it provided possible interpretations for cognitive deficits in VaD patients. Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  11. Effects of upper-extremity vascular access creation on cardiac events in patients undergoing coronary artery bypass grafting.

    PubMed

    Han, Youngjin; Choo, Suk Jung; Kwon, Hyunwook; Lee, Jae Won; Chung, Cheol Hyun; Kim, Hyangkyoung; Kwon, Tae-Won; Cho, Yong-Pil

    2017-01-01

    The present study was conducted to investigate whether upper-extremity vascular access (VA) creation increases the risk for major adverse cardiac events (MACE) and death in patients undergoing coronary artery bypass grafting (CABG) with an in situ left internal thoracic artery (ITA) graft. A total of 111 patients with CABG with a left ITA graft who underwent upper-extremity VA creation were analyzed retrospectively; 93 patients received left VA creation (83.8%, ipsilateral group) and 18 patients received right VA creation (16.2%, contralateral group). The primary outcome was the occurrence of MACE, and the secondary outcome was the composite of MACE or late death. There were no significant differences in the incidence of primary (P = 0.30) or secondary (P = 0.09) outcomes between the two groups. Multivariate regression analysis indicated that prior cerebrovascular accidents (hazard ratio [HR] 3.30; 95% confidence interval [CI] 1.37-7.97; P = 0.01) and type of VA (HR 3.44; 95% CI 1.34-8.82; P = 0.01) were independently associated with MACE; prior peripheral arterial occlusive disease (HR 4.22; 95% CI 1.62-10.98; P<0.01) and type of VA (arteriovenous fistula vs. prosthetic arteriovenous grafting) (HR 3.06; 95% CI, 1.42-6.61; P<0.01) were associated with the composite of MACE or death. The side and location of VA were not associated with MACE or death. Our study showed no definite evidence that ipsilateral VA creation affects the subsequent occurrence of MACE or late death from any cause. The type of VA (a prosthetic arteriovenous grafting) is a significant predictor of the subsequent occurrence of MACE or late death.

  12. Effects of upper-extremity vascular access creation on cardiac events in patients undergoing coronary artery bypass grafting

    PubMed Central

    Han, Youngjin; Choo, Suk Jung; Kwon, Hyunwook; Lee, Jae Won; Chung, Cheol Hyun; Kim, Hyangkyoung; Kwon, Tae-Won

    2017-01-01

    The present study was conducted to investigate whether upper-extremity vascular access (VA) creation increases the risk for major adverse cardiac events (MACE) and death in patients undergoing coronary artery bypass grafting (CABG) with an in situ left internal thoracic artery (ITA) graft. A total of 111 patients with CABG with a left ITA graft who underwent upper-extremity VA creation were analyzed retrospectively; 93 patients received left VA creation (83.8%, ipsilateral group) and 18 patients received right VA creation (16.2%, contralateral group). The primary outcome was the occurrence of MACE, and the secondary outcome was the composite of MACE or late death. There were no significant differences in the incidence of primary (P = 0.30) or secondary (P = 0.09) outcomes between the two groups. Multivariate regression analysis indicated that prior cerebrovascular accidents (hazard ratio [HR] 3.30; 95% confidence interval [CI] 1.37–7.97; P = 0.01) and type of VA (HR 3.44; 95% CI 1.34–8.82; P = 0.01) were independently associated with MACE; prior peripheral arterial occlusive disease (HR 4.22; 95% CI 1.62–10.98; P<0.01) and type of VA (arteriovenous fistula vs. prosthetic arteriovenous grafting) (HR 3.06; 95% CI, 1.42–6.61; P<0.01) were associated with the composite of MACE or death. The side and location of VA were not associated with MACE or death. Our study showed no definite evidence that ipsilateral VA creation affects the subsequent occurrence of MACE or late death from any cause. The type of VA (a prosthetic arteriovenous grafting) is a significant predictor of the subsequent occurrence of MACE or late death. PMID:28873444

  13. Risk stratification for death and all-cause hospitalization in heart failure clinic outpatients.

    PubMed

    Hummel, Scott L; Ghalib, Hussam H; Ratz, David; Koelling, Todd M

    2013-11-01

    Most heart failure (HF) risk stratification models were developed for inpatient use, and available outpatient models use a complex set of variables. We hypothesized that routinely collected clinical data could predict the 6-month risk of death and all-cause medical hospitalization in HF clinic outpatients. Using a quality improvement database and multivariable Cox modeling, we derived the Heart Failure Patient Severity Index (HFPSI) in the University of Michigan HF clinic (UM cohort, n = 1,536; 314 reached primary outcome). We externally validated the HFPSI in the Ann Arbor Veterans' Affairs HF clinic (VA cohort, n = 445; 106 outcomes) and explored "real-time" HFPSI use (VA-RT cohort, n = 486; 141 outcomes) by tracking VA patients for 6 months from their most recently calculated HFPSI, rather than using an arbitrary start date for the cohort. The HFPSI model included blood urea nitrogen, B-type natriuretic peptide, New York Heart Association class, diabetes status, history of atrial fibrillation/flutter, and all-cause hospitalization within the prior 1 and 2 to 6 months. The concordance c statistics in the UM/VA/VA-RT cohorts were 0.71/0.68/0.74. Kaplan-Meier curves and log-rank testing demonstrated excellent risk stratification, particularly between a large, low-risk group (40% of patients, 6-month event rates in the UM/VA/VA-RT cohorts 8%/12%/12%) and a small, high-risk group (10% of patients, 6-month event rates in the UM/VA/VA-RT cohorts 57%/58%/79%). The HFPSI uses readily available data to predict the 6-month risk of death and/or all-cause medical hospitalization in HF clinic outpatients and could potentially help allocate specialized HF resources within health systems. © 2013.

  14. Prevalence and causes of visual impairment in Asian and non-Hispanic white preschool children: Multi-ethnic Pediatric Eye Disease Study.

    PubMed

    Tarczy-Hornoch, Kristina; Cotter, Susan A; Borchert, Mark; McKean-Cowdin, Roberta; Lin, Jesse; Wen, Ge; Kim, Jeniffer; Varma, Rohit

    2013-06-01

    To determine the prevalence and causes of decreased visual acuity (VA). Population-based cross-sectional study. Multi-ethnic sample of children 30 to 72 months of age identified in Los Angeles. All eligible children underwent a comprehensive ophthalmic evaluation including monocular VA testing, cover testing, cycloplegic autorefraction, fundus evaluation, and VA retesting with refractive correction. Decreased VA was defined as presenting or best-measured VA worse than 20/50 in children 30 to 47 months of age and worse than 20/40 for children 48 months of age and older. The prevalence and causes of decreased VA were determined, for both presenting and best-measured VA, in the better-seeing and the worse-seeing eyes. Prevalence and causes of decreased vision. Presenting VA was assessed in 1840 children and best-measured VA was assessed in 1886 children. Presenting VA was decreased in the worse eye of 4.2% of Asian children and of 3.6% of non-Hispanic white (NHW) children. Close to one-fourth of these cases had no identifiable cause, and 81% of these resolved on retesting. Decreased presenting VA in the worse eye with an identifiable ophthalmic cause was present in 3.4% of Asian children and in 2.6% of NHW children. Decreased presenting VA attributable to simple refractive error (myopia ≥ 0.5 diopters [D]; hyperopia ≥ 3.0 D; astigmatism ≥ 2.0 D or ≥ 1.5 D for children older than 36 months) was present in the worse eye of 2.3% of Asian children and of 1.4% of NHW children and in the better eye of 0.5% of Asian children and of 0.3% of NHW children. Decreased best-measured VA attributable to a cause was present in the worse eye of 1.2% of both Asian children and NHW children and in the better eye of 0.2% of Asian and of 0.3% of NHW children. Amblyopia related to refractive error was the most common cause, and was 10 times as common as ocular disease. Severe visual impairment was rare. Seventy percent of all decreased VA in Asian and NHW preschool children and more than 90% of decreased VA with an identifiable cause is related to refractive error--either uncorrected refractive error or amblyopia resulting from refractive error. The author(s) have no proprietary or commercial interest in any materials discussed in this article. Copyright © 2013 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  15. A Decade’s Experience With Quality Improvement in Cardiac Surgery Using the Veterans Affairs and Society of Thoracic Surgeons National Databases

    PubMed Central

    Grover, Frederick L.; Shroyer, A. Laurie W.; Hammermeister, Karl; Edwards, Fred H.; Ferguson, T. Bruce; Dziuban, Stanley W.; Cleveland, Joseph C.; Clark, Richard E.; McDonald, Gerald

    2001-01-01

    Objective To review the Department of Veteran Affairs (VA) and the Society of Thoracic Surgeons (STS) national databases over the past 10 years to evaluate their relative similarities and differences, to appraise their use as quality improvement tools, and to assess their potential to facilitate improvements in quality of cardiac surgical care. Summary Background Data The VA developed a mandatory risk-adjusted database in 1987 to monitor outcomes of cardiac surgery at all VA medical centers. In 1989 the STS developed a voluntary risk-adjusted database to help members assess quality and outcomes in their individual programs and to facilitate improvements in quality of care. Methods A short data form on every veteran operated on at each VA medical center is completed and transmitted electronically for analysis of unadjusted and risk-adjusted death and complications, as well as length of stay. Masked, confidential semiannual reports are then distributed to each program’s clinical team and the associated administrator. These reports are also reviewed by a national quality oversight committee. Thus, VA data are used both locally for quality improvement and at the national level with quality surveillance. The STS dataset (217 core fields and 255 extended fields) is transmitted for each patient semiannually to the Duke Clinical Research Institute (DCRI) for warehousing, analysis, and distribution. Site-specific reports are produced with regional and national aggregate comparisons for unadjusted and adjusted surgical deaths and complications, as well as length of stay for coronary artery bypass grafting (CABG), valvular procedures, and valvular/CABG procedures. Both databases use the logistic regression modeling approach. Data for key processes of care are also captured in both databases. Research projects are frequently carried out using each database. Results More than 74,000 and 1.6 million cardiac surgical patients have been entered into the VA and STS databases, respectively. Risk factors that predict surgical death for CABG are very similar in the two databases, as are the odds ratios for most of the risk factors. One major difference is that the VA is 99% male, the STS 71% male. Both databases have shown a significant reduction in the risk-adjusted surgical death rate during the past decade despite the fact that patients have presented with an increased risk factor profile. The ratio of observed to expected deaths decreased from 1.05 to 0.9 for the VA and from 1.5 to 0.9 for the STS. Conclusion It appears that the routine feedback of risk-adjusted data on local performance provided by these programs heightens awareness and leads to self-examination and self-assessment, which in turn improves quality and outcomes. This general quality improvement template should be considered for application in other settings beyond cardiac surgery. PMID:11573040

  16. Stress Testing After Percutaneous Coronary Intervention in the Veterans Affairs HealthCare System: Insights from the Veterans Affairs Clinical Assessment, Reporting, and Tracking Program.

    PubMed

    Bradley, Steven M; Hess, Edward; Winchester, David E; Sussman, Jeremy B; Aggarwal, Vikas; Maddox, Thomas M; Barón, Anna E; Rumsfeld, John S; Ho, P Michael

    2015-09-01

    Stress testing after percutaneous coronary intervention (PCI) in fee-for-service settings is common and rates vary by hospital. Rates of stress testing after PCI within integrated healthcare systems, such as the Veterans Affairs (VA) are unknown. We evaluated all VA patients who underwent PCI from October 2007 through June 2010. To avoid the influence of Medicare eligibility on rates of stress testing use in the VA, we excluded Medicare eligible patients during the follow-up period. Hospital-level variation in risk-standardized rates of stress testing and the association with 1-year mortality and myocardial infarction was determined from Markov chain Monte Carlo methods. Among 10 293 patients undergoing PCI at 55 VA hospitals, 2239 (21.8%) had a stress test performed within 1 year of PCI and 3902 (37.9%) within 2 years. Most stress tests after PCI were performed with nuclear imaging (79.8%). The hospital-level risk-standardized rate of stress testing differed significantly from the average at 14 hospitals, with 8 (14.5%) hospitals significantly below and 6 (10.9%) hospitals significantly above the average stress testing rate. Hospital-level risk-standardized stress testing rates were not significantly correlated with risk-standardized mortality (Spearman ρ=-0.24; P=0.08) or myocardial infarction rates (Spearman ρ=0.20; P=0.14). In the VA, nearly 40% of patients underwent stress testing in the 2 years after PCI, which is a third less than published studies from other healthcare systems. However, stress testing rates varied across VA hospitals, suggesting opportunities to optimize the use of stress testing are still present in integrated healthcare systems. © 2015 American Heart Association, Inc.

  17. Reactivity of catecholamine-driven Fenton reaction and its relationships with iron(III) speciation.

    PubMed

    Melin, Victoria; Henríquez, Adolfo; Freer, Juanita; Contreras, David

    2015-03-01

    Fenton reaction is the main source of free radicals in biological systems. The reactivity of this reaction can be modified by several factors, among these iron ligands are important. Catecholamine (dopamine, epinephrine, and norepinephrine) are able to form Fe(III) complexes whose extension in the coordination number depends upon the pH. Fe(III)-catecholamine complexes have been related with the development of several pathologies. In this work, the ability of catecholamines to enhance the oxidative degradation of an organic substrate (veratryl alcohol, VA) through Fenton and Fenton-like reactions was studied. The initial VA degradation rate at different pH values and its relationship to the different iron species present in solution were determined. Furthermore, the oxidative degradation of VA after 24 hours of reaction and its main oxidation products were also determined. The catecholamine-driven Fenton and Fenton-like systems showed higher VA degradation compared to unmodified Fenton or Fenton-like systems, which also showed an increase in the oxidation state of the VA degradation product. All of this oxidative degradation takes place at pH values lower than 5.50, where the primarily responsible species would be the Fe(III) mono-complex. The presence of Fe(III) mono-complex is essential in the ability of catecholamines to increase the oxidative capacity of Fenton systems.

  18. Modeling of Mean-VaR portfolio optimization by risk tolerance when the utility function is quadratic

    NASA Astrophysics Data System (ADS)

    Sukono, Sidi, Pramono; Bon, Abdul Talib bin; Supian, Sudradjat

    2017-03-01

    The problems of investing in financial assets are to choose a combination of weighting a portfolio can be maximized return expectations and minimizing the risk. This paper discusses the modeling of Mean-VaR portfolio optimization by risk tolerance, when square-shaped utility functions. It is assumed that the asset return has a certain distribution, and the risk of the portfolio is measured using the Value-at-Risk (VaR). So, the process of optimization of the portfolio is done based on the model of Mean-VaR portfolio optimization model for the Mean-VaR done using matrix algebra approach, and the Lagrange multiplier method, as well as Khun-Tucker. The results of the modeling portfolio optimization is in the form of a weighting vector equations depends on the vector mean return vector assets, identities, and matrix covariance between return of assets, as well as a factor in risk tolerance. As an illustration of numeric, analyzed five shares traded on the stock market in Indonesia. Based on analysis of five stocks return data gained the vector of weight composition and graphics of efficient surface of portfolio. Vector composition weighting weights and efficient surface charts can be used as a guide for investors in decisions to invest.

  19. Low serum insulin-like growth factor-I (IGF-I) level is associated with increased risk of vascular dementia.

    PubMed

    Quinlan, Patrick; Horvath, Alexandra; Nordlund, Arto; Wallin, Anders; Svensson, Johan

    2017-12-01

    Insulin-like growth factor-I (IGF-I) is important for the adult brain, but little is known of the role of IGF-I in Alzheimeŕs disease (AD) or vascular dementia (VaD). A prospective study of 342 patients with subjective or objective mild cognitive impairment recruited at a single memory clinic. We determined whether serum IGF-I concentrations at baseline were associated with the risk of all-cause dementia, AD, or VaD. Patients developing mixed forms of AD and VaD were defined as suffering from VaD. The statistical analyses included Cox proportional hazards regression analysis. During the follow-up (mean 3.6 years), 95 (28%) of the patients developed all-cause dementia [AD, n=37 (11%) and VaD, n=42 (12%)]. Low as well as high serum IGF-I (quartile 1 or 4 vs. quartiles 2-3) did not associate with all-cause dementia [crude hazard ratio (HR) 1.30, 95% confidence interval (CI): 0.81-2.08 and crude HR 1.05, 95% CI: 0.63-1.75, respectively] or AD (crude HR 0.79, 95% CI: 0.35-1.79 and crude HR 0.94, 95% CI: 0.43-2.06, respectively]. In contrast, low serum IGF-I concentrations were associated with increased risk of VaD (quartile 1 vs. quartiles 2-3, crude HR 2.22, 95% CI: 1.13-4.36). The latter association remained significant also after adjustment for multiple covariates. In a memory clinic population, low serum IGF-I was a risk marker for subsequent VaD whereas low IGF-I did not associate with the risk of AD. High serum IGF-I was not related to the risk of conversion to dementia. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. 77 FR 64596 - Proposed Information Collection (Income Verification) Activity: Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-22

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0518] Proposed Information Collection (Income... to income- dependent benefits. DATES: Written comments and recommendations on the proposed collection... techniques or the use of other forms of information technology. Title: Income Verification, VA Form 21-0161a...

  1. 38 CFR 21.1030 - Claims.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... forms include: (i) DA Form 2171, Request for Tuition Assistance-Army Continuing Education System; (ii... REHABILITATION AND EDUCATION Claims and Applications for Educational Assistance Claims § 21.1030 Claims. (a... administered by VA for pursuit of a program of education, he or she must file an application for educational...

  2. Thulium laser VapoResection of the prostate versus traditional transurethral resection of the prostate or transurethral plasmakinetic resection of prostate for benign prostatic obstruction: a systematic review and meta-analysis.

    PubMed

    Deng, Zheng; Sun, Menghao; Zhu, Yiping; Zhuo, Jian; Zhao, Fujun; Xia, Shujie; Han, Bangmin; Herrmann, Thomas R W

    2018-04-12

    To compare the efficacy and safety of thulium laser VapoResection of the prostate (ThuVaRP) versus standard traditional transurethral resection of the prostate (TURP) or plasmakinetic resection of prostate (PKRP) for benign prostatic obstruction. Systematic searches were performed in the Medline, EMBASE, the Cochrane Library, Web of Science, and CNKI in December 2017. The outcomes of demographic and clinical characteristics, perioperative variables, complications, and postoperative efficacy including International Prostate Symptom Score (IPSS), quality of life (QoL), maximum flow rate (Qmax), and postvoid residual (PVR) were assessed. 16 studies were selected in the meta-analysis including nine randomized controlled trials (RCTs) and seven non-RCTs. Among of them, nine studies compared ThuVaRP with PKRP, while seven studies compared ThuVaRP with TURP. It seemed that ThuVaRP needed longer operation time than TURP (WMD = 6.41, 95% CI 1.38-11.44, p = 0.01) and PKRP (WMD = 10.15, 95% CI 5.20-15.10, p < 0.0001). ThuVaRP was associated with less serum hemoglobin decreased, catheterization time, and the length of hospital stay compared with TURP (WMD = - 0.58, 95% CI - 0.77 to 0.38, p < 0.00001; WMD = - 1.89, 95% CI - 2.67 to 1.11, p < 0.00001; WMD = - 2.25, 95% CI - 2.91 to 1.60, p < 0.00001) and PKRP (WMD = - 0.28, 95% CI - 0.46 to 0.10, p = 0.002; WMD = - 1.88, 95% CI - 2.87 to 0.89, p = 0.0002; WMD = - 2.08, 95% CI - 2.63 to 1.54, p<0.00001). According to our assessment, there was no significantly difference in postoperative efficacy. The pooled data indicated that ThuVaRP had a nearly efficacy to TURP and PKRP based on IPSS, QoL, Qmax, and PVR. Although ThuVaRP was associated with longer operation time, it got distinct superiority on serum hemoglobin decreased, catheterization time, and hospital stay.

  3. Designing Futuristic Nursing Programs. Highlights of the Workshop, Chiefs, Nursing Service (Bethesda, Maryland, November 10-14, 1975).

    ERIC Educational Resources Information Center

    Veterans Administration, Washington, DC. Dept. of Medicine and Surgery.

    Major contents of this report are the four major presentations made at a workshop designed to give 200 nursing service chiefs a uniform approach for upgrading and expanding skills and knowledge relevant to achieving the mission of the Veterans Administration (VA) Nursing Service. "Facing the Future" focuses on the VA Nursing Service as…

  4. 75 FR 3787 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-22

    ...The Privacy Act of 1974 (5 U.S.C. 552(e) (4)) requires that all agencies publish in the Federal Register a notice of the existence and character of their systems of records. Notice is hereby given that the Department of Veterans Affairs (VA) is establishing a new system of records entitled ``All Employee Survey'' (160VA10A2).

  5. Production of Ethanol From Newly Developed and Improved Winter Barley Cultivars.

    PubMed

    Nghiem, Nhuan P; Brooks, Wynse S; Griffey, Carl A; Toht, Matthew J

    2017-05-01

    Winter barley has attracted strong interest as a potential feedstock for fuel ethanol production in regions with mild winter climate such as the mid-Atlantic and northeastern USA. Ten recently developed and improved winter barley cultivars and breeding lines including five hulled and five hull-less lines were experimentally evaluated for potential ethanol production. The five hulled barley lines included three released cultivars (Thoroughbred, Atlantic, and Secretariat) and two breeding lines (VA09B-34 and VA11B-4). The five hull-less lines also included three released cultivars (Eve, Dan, and Amaze 10) and two breeding lines (VA08H-65 and VA13H-34). On the average, the hull-less barley cultivars produced more ethanol per unit mass because of their higher starch and β-glucan contents. However, since the hulled barley cultivars had higher agronomic yield, the potential ethanol production per acre of land for the two types were approximately equal. Among the ten cultivars tested, the hull-less cultivar Amaze 10 was the best one for ethanol production. The ethanol yield values obtained for this cultivar were 2.61 gal per bushel and 292 gal per acre.

  6. Estimating Drug Costs: How do Manufacturer Net Prices Compare with Other Common US Price References?

    PubMed

    Mattingly, T Joseph; Levy, Joseph F; Slejko, Julia F; Onwudiwe, Nneka C; Perfetto, Eleanor M

    2018-05-12

    Drug costs are frequently estimated in economic analyses using wholesale acquisition cost (WAC), but what is the best approach to develop these estimates? Pharmaceutical manufacturers recently released transparency reports disclosing net price increases after accounting for rebates and other discounts. Our objective was to determine whether manufacturer net prices (MNPs) could approximate the discounted prices observed by the U.S. Department of Veterans Affairs (VA). We compared the annual, average price discounts voluntarily reported by three pharmaceutical manufacturers with the VA price for specific products from each company. The top 10 drugs by total sales reported from company tax filings for 2016 were included. The discount observed by the VA was determined from each drug's list price, reported as WAC, in 2016. Descriptive statistics were calculated for the VA discount observed and a weighted price index was calculated using the lowest price to the VA (Weighted VA Index), which was compared with the manufacturer index. The discounted price as a percentage of the WAC ranged from 9 to 74%. All three indexes estimated by the average discount to the VA were at or below the manufacturer indexes (42 vs. 50% for Eli Lilly, 56 vs. 65% for Johnson & Johnson, and 59 vs. 59% for Merck). Manufacturer-reported average net prices may provide a close approximation of the average discounted price granted to the VA, suggesting they may be a useful proxy for the true pharmacy benefits manager (PBM) or payer cost. However, individual discounts for products have wide variation, making a standard discount adjustment across multiple products less acceptable.

  7. Blood pressure at age 60-65 versus age 70-75 and vascular dementia: a population based observational study.

    PubMed

    Peng, Mingkai; Chen, Guanmin; Tang, Karen L; Quan, Hude; Smith, Eric E; Faris, Peter; Hachinski, Vladimir; Campbell, Norm R C

    2017-10-27

    Vascular dementia (VaD) is the second most common form of dementia. However, there were mixed evidences about the association between blood pressure (BP) and risk of VaD in midlife and late life and limited evidence on the association between pulse pressure and VaD. This is a population-based observational study. 265,897 individuals with at least one BP measurement between the ages of 60 to 65 years and 211,116 individuals with at least one BP measurement between the ages of 70 to 75 years were extracted from The Health Improvement Network in United Kingdom. Blood pressures were categorized into four groups: normal, prehypertension, stage 1 hypertension, and stage 2 hypertension. Cases of VaD were identified from the recorded clinical diagnoses. Multivariable survival analysis was used to adjust other confounders and competing risk of death. All the analysis were stratified based on antihypertensive drug use status. Multiple imputation was used to fill in missing values. After accounting for the competing risk of death and adjustment for potential confounders, there was an association between higher BP levels in the age 60-65 cohort with the risk of developing VaD (hazard ratio [HR] 1.53 (95% confidence interval: 1.04, 2.25) for prehypertension, 1.90 (1.30, 2.78) for stage 1 hypertension, and 2.19 (1.48, 3.26) for stage 2 hypertension) in the untreated group. There was no statistically significant association between BP levels and VaD in the treated group in the age 60-65 cohort and age 70-75 cohort. Analysis on Pulse Pressure (PP) stratified by blood pressure level showed that PP was not independently associated with VaD. High BP between the ages of 60 to 65 years is a significant risk for VaD in late midlife. Greater efforts should be placed on early diagnosis of hypertension and tight control of BP for hypertensive patients for the prevention of VaD.

  8. Structural basis of cargo recognitions for class V myosins

    PubMed Central

    Wei, Zhiyi; Liu, Xiaotian; Yu, Cong; Zhang, Mingjie

    2013-01-01

    Class V myosins (MyoV), the most studied unconventional myosins, recognize numerous cargos mainly via the motor’s globular tail domain (GTD). Little is known regarding how MyoV-GTD recognizes such a diverse array of cargos specifically. Here, we solved the crystal structures of MyoVa-GTD in its apo-form and in complex with two distinct cargos, melanophilin and Rab interacting lysosomal protein-like 2. The apo-MyoVa-GTD structure indicates that most mutations found in patients with Griscelli syndrome, microvillus inclusion disease, or cancers or in “dilute” rodents likely impair the folding of GTD. The MyoVa-GTD/cargo complex structure reveals two distinct cargo-binding surfaces, one primarily via charge–charge interaction and the other mainly via hydrophobic interactions. Structural and biochemical analysis reveal the specific cargo-binding specificities of various isoforms of mammalian MyoV as well as very different cargo recognition mechanisms of MyoV between yeast and higher eukaryotes. The MyoVa-GTD structures resolved here provide a framework for future functional studies of vertebrate class V myosins. PMID:23798443

  9. Hypertension and vascular dementia in the elderly: the potential role of anti-hypertensive agents.

    PubMed

    Coca, Antonio

    2013-09-01

    Vascular dementia (VaD) - a severe form of vascular cognitive impairment - and cognitive decline are associated with hypertension and therefore it seems logical to consider that reducing BP with anti-hypertensive therapy may protect against the development/onset of cognitive function impairment or dementia. This narrative, non-systematic review discusses the available evidence on the potential correlation between the use of anti-hypertensive agents and the risk of VaD and cognitive decline. MEDLINE was searched for inclusion of relevant studies. No limitations in time were considered. A consensus on the potential effects of anti-hypertensive treatment in the reduction of VaD and associated cognitive decline has not been reached. A protective effect of anti-hypertensive agents has been observed in a number of studies although it is still unclear whether different classes of anti-hypertensive agents have a different effect on the development of VaD. The protective effect of anti-hypertensive agents appears to depend on the specific drug used - positive effects have been observed with calcium channel blockers (CCBs), such as lercanidipine and nitrendipine, the combination perindopril-indapamide and telmisartan.

  10. 75 FR 34178 - Investigations Regarding Certifications of Eligibility To Apply for Worker Adjustment Assistance

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-16

    ..., OR...... 05/25/10 05/24/10. (Workers). 74137 SPS Technologies Cleveland, OH...... 05/25/10 05/24/10.../10. (Workers). 74146 Furniture Crafters of Collinsville, VA... 05/25/10 05/14/10. Virginia (Workers...

  11. Population mental health among U.S. military veterans: results of the Veterans Health Module of the Behavioral Risk Factor Surveillance System, 2011-2012.

    PubMed

    Blosnich, John R; Brenner, Lisa A; Bossarte, Robert M

    2016-08-01

    To examine mental health indicators, in aggregate and stratified by sex, among a population-based sample of U.S. military veterans. Data are from veteran who completed the Veterans Health Module (VHM) of the 2011 and 2012 Behavioral Risk Factor Surveillance System (n = 10,406). VHM items included lifetime diagnoses of mental illnesses, service in a combat zone, sources of mental health care, and past 12-month suicidal ideation and attempt. We used weighted, multiple logistic regression models, adjusted for sociodemographics, to examine differences in suicidal ideation and attempt among men and women. Overall, 5.0% of the sample reported recent suicidal ideation and 1.0% reported attempting suicide. Among men, unemployment was positively associated with suicidal ideation, and combat exposure was negatively associated with suicidal ideation. Being separated, divorced, or widowed was positively associated with suicidal ideation among women. After adjusting for sociodemographic and VHM variables, veterans who sought mental health treatment from both Veterans Affairs (VA) and non-VA facilities had more than fourfold increased odds of suicidal ideation than veteran who sought mental health treatment from only VA facilities (adjusted odds ratio = 4.02; 95% confidence interval 1.23-13.13). Correlates of suicidal ideation differ between male and female veterans. Veterans who use both non-VA and VA facilities for mental health services may have greater risk of self-directed violence. Published by Elsevier Inc.

  12. 78 FR 69747 - Proposed Information Collection (Designation of Certifying Official(s)); Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-20

    ... individuals authorized to certify reports on behalf of an educational institution or job training... of automated collection techniques or the use of other forms of information technology. Titles: a... collection. Abstracts: a. Educational institutions and job training establishments complete VA Form 22-8794...

  13. 78 FR 36642 - Proposed Information Collection (Statement of Dependency of Parent(s)) Activity: Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-18

    ... (Statement of Dependency of Parent(s)) Activity: Comment Request AGENCY: Veterans Benefits Administration... claimant's parents' dependency. DATES: Written comments and recommendations on the proposed collection of... use of other forms of information technology. Title: Statement of Dependency of Parent(s), VA Form 21...

  14. 75 FR 61251 - Proposed Information Collection (Statement of Dependency of Parent(s)) Activity: Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-04

    ... (Statement of Dependency of Parent(s)) Activity: Comment Request AGENCY: Veterans Benefits Administration... claimant's parents' dependency. DATES: Written comments and recommendations on the proposed collection of... use of other forms of information technology. Title: Statement of Dependency of Parent(s), VA Form 21...

  15. 76 FR 67558 - Proposed Information Collection (Application for Work-Study Allowance) Activity: Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-01

    ... (Application for Work-Study Allowance) Activity: Comment Request AGENCY: Veterans Benefits Administration... claimant's eligibility for work-study benefits. DATES: Written comments and recommendations on the proposed... use of other forms of information technology. Titles: a. Application for Work-Study Allowance, VA Form...

  16. 76 FR 15050 - Proposed Information Collection (Certification of School Attendance or Termination) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-18

    ... (Certification of School Attendance or Termination) Activity: Comment Request AGENCY: Veterans Benefits... through the use of automated collection techniques or the use of other forms of information technology. Title: Certification of School Attendance or Termination, VA Forms 21-8960 and 21-8960-1. OMB Control...

  17. 76 FR 60134 - Agency Information Collection (Child Care Subsidy) Activity Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-28

    ... Care Subsidy) Activity Under OMB Review AGENCY: Human Resources and Administration, Department of....gov . Please refer to ``OMB Control No. 2900-0717.'' SUPPLEMENTARY INFORMATION: Titles a. Child Care Subsidy Application Form, VA Form 0730a. b. Child Care Provider Information (For the Child Care Subsidy...

  18. Forecasting VaR and ES of stock index portfolio: A Vine copula method

    NASA Astrophysics Data System (ADS)

    Zhang, Bangzheng; Wei, Yu; Yu, Jiang; Lai, Xiaodong; Peng, Zhenfeng

    2014-12-01

    Risk measurement has both theoretical and practical significance in risk management. Using daily sample of 10 international stock indices, firstly this paper models the internal structures among different stock markets with C-Vine, D-Vine and R-Vine copula models. Secondly, the Value-at-Risk (VaR) and Expected Shortfall (ES) of the international stock markets portfolio are forecasted using Monte Carlo method based on the estimated dependence of different Vine copulas. Finally, the accuracy of VaR and ES measurements obtained from different statistical models are evaluated by UC, IND, CC and Posterior analysis. The empirical results show that the VaR forecasts at the quantile levels of 0.9, 0.95, 0.975 and 0.99 with three kinds of Vine copula models are sufficiently accurate. Several traditional methods, such as historical simulation, mean-variance and DCC-GARCH models, fail to pass the CC backtesting. The Vine copula methods can accurately forecast the ES of the portfolio on the base of VaR measurement, and D-Vine copula model is superior to other Vine copulas.

  19. Veterans’ Pensions: Verifying Income with Tax Data Can Identify Significant Payment Problems.

    DTIC Science & Technology

    1988-03-01

    NOT RETURN THE COMPLETED FORM TO THE VA BY DC 1, -1’on YOUR BENEFITS WILL BE DISCONTINUEr IMPOPTA -Pless. read the inclosO Evp IsuctIos (VA Porn 2 1...physically or mentally helpless before age 18. If you have unmarried children in any of these categories. show the number of such children. If a child is...away at school but still a member of your household, consider that child to be IN YOUR CUSTODY It you have no dependent children show Ŕ". 2. INCOME

  20. Persistence of an intact endometrial matrix and vessels structure in women exposed to VA-2914, a selective progesterone receptor modulator.

    PubMed

    Ravet, S; Munaut, C; Blacher, S; Brichant, G; Labied, S; Beliard, A; Chabbert-Buffet, N; Bouchard, P; Foidart, J-M; Pintiaux, A

    2008-11-01

    VA-2914 is a selective progesterone receptor modulator with potential contraceptive activity that induces amenorrhea, whereas progestins cause endometrial spotting and bleeding. This abnormal bleeding due to progestins is a consequence of focal stromal proteolysis by an increase in naked vessel size and density. Our objective was to quantify the effects of VA-2914 on endometrial vascularization, fibrillar matrix, and vascular endothelial growth factor (VEGF)-A expression in endometrial biopsies from 41 women before and after 12 wk daily treatment with a placebo, or 2.5, 5, or 10 mg VA-2914. Collagen fibrillar network was stained by silver impregnation. Vessel area, density, and structure were quantified with a computer-assisted image analysis system after double immunostaining using an anti-von Willebrand factor (endothelial cells) and an anti-alpha smooth muscle actin (vascular smooth muscle cells) marker antibody. VEGF-A mRNAs were quantified by RT-PCR and localized by immunohistochemistry. The endometrial vessels, collagen network, and mRNA levels of VEGF-A were identical during the luteal phase at baseline and in VA-2914 treated women. VEGF-A distribution was unchanged. VA-2914 does not alter the endometrial matrix and cells, and does not modify the endometrial vessel morphology as compared with baseline biopsies.

  1. Longitudinal Changes in Visual Acuity and Health Related Quality of Life. The Los Angeles Latino Eye Study

    PubMed Central

    McKean-Cowdin, Roberta; Varma, Rohit; Hays, Ron D.; Wu, Joanne; Choudhury, Farzana; Azen, Stanley P.

    2010-01-01

    Purpose To examine the association between longitudinal changes in visual acuity (VA) and Health Related Quality of Life (HRQOL) in a population-based sample of adult Latinos. Design A population-based cohort study of eye disease in Latinos. Participants 3,169 adult Latino participants who live in the city of La Puente, California. Methods Data for these analyses were collected for the Los Angeles Latino Eye Study (LALES). Distance visual acuity (VA) was measured during a detailed ophthalmologic examination using the standard Early Treatment Diabetic Retinopathy Study protocol at baseline and a 4 year follow-up examination. HRQOL was assessed by the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) and the Medical Outcomes Study 12-Item Short-Form Health Survey version 1 (SF-12 v.1). Main Outcome Measures Mean differences in HRQOL composite and subscale scores between baseline and follow-up were calculated for 3,169 participants with complete clinical examination and HRQOL data at both time points. Mean differences and effect sizes (ES) for NEI-VFQ and SF-12 v.1 scores were calculated for 3 categories of VA change over the 4 year follow-up period (VA improved ≥ 2 lines, no change in VA or −2

  2. High Electromechanical Response of Ionic Polymer Actuators with Controlled-Morphology Aligned Carbon Nanotube/Nafion Nanocomposite Electrodes

    PubMed Central

    Liu, Sheng; Liu, Yang; Cebeci, Hülya; de Villoria, Roberto Guzmán; Lin, Jun-Hong

    2011-01-01

    Recent advances in fabricating controlled-morphology vertically aligned carbon nanotubes (VA-CNTs) with ultrahigh volume fraction create unique opportunities for markedly improving the electromechanical performance of ionic polymer conductor network composite (IPCNC) actuators. Continuous paths through inter-VA-CNT channels allow fast ion transport, and high electrical conduction of the aligned CNTs in the composite electrodes lead to fast device actuation speed (>10% strain/second). One critical issue in developing advanced actuator materials is how to suppress the strain that does not contribute to the actuation (unwanted strain) thereby reducing actuation efficiency. Here our experiments demonstrate that the VA-CNTs give an anisotropic elastic response in the composite electrodes, which suppresses the unwanted strain and markedly enhances the actuation strain (>8% strain under 4 volts). The results reported here suggest pathways for optimizing the electrode morphology in IPCNCs using ultra-high volume fraction VA-CNTs to further enhanced performance. PMID:21765822

  3. Neuropsychiatric Symptoms in Alzheimer Disease, Vascular Dementia, and Mixed Dementia.

    PubMed

    Anor, Cassandra J; O'Connor, Sean; Saund, Amardeep; Tang-Wai, David F; Keren, Ron; Tartaglia, Maria Carmela

    2017-01-01

    Neuropsychiatric symptoms (NPS) are common in Alzheimer disease (AD) and vascular dementia (VaD), and are distressful to patients and caregivers. NPS are likely related to the underlying pathology. Previous studies suggest that frontal lobe lesions and vascular changes such as white matter hyperintensities (WMH) have a significant association with specific NPS. The current study aimed to compare NPS in patients with AD, VaD, and mixed AD/VaD, and to evaluate the differences in the prevalence of NPS in relation to frontal WMH volume. In total, 180 patients with NPS and MRI data (92 probable AD, 51%; 34 probable VaD, 19%; and 54 probable mixed AD/VaD, 30%) were included in the study. Regression analyses were performed to determine the relationships between NPS prevalence and diagnosis, and between NPS and frontal WMH. VaD patients had significantly more agitation (p < 0.05; 40 vs. 14%) and sleep disturbances (p < 0.05; 57 vs. 32%) than AD patients, and significantly more depression (p < 0.05; 48 vs. 20%) and aberrant motor behaviors (p < 0.05; 31 vs. 13%) than mixed AD/VaD patients. AD patients with delusions had significantly greater right frontal WMH volumes than those without (p < 0.05; delusions 1/0 = 314.8/112.6 mm3). Differences in NPS prevalence are likely related to the underlying pathology and warrant further study as they have implications for treatment. © 2017 S. Karger AG, Basel.

  4. Assessment of cardiovascular risk and vascular age in overweight/obese adults with primary hypertension: the EXERDIET-HTA study.

    PubMed

    Gorostegi-Anduaga, Ilargi; Pérez-Asenjo, Javier; Aispuru, Gualberto Rodrigo; Fryer, Simon M; Alonso-Colmenero, Ainara; Romaratezabala, Estíbaliz; Maldonado-Martín, Sara

    2017-06-01

    Hypertension (HTN), obesity and low cardiorespiratory fitness (CRF) are associated with an increased risk for a cardiovascular event. Enrolling overweight/obese individuals with HTN, the current study aimed to estimate cardiovascular risk (CVR) and vascular age (VA) profiles analyzing potential sex differences, determine whether VA is higher than chronological age, and whether CVR is associated with a low level of CRF. Overweight/obese non-Hispanic White participants (n=209; 141 men and 68 women) with primary HTN had their CVR and VA determined using the New Pooled Cohort Risk Equations and The Framingham method, respectively. Considering values of peak oxygen uptake, participants were divided into tertiles for each sex. The CVR, but not VA (P=0.339), was higher (P<0.001) in men compared with women irrespective of age. Irrespective of sex, VA was higher than chronological age (P<0.001). Age and BMI were higher (P<0.05) in the low CRF group compared with that in other groups. There were no differences in CVR (P=0.907) and VA (P=1.643) when values were separated into CRF groups. Pooled Cohort Equations could underestimate the risk of suffering a cardiovascular event in the following 10 years in overweight/obese non-Hispanic White women with HTN compared with men. The VA appears to be a useful tool in communicating CVR in this population irrespective of sex. The CRF alone may not be enough to moderate the CVR.

  5. Macrovascular Decompression of Facial Nerve With Anteromedial Transposition of a Dolichoectatic Vertebral Artery: 3-Dimensional Operative Video.

    PubMed

    Tabani, Halima; Yousef, Sonia; Burkhardt, Jan-Karl; Gandhi, Sirin; Benet, Arnau; Lawton, Michael T

    2018-05-21

    Most cranial nerve compression syndromes (ie, trigeminal neuralgia and hemifacial spasm) are caused by small arteries impinging on a nerve and are relieved by microvascular decompression. Rarely, cranial nerve compression syndromes can be caused by large artery impingement and can be relieved by macrovascular decompression. When present, this compression often occurs in association with degenerative atherosclerosis in the vertebral arteries (VA) and basilar artery. Conservative treatment is recommended for mild forms, but surgical transposition of the VA away from the root entry zone (REZ) can be considered. This video demonstrates macrovascular decompression of a dolichoectatic VA in a 74-yr-old female with refractory left hemifacial spasm. After obtaining IRB approval, patient consent was sought for the procedure. With the patient in three-quarter-prone position, a far-lateral craniotomy was performed. The dentate ligament was cut to free the VA, and the suprahypoglossal portion of the vagoaccessory triangle was widened. VA compressed the REZ of the facial nerve, but was mobilized anteromedially off the REZ. A muslin sling was wrapped around the VA and its tail brought down to the clival dura, which was punctured with a 19-gauge needle and enlarged with a dissector. The sling was pulled anteromedially to this puncture site and secured to the dura with an aneurysm clip, relieving the REZ of all compression. The patient tolerated the procedure with mild, transient hoarseness and her hemifacial spasm resolved completely. This case demonstrates the macrovascular decompression technique with anteromedial transposition of the vertebrobasilar artery, which can also be used for trigeminal neuralgia.

  6. Improvement of visual acuity in children with anisometropic amblyopia treated with rotated prisms combined with near activity

    PubMed Central

    Lin, Chao-Chyun; Chen, Po-Liang

    2013-01-01

    AIM To evaluate the efficacy of a new modality for improving visual acuity (VA) in pediatric patients with anisometropic amblyopia. METHODS Retrospective and interventional case series. Medical records of 360 children with anisometropic amblyopia treated with a modality that included rotated prisms, lenses, and near activities from January 2008 to January 2012 were analyzed. Characteristics such as improvement of VA and contrast sensitivity in amblyopic eyes and resolution of amblyopia (VA ≤0.1logMAR or a difference of ≤2 lines in logMAR between the eyes) were assessed. RESULTS Among the patients, the mean VA of the amblyopic eyes improved from 0.48logMAR (SD=0.16) to 0.12logMAR (SD=0.16) and the mean VA improvement was 0.36logMAR (SD=0.10, P<0.001). Resolution of amblyopia was achieved in 233 of 360 patients (64.72%). The mean time for resolution of amblyopia was 8.05 weeks (SD=4.83) or 14.14 sessions (SD=8.76). Among the study group, refraction error did not change significantly after treatment (P=0.437). We found that better baseline VA may be related to success and shorten the time to amblyopic resolution. CONCLUSION VA and contrast sensitivity improved with rotated prisms, correcting lenses, and near activities in children with anisometropic amblyopia. The VA improvement by this modality was comparable to other methods. However, the time to resolution of amblyopia was shorter with this method than with other modalities. Rotated prisms combined with near acuity could provide an alternative treatment in children with anisometropic amblyopia who can't tolerant traditional therapy method like patching. PMID:23991384

  7. Exploring the role narrative free-text plays in discrepancies between physician coding and the InterVA regarding determination of malaria as cause of death, in a malaria holo-endemic region

    PubMed Central

    2012-01-01

    Background In countries where tracking mortality and clinical cause of death are not routinely undertaken, gathering verbal autopsies (VA) is the principal method of estimating cause of death. The most common method for determining probable cause of death from the VA interview is Physician-Certified Verbal Autopsy (PCVA). A recent alternative method to interpret Verbal Autopsy (InterVA) is a computer model using a Bayesian approach to derive posterior probabilities for causes of death, given an a priori distribution at population level and a set of interview-based indicators. The model uses the same input information as PCVA, with the exception of narrative text information, which physicians can consult but which were not inputted into the model. Comparing the results of physician coding with the model, large differences could be due to difficulties in diagnosing malaria, especially in holo-endemic regions. Thus, the aim of the study was to explore whether physicians' access to electronically unavailable narrative text helps to explain the large discrepancy in malaria cause-specific mortality fractions (CSMFs) in physician coding versus the model. Methods Free-texts of electronically available records (N = 5,649) were summarised and incorporated into the InterVA version 3 (InterVA-3) for three sub-groups: (i) a 10%-representative subsample (N = 493) (ii) records diagnosed as malaria by physicians and not by the model (N = 1035), and (iii) records diagnosed by the model as malaria, but not by physicians (N = 332). CSMF results before and after free-text incorporation were compared. Results There were changes of between 5.5-10.2% between models before and after free-text incorporation. No impact on malaria CSMFs was seen in the representative sub-sample, but the proportion of malaria as cause of death increased in the physician sub-sample (2.7%) and saw a large decrease in the InterVA subsample (9.9%). Information on 13/106 indicators appeared at least once in the free-texts that had not been matched to any item in the structured, electronically available portion of the Nouna questionnaire. Discussion Free-texts are helpful in gathering information not adequately captured in VA questionnaires, though access to free-text does not explain differences in physician and model determination of malaria as cause of death. PMID:22353802

  8. Exploring the role narrative free-text plays in discrepancies between physician coding and the InterVA regarding determination of malaria as cause of death, in a malaria holo-endemic region.

    PubMed

    Rankin, Johanna C; Lorenz, Eva; Neuhann, Florian; Yé, Maurice; Sié, Ali; Becher, Heiko; Ramroth, Heribert

    2012-02-21

    In countries where tracking mortality and clinical cause of death are not routinely undertaken, gathering verbal autopsies (VA) is the principal method of estimating cause of death. The most common method for determining probable cause of death from the VA interview is Physician-Certified Verbal Autopsy (PCVA). A recent alternative method to interpret Verbal Autopsy (InterVA) is a computer model using a Bayesian approach to derive posterior probabilities for causes of death, given an a priori distribution at population level and a set of interview-based indicators. The model uses the same input information as PCVA, with the exception of narrative text information, which physicians can consult but which were not inputted into the model. Comparing the results of physician coding with the model, large differences could be due to difficulties in diagnosing malaria, especially in holo-endemic regions. Thus, the aim of the study was to explore whether physicians' access to electronically unavailable narrative text helps to explain the large discrepancy in malaria cause-specific mortality fractions (CSMFs) in physician coding versus the model. Free-texts of electronically available records (N = 5,649) were summarised and incorporated into the InterVA version 3 (InterVA-3) for three sub-groups: (i) a 10%-representative subsample (N = 493) (ii) records diagnosed as malaria by physicians and not by the model (N = 1035), and (iii) records diagnosed by the model as malaria, but not by physicians (N = 332). CSMF results before and after free-text incorporation were compared. There were changes of between 5.5-10.2% between models before and after free-text incorporation. No impact on malaria CSMFs was seen in the representative sub-sample, but the proportion of malaria as cause of death increased in the physician sub-sample (2.7%) and saw a large decrease in the InterVA subsample (9.9%). Information on 13/106 indicators appeared at least once in the free-texts that had not been matched to any item in the structured, electronically available portion of the Nouna questionnaire. Free-texts are helpful in gathering information not adequately captured in VA questionnaires, though access to free-text does not explain differences in physician and model determination of malaria as cause of death.

  9. Lightweight, high-frequency transformers

    NASA Technical Reports Server (NTRS)

    Schwarze, G. E.

    1983-01-01

    The 25-kVA space transformer was developed under contract by Thermal Technology Laboratory, Buffalo, N. Y. The NASA Lewis transformer technology program attempted to develop the baseline technology. For the 25-kVA transformer the input voltage was chosen as 200 V, the output voltage as 1500 V, the input voltage waveform as square wave, the duty cycle as continuous, the frequency range (within certain constraints) as 10 to 40 kHz, the operating temperatures as 85 deg. and 130 C, the baseplate temperature as 50 C, the equivalent leakage inductance as less than 10 micro-h, the operating environment as space, and the life expectancy as 10 years. Such a transformer can also be used for aircraft, ship and terrestrial applications.

  10. Prevalence of refractive errors in children in Equatorial Guinea.

    PubMed

    Soler, Margarita; Anera, Rosario G; Castro, José J; Jiménez, Raimundo; Jiménez, José R

    2015-01-01

    The aim of this work is to evaluate the epidemiological aspects of the refractive errors in school-aged children in Malabo (Island of Bioko), Equatorial Guinea (western-central Africa). A total of 425 schoolchildren (209 male subjects and 216 female subjects, aged between 6 and 16 years) were examined to evaluate their refraction errors in Malabo, Equatorial Guinea (western-central Africa). The examination included autorefraction with cycloplegia, measurement of visual acuity (VA) for far vision, and the curvature radii of the main meridians of the anterior surface of the cornea. A low prevalence of myopia was found (≤-0.50 diopters [D] spherical equivalent), with unilateral and bilateral myopia being 10.4 and 5.2%, respectively. The prevalence of unilateral and bilateral hypermetropia (≥2.0 D spherical equivalent) was 3.1 and 1.6%, respectively. Astigmatism (≤-0.75 D) was found in unilateral form in 32.5% of these children, whereas bilateral astigmatism was found in 11.8%. After excluding children having any ocular pathology, the low prevalence of high refractive errors signified good VA in these children. Significant differences were found in the distribution of the refractive errors by age and type of schooling (public or private) but not by sex. In general, the radii of the anterior of the cornea did not vary significantly with age. The mean refractive errors found were low and therefore VA was high in these children. There was a low prevalence of myopia, with significantly higher values in those who attended private schools (educationally and socioeconomically more demanding). Astigmatism was the most frequent refractive error.

  11. Alzheimer disease with cerebrovascular disease and vascular dementia: clinical features and course compared with Alzheimer disease.

    PubMed

    Bruandet, A; Richard, F; Bombois, S; Maurage, C A; Deramecourt, V; Lebert, F; Amouyel, P; Pasquier, F

    2009-02-01

    Vascular dementia (VaD) and Alzheimer disease with cerebrovascular disease (AD+CVD) are the leading causes of dementia after Alzheimer disease alone (AD). Little is known about the progression of either VaD or AD+CVD. The aim of this study was to compare demographic features, cognitive decline and survival of patients with VaD, AD+CVD and AD alone attending a memory clinic. This study included 970 patients who were followed at the Lille-Bailleul memory clinic, France. Cognitive functions were measured with the Mini Mental State Examination (MMSE) and the Dementia Rating Scale (DRS). Survival rate was analysed with a left-truncated Cox model. Analyses were adjusted for age, sex, education, hypertension, diabetes and baseline MMSE and DRS. Of 970 patients, 141 had VaD, 663 AD alone and 166 AD+CVD. The latter were significantly older than AD or VaD patients at onset (71 (SD 7) vs 69 (9) and 68 (9) years, p = 0.01) and at first visit (75 (6) vs 73 (8) and 72 (8) years, p = 0.0002). Baseline MMSE and DRS evaluations were highest for VaD compared with AD alone or AD+CVD patients (p<0.006). Cognitive decline during follow-up was slowest for VaD, intermediate for AD+CVD and fastest for AD alone (p = 0.03). After adjustment, compared with AD patients, mortality risk was similar for those with VaD (relative mortality risk (RR) = 0.7 (0.5 to 1.1)) and tended to be lower for AD+CVD (RR = 0.7 (0.5 to 1.0)). The shorter the delay between first symptoms and first visit, the longer patients survived. This clinical cohort study shows that patients with VaD, AD+CVD and AD present different characteristics at baseline and during follow-up, and underlines the need to distinguish between them.

  12. Crowded letter and crowded picture logMAR acuity in children with amblyopia: a quantitative comparison.

    PubMed

    O'Boyle, Cathy; Chen, Sean I; Little, Julie-Anne

    2017-04-01

    Clinically, picture acuity tests are thought to overestimate visual acuity (VA) compared with letter tests, but this has not been systematically investigated in children with amblyopia. This study compared VA measurements with the LogMAR Crowded Kay Picture test to the LogMAR Crowded Keeler Letter acuity test in a group of young children with amblyopia. 58 children (34 male) with amblyopia (22 anisometropic, 18 strabismic and 18 with both strabismic/anisometropic amblyopia) aged 4-6 years (mean=68.7, range=48-83 months) underwent VA measurements. VA chart testing order was randomised, but the amblyopic eye was tested before the fellow eye. All participants wore up-to-date refractive correction. The Kay Picture test significantly overestimated VA by 0.098 logMAR (95% limits of agreement (LOA), 0.13) in the amblyopic eye and 0.088 logMAR (95% LOA, 0.13) in the fellow eye, respectively (p<0.001). No interactions were found from occlusion therapy, refractive correction or type of amblyopia on VA results (p>0.23). For both the amblyopic and fellow eyes, Bland-Altman plots demonstrated a systematic and predictable difference between Kay Picture and Keeler Letter charts across the range of acuities tested (Keeler acuity: amblyopic eye 0.75 to -0.05 logMAR; fellow eye 0.45 to -0.15 logMAR). Linear regression analysis (p<0.00001) and also slope values close to one (amblyopic 0.98, fellow 0.86) demonstrate that there is no proportional bias. The Kay Picture test consistently overestimated VA by approximately 0.10 logMAR when compared with the Keeler Letter test in young children with amblyopia. Due to the predictable difference found between both crowded logMAR acuity tests, it is reasonable to adjust Kay Picture acuity thresholds by +0.10 logMAR to compute expected Keeler Letter acuity scores. 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/.

  13. 76 FR 67558 - Proposed Information Collection (Request for Change of Program or Place of Training) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-01

    ... information needed to determine a claimant's eligibility for continued educational assistance when he or she... use of other forms of information technology. Title: Request for Change of Program or Place of... collection. Abstract: Claimants receiving educational benefits complete VA Form 22-1995 to request a change...

  14. 76 FR 27380 - Proposed Information Collection (Offer To Purchase and Contract of Sale) Activity: Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-11

    ... To Purchase and Contract of Sale) Activity: Comment Request AGENCY: Veterans Benefits Administration... through the use of automated collection techniques or the use of other forms of information technology. Titles a. Offer to Purchase and Contract of Sale, VA Form 26-6705. b. Credit Statement of Prospective...

  15. Compensation: How to Apply

    MedlinePlus

    ... assist them in completing their claims. Claims for Dependency and Indemnity Compensation made by surviving spouses or ... Benefits or VA Form 21-534a, Application for Dependency and Indemnity Compensation by a Surviving Spouse or ...

  16. 75 FR 68037 - Proposed Information Collection (Application for Reinstatement (Insurance Lapsed More Than 6...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-04

    ... Medical--Comparative Health Statement)) Activity: Comment Request AGENCY: Veterans Benefits Administration... Disability Income Provision, VA Form 29-352, and Application for Reinstatement (Non Medical--Comparative...

  17. 75 FR 52066 - Proposed Information Collection (Application for Reinstatement (Insurance Lapsed More than 6...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-24

    ... Medical--Comparative Health Statement)) Activity: Comment Request AGENCY: Veterans Benefits Administration... Disability Income Provision, VA Form 29-352, and Application for Reinstatement (Non Medical--Comparative...

  18. Profile of Prior-Service Accessions to the U.S. (United States) Navy: Fiscal Years 1973-1981.

    DTIC Science & Technology

    1983-04-01

    ORGANIZATION NAME AND ADDRESS 10. PROGRAM ELEMENT. PROJECT. TASK AREA A WORKC UNIT NUMBERS " Institute for Policy Research and Evaluation N-253...research effort aimed at enhancing Navy manpower policy. * *. . . . . . .. - Distribution List Director Technology Programs Office of Naval Research (Code...200) Arlington, VA 22217 Director Research Programs Office of Naval Research (Code 400) Arlington, VA 22217 Manpower, Personnel and Training

  19. Interactions between Leishmania braziliensis and Macrophages Are Dependent on the Cytoskeleton and Myosin Va

    PubMed Central

    Azevedo, Elisama; Oliveira, Leandro Teixeira; Castro Lima, Ana Karina; Terra, Rodrigo; Dutra, Patrícia Maria Lourenço; Salerno, Verônica P.

    2012-01-01

    Leishmaniasis is a neglected tropical disease with no effective vaccines. Actin, microtubules and the actin-based molecular motor myosin Va were investigated for their involvement in Leishmania braziliensis macrophage interactions. Results showed a decrease in the association index when macrophages were without F-actin or microtubules regardless of the activation state of the macrophage. In the absence of F-actin, the production of NO in non-activated cells increased, while in activated cells, the production of NO was reduced independent of parasites. The opposite effect of an increased NO production was observed in the absence of microtubules. In activated cells, the loss of cytoskeletal components inhibited the release of IL-10 during parasite interactions. The production of IL-10 also decreased in the absence of actin or microtubules in non-activated macrophages. Only the disruption of actin altered the production of TNF-α in activated macrophages. The expression of myosin Va tail resulted in an acute decrease in the association index between transfected macrophages and L. braziliensis promastigotes. These data reveal the importance of F-actin, microtubules, and myosin-Va suggesting that modulation of the cytoskeleton may be a mechanism used by L. braziliensis to overcome the natural responses of macrophages to establish infections. PMID:22792440

  20. Interactions between Leishmania braziliensis and Macrophages Are Dependent on the Cytoskeleton and Myosin Va.

    PubMed

    Azevedo, Elisama; Oliveira, Leandro Teixeira; Castro Lima, Ana Karina; Terra, Rodrigo; Dutra, Patrícia Maria Lourenço; Salerno, Verônica P

    2012-01-01

    Leishmaniasis is a neglected tropical disease with no effective vaccines. Actin, microtubules and the actin-based molecular motor myosin Va were investigated for their involvement in Leishmania braziliensis macrophage interactions. Results showed a decrease in the association index when macrophages were without F-actin or microtubules regardless of the activation state of the macrophage. In the absence of F-actin, the production of NO in non-activated cells increased, while in activated cells, the production of NO was reduced independent of parasites. The opposite effect of an increased NO production was observed in the absence of microtubules. In activated cells, the loss of cytoskeletal components inhibited the release of IL-10 during parasite interactions. The production of IL-10 also decreased in the absence of actin or microtubules in non-activated macrophages. Only the disruption of actin altered the production of TNF-α in activated macrophages. The expression of myosin Va tail resulted in an acute decrease in the association index between transfected macrophages and L. braziliensis promastigotes. These data reveal the importance of F-actin, microtubules, and myosin-Va suggesting that modulation of the cytoskeleton may be a mechanism used by L. braziliensis to overcome the natural responses of macrophages to establish infections.

  1. Activation energy-activation volume master plots for ion transport behavior in polymer electrolytes and supercooled molten salts.

    PubMed

    Ingram, Malcolm D; Imrie, Corrie T; Stoeva, Zlatka; Pas, Steven J; Funke, Klaus; Chandler, Howard W

    2005-09-08

    We demonstrate the use of activation energy versus activation volume "master plots" to explore ion transport in typical fragile glass forming systems exhibiting non-Arrhenius behavior. These systems include solvent-free salt complexes in poly(ethylene oxide) (PEO) and low molecular weight poly(propylene oxide) (PPO) and molten 2Ca(NO3)2.3KNO3 (CKN). Plots showing variations in apparent activation energy EA versus apparent activation volume VA are straight lines with slopes given by M = DeltaEA/DeltaVA. A simple ion transport mechanism is described where the rate determining step involves a dilatation (expressed as VA) around microscopic cavities and a corresponding work of expansion (EA). The slopes of the master plots M are equated to internal elastic moduli, which vary from 1.1 GPa for liquid PPO to 5.0 GPa for molten CKN on account of differing intermolecular forces in these materials.

  2. Geologic map of the Middletown quadrangle, Frederick, Shenandoah, and Warren Counties, Virginia

    USGS Publications Warehouse

    Orndorff, Randall C.; Epstein, Jack Burton; McDowell, Robert C.

    1999-01-01

    The Middletown 1:24,000-scale quadrangle is one of several quadrangles in Frederick County, Virginia mapped or being mapped by geologists from the U.S. Geological Survey in Reston, VA with funding from the National Cooperative Geologic Mapping Program. This map was originally published as a paper product in 1999. It has been converted to GIS-based digital form. This work is part of a project being lead by the U.S. Geological Survey Water Resources Discipline, Virginia District, to investigate the geologic framework and groundwater resources of Frederick County as well as other areas in the northern Shenandoah Valley of Virginia and West Virginia. For more information about the Project see: http://geology.er.usgs.gov/eespteam/Karst/index.html for Geologic Discipline efforts and http://va.water.usgs.gov/va134/index.htm for Water Resources Discipline efforts.

  3. Effect of tone mapping operators on visual attention deployment

    NASA Astrophysics Data System (ADS)

    Narwaria, Manish; Perreira Da Silva, Matthieu; Le Callet, Patrick; Pepion, Romuald

    2012-10-01

    High Dynamic Range (HDR) images/videos require the use of a tone mapping operator (TMO) when visualized on Low Dynamic Range (LDR) displays. From an artistic intention point of view, TMOs are not necessarily transparent and might induce different behavior to view the content. In this paper, we investigate and quantify how TMOs modify visual attention (VA). To that end both objective and subjective tests in the form of eye-tracking experiments have been conducted on several still image content that have been processed by 11 different TMOs. Our studies confirm that TMOs can indeed modify human attention and fixation behavior significantly. Therefore our studies suggest that VA needs consideration for evaluating the overall perceptual impact of TMOs on HDR content. Since the existing studies so far have only considered the quality or aesthetic appeal angle, this study brings in a new perspective regarding the importance of VA in HDR content processing for visualization on LDR displays.

  4. Assessment of the reliability of data collected for the Department of Veterans Affairs national surgical quality improvement program.

    PubMed

    Davis, Chester L; Pierce, John R; Henderson, William; Spencer, C David; Tyler, Christine; Langberg, Robert; Swafford, Jennan; Felan, Gladys S; Kearns, Martha A; Booker, Brigitte

    2007-04-01

    The Office of the Medical Inspector of the Department of Veterans Affairs (VA) studied the reliability of data collected by the VA's National Surgical Quality Improvement Program (NSQIP). The study focused on case selection bias, accuracy of reports on patients who died, and interrater reliability measurements of patient risk variables and outcomes. Surgical data from a sample of 15 VA medical centers were analyzed. For case selection bias, reviewers applied NSQIP criteria to include or exclude 2,460 patients from the database, comparing their results with those of NSQIP staff. For accurate reporting of patients who died, reviewers compared Social Security numbers of 10,444 NSQIP records with those found in the VA Beneficiary Identification and Records Locator Subsystem, VA Patient Treatment Files, and Social Security Administration death files. For measurement of interrater reliability, reviewers reabstracted 59 variables in each of 550 patient medical records that also were recorded in the NSQIP database. On case selection bias, the reviewers agreed with NSQIP decisions on 2,418 (98%) of the 2,460 cases. Computer record matching identified 4 more deaths than the NSQIP total of 198, a difference of about 2%. For 52 of the categorical variables, agreement, uncorrected for chance, was 96%. For 48 of 52 categorical variables, kappas ranged from 0.61 to 1.0 (substantial to almost perfect agreement); none of the variables had kappas of less than 0.20 (slight to poor agreement). This sample of medical centers shows adherence to criteria in selecting cases for the NSQIP database, for reporting deaths, and for collecting patient risk variables.

  5. Prevalence of Color Vision Deficiency and its Correlation with Amblyopia and Refractive Errors among Primary School Children.

    PubMed

    Rajavi, Zhale; Sabbaghi, Hamideh; Baghini, Ahmad Shojaei; Yaseri, Mehdi; Sheibani, Koroush; Norouzi, Ghazal

    2015-01-01

    To determine the prevalence of color vision deficiency (CVD) and its correlation with amblyopia and refractive errors among primary school children. In this population-based cross-sectional study, 2160 children were selected from 36 primary schools; 60 students were from each school (10 students in each grade), with equal sex distribution. A complete eye examination including refraction using a photorefractometer, determination of visual acuity (VA) and color vision using a Yang vision tester, and evaluation of ocular media opacity using a direct ophthalmoscope was performed. Children who could not answer at least 4 plates of the Ishihara color test were considered as color vision deficient subjects. Amblyopia was determined if pinhole VA was worse than 0.3 LogMAR (equal to 20/40). The prevalence of CVD was 2.2% (95% CI: 1.5% to 3%) which was higher in male subjects (37 [3.5%] boys vs. 11 [1.0%] girls, P < 0.001). Mean VA was lower among students with CVD as compared to normal color vision children (P = 0.035) and amblyopia was observed in 8.3% (95% CI: 0.2% to 16.4%) of patients with CVD versus 2.1% (95% CI: 1.5% to 2.08%) of children with normal color vision perception (P = 0.005). A statistically significant correlation between lower VA and CVD was observed (P = 0.023). Although CVD was correlated with lower VA and amblyopia, there was no relationship between CVD and the type of amblyopia, refractive error, anisometropia or strabismus.

  6. Indocyanine Green Videoangiography Transoptic Visualization and Clipping Confirmation of an Optic Splitting Ophthalmic Artery Aneurysm.

    PubMed

    Rustemi, Oriela; Cester, Giacomo; Causin, Francesco; Scienza, Renato; Della Puppa, Alessandro

    2016-06-01

    Ophthalmic artery aneurysms with medial and superior projection in exceptionally rare cases can split the optic nerve. Treatment of these aneurysms is challenging, because the aneurysm dome is hidden from the optic nerve, rendering its visualization and clipping confirmation difficult. In addition, optic nerve function should be preserved during surgical maneuvers. Preoperative detection of this growing feature is usually missing. We illustrate the first case of indocyanine green videoangiography (ICG-VA) application in an optic penetrating ophthalmic artery aneurysm treatment. A 57-year-old woman presented with temporal hemianopsia, slight right visual acuity deficit, and new onset of headache. The cerebral angiography detected a right ophthalmic artery aneurysm medially and superiorly projecting. The A1 tract of the ipsilateral anterior cerebral artery was elevated and curved, being suspicious for an under optic aneurysm growth. Surgery was performed. Initially the aneurysm was not visible. ICG-VA permitted the transoptic aneurysm visualization. After optic canal opening, the aneurysm was clipped and transoptic ICG-VA confirmed the aneurysm occlusion. ICG-VA showed also the slight improvement of the optic nerve pial vascularization. Postoperatively, the visual acuity was 10/10 and the hemianopsia did not worsen. The elevation and curve of the A1 tract in medially and superiorly projecting ophthalmic aneurysms may be an indirect sign of under optic growth, or optic splitting aneurysms. ICG-VA transoptic aneurysm detection and occlusion confirmation reduces the surgical maneuvers on the optic nerve, contributing to function preservation. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. 75 FR 68038 - Agency Information Collection (Application for Reinstatement (Insurance Lapsed More than 6 Months...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-04

    ... Medical--Comparative Health Statement)) Activities Under OMB Review AGENCY: Veterans Benefits... Disability Income Provision, VA Form 29-352. b. Application for Reinstatement (Non Medical--Comparative...

  8. 78 FR 53011 - Agency Information Collection (Application for Reinstatement (Insurance Lapsed More Than 6 Months...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-27

    ... Medical--Comparative Health Statement)) Activities Under OMB Review AGENCY: Veterans Benefits... Reinstatement (Non Medical--Comparative Health Statement), Government Life Insurance, VA Form 29-353. OMB...

  9. Goalpha regulates volatile anesthetic action in Caenorhabditis elegans.

    PubMed Central

    van Swinderen, B; Metz, L B; Shebester, L D; Mendel, J E; Sternberg, P W; Crowder, C M

    2001-01-01

    To identify genes controlling volatile anesthetic (VA) action, we have screened through existing Caenorhabditis elegans mutants and found that strains with a reduction in Go signaling are VA resistant. Loss-of-function mutants of the gene goa-1, which codes for the alpha-subunit of Go, have EC(50)s for the VA isoflurane of 1.7- to 2.4-fold that of wild type. Strains overexpressing egl-10, which codes for an RGS protein negatively regulating goa-1, are also isoflurane resistant. However, sensitivity to halothane, a structurally distinct VA, is differentially affected by Go pathway mutants. The RGS overexpressing strains, a goa-1 missense mutant found to carry a novel mutation near the GTP-binding domain, and eat-16(rf) mutants, which suppress goa-1(gf) mutations, are all halothane resistant; goa-1(null) mutants have wild-type sensitivities. Double mutant strains carrying mutations in both goa-1 and unc-64, which codes for a neuronal syntaxin previously found to regulate VA sensitivity, show that the syntaxin mutant phenotypes depend in part on goa-1 expression. Pharmacological assays using the cholinesterase inhibitor aldicarb suggest that VAs and GOA-1 similarly downregulate cholinergic neurotransmitter release in C. elegans. Thus, the mechanism of action of VAs in C. elegans is regulated by Goalpha, and presynaptic Goalpha-effectors are candidate VA molecular targets. PMID:11404329

  10. Recurrence risk model for esophageal cancer after radical surgery.

    PubMed

    Lu, Jincheng; Tao, Hua; Song, Dan; Chen, Cheng

    2013-10-01

    The aim of the present study was to construct a risk assessment model which was tested by disease-free survival (DFS) of esophageal cancer after radical surgery. A total of 164 consecutive esophageal cancer patients who had undergone radical surgery between January 2005 and December 2006 were retrospectively analyzed. The cutpoint of value at risk (VaR) was inferred by stem-and-leaf plot, as well as by independent-samples t-test for recurrence-free time, further confirmed by crosstab chi-square test, univariate analysis and Cox regression analysis for DFS. The cutpoint of VaR was 0.3 on the basis of our model. The rate of recurrence was 30.3% (30/99) and 52.3% (34/65) in VaR <0.3 and VaR ≥0.3 (chi-square test, (χ) (2) =7.984, P=0.005), respectively. The 1-, 3-, and 5-year DFS of esophageal cancer after radical surgery was 70.4%, 48.7%, and 45.3%, respectively in VaR ≥0.3, whereas 91.5%, 75.8%, and 67.3%, respectively in VaR <0.3 (Log-rank test, (χ) (2) =9.59, P=0.0020), and further confirmed by Cox regression analysis [hazard ratio =2.10, 95% confidence interval (CI): 1.2649-3.4751; P=0.0041]. The model could be applied for integrated assessment of recurrence risk after radical surgery for esophageal cancer.

  11. Recurrence risk model for esophageal cancer after radical surgery

    PubMed Central

    Tao, Hua; Song, Dan; Chen, Cheng

    2013-01-01

    Objective The aim of the present study was to construct a risk assessment model which was tested by disease-free survival (DFS) of esophageal cancer after radical surgery. Methods A total of 164 consecutive esophageal cancer patients who had undergone radical surgery between January 2005 and December 2006 were retrospectively analyzed. The cutpoint of value at risk (VaR) was inferred by stem-and-leaf plot, as well as by independent-samples t-test for recurrence-free time, further confirmed by crosstab chi-square test, univariate analysis and Cox regression analysis for DFS. Results The cutpoint of VaR was 0.3 on the basis of our model. The rate of recurrence was 30.3% (30/99) and 52.3% (34/65) in VaR <0.3 and VaR ≥0.3 (chi-square test, χ2 =7.984, P=0.005), respectively. The 1-, 3-, and 5-year DFS of esophageal cancer after radical surgery was 70.4%, 48.7%, and 45.3%, respectively in VaR ≥0.3, whereas 91.5%, 75.8%, and 67.3%, respectively in VaR <0.3 (Log-rank test, χ2 =9.59, P=0.0020), and further confirmed by Cox regression analysis [hazard ratio =2.10, 95% confidence interval (CI): 1.2649-3.4751; P=0.0041]. Conclusions The model could be applied for integrated assessment of recurrence risk after radical surgery for esophageal cancer. PMID:24255579

  12. 77 FR 67406 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-09

    ... International Business Richmond, VA 10/15/12 10/11/12 Machines Corporation (IBM) (State/One-Stop). 82081 Teters... (State/One- Stop). 82091 T-Shirt International Inc. Culloden, WV 10/18/12 10/16/12 (Company). 82092...

  13. KiVa Anti-Bullying Program in Italy: Evidence of Effectiveness in a Randomized Control Trial.

    PubMed

    Nocentini, Annalaura; Menesini, Ersilia

    2016-11-01

    The present study aims to evaluate the effectiveness of the KiVa anti-bullying program in Italy through a randomized control trial of students in grades 4 and 6. The sample involved 2042 students (51 % female; grade 4, mean age = 8.85; ds = 0.43; grade 6, mean age = 10.93; ds = 0.50); 13 comprehensive schools were randomly assigned into intervention (KiVa) or control (usual school provision) conditions. Different outcomes (bullying, victimization, pro-bullying attitudes, pro-victim attitudes, empathy toward victims), analyses (longitudinal mixed model with multiple-item scales; longitudinal prevalence of bullies and victims using Olweus' single question), and estimates of effectiveness (Cohen's d; odds ratios) were considered in order to compare the Italian results with those from other countries. Multilevel models showed that KiVa reduced bullying and victimization and increased pro-victim attitudes and empathy toward the victim in grade 4, with effect sizes from 0.24 to 0.40. In grade 6, KiVa reduced bullying, victimization, and pro-bullying attitudes; the effects were smaller as compared to grade 4, yet significant (d ≥ 0.20). Finally, using Olweus dichotomous definition of bullies and victims, results showed that the odds of being a victim were 1.93 times higher for a control student than for a KiVa student in grade 4. Overall, the findings provide evidence of the effectiveness of the program in Italy; the discussion will focus on factors that influenced successfully the transportability of the KiVa program in Italy.

  14. The prophylactic effect of Viscum album in streptozotocin-induced diabetic rats

    PubMed Central

    Turkkan, Asuman; Savas, Hasan Basri; Yavuz, Berire; Yigit, Ayse; Uz, Efkan; Bayram, Nezire Asli; Kale, Banu

    2016-01-01

    OBJECTIVE: Viscum album (VA) is a species of mistletoe in the family Santalaceae that is thought to have therapeutic properties for several diseases, including diabetes. In the present study, conventional experimental rat model was used with diabetes induced with streptozotocin (STZ) to evaluate effect of VA on lipid peroxidation and antioxidant system. METHODS: Total of 32 adult, male Sprague-Dawley rats were divided into 4 groups of 8 rats: Control group, STZ group, VA group, and group administered VA+STZ. VA extract was 100 mg/kg preparation delivered once a day by oral gavage for 10 days. Single dose of 55 mg/kg STZ citrate buffer (0.1 M, pH 4.5) was administered intraperitoneally to induce diabetes. Fasting blood glucose level was measured and recorded. Animals were sacrificed, and catalase (CAT), malondialdehyde (MDA), and protein present in liver and kidney tissue samples were measured. Activity of CAT, an antioxidant enzyme, was studied according to the Aebi method. MDA, a product of lipid peroxidation, was analyzed using Draper and Hadley spectrophotometric procedure. Protein level was determined using supernatant and extract of tissue homogenates according to Lowry method. Data were assessed using one-way analysis of variance and pairwise comparisons between groups. Post-hoc analysis included Dunnet test, Duncan test, and least significant difference test. P<0.05 was considered significant probability value. RESULTS: Oxidative stress is associated with diabetic complications. VA administered to diabetic rats reduced oxidative stress and improved their general condition. CONCLUSION: Further studies are needed to enhance understanding of potential antidiabetic and antioxidant effects of VA. PMID:28058393

  15. Induction of maturation and activation of human dendritic cells: a mechanism underlying the beneficial effect of Viscum album as complimentary therapy in cancer.

    PubMed

    Elluru, Sri Ramulu; Duong van Huyen, Jean-Paul; Delignat, Sandrine; Kazatchkine, Michel D; Friboulet, Alain; Kaveri, Srini V; Bayry, Jagadeesh

    2008-06-04

    Viscum album (VA) preparations have been used as a complimentary therapy in cancer. In addition to their cytotoxic properties, they have also been shown to have immunostimulatory properties. In the present study, we examine the hypothesis that the VA preparations induce activation of human DC that facilitates effective tumor regression. Four day old monocyte-derived immature DCs were treated with VA Qu Spez at 5, 10 and 15 microg/ml for 48 hrs. The expression of surface molecules was analyzed by flow cytometry. The ability of Qu Spez-educated DC to stimulate T cells was analyzed by allogeneic mixed lymphocyte reaction and activation of Melan-A/MART-1-specific M77-80 CD8+T cells. Cytokines in cell free culture supernatant was analyzed by cytokine bead array assay. VA Qu Spez stimulated DCs presented with increased expression of antigen presenting molecule HLA-DR and of co-stimulatory molecules CD40, CD80 and CD86. The VA Qu Spez also induced the secretion of inflammatory cytokines IL-6 and IL-8. Further, Qu Spez-educated DC stimulated CD4+T cells in a allogeneic mixed lymphocyte reaction and activated melanoma antigen Melan-A/MART-1-specific M77-80 CD8+T cells as evidenced by increased secretion of TNF-alpha and IFNgamma. The VA preparations stimulate the maturation and activation of human DCs, which may facilitate anti-tumoral immune responses. These results should assist in understanding the immunostimulatory properties of VA preparations and improving the therapeutic strategies.

  16. Induction of maturation and activation of human dendritic cells: A mechanism underlying the beneficial effect of Viscum album as complimentary therapy in cancer

    PubMed Central

    Elluru, Sri Ramulu; van Huyen, Jean-Paul Duong; Delignat, Sandrine; Kazatchkine, Michel D; Friboulet, Alain; Kaveri, Srini V; Bayry, Jagadeesh

    2008-01-01

    Background Viscum album (VA) preparations have been used as a complimentary therapy in cancer. In addition to their cytotoxic properties, they have also been shown to have immunostimulatory properties. In the present study, we examine the hypothesis that the VA preparations induce activation of human DC that facilitates effective tumor regression. Methods Four day old monocyte-derived immature DCs were treated with VA Qu Spez at 5, 10 and 15 μg/ml for 48 hrs. The expression of surface molecules was analyzed by flow cytometry. The ability of Qu Spez-educated DC to stimulate T cells was analyzed by allogeneic mixed lymphocyte reaction and activation of Melan-A/MART-1-specific M77-80 CD8+T cells. Cytokines in cell free culture supernatant was analyzed by cytokine bead array assay. Results VA Qu Spez stimulated DCs presented with increased expression of antigen presenting molecule HLA-DR and of co-stimulatory molecules CD40, CD80 and CD86. The VA Qu Spez also induced the secretion of inflammatory cytokines IL-6 and IL-8. Further, Qu Spez-educated DC stimulated CD4+T cells in a allogeneic mixed lymphocyte reaction and activated melanoma antigen Melan-A/MART-1-specific M77-80 CD8+T cells as evidenced by increased secretion of TNF-α and IFNγ. Conclusion The VA preparations stimulate the maturation and activation of human DCs, which may facilitate anti-tumoral immune responses. These results should assist in understanding the immunostimulatory properties of VA preparations and improving the therapeutic strategies. PMID:18533025

  17. Multiple inert gas elimination technique by micropore membrane inlet mass spectrometry--a comparison with reference gas chromatography.

    PubMed

    Kretzschmar, Moritz; Schilling, Thomas; Vogt, Andreas; Rothen, Hans Ulrich; Borges, João Batista; Hachenberg, Thomas; Larsson, Anders; Baumgardner, James E; Hedenstierna, Göran

    2013-10-15

    The mismatching of alveolar ventilation and perfusion (VA/Q) is the major determinant of impaired gas exchange. The gold standard for measuring VA/Q distributions is based on measurements of the elimination and retention of infused inert gases. Conventional multiple inert gas elimination technique (MIGET) uses gas chromatography (GC) to measure the inert gas partial pressures, which requires tonometry of blood samples with a gas that can then be injected into the chromatograph. The method is laborious and requires meticulous care. A new technique based on micropore membrane inlet mass spectrometry (MMIMS) facilitates the handling of blood and gas samples and provides nearly real-time analysis. In this study we compared MIGET by GC and MMIMS in 10 piglets: 1) 3 with healthy lungs; 2) 4 with oleic acid injury; and 3) 3 with isolated left lower lobe ventilation. The different protocols ensured a large range of normal and abnormal VA/Q distributions. Eight inert gases (SF6, krypton, ethane, cyclopropane, desflurane, enflurane, diethyl ether, and acetone) were infused; six of these gases were measured with MMIMS, and six were measured with GC. We found close agreement of retention and excretion of the gases and the constructed VA/Q distributions between GC and MMIMS, and predicted PaO2 from both methods compared well with measured PaO2. VA/Q by GC produced more widely dispersed modes than MMIMS, explained in part by differences in the algorithms used to calculate VA/Q distributions. In conclusion, MMIMS enables faster measurement of VA/Q, is less demanding than GC, and produces comparable results.

  18. Should tumbling E go out of date in amblyopia screening? Evidence from a population-based sample normative in children aged 3-4 years.

    PubMed

    Guimaraes, Sandra; Fernandes, Tiago; Costa, Patrício; Silva, Eduardo

    2018-06-01

    To determine a normative of tumbling E optotype and its feasibility for visual acuity (VA) assessment in children aged 3-4 years. A cross-sectional study of 1756 children who were invited to participate in a comprehensive non-invasive eye exam. Uncorrected monocular VA with crowded tumbling E with a comprehensive ophthalmological examination were assessed. Testability rates of the whole population and VA of the healthy children for different age subgroups, gender, school type and the order of testing in which the ophthalmological examination was performed were evaluated. The overall testability rate was 95% (92% and 98% for children aged 3 and 4 years, respectively). The mean VA of the first-day assessment (first-VA) and best-VA over 2 days' assessments was 0.14 logMAR (95% CI 0.14 to 0.15) (decimal=0.72, 95% CI 0.71 to 0.73) and 0.13 logMAR (95% CI 0.13 to 0.14) (decimal=0.74, 95% CI 0.73 to 0.74). Analysis with age showed differences between groups in first-VA (F(3,1146)=10.0; p<0.001; η2=0.026) and best-VA (F(3,1155)=8.8; p<0.001; η2=0.022). Our normative was very highly correlated with previous reported HOTV-Amblyopia-Treatment-Study (HOTV-ATS) (first-VA, r=0.97; best-VA, r=0.99), with 0.8 to 0.7 lines consistent overestimation for HOTV-ATS as described in literature. Overall false-positive referral was 1.3%, being specially low regarding anisometropias of ≥2 logMAR lines (0.17%). Interocular difference ≥1 line VA logMAR was not associated with age (p=0.195). This is the first normative for European Caucasian children with single crowded tumbling E in healthy eyes and the largest study comparing 3 and 4 years old testability. Testability rates are higher than found in literature with other optotypes, especially in children aged 3 years, where we found 5%-11% better testability rates. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. Advanced control architecture for autonomous vehicles

    NASA Astrophysics Data System (ADS)

    Maurer, Markus; Dickmanns, Ernst D.

    1997-06-01

    An advanced control architecture for autonomous vehicles is presented. The hierarchical architecture consists of four levels: a vehicle level, a control level, a rule-based level and a knowledge-based level. A special focus is on forms of internal representation, which have to be chosen adequately for each level. The control scheme is applied to VaMP, a Mercedes passenger car which autonomously performs missions on German freeways. VaMP perceives the environment with its sense of vision and conventional sensors. It controls its actuators for locomotion and attention focusing. Modules for perception, cognition and action are discussed.

  20. Vestibular Assessment and Rehabilitation: Ten-Year Survey Trends of Audiologists' Opinions and Practice.

    PubMed

    Nelson, M Dawn; Akin, Faith W; Riska, Kristal M; Andresen, Kimberly; Mondelli, Stephanie Stamps

    2016-02-01

    The past decade has yielded changes in the education and training of audiologists and technological advancements that have become widely available for clinical balance function testing. It is unclear if recent advancements in vestibular instrumentation or the transition to an AuD degree have affected audiologists' vestibular clinical practice or opinions. The purpose of this study was to examine predominant opinions and practices for vestibular assessment (VA) and vestibular rehabilitation (VR) over the past decade and between master's- and AuD-level audiologists. A 31-question survey was administered to audiologists via U.S. mail in 2003 (N = 7,500) and electronically in 2014 (N = 9,984) with a response rate of 12% and 10%, respectively. There was an increase in the number of audiologists providing vestibular services in the past decade. Most respondents agreed that audiologists were the most qualified professionals to conduct VA. Less than half of the surveyed audiologists felt that graduate training was adequate for VA. AuD-level audiologists were more satisfied with graduate training and felt more comfortable performing VA compared to master's-level audiologists. Few respondents agreed that audiologists were the most qualified professionals to conduct VR or that graduate training prepared them to conduct VR. The basic vestibular test battery was unchanged across surveys and included: calorics, smooth pursuit, saccades, search for spontaneous, positional, gaze and optokinetic nystagmus, Dix-Hallpike, case history, and hearing evaluation. There was a trend toward greater use of air (versus water) calorics, videonystagmography (versus electronystagmography), and additional tests of vestibular and balance function. VA is a growing specialty area in the field of audiology. Better training opportunities are needed to increase audiologists' knowledge and skills for providing vestibular services. The basic tests performed during VA have remained relatively unchanged over the past 10 yr. American Academy of Audiology.

  1. State-to-state collisional interelectronic and intraelectronic energy transfer involving CN A 2Π v=3 and X 2Σ+ v=7 rotational levels

    NASA Astrophysics Data System (ADS)

    Jihua, Guo; Ali, Ashraf; Dagdigian, Paul J.

    1986-12-01

    Collisional transfer within the CN A 2Π v=3 vibrational manifold and to the X 2Σ+ v=7 manifold has been studied with initial and final rotational state resolution by an optical-optical double resonance technique. Despite the large energy gap between these two manifolds, the interelectronic cross sections are significant for only a relatively small range of ΔJ, and there is no observable propensity for energy resonant, large ΔJ transitions. The even-odd alternation vs N, observed previously in vA=7 collisions [N. Furio, A. Ali, and P. J. Dagdigian, J. Chem. Phys. 85, 3860 (1986)] and indicative of the near homonuclear form of the CN-Ar interaction potentials, is even more pronounced here for vA=3. The relative rate of intraelectronic and interelectronic energy transfer for the vA=3 N=6 F1f initial level was found to be comparable to that for the corresponding vA=7 level, despite the smaller Franck-Condon factor and larger energy gap to the neighboring vX=vA-4 manifold for the former.

  2. Biofortified orange maize is as efficacious as a vitamin A supplement in Zambian children even in the presence of high liver reserves of vitamin A: a community-based, randomized placebo-controlled trial.

    PubMed

    Gannon, Bryan; Kaliwile, Chisela; Arscott, Sara A; Schmaelzle, Samantha; Chileshe, Justin; Kalungwana, Ngándwe; Mosonda, Mofu; Pixley, Kevin; Masi, Cassim; Tanumihardjo, Sherry A

    2014-12-01

    Biofortification is a strategy to relieve vitamin A (VA) deficiency. Biofortified maize contains enhanced provitamin A concentrations and has been bioefficacious in animal and small human studies. The study sought to determine changes in total body reserves (TBRs) of vitamin A with consumption of biofortified maize. A randomized, placebo-controlled biofortified maize efficacy trial was conducted in 140 rural Zambian children. The paired (13)C-retinol isotope dilution test, a sensitive biomarker for VA status, was used to measure TBRs before and after a 90-d intervention. Treatments were white maize with placebo oil (VA-), orange maize with placebo (orange), and white maize with VA in oil [400 μg retinol activity equivalents (RAEs) in 214 μL daily] (VA+). In total, 133 children completed the trial and were analyzed for TBRs (n = 44 or 45/group). Change in TBR residuals were not normally distributed (P < 0.0001); median changes (95% CI) were as follows: VA-, 13 (-19, 44) μmol; orange, 84 (21, 146) μmol; and VA+, 98 (24, 171) μmol. Nonparametric analysis showed no statistical difference between VA+ and orange (P = 0.34); both were higher than VA- (P = 0.0034). Median (95% CI) calculated liver reserves at baseline were 1.04 (0.97, 1.12) μmol/g liver, with 59% >1 μmol/g, the subtoxicity cutoff; none were <0.1 μmol/g, the deficiency cutoff. The calculated bioconversion factor was 10.4 μg β-carotene equivalents/1 μg retinol by using the middle 3 quintiles of change in TBRs from each group. Serum retinol did not change in response to intervention (P = 0.16) but was reduced with elevated C-reactive protein (P = 0.0029) and α-1-acid glycoprotein (P = 0.0023) at baseline. β-Carotene from maize was efficacious when consumed as a staple food in this population and could avoid the potential for hypervitaminosis A that was observed with the use of preformed VA from supplementation and fortification. Use of more sensitive methods other than serum retinol alone, such as isotope dilution, is required to accurately assess VA status, evaluate interventions, and investigate the interaction of VA status and infection. This trial was registered at clinicaltrials.gov as NCT01814891. © 2014 American Society for Nutrition.

  3. Homeland security and public health: role of the Department of Veterans Affairs, the US Department of Homeland Security, and implications for the public health community.

    PubMed

    Koenig, Kristi L

    2003-01-01

    The terrorist attacks of 11 September 2001 led to the largest US Government transformation since the formation of the Department of Defense following World War II. More than 22 different agencies, in whole or in part, and >170,000 employees were reorganized to form a new Cabinet-level Department of Homeland Security (DHS), with the primary mission to protect the American homeland. Legislation enacted in November 2002 transferred the entire Federal Emergency Management Agency and several Department of Health and Human Services (HHS) assets to DHS, including the Office of Emergency Response, and oversight for the National Disaster Medical System, Strategic National Stockpile, and Metropolitan Medical Response System. This created a potential separation of "health" and "medical" assets between the DHS and HHS. A subsequent presidential directive mandated the development of a National Incident Management System and an all-hazard National Response Plan. While no Department of Veterans Affairs (VA) assets were targeted for transfer, the VA remains the largest integrated healthcare system in the nation with important support roles in homeland security that complement its primary mission to provide care to veterans. The Emergency Management Strategic Healthcare Group (EMSHG) within the VA's medical component, the Veteran Health Administration (VHA), is the executive agent for the VA's Fourth Mission, emergency management. In addition to providing comprehensive emergency management services to the VA, the EMSHG coordinates medical back-up to the Department of Defense, and assists the public via the National Disaster Medical System and the National Response Plan. This article describes the VA's role in homeland security and disasters, and provides an overview of the ongoing organizational and operational changes introduced by the formation of the new DHS. Challenges and opportunities for public health are highlighted.

  4. Vacuum arc behavior and its voltage characteristics in drawing process controlled by composite magnetic fields along axial and transverse directions

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

    Wang, Lijun, E-mail: lijunwang@mail.xjtu.edu.cn; Deng, Jie; Wang, Haijing

    In this research, drawing vacuum arc (VA) experiments were conducted using composite contacts under currents ranging from 5 kA to 20 kA root mean square (rms). The new type of contact comprised an axial magnetic field (AMF) configuration and a transverse magnetic field (TMF) configuration. The TMF plate was in the center, surrounded by the AMF plate. The contact generated both AMFs and TMFs simultaneously. VA appearances and arc voltages were recorded, and the VA was modeled as a conductor for electromagnetic force analysis in ANSYS software. The results showed that the coaxiality of operating mechanisms significantly influenced arc behavior just asmore » the arc was ignited. When arc brightness did not increase after ignition, there was a voltage drop accompanied with diffusion of the VA. As to VA development, when an arc was ignited on an AMF plate, it spread on the plate and rotated. Over time the arc current increased, the constricting arc forms, and the arc column rotated on the TMF plate under the action of Ampere's force. With regard to the influence of a magnetic field on a VA at different stages, in the initial drawing arc stage the TMF was dominant, and the arc started to rotate under the action of Ampere's force. Afterwards, the AMF was dominant, with a steadily burning arc. As for contact melting, in the initial arcing period, a contracted short arc caused severe melting and erosion of the contact plate. When the ignition spot or root was close to the slot of plate, the electromagnetic force pushed the arc toward slot and contact edge, resulting in local erosion of the slot region.« less

  5. A Reverse-phase Protein Microarray-based Screen Identifies Host Signaling Dynamics upon Burkholderia spp. Infection

    DTIC Science & Technology

    2015-07-27

    University, Manassas, VA, USA, 4 PerkinElmer, Inc., Waltham, MA, USA Burkholderia is a diverse genus of gram-negative bacteria that causes high...Burkholderia spp. infections. Materials and Methods Bacterial Strains Bm ATCC 23344, NCTC 10247, NCTC 10229, NCTC 3708, NCTC 3709, 2002721278 (Burtnick...macrophage cell line RAW264.7 was obtained from ATCC (Manassas, VA). Cells were cultured in DMEM (Life Technologies) supplemented with 10% fetal

  6. Outcomes of Anti-Vascular Endothelial Growth Factor Treatment for Choroidal Neovascularization in Fellow Eyes of Previously Treated Patients With Neovascular Age-Related Macular Degeneration.

    PubMed

    Stem, Maxwell S; Moinuddin, Omar; Kline, Noah; Thanos, Aristomenis; Rao, Prethy; Williams, George A; Hassan, Tarek S

    2018-05-10

    Neovascular age-related macular degeneration (nvAMD) is a leading cause of vision loss. The optimal screening protocol to detect choroidal neovascularization (CNV) in fellow eyes of patients undergoing treatment for unilateral CNV has not been determined. To compare the visual outcomes of eyes with established, active nvAMD in index eyes with outcomes of fellow eyes that subsequently developed CNV during the management protocol. In this retrospective single-center case series conducted at a private vitreoretinal practice, data were collected for all patients treated for bilateral nvAMD between October 1, 2015, and October 1, 2016, for whom we could determine the date of index eye and fellow eye conversion to nvAMD (n = 1600). Per institutional protocol, patients were screened for new CNV in the fellow eye at every office visit. Patients were excluded if they had a condition that could result in marked asymmetric vision loss. Development of nvAMD. Visual acuity (VA) at the time of diagnosis of nvAMD and at equivalent time points following conversion to nvAMD for both index eyes and fellow eyes. A total of 264 patients met the inclusion criteria; 197 (74.6%) were women and 253 (95.8%) were white, and the mean (SD) age was 79.1 (8.2) years at time of index eye conversion to nvAMD and 80.6 (8.2) years at time of fellow eye conversion to nvAMD. Fellow eyes presented with better VA (mean VA, 20/50 [0.40 logMAR]) compared with index eyes (mean VA, 20/90 [0.67 logMAR]) at the time of conversion (difference, 14 letters [0.27 logMAR]; 95% CI, 10-17 [0.20-0.34]; P < .001). Index eyes did not achieve the same level of VA as fellow eyes after an equivalent postconversion follow-up of approximately 20 months (mean VA: index eye; 20/70 [0.56 logMAR]; fellow eye, 20/50 [0.40 logMAR]; difference, 8 letters [0.15 logMAR]; 95% CI, 4-11 [0.08-0.22]; P < .001). No difference was detected between the mean number of anti-vascular endothelial growth factor injections received by fellow eyes and index eyes (9.7 vs 10.0 injections, respectively). This retrospective study suggests that fellow eyes of previously treated patients with nvAMD may achieve better VA than their index eye counterparts after an equivalent amount of follow-up. This may be because the CNV was detected and treated earlier and at a better level of VA, although it is unknown whether the frequent office visits, VA measurements, or optical coherence tomography testing was responsible for the detection at a better level of VA.

  7. 78 FR 76411 - Agency Information Collection (Residency Verification Report-Veterans and Survivors) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-17

    ...: VA Form Letter 21-914 is use to verify whether Filipino veterans of the Special Philippine Scouts, Commonwealth Army of the Philippines, organized guerilla groups receiving service-connected compensation...

  8. 50 CFR 10.21 - Director.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Addresses § 10.21 Director. (a) Mail forwarded to the Director for law enforcement purposes should be.... Fairfax Drive, Room 700, Arlington, VA 22203. Address mail for the following permits to the Regional...

  9. 50 CFR 10.21 - Director.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Addresses § 10.21 Director. (a) Mail forwarded to the Director for law enforcement purposes should be.... Fairfax Drive, Room 700, Arlington, VA 22203. Address mail for the following permits to the Regional...

  10. 78 FR 13886 - Agency Information Collection Activities: Comment Request for the Production Estimate (2 Forms)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-01

    ... DEPARTMENT OF THE INTERIOR U.S. Geological Survey [USGS-GX13LR000F60100] Agency Information Collection Activities: Comment Request for the Production Estimate (2 Forms) AGENCY: U.S. Geological Survey... Officer, U.S. Geological Survey, 12201 Sunrise Valley Drive, Mail Stop 807, Reston, VA 20192 (mail); 703...

  11. Epidemiology and burden of influenza in the U.S. Department of Veterans Affairs.

    PubMed

    Lucero-Obusan, Cynthia; Schirmer, Patricia L; Wendelboe, Aaron; Oda, Gina; Holodniy, Mark

    2018-03-01

    We describe influenza activity in the US Veterans Affairs (VA) population for the 2010-2011 through 2015-2016 seasons and compare with national CDC FluView data. VA confirmed influenza cases ranged from 1005 to 11 506 per season; triage calls from 6090 to 10 346; outpatient visits from 3849 to 13 406; antiviral prescriptions from 3650 to 32 826; hospitalizations from 546 to 4673; and deaths in hospitalized patients from 17 to 139. Peak activity was generally the same as observed nationally by the CDC. For the seasons analyzed, correlation between VA and CDC %ILI visits (r = .863), influenza hospitalizations (r = .953), positive tests (r = .948), and percent of tests positive (r = .938) was strong. Understanding influenza burden is important for evaluating prevention priorities and resource allocation within VA. © 2017 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

  12. Ferroelectric PLZT thick films grown by poly(1-vinylpyrrolidone-co-vinyl acetate) (PVP/VA)-modified sol-gel process

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

    Hu, Zhongqiang; Ma, Beihai; Li, Meiya

    2016-03-01

    We report the growth of ferroelectric Pb0.92La0.08Zr0.52Ti0.48O3 (PLZT) thick films using a poly(1-vinylpyrrolidone-co-vinyl acetate) (PVP/VA)-modified sol–gel process. A per-coating thickness of ≈0.66 μm has been demonstrated using PVP/VA-modified solution, which is more than doubled that of the PLZT films grown by PVP-modified method, and nearly 6 times the per-coating thickness of films prepared by conventional sol–gel process. PLZT thick films grown on LNO/Ni substrates exhibited denser microstructure, higher remanent polarization (11 μC/cm 2) and dielectric tunability (45%), lower leakage current density (≈1.2 × 10 -8 A/cm 2), and higher breakdown strength (≈1.6 MV/cm) than those for the samples grown onmore » PtSi substrates. These results demonstrated great potential of using PVP/VA-modified sol–gel process for high power film capacitor applications.« less

  13. Factors associated with receipt of pension and compensation benefits for homeless veterans in the VBA/VHA Homeless Outreach Initiative.

    PubMed

    Chen, Joyce H; Rosenheck, Robert A; Greenberg, Greg A; Seibyl, Catherine

    2007-03-01

    Public support payments may facilitate exit from homelessness for persons with mental illness. We examined data from 10,641 homeless veterans contacted from October 1, 1995 to September 30, 2002 in a collaborative outreach program designed to facilitate access to Department of Veterans Affairs (VA) disability benefits. Those who were awarded benefits (22% of contacted veterans) were more likely to report disability, poor to fair self-rated health, and were more likely to have used VA services in the past. Thus, this program achieved only modest success and was most successful with veterans who were already receiving VA services and who might have received benefits even without the outreach effort.

  14. 10. DETAIL VIEW OF ADMINISTRATION BUILDING. INTERIOR VIEW SHOWING SECOND ...

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

    10. DETAIL VIEW OF ADMINISTRATION BUILDING. INTERIOR VIEW SHOWING SECOND FLOOR CORRIDOR. VIEW TO NORTH. - VA Medical Center, Aspinwall Division, Administration Building, 5103 Delafield Avenue, Aspinwall, Allegheny County, PA

  15. Formulation of 3D Printed Tablet for Rapid Drug Release by Fused Deposition Modeling: Screening Polymers for Drug Release, Drug-Polymer Miscibility and Printability.

    PubMed

    Solanki, Nayan G; Tahsin, Md; Shah, Ankita V; Serajuddin, Abu T M

    2018-01-01

    The primary aim of this study was to identify pharmaceutically acceptable amorphous polymers for producing 3D printed tablets of a model drug, haloperidol, for rapid release by fused deposition modeling. Filaments for 3D printing were prepared by hot melt extrusion at 150°C with 10% and 20% w/w of haloperidol using Kollidon ® VA64, Kollicoat ® IR, Affinsiol ™ 15 cP, and HPMCAS either individually or as binary blends (Kollidon ® VA64 + Affinisol ™ 15 cP, 1:1; Kollidon ® VA64 + HPMCAS, 1:1). Dissolution of crushed extrudates was studied at pH 2 and 6.8, and formulations demonstrating rapid dissolution rates were then analyzed for drug-polymer, polymer-polymer and drug-polymer-polymer miscibility by film casting. Polymer-polymer (1:1) and drug-polymer-polymer (1:5:5 and 2:5:5) mixtures were found to be miscible. Tablets with 100% and 60% infill were printed using MakerBot printer at 210°C, and dissolution tests of tablets were conducted at pH 2 and 6.8. Extruded filaments of Kollidon ® VA64-Affinisol ™ 15 cP mixtures were flexible and had optimum mechanical strength for 3D printing. Tablets containing 10% drug with 60% and 100% infill showed complete drug release at pH 2 in 45 and 120 min, respectively. Relatively high dissolution rates were also observed at pH 6.8. The 1:1-mixture of Kollidon ® VA64 and Affinisol ™ 15 cP was thus identified as a suitable polymer system for 3D printing and rapid drug release. Copyright © 2018 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  16. Pen Devices for Insulin Self-Administration Compared With Needle and Vial: Systematic Review of the Literature and Meta-Analysis.

    PubMed

    Lasalvia, Pieralessandro; Barahona-Correa, Julián Esteban; Romero-Alvernia, Diana Marcela; Gil-Tamayo, Sebastián; Castañeda-Cardona, Camilo; Bayona, Juan Gabriel; Triana, Juan José; Laserna, Andrés Felipe; Mejía-Torres, Miguel; Restrepo-Jimenez, Paula; Jimenez-Zapata, Juliana; Rosselli, Diego

    2016-07-01

    Pen devices offer advantages compared with vial and syringe (VaS). The purpose of this article was to evaluate efficacy of pen devices compared to VaS. A systematic review of literature was performed in 8 different databases. References were independently screened and selected. Primary observational or experimental studies comparing pen devices with VaS for insulin administrations were included. Studies on specific populations were excluded. Risk of bias was evaluated using appropriate tools. Data on glycosylated hemoglobin (HbA1c), hypoglycemia, adherence, persistence, patient preference, and quality of life (QOL) were collected. Meta-analysis was performed when appropriate. Heterogeneity and risk of publication bias were evaluated. Otherwise, descriptive analyses of the available data was done. In all, 10 348 articles were screened. A total of 17 studies were finally selected: 7 experimental and 10 analytical. The populations of the included articles were mainly composed of adults with type 2 diabetes mellitus. Important risk of bias was found in all of the articles, particularly experimental studies. Meta-analyses were performed for HbA1c, hypoglycemia, adherence and persistence. Pen device showed better results in mean HbA1c change, patients with hypoglycemia, adherence and persistence compared to VaS. No difference was observed in number of patients achieving <7% HbA1c. Preference studies showed a tendency favoring pen devices, however nonvalidated tools were used. One QoL study showed improvements in some subscales of SF-36. There is evidence that pen devices offer benefits in clinical and, less clearly, patient-reported outcomes compared to VaS for insulin administration. However, these results should be taken with caution. © 2016 Diabetes Technology Society.

  17. Voluntary activation of the trapezius muscle in cases with neck/shoulder pain compared to healthy controls.

    PubMed

    Bech, Katrine Tholstrup; Larsen, Camilla Marie; Sjøgaard, Gisela; Holtermann, Andreas; Taylor, Janet L; Søgaard, Karen

    2017-10-01

    Subjects reporting neck/shoulder pain have been shown to generate less force during maximal voluntary isometric contractions (MVC) of the shoulder muscles compared to healthy controls. This has been suggested to be caused by a pain-related decrease in voluntary activation (VA) rather than lack of muscle mass. The aim of the present study was to investigate VA of the trapezius muscle during MVCs in subjects with and without neck/shoulder pain by use of the twitch interpolation technique. Ten cases suffering from pain and ten age and gender matched, healthy controls were included in the study. Upper trapezius muscle thickness was measured using ultrasonography and pain intensity was measured on a 100mm visual analog scale (VAS). VA was calculated from five maximal muscle activation attempts. Superimposed stimuli were delivered to the accessory nerve at peak force and during a 2% MVC following the maximal contraction. Presented as mean±SD for cases and controls, respectively: VAS; 16.0±14.4mm and 2.1±4.1mm (P=0.004), MVC; 545±161N and 664±195N (P=0.016), upper trapezius muscle thickness; 10.9±1.9mm and 10.4±1.5mm (P=0.20), VA; 93.6±14.2% and 96.3±6.0% (P=0.29). In spite of significantly eight-fold higher pain intensity and ∼20% lower MVC for cases compared to controls, no difference was found in VA. Possible explanations for the reduction in MVC could be differences in co-activation of antagonists and synergists as well as muscle quality. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Disorders of "taste cognition" are associated with insular involvement in patients with Alzheimer's disease and vascular dementia: "memory of food is impaired in dementia and responsible for poor diet".

    PubMed

    Suto, Teiko; Meguro, Kenichi; Nakatsuka, Masahiro; Kato, Yuriko; Tezuka, Kimihiro; Yamaguchi, Satoshi; Tashiro, Manabu

    2014-07-01

    In dementia patients, dietary intake problems may occur despite the absence of swallowing problems. We investigated cognitive functions on food and taste in Alzheimer's disease (AD) and vascular dementia (VaD) patients. Participants included 15 healthy controls (HC), 30 AD and 20 VaD patients. Food Cognition Test: Replicas of three popular foods in Japan with no odors were presented visually to each participant, with the instruction to respond with the name of each food. Replicas of food materials were subsequently presented to ask whether they were included in these foods. Taste Cognition Test: Replicas of 12 kinds of foods were presented to describe their expected tastes. The AD/VaD groups exhibited significantly lower scores on Food/Taste Cognition Tests compared with the HC group. These scores correlated inversely with Mini-Mental State Examination (MMSE) scores in the AD group. Decreased dietary intake was observed in 12 of the 50 patients; 8 of the 12 exhibited decreased Taste Cognition Test scores, higher than that of the normal-intake patients. There was no difference in the filter paper taste disc test between HC/AD/VaD groups. To test the hypothesis that the insula is associated with taste cognition, two MMSE-matched AD subgroups (n = 10 vs. 10) underwent positron emission tomography. Glucose metabolism in the right insula was lower in the low taste cognition subgroup. The VaD patients with insular lesions exhibited impaired Taste Cognition Test findings. It is important to consider the cognitive aspect of dietary intake when we care for dementia patients.

  19. Recurrence of amblyopia after occlusion therapy.

    PubMed

    Bhola, Rahul; Keech, Ronald V; Kutschke, Pamela; Pfeifer, Wanda; Scott, William E

    2006-11-01

    To determine the stability of visual acuity (VA) after a standardized occlusion regimen in children with strabismic and/or anisometropic amblyopia. Retrospective, population-based, consecutive observational case series. Four hundred forty-nine patients younger than 10 years who underwent an occlusion trial for amblyopia and were observed until there was a recurrence of amblyopia or for a maximum of 1 year after decrease or cessation of occlusion therapy. We performed a retrospective chart review of all patients treated by occlusion therapy for strabismic and/or anisometropic amblyopia at our institution over a 34-year period. Of the 1621 patients identified in our database, 449 met the eligibility criteria and were included in this study. Patients having at least a 2 logarithm of the minimum angle of resolution (logMAR)-level improvement in VA by optotypes or a change from unmaintained to maintained fixation preference during the course of occlusion therapy were included. A recurrence of amblyopia was defined as > or =2 logMAR levels of VA reduction or reversal of fixation preference within 1 year after a decrease or cessation of occlusion therapy. Recurrence of amblyopia after a decrease or cessation of occlusion therapy and its relationship with patient age and VA of the amblyopic eye at the time of decrease or cessation of occlusion therapy. Of 653 occlusion trials, 179 (27%) resulted in recurrence of amblyopia. The recurrence was found to be inversely correlated with patient age. There was no statistically significant association between the recurrence of amblyopia and VA of the amblyopic eye at the end of maximal occlusion therapy. There is a clinically important risk of amblyopia recurrence when occlusion therapy is decreased before the age of 10 years. The risk of recurrence is inversely correlated with age (P<0.0001).

  20. 48 CFR 819.7110 - Developmental assistance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS VA Mentor-Protégé Program 819.7110 Developmental assistance. The forms of developmental assistance a mentor can provide to a protégé include, but are not limited...

  1. 78 FR 46424 - Proposed Information Collection (Residency Verification Report-Veterans and Survivors) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-31

    ... to determine Filipino Veterans or beneficiaries receiving benefit at the full-dollar rate continues... approved collection. Abstract: VA Form Letter 21-914 is use to verify whether Filipino Veterans of the...

  2. 75 FR 62186 - Proposed Information Collection (Residency Verification Report-Veterans and Survivors) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-07

    ... to determine Filipino veterans or beneficiaries receiving benefit at the full-dollar rate continues... approved collection. Abstract: VA Form Letter 21-914 is use to verify whether Filipino veterans of the...

  3. Development of a Natural Gas-Powered APU for a Hybrid Electric S-10 Pickup Truck.

    DTIC Science & Technology

    1997-12-01

    the result is increased power and efficiency. The Kohler CH22 has a compression ratio of 8:1 in stock form. Natural aspirated spark ignition engines...a schematic layout of the acoustic intensity survey grid areas. B-8 N O c a 3 0» X © © © © © H H Z w S « S ( vap ) ids B-9...l _l _i li- u. LL cr LL ir 1- i Ü c CD 3 cr c m O OS © o OS o cu Q Z Ö o a H U o o OS NX SB H OS p o NX CO !■-- ( vaP

  4. Air Force Officer Qualifying Test (AFOQT) Form P: Test Manual

    DTIC Science & Technology

    1990-04-01

    103 59.19 14.20 58.75 13.99 Navigator-Technical 131 77.10 18.63 75.96 18.26 Academic Aptitude 75 46.79 12.89 46.56 13.01 Verbal 39 24.17 7.26 24.46 7.44...and even extrate rrestrial in tiraction such as nn)1tVi), inrid grai% iLttIo)ni 6)frces. ’Ihe earth, in actuality, is aI large rock V-A i n .I stU it i...E polymers. 3. Lack of iodine is often related to which of the following diseases? 3-A Beriberi 3-B Scurvy 3-C Rickets 3-D Goiter 3-E Asthma 4. The

  5. Microwave generated solid dispersions containing Ibuprofen.

    PubMed

    Moneghini, Mariarosa; Bellich, Barbara; Baxa, Pietro; Princivalle, Francesco

    2008-09-01

    The purpose of this study was to apply the attractive technique of the microwaves irradiation (MW) for the preparation of solvent-free solid dispersions (SD). In particular, the microwave technology has been considered in order to prepare an enhanced release dosage form for the poorly soluble drug Ibuprofen (IBU), employing PVP/VA 60/40 (PVP/VA 64) and hydroxypropyl-beta-cyclodextrin (HP-beta-CD) as hydrophilic carriers. Their physico-chemical characteristics and dissolution properties were compared to the corresponding physical mixtures and the drug alone. The results of physico-chemical characterization attested a correspondence of the solid state of the drug before and after irradiation treatment and that an amorphous form of the drug was obtained. This result, together with the presence of the hydrophilic polymers determined a remarkable enhancement of the in vitro dissolution rate of the drug suggesting that the microwave technique could be considered as a new and interesting method to prepare drug-polymer systems.

  6. Quantitative Campylobacter spp., antibiotic resistance genes, and veterinary antibiotics in surface and ground water following manure application: Influence of tile drainage control.

    PubMed

    Frey, Steven K; Topp, Edward; Khan, Izhar U H; Ball, Bonnie R; Edwards, Mark; Gottschall, Natalie; Sunohara, Mark; Lapen, David R

    2015-11-01

    This work investigated chlortetracycline, tylosin, and tetracycline (plus transformation products), and DNA-based quantitative Campylobacter spp. and Campylobacter tetracycline antibiotic resistant genes (tet(O)) in tile drainage, groundwater, and soil before and following a liquid swine manure (LSM) application on clay loam plots under controlled (CD) and free (FD) tile drainage. Chlortetracycline/tetracycline was strongly bound to manure solids while tylosin dominated in the liquid portion of manure. The chlortetracycline transformation product isochlortetracycline was the most persistent analyte in water. Rhodamine WT (RWT) tracer was mixed with manure and monitored in tile and groundwater. RWT and veterinary antibiotic (VA) concentrations were strongly correlated in water which supported the use of RWT as a surrogate tracer. While CD reduced tile discharge and eliminated application-induced VA movement (via tile) to surface water, total VA mass loading to surface water was not affected by CD. At both CD and FD test plots, the biggest 'flush' of VA mass and highest VA concentrations occurred in response to precipitation received 2d after application, which strongly influenced the flow abatement capacity of CD on account of highly elevated water levels in field initiating overflow drainage for CD systems (when water level <0.3m below surface). VA concentrations in tile and groundwater became very low within 10d following application. Both Campylobacter spp. and Campylobacter tet(O) genes were present in groundwater and soil prior to application, and increased thereafter. Unlike the VA compounds, Campylobacter spp. and Campylobacter tet(O) gene loadings in tile drainage were reduced by CD, in relation to FD. Crown Copyright © 2015. Published by Elsevier B.V. All rights reserved.

  7. Regulation of IL-8 promoter activity by verrucarin A in human monocytic THP-1 cells.

    PubMed

    Liu, Jun; Simmons, Steve O; Pei, Ruoting

    2014-01-01

    Macrocyclic trichothecenes have been frequently detected in fungi in water-damaged buildings and exhibited higher toxicity than the well-studied trichothecenes; however, the mechanism underlying their toxicity has been poorly understood. In this study, transcriptional regulation of the cytokine interleukin (IL)-8 by a macrocyclic trichothecene, verrucarin A (VA), in human monocytic THP-1 cells is reported. Consistent with previous findings, VA was 100-fold more cytotoxic than deoxynivalenol (DON), while ochratoxin A (OA) was not cytotoxic. In cells transduced with the wild-type IL-8 promoter luciferase construct, VA induced a biphasic dose response composed of an upregulation of luciferase expression at low concentrations of 0.01-1 ng/ml and a downregulation at high levels of 10 ng/ml and higher. In contrast, DON induced a sigmoid-shaped dose response with the EC50 of 11.6 ng/ml, while OA did not markedly affect the IL-8 expression. When cells were transduced with IL-8 promoter with a mutation of transcription factor nuclear factor-κB (NF-κB)-binding site, VA (1 ng/ml), DON (1000 ng/ml), and tumor necrosis factor (TNF) α (20 ng/ml)-induced luciferase expression were impaired. In addition, the NF-κB inhibitor caffeic acid phenethyl ester inhibited VA-, DON-, and TNFα-induced luciferase expression. Mutation of the CCAAT/enhancer-binding protein (CEBP) β binding site of the IL-8 promoter affected only DON-, but not VA- and TNFα-induced luciferase expression. Taken together, these results suggested that VA activated IL-8 promoter via an NF-κB-dependent, but not CEBPβ-dependent, pathway in human monocytes.

  8. Retinal Pigment Epithelial Tears in the Era of Intravitreal Pharmacotherapy: Risk Factors, Pathogenesis, Prognosis and Treatment (An American Ophthalmological Society Thesis)

    PubMed Central

    Sarraf, David; Joseph, Anthony; Rahimy, Ehsan

    2014-01-01

    Purpose: To describe the risk factors, pathogenesis, and prognosis of retinal pigment epithelial (RPE) tears and to demonstrate our hypothesis that continued anti–vascular endothelial growth factor (VEGF) therapy after an RPE tear has occurred correlates with improved long-term visual and anatomical outcomes. Methods: We searched a database of 10,089 patients and retrospectively identified a large case series of 56 eyes with neovascular age-related macular degeneration (AMD) complicated by an RPE tear over an 8-year period. Baseline visual acuity (VA) was tabulated and analysis of the RPE tear was performed with multimodal imaging. Follow-up VA, progression of the tear, and severity of fibrosis were evaluated, and each was correlated with number of anti-VEGF injections. Results: Average follow-up for the 56 eyes was 42 months, and mean logMAR VA at baseline was 0.88 (Snellen VA 20/150) with minimal decline over 3 years. LogMAR VA plotted against number of anti-VEGF injections demonstrated that more frequent and cumulative injections correlated with better VA (P<.0001). A greater number of anti-VEGF injections was associated with minimal progression of the RPE tear, reduced fibrosis, and lower risk of a large, end-stage exudative disciform scar. Conclusions: Fifteen to 20% of vascularized pigment epithelial detachments (PEDs) may develop RPE tears after anti-VEGF therapy due to progressive contraction of the type 1 choroidal neovascular membrane in a PED at risk. Continued monitoring of RPE tears for exudative changes warranting anti-VEGF therapy may stabilize VA, improve anatomical outcomes, reduce fibrosis, and decrease the risk of developing a large blinding end-stage exudative disciform scar. PMID:25646033

  9. Audit of cataract surgery in Cadiz: visual outcomes and complications.

    PubMed

    Royo-Dujardin, L; Alcalde-Vílchez, E; Rodríguez-de la Rúa, E; Novalbos-Ruiz, J P

    2018-06-01

    To publish the outcomes and complications of age-related cataract surgery in Cadiz (Spain). Due to the lack of national audits, a comparison was made between the results obtained here and those of the most recent European audit, EUREQUO (2013), and the British audit RCOphth NOD (2015). A prospective, longitudinal, before-after study of 312 patients undergoing cataract surgery in the University Hospitals of Puerta del Mar and Puerto Real (Cadiz), in 2013-14. Outcome measurements included sociodemographic characteristics, visual acuity (VA), symptoms secondary to cataract, ocular comorbidity, waiting time, expertise of surgeon (consultant vs. trainee), rate and type of surgical complications. The median age at surgery was 73.92±7.31. Almost all (98.3%) of patients at consultation had a VA ≥0.60logMAR, with a mean pre-surgical VA of 1.01logMAR (0.92-1.10). There was a 6.7% complication rate, with 3.8% posterior capsule ruptures and 2.8% corneal decompensations. No cases of endophthalmitis occurred. The mean post-operative VA was 0.28logMAR (0.22-0.33). More than three-quarters (78.8%) of cases achieved a post-operative VA ≤0.3logMAR, and 27.6% of cases achieved a VA ≤0.0logMAR. Our success rate was inferior to the EUREQUO and RCOphth NOD studies, with the percentage of patients acquiring a postoperative VA ≤0.3logMAR being 98% and 89%, respectively. However, the populations were not comparable. It is hoped that this study will encourage other public hospitals in Spain to undertake audits and share their results, in order to provide a tool for constructive criticism and quality improvement initiatives. Copyright © 2018 Sociedad Española de Oftalmología. All rights reserved.

  10. Indocyanine Green Fluorescence for Free-Flap Perfusion Imaging Revisited: Advanced Decision Making by Virtual Perfusion Reality in Visionsense Fusion Imaging Angiography.

    PubMed

    Bigdeli, Amir Khosrow; Gazyakan, Emre; Schmidt, Volker Juergen; Hernekamp, Frederick Jochen; Harhaus, Leila; Henzler, Thomas; Kremer, Thomas; Kneser, Ulrich; Hirche, Christoph

    2016-06-01

    Near-infrared indocyanine green video angiography (ICG-NIR-VA) has been introduced for free-flap surgery and may provide intraoperative flap designing as well as postoperative monitoring. Nevertheless, the technique has not been established in clinical routine because of controversy over benefits. Improved technical features of the novel Visionsense ICG-NIR-VA surgery system are promising to revisit the field of application. It features a unique real-time fusion image of simultaneous NIR and white light visualization, with highlighted perfusion, including a color-coded perfusion flow scale for optimized anatomical understanding. In a feasibility study, the Visionsense ICG-NIR-VA system was applied during 10 free-flap surgeries in 8 patients at our center. Indications included anterior lateral thigh (ALT) flap (n = 4), latissimus dorsi muscle flap (n = 1), tensor fascia latae flap (n = 1), and two bilateral deep inferior epigastric artery perforator flaps (n = 4). The system was used intraoperatively and postoperatively to investigate its impact on surgical decision making and to observe perfusion patterns correlated to clinical monitoring. Visionsense ICG-NIR-VA aided assessing free-flap design and perfusion patterns in all cases and correlated with clinical observations. Additional interventions were performed in 2 cases (22%). One venous anastomosis was revised, and 1 flap was redesigned. Indicated by ICG-NIR-VA, 1 ALT flap developed partial flap necrosis (11%). The Visionsense ICG-NIR-VA system allowed a virtual view of flap perfusion anatomy by fusion imaging in real-time. The system improved decision making for flap design and surgical decisions. Clinical and ICG-NIR-VA parameters correlated. Its future implementation may aid in improving outcomes for free-flap surgery, but additional experience is needed to define its final role. © The Author(s) 2015.

  11. Do school classrooms meet the visual requirements of children and recommended vision standards?

    PubMed

    Negiloni, Kalpa; Ramani, Krishna Kumar; Sudhir, Rachapalle Reddi

    2017-01-01

    Visual demands of school children tend to vary with diverse classroom environments. The study aimed to evaluate the distance and near Visual Acuity (VA) demand in Indian school classrooms and their comparison with the recommended vision standards. The distance and near VA demands were assessed in 33 classrooms (grades 4 to 12) of eight schools. The VA threshold demand relied on the smallest size of distance and near visual task material and viewing distance. The logMAR equivalents of minimum VA demand at specific seating positions (desk) and among different grades were evaluated. The near threshold was converted into actual near VA demand by including the acuity reserve. The existing dimensions of chalkboard and classroom, gross area in a classroom per student and class size in all the measured classrooms were compared to the government recommended standards. In 33 classrooms assessed (35±10 students per room), the average distance and near logMAR VA threshold demand was 0.31±0.17 and 0.44±0.14 respectively. The mean distance VA demand (minimum) in front desk position was 0.56±0.18 logMAR. Increased distance threshold demand (logMAR range -0.06, 0.19) was noted in 7 classrooms (21%). The mean VA demand in grades 4 to 8 and grades 9 to 12 was 0.35±0.16 and 0.24±0.16 logMAR respectively and the difference was not statistically significant (p = 0.055). The distance from board to front desk was greater than the recommended standard of 2.2m in 27 classrooms (82%). The other measured parameters were noted to be different from the proposed standards in majority of the classrooms. The study suggests the inclusion of task demand assessment in school vision screening protocol to provide relevant guidance to school authorities. These findings can serve as evidence to accommodate children with mild to moderate visual impairment in the regular classrooms.

  12. Respiratory comfort and breathing pattern during volume proportional assist ventilation and pressure support ventilation: a study on volunteers with artificially reduced compliance.

    PubMed

    Mols, G; von Ungern-Sternberg, B; Rohr, E; Haberthür, C; Geiger, K; Guttmann, J

    2000-06-01

    To assess respiratory comfort and associated breathing pattern during volume assist (VA) as a component of proportional assist ventilation and during pressure support ventilation (PSV). Prospective, double-blind, interventional study. Laboratory. A total of 15 healthy volunteers (11 females, 4 males) aged 21-31 yrs. Decreased respiratory system compliance was simulated by banding of the thorax and abdomen. Volunteers breathed via a mouthpiece with VA and PSV each applied at two levels (VA, 8 cm H2O/L and 12 cm H2O/L; PSV, 10 cm H2O and 15 cm H2O) using a positive end-expiratory pressure of 5 cm H2O throughout. The study was subdivided into two parts. In Part 1, volunteers breathed three times with each of the four settings for 2 mins in random order. In Part 2, the first breath effects of multiple, randomly applied mode, and level shifts were studied. In Part 1, the volunteers were asked to estimate respiratory comfort in comparison with normal breathing using a visual analog scale. In Part 2, they were asked to estimate the change of respiratory comfort as increased, decreased, or unchanged immediately after a mode shift. Concomitantly, the respiratory pattern (change) was characterized with continuously measured tidal volume, respiratory rate, pressure, and gas flow. Respiratory comfort during VA was higher than during PSV. The higher support level was less important during VA but had a major negative influence on comfort during PSV. Both modes differed with respect to the associated breathing pattern. Variability of breathing was higher during VA than during PSV (Part 1). Changes in respiratory variables were associated with changes in respiratory comfort (Part 2). For volunteers breathing with artificially reduced respiratory system compliance, respiratory comfort is higher with VA than with PSV. This is probably caused by a better adaptation of the ventilatory support to the volunteer's need with VA.

  13. Clinical and radiological outcomes following traumatic Grade 3 and 4 vertebral artery injuries: a 10-year retrospective analysis from a Level I trauma center. The Parkland Carotid and Vertebral Artery Injury Survey.

    PubMed

    Scott, William W; Sharp, Steven; Figueroa, Stephen A; Eastman, Alexander L; Hatchette, Charles V; Madden, Christopher J; Rickert, Kim L

    2015-05-01

    Grade 3 and 4 blunt vertebral artery (VA) injuries may carry a different natural course from that of lower-grade blunt VA injuries. Proper screening, management, and follow-up of these injuries remain controversial. Grade 3 and 4 blunt VA injuries were analyzed to define their natural history and establish a rational management plan based on lesion progression and cerebral infarction. A retrospective review of a prospectively maintained database of all blunt traumatic carotid and vertebral artery injuries from August 2003 to April 2013 was performed, and Grade 3 and 4 blunt VA injuries were identified. Grade 3 injuries were defined as stenosis of the vessel greater than 50% or the development of a pseudoaneurysm, and Grade 4 injuries were defined as complete vessel occlusion. Demographic information, radiographic imaging findings, number of imaging sessions performed per individual, length of radiographic follow-up, radiographic outcome at end of follow-up, treatment(s) provided, and documentation of ischemic stroke or transient ischemic attack were recorded. A total of 79 high-grade (Grade 3 and 4) blunt VA injuries in 67 patients were identified. Fifty-nine patients with 66 high-grade blunt VA injuries were available for follow-up. There were 17 patients with 23 Grade 3 injuries and 42 patients with 43 Grade 4 injuries. The mean follow-up duration was 58 days for Grade 3 and 67 days for Grade 4 blunt VA injuries. Repeat imaging of Grade 3 blunt VA injuries showed that 39% of injuries were radiographically stable, 43% resolved, and 13% improved, while 1 injury radiographically worsened. Repeat imaging of the Grade 4 blunt VA injuries showed that 65% of injuries were radiographically stable (persistent occlusion), 30% improved (recanalization of the vessel), and in 2 cases (5%) the injury resolved. All Grade 3 injuries that were treated were managed with aspirin or clopidogrel alone, as were the majority of Grade 4 injuries. There were 3 cerebral infarctions thought to be related to Grade 4 blunt VA injuries, which were likely present on admission. All 3 of these patients died at a mean of 13.7 days after hospital admission. No cerebral infarctions directly related to Grade 3 blunt VA injuries were identified. The majority of high-grade blunt VA injuries remain stable or are improved at final follow-up. Despite a 4% rate of radiographic worsening in the Grade 3 blunt VA injury group and a 35% recanalization rate in the Grade 4 blunt VA injury group, there were no adverse clinical outcomes associated with these radiographic changes. No cerebral infarctions were noted in the Grade 3 group. A 7% stroke rate was identified in the Grade 4 blunt VA injury group; however, this was confined to the immediate postinjury period and was associated with 100% mortality. While these data suggest that these high-grade vertebral artery injuries may require less intensive radiographic follow-up, future prospective studies are needed to make conclusive changes related to treatment and management.

  14. Development of Acceptance Plans for Airport Pavement Materials. Volume 1. Development

    DTIC Science & Technology

    1990-05-01

    Robert A. Bacza Mr. Kenneth P. Knoll Mr. Timothy Dyer Mr. John Moretto 04/08/87 Harrisburg ADO Mr. Dan Cassidy Mr. Fred Waldmer *04/10/87 Beckley AFO... Hoyle , Tanner & Associates, Inc., Bedford, NH *06/24/87 Calcerinos-Spina, Liverpool, NY *06/25/87 Nigara Frontier Transportation Authority, Buffalo, NY...VA; Suffolk Municipal Airport, Suffolk, VA. 13. Hoyle , Tanner & Asociates, Inc., Bedford, NH, Barry W. Lussier; East Hampton Airport, East Hampton, NY

  15. The Top 10 Challenges in Extreme-Scale Visual Analytics

    PubMed Central

    Wong, Pak Chung; Shen, Han-Wei; Johnson, Christopher R.; Chen, Chaomei; Ross, Robert B.

    2013-01-01

    In this issue of CG&A, researchers share their R&D findings and results on applying visual analytics (VA) to extreme-scale data. Having surveyed these articles and other R&D in this field, we’ve identified what we consider the top challenges of extreme-scale VA. To cater to the magazine’s diverse readership, our discussion evaluates challenges in all areas of the field, including algorithms, hardware, software, engineering, and social issues. PMID:24489426

  16. Fixation Preference and Visual Acuity Testing in a Population-based Cohort of Preschool Children with Amblyopia Risk Factors

    PubMed Central

    Cotter, Susan A.; Tarczy-Hornoch, Kristina; Song, Erin; Lin, Jesse; Borchert, Mark; Azen, Stanley P.; Varma, Rohit

    2009-01-01

    Purpose To compare the clinical assessment of fixation preference (FP) to visual acuity (VA) in a population-based sample of preschool children with amblyopia risk factors. Design Evaluation of diagnostic test in a population-based study. Participants Two hundred forty-three children with amblyopia and/or strabismus, aged 30–72 months, living in Los Angeles County, California. Methods Before measuring VA, FP testing was performed at near and usually without correction, using the binocular fixation pattern in children with strabismus >10 diopters (D), or the induced tropia test for children with strabismus ≤10D, or without strabismus. We determined the sensitivity and specificity of FP testing for predicting unilateral amblyopia, defined by optotype VA, among children with amblyopia risk factors. Main Outcome Measure Grade of FP. Results Sensitivity of FP testing for amblyopia among children with anisometropia was 20% (9/44) and specificity was 94% (102/109). Among strabismic children, sensitivity was 69% (9/13; worse in children 30–47 than 48–72 months old) and specificity was 79% (70/89), with similar findings for esotropia and exotropia. Conclusion The ability of FP testing to correctly identify amblyopia in preschool children with amblyopia risk factors is poor. Clinicians should be wary of using FP as a surrogate measure of intraocular difference in VA in young children. PMID:18962921

  17. X-Linked Retinoschisis in Juveniles: Follow-Up by Optical Coherence Tomography.

    PubMed

    Hu, Qin-Rui; Huang, Lv-Zhen; Chen, Xiao-Li; Xia, Hui-Ka; Li, Tian-Qi; Li, Xiao-Xin

    2017-01-01

    Purpose. To explore the structural progression of X-linked retinoschisis (XLRS) in patients by using spectral-domain optical coherence tomography (SD-OCT). Design. Retrospective, observational study. Methods. Patients who were diagnosed with XLRS by genetic testing underwent comprehensive ophthalmological examinations from December 2014 to October 2016. Each eye was measured by SD-OCT using the same clinical protocol. A correlation between best-corrected visual acuity (VA) and SD-OCT measurements was observed. Results. Six patients demonstrated retinoschisis (12 eyes) and typical foveal cyst-like cavities (10 eyes) on SD-OCT images with a mean logMAR VA of 0.48. The median age was 7.5 years at the initial visit. Their foveal retinal thickness (516.9  μ m) and choroid thickness (351.4  μ m) decreased at a rate of 38.1 and 7.5  μ m, respectively, at the 10.5-month follow-up visit; however, there were no significant differences ( P = 0.622 and P = 0.406, resp.). There was no significant correlation between VA, the foveal retinal thickness, and subfoveal choroid thickness. Conclusions. SD-OCT images for XLRS patients during the juvenile period revealed no significant changes in the fundus structure, including the foveal retinal thickness and choroid thickness within one-year follow-up. There was a lack of correlation between VA, foveal retinal thickness, and subfoveal choroid thickness.

  18. X-Linked Retinoschisis in Juveniles: Follow-Up by Optical Coherence Tomography

    PubMed Central

    Hu, Qin-rui; Huang, Lv-zhen; Xia, Hui-ka; Li, Tian-qi

    2017-01-01

    Purpose. To explore the structural progression of X-linked retinoschisis (XLRS) in patients by using spectral-domain optical coherence tomography (SD-OCT). Design. Retrospective, observational study. Methods. Patients who were diagnosed with XLRS by genetic testing underwent comprehensive ophthalmological examinations from December 2014 to October 2016. Each eye was measured by SD-OCT using the same clinical protocol. A correlation between best-corrected visual acuity (VA) and SD-OCT measurements was observed. Results. Six patients demonstrated retinoschisis (12 eyes) and typical foveal cyst-like cavities (10 eyes) on SD-OCT images with a mean logMAR VA of 0.48. The median age was 7.5 years at the initial visit. Their foveal retinal thickness (516.9 μm) and choroid thickness (351.4 μm) decreased at a rate of 38.1 and 7.5 μm, respectively, at the 10.5-month follow-up visit; however, there were no significant differences (P = 0.622 and P = 0.406, resp.). There was no significant correlation between VA, the foveal retinal thickness, and subfoveal choroid thickness. Conclusions. SD-OCT images for XLRS patients during the juvenile period revealed no significant changes in the fundus structure, including the foveal retinal thickness and choroid thickness within one-year follow-up. There was a lack of correlation between VA, foveal retinal thickness, and subfoveal choroid thickness. PMID:28286756

  19. Is vaccenic acid (18:1t n-7) associated with an increased incidence of hip fracture? An explanation for the calcium paradox.

    PubMed

    Hamazaki, Kei; Suzuki, Nobuo; Kitamura, Kei-Ichiro; Hattori, Atsuhiko; Nagasawa, Tetsuro; Itomura, Miho; Hamazaki, Tomohito

    2016-06-01

    High calcium intake may increase hip fracture (HF) incidence. This phenomenon, known as the calcium paradox, might be explained by vaccenic acid (18:1t n-7, VA), the highly specific trans fatty acid (TFA) present in dairy products. First, we ecologically investigated the relationship between 18:1 TFA intake and HF incidence using data from 12 to 13 European countries collected before 2000; then we measured the effects of VA and elaidic acid (18:1t n-9, EA) on osteoblasts from goldfish scales (tissues very similar to mammalian bone), with alkaline phosphatase as a marker; and finally we measured the effect of VA on mRNA expression in the scales for the major bone proteins type I collagen and osteocalcin. HF incidence was significantly correlated with 18:1 TFA intake in men (r=0.57) and women (r=0.65). Incubation with 1μmol/L VA and EA for 48h significantly decreased alkaline phosphatase activity by 25% and 21%, respectively. Incubation of scales with 10μmol/L VA for 48h significantly decreased mRNA expression for type I collagen and osteocalcin (by about 50%). In conclusion, VA may be causatively related to HF and could explain the calcium paradox. It may be prudent to reduce 18:1 TFA intake, irrespective of trans positions, to prevent HF. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Randomized trial of pragmatic education for low-risk COPD patients: impact on hospitalizations and emergency department visits.

    PubMed

    Siddique, Haamid H; Olson, Raymond H; Parenti, Connie M; Rector, Thomas S; Caldwell, Michael; Dewan, Naresh A; Rice, Kathryn L

    2012-01-01

    Most interventions aimed at reducing hospitalizations and emergency department (ED) visits in patients with chronic obstructive pulmonary disease (COPD) have employed resource-intense programs in high-risk individuals. Although COPD is a progressive disease, little is known about the effectiveness of proactive interventions aimed at preventing hospitalizations and ED visits in the much larger population of low-risk (no known COPD-related hospitalizations or ED visits in the prior year) patients, some of whom will eventually become high-risk. We tested the effect of a simple educational and self-efficacy intervention (n = 2243) versus usual care (n = 2182) on COPD/breathing-related ED visits and hospitalizations in a randomized study of low-risk patients at three Veterans Affairs (VA) medical centers in the upper Midwest. Administrative data was used to track VA admissions and ED visits. A patient survey was used to determine health-related events outside the VA. Rates of COPD-related VA hospitalizations in the education and usual care group were not significantly different (3.4 versus 3.6 admissions per 100 person-years, respectively; 95% CI of difference -1.3 to 1.0, P = 0.77). The much higher patient-reported rates of non-VA hospitalizations for breathing-related problems were lower in the education group (14.0 versus 19.0 per 100 person-years; 95% CI -8.6 to -1.4, P = 0.006). Rates of COPD-related VA ED visits were not significantly different (6.8 versus 5.3; 95% CI -0.1 to 3.0, P = 0.07), nor were non-VA ED visits (32.4 versus 36.5; 95% CI -9.3 to 1.1, P = 0.12). All-cause VA admission and ED rates did not differ. Mortality rates (6.9 versus 8.3 per 100 person-years, respectively; 95% CI -3.0 to 0.4, P = 0.13) did not differ. An educational intervention that is practical for large numbers of low-risk patients with COPD may reduce the rate of breathing-related hospitalizations. Further research that more closely tracks hospitalizations to non-VA facilities is needed to confirm this finding.

  1. Emergency extracorporeal membrane oxygenation in transcatheter aortic valve implantation: A two-center experience of incidence, outcome and temporal trends from 2010 to 2015.

    PubMed

    Trenkwalder, Teresa; Pellegrini, Costanza; Holzamer, Andreas; Philipp, Alois; Rheude, Tobias; Michel, Jonathan; Reinhard, Wibke; Joner, Michael; Kasel, Albert M; Kastrati, Adnan; Schunkert, Heribert; Endemann, Dierk; Debl, Kurt; Mayr, N Patrick; Hilker, Michael; Hengstenberg, Christian; Husser, Oliver

    2017-11-11

    Although the incidence of periprocedural complications has decreased in transcatheter aortic valve implantation (TAVI), life-threatening complications occur and emergency veno-arterial extracorporeal membrane oxygenation (vaECMO) can provide immediate circulatory stabilization. We report our two-center experience of vaECMO during life-threatening complications in TAVI. From January 2010 to December 2015, 1,810 consecutive patients underwent TAVI at two centers. Clinical characteristics, type of complication, outcome and temporal trends in the requirement of emergency vaECMO were evaluated. Life-threatening complications requiring vaECMO occurred in 1.8% of cases (33 patients; 22 transfemoral, 11 transapical). Indications for vaECMO were ventricular rupture (30%, 10/33), low output (15%, 5/33), bleeding (12%, 4/33), coronary artery impairment (9%, 3/33), ventricular arrhythmias (6%, 2/33), severe aortic regurgitation (6%, 2/33), aortic annular rupture (6%, 2/33), and aortic dissection (3%, 1/33). In 4 cases, no definite cause for hemodynamic instability was identified. Conversion to open heart surgery was necessary in 42% of patients (14/33). Percutaneous coronary intervention was performed in all cases with coronary artery impairment (9%, 3/33). Patients with severe aortic regurgitation (6%, 2/33) underwent emergency valve-in-valve implantation. Other patients received, in addition to vaECMO support conservative treatment (42%, 14/33). In-hospital mortality and 30-day mortality were 46% (15/33). Of patients discharged, 67% (12/18) had no neurological impairment, whereas mild and severe neurological impairment was found in 11% (2/18) and 22% (4/18), respectively. From 2010 to 2015, with increasing procedures (from n = 43 to n = 553) requirement of vaECMO decreased from 9.3% to 0.9% (P for the trend <0.001). Over a 6-year period, need for emergency vaECMO during TAVI significantly decreased over time. Despite high in-hospital mortality, vaECMO represents a feasible strategy for hemodynamic support in case of life-threatening complications. © 2017 Wiley Periodicals, Inc.

  2. Veterans' Preferences for Exchanging Information Using Veterans Affairs Health Information Technologies: Focus Group Results and Modeling Simulations.

    PubMed

    Haun, Jolie N; Chavez, Margeaux; Nazi, Kim; Antinori, Nicole; Melillo, Christine; Cotner, Bridget A; Hathaway, Wendy; Cook, Ashley; Wilck, Nancy; Noonan, Abigail

    2017-10-23

    The Department of Veterans Affairs (VA) has multiple health information technology (HIT) resources for veterans to support their health care management. These include a patient portal, VetLink Kiosks, mobile apps, and telehealth services. The veteran patient population has a variety of needs and preferences that can inform current VA HIT redesign efforts to meet consumer needs. This study aimed to describe veterans' experiences using the current VA HIT and identify their vision for the future of an integrated VA HIT system. Two rounds of focus group interviews were conducted with a single cohort of 47 veterans and one female caregiver recruited from Bedford, Massachusetts, and Tampa, Florida. Focus group interviews included simulation modeling activities and a self-administered survey. This study also used an expert panel group to provide data and input throughout the study process. High-fidelity, interactive simulations were created and used to facilitate collection of qualitative data. The simulations were developed based on system requirements, data collected through operational efforts, and participants' reported preferences for using VA HIT. Pairwise comparison activities of HIT resources were conducted with both focus groups and the expert panel. Rapid iterative content analysis was used to analyze qualitative data. Descriptive statistics summarized quantitative data. Data themes included (1) current use of VA HIT, (2) non-VA HIT use, and (3) preferences for future use of VA HIT. Data indicated that, although the Secure Messaging feature was often preferred, a full range of HIT options are needed. These data were then used to develop veteran-driven simulations that illustrate user needs and expectations when using a HIT system and services to access VA health care services. Patient participant redesign processes present critical opportunities for creating a human-centered design. Veterans value virtual health care options and prefer standardized, integrated, and synchronized user-friendly interface designs. ©Jolie N. Haun, Margeaux Chavez, Kim Nazi, Nicole Antinori, Christine Melillo, Bridget A Cotner, Wendy Hathaway, Ashley Cook, Nancy Wilck, Abigail Noonan. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 23.10.2017.

  3. Targeting Behavioral Symptoms and Functional Decline in Dementia: A Randomized Clinical Trial.

    PubMed

    Gitlin, Laura N; Arthur, Paul; Piersol, Catherine; Hessels, Virginia; Wu, Samuel S; Dai, Yunfeng; Mann, William C

    2018-02-01

    Dementia-related behavioral symptoms and functional dependence result in poor quality of life for persons with dementia and their caregivers. The goal was to determine whether a home-based activity program (Tailored Activity Program; TAP-VA) would reduce behavioral symptoms and functional dependence of veterans with dementia and caregiver burden. Single-blind (interviewer), parallel, randomized, controlled trial (Clinicaltrials.gov: NCT01357564). Veteran's homes. Veterans with dementia and their family caregivers (N = 160 dyads). Dyads in TAP-VA underwent 8 sessions with occupational therapists to customize activities to the interests and abilities of the veterans and educate their caregivers about dementia and use of customized activity. Caregivers assigned to attention control received up to 8 telephone-based dementia education sessions with a research team member. Primary outcomes included number of behaviors and frequency of their occurrence multiplied by severity of occurrence; secondary outcomes were functional dependence, pain, emotional well-being, caregiver burden (time spent caregiving, upset with behaviors) and affect at 4 (primary endpoint) and 8 months. Of 160 dyads (n = 76 TAP-VA; n = 84 control), 111 completed 4-month interviews (n = 51 TAP-VA; n = 60 control), and 103 completed 8-month interviews (n = 50 TAP-VA; n = 53 control). At 4 months, compared to controls, the TAP-VA group showed reductions in number (difference in mean change from baseline = -0.68, 95% CI = -1.23 to -0.13) and frequency by severity (-24.3, 95% CI = -45.6 to -3.1) of behavioral symptoms, number of activities needing assistance with (-0.80, 95% CI = -1.41 to -0.20), functional dependence level (4.09, 95% CI = 1.06, 7.13), and pain (-1.18, 95% CI = -2.10 to -0.26). Caregivers of veterans in TAP-VA reported less behavior-related distress. Benefits did not extend to 8 months. TAP-VA had positive immediate effects and no adverse events. Because TAP-VA reduces behavioral symptoms, slows functional dependence, and alleviates pain and caregiver distress, it is a viable treatment option for families. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  4. 75 FR 52437 - IFR Altitudes; Miscellaneous Amendments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-26

    ... Part GORDONSVILLE, VA VORTAC LURAY, VA FIX 6100 LURAY, VA FIX *KERRE, VA FIX **6000 *7000--MRA **5000--MOCA *KERRE, VA FIX MARTINSBURG, WV VORTAC.. **6000 *7000--MRA **5000--MOCA Sec. 95.6005 VOR Federal... GORDONSVILLE, VA VORTAC LURAY, VA FIX 6100 LURAY, VA FIX *KERRE, VA FIX **6000 *7000--MRA **5000--MOCA *KERRE...

  5. Mechanical cardiac support in children with congenital heart disease with intention to bridge to heart transplantation†.

    PubMed

    De Rita, Fabrizio; Hasan, Asif; Haynes, Simon; Crossland, David; Kirk, Richard; Ferguson, Lee; Peng, Edward; Griselli, Massimo

    2014-10-01

    A significant number of children affected by congenital heart disease (CHD) develop heart failure early or late after surgery, and heart transplantation (OHTx) remains the last treatment option. Due to shortage of donor organs in paediatric group, mechanical circulatory support (MCS) is now routinely applied as bridging strategy to increase survival on the waiting list for OTHx. We sought to assess the impact of MCS as intention to bridge to OHTx in patients with CHD less than 16 years of age. From 1998 to 2013, 106 patients received 113 episodes of MCS with paracorporeal devices as intention to bridge to OHTx. Twenty-nine had CHD, 15 (52%) with two-ventricle (Group A) and 14 (48%) with single-ventricle physiology (Group B). In Group A, 5 children had venoarterial extracorporeal membrane oxygenation (VA ECMO), 6 left ventricular assist device (LVAD), 2 biventricular assist device (BIVAD), 1 VA ECMO followed by BIVAD and 1 BIVAD followed by VA ECMO. In Group B, VA ECMO was used in 7 children, univentricular assist device (UVAD) changed to VA ECMO in 4, UVAD in 2 and surgical conversion to two-ventricles physiology with BIVAD support changed to VA ECMO in 1. Twenty-one of 29 (72%) children survived to recovery/OHTx. Seven of 29 (59%) survived to discharge. In Group A, 11/15 (73%) survived to recovery/OHTx and 9/15 (60%) survived to discharge. Four of 15 (27%) died awaiting OHTx. One child had graft failure requiring VA ECMO and was bridged successfully to retransplantation. One child dying after OHTx had acute rejection, was supported with VA ECMO and then BIVAD but did not recover. One patient had an unsuccessful second run on BIVAD 1 year after recovery from VA ECMO. In Group B, 10/14 (71%) survived to recovery/OHTx and 8/14 (57%) survived to discharge. Four of 14 (29%) died awaiting OHTx. Of deaths after OHTx, 1 occurred intraoperatively and 1 was consequent to graft failure and had an unsuccessful second run with VA ECMO. Children with CHD can be successfully bridged with MCS to heart transplantation. Single-ventricle circulation compared with biventricular physiology does not increase the risk of death before transplant or before hospital discharge. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  6. 77 FR 60027 - Agency Information Collection (Notice of Disagreement) Activities Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-01

    ... of Disagreement. OMB Control Number: 2900-NEW (VA Form 21-0958). Type of Review: New data collection... Office. This is the first step in the appeals process. The respondent may or may not continue with an appeal to the Board of Veteran Appeals (BVA) for an appeal, this form will be included in the claim...

  7. To Use or Not to Use

    PubMed Central

    Washington, Donna L; Yano, Elizabeth M; Simon, Barbara; Sun, Su

    2006-01-01

    BACKGROUND AND OBJECTIVE Effects of advances in Department of Veterans Affairs (VA) women's health care on women veterans' health care decision making are unknown. Our objective was to determine why women veterans use or do not use VA health care. DESIGN AND PARTICIPANTS Cross-sectional survey of 2,174 women veteran VA users and VA-eligible nonusers throughout southern California and southern Nevada. MEASUREMENTS VA utilization, attitudes toward care, and socio-demographics. RESULTS Reasons cited for VA use included affordability (67.9%); women's health clinic (WHC) availability (58.8%); quality of care (54.8%); and convenience (47.9%). Reasons for choosing health care in non-VA settings included having insurance (71.0%); greater convenience of non-VA care (66.9%); lack of knowledge of VA eligibility and services (48.5%); and perceived better non-VA quality (34.5%). After adjustment for socio-demographics, health characteristics, and VA priority group, knowledge deficits about VA eligibility and services and perceived worse VA care quality predicted outside health care use. VA users were less likely than non-VA users to have after-hours access to nonemergency care, but more likely to receive both general and gender-related care from the same clinic or provider, to use a WHC for gender-related care, and to consider WHC availability very important. CONCLUSIONS Lack of information about VA, perceptions of VA quality, and inconvenience of VA care, are deterrents to VA use for many women veterans. VA WHCs may foster VA use. Educational campaigns are needed to fill the knowledge gap regarding women veterans' VA eligibility and advances in VA quality of care, while VA managers consider solutions to after-hours access barriers. PMID:16637939

  8. 78 FR 53014 - Agency Information Collection (Claim for One Sum Payment (Government Life Insurance)) Activities...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-27

    ... for One Sum Payment (Government Life Insurance)) Activities Under OMB Review AGENCY: Veterans Benefits....'' SUPPLEMENTARY INFORMATION Titles: a. Claim for One Sum Payment (Government Life Insurance), VA Form 29-4125. [[Page 53015

  9. 78 FR 44625 - Proposed Information Collection (Wrist Conditions Disability Benefits Questionnaire) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-24

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-NEW] Proposed Information Collection (Wrist Conditions Disability Benefits Questionnaire) Activity: Withdrawal AGENCY: Veterans Benefits Administration... proposed information collection titled ``Wrist Conditions Disability Benefits Questionnaire, VA Form 21...

  10. 76 FR 13021 - Agency Information Collection (Conflicting Interests Certification for Proprietary Schools) Under...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-09

    ... Interests Certification for Proprietary Schools Only, VA Form 22-1919. OMB Control Number: 2900-0657. Type... certifying that the institution and enrollees do not have any conflict of interest. An agency may not conduct...

  11. 78 FR 68905 - Proposed Information Collection (Annual Certification of Veteran Status and Veteran-Relatives...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-15

    ... and Veteran- Relatives, VA Form 20-0344. OMB Control Number: 2900-0654. Type of Review: Revision of a... benefit records require special handling to guard against fraud, conflict of interest, improper influence...

  12. Health-Related Quality of Life in Men with Erectile Dysfunction

    PubMed Central

    Litwin, Mark S; Nied, Robert J; Dhanani, Nasreen

    1998-01-01

    OBJECTIVE To assess health-related quality of life (HRQOL) in men with erectile dysfunction. DESIGN Descriptive survey with general and disease-specific measures. The instrument contained three established, validated HRQOL measures, a validated comorbidity checklist, and sociodemographics. The RAND 36-Item Health Survey 1.0 (SF-36) was used to assess general HRQOL. Sexual function and sexual bother were assessed using the UCLA Prostate Cancer Index. The marital interaction scale from the Cancer Rehabilitation Evaluation System Short Form (CARES-SF) was used to assess each patient's relationship with his sexual partner. SETTING Urology clinics at a university medical center and the affiliated Veterans Affairs (VA) Medical Center. PARTICIPANTS Thirty-five (67%) of 54 consecutive university patients presenting for erectile dysfunction and 22 (42%) of 52 VA patients who were awaiting a previously prescribed vacuum erection device participated. MAIN RESULTS The university respondents scored slightly lower than population normals in social function, role limitations due to emotional problems, and emotional well-being. The VA respondents scored lower than expected in all eight domains. Scores for the VA population were significantly lower than those for the university population in physical function, role limitations due to physical problems, bodily pain, and social function. A significant correlation was seen between marital interaction and sexual function (r = −.33, p = .01) but not between marital interaction and sexual bother (r = −.15, p = .26) in the total sample. Sexual function also correlated significantly with general health perceptions (r = .34, p = .01), role limitations due to physical problems (r = .29, p = .03), and role limitations due to emotional problems (r = .30, p = .03). Sexual bother did not correlate with any of the general HRQOL domains. Affluent men reported better sexual function (p = .03). CONCLUSIONS The emotional domains of the SF-36 are associated with more profound impairment than are the physical domains in men with erectile dysfunction. Erectile dysfunction and the bother it causes are discrete domains of HRQOL and distinct from each other in these patients. With increased attention to patient-centered medical outcomes, greater emphasis has been placed on such variables as HRQOL. This should be particularly true for a patient-driven symptom, such as erectile dysfunction. PMID:9541372

  13. Atelectasis after airway extubation during veno-arterial extracorporeal membrane oxygenation support.

    PubMed

    Wang, Hong; Jia, Ming; Mao, Bin; Hou, Xiaotong

    2017-09-01

    Veno-arterial extracorporeal membrane oxygenation (VA ECMO) is used in cardiopulmonary failure patients to provide temporary assisted circulation. Usually, prolonged intubation and invasive mechanical ventilation are required in patients with ECMO support. We report on two cases of patients who had no pre-existing injuries of the affected lung, underwent VA ECMO support after open-heart surgery and received airway extubation (AE) or awake ECMO with the recovery of left ventricular ejection fraction. Atelectasis happened after AE and non-invasive positive pressure ventilation attenuated the atelectasis of one patient. The atelectasis of the other patient was corrected 10 hours after weaning from ECMO. Both patients were discharged successfully. Awake VA ECMO for post-cardiac surgery patients should be performed with prudence and needs further research.

  14. Association Between Vessel Density and Visual Acuity in Patients With Diabetic Retinopathy and Poorly Controlled Type 1 Diabetes.

    PubMed

    Dupas, Bénédicte; Minvielle, Wilfried; Bonnin, Sophie; Couturier, Aude; Erginay, Ali; Massin, Pascale; Gaudric, Alain; Tadayoni, Ramin

    2018-05-10

    Capillary dropout is a hallmark of diabetic retinopathy, but its role in visual loss remains unclear. To examine how macular vessel density is correlated with visual acuity (VA) in patients younger than 40 years who have type 1 diabetes without macular edema but who have diabetic retinopathy requiring panretinal photocoagulation. Retrospective cohort study of VA and optical coherence tomography angiography data collected from consecutive patients during a single visit to Lariboisière Hospital, a tertiary referral center in Paris, France. The cohort included 22 eyes of 22 patients with type 1 diabetes without macular edema but with bilateral rapidly progressive diabetic retinopathy that was treated with panretinal photocoagulation between August 15, 2015, and December 30, 2016. Eyes were classified into 2 groups by VA: normal (logMAR, 0; Snellen equivalent, 20/20) and decreased (logMAR, >0; Snellen equivalent, <20/20). The control group included 12 eyes from age-matched healthy participants with normal vision. Visual acuity and mean vessel density in 4 retinal vascular plexuses: the superficial vascular plexus and the deep capillary complex, which comprises the intermediate capillary plexus and the deep capillary plexus. Of the 22 participants, 11 (50%) were men, mean (SD) age was 30 (6) years, and mean (SD) hemoglobin A1c level was 8.9% (1.6%). Of the 22 eyes with diabetic retinopathy, 13 (59%) had normal VA and 9 (41%) had decreased VA (mean [SD]: logMAR, 0.12 [0.04]; Snellen equivalent, 20/25). Mean [SE] vessel density was lower for eyes with diabetic retinopathy and normal VA compared with the control group in the superficial vascular plexus (44.1% [0.9%] vs 49.1% [0.9%]; difference, -5.0% [1.3%]; 95% CI, -7.5% to -2.4%; P < .001), in the deep capillary complex (44.3% [1.2%] vs 50.6% [1.3%]; difference, -6.3% [1.8%]; 95% CI, -9.9% to -2.7%; P = .001), in the intermediate capillary plexus (43.8% [1.2%] vs 49.3% [1.2%]; difference, -5.5% [1.7%]; 95% CI, -9.0% to -2.0%; P = .003), and in the deep capillary plexus (24.5% [1.0%] vs 30.5% [1.0%]; difference, -6.1% [1.4%]; 95% CI, -8.9% to -3.2%; P < .001). Mean vessel density was lower in eyes with diabetic retinopathy and decreased VA compared with eyes with diabetic retinopathy and normal VA; the mean (SE) loss was more pronounced in the deep capillary complex (34.6% [1.5%] vs 44.3% [1.2%]; difference, -9.6% [1.9%]; 95% CI, -13.6% to -5.7%; P < .001), especially in the deep capillary plexus (15.2% [1.2%] vs 24.5% [1.0%]; difference, -9.3% [1.5%]; 95% CI, -12.4% to -6.1%; P < .001), than in the superficial vascular plexus (39.6% [1.1%] vs 44.1% [0.9%]; difference, -4.5% [1.4%]; 95% CI, -7.3% to -1.7%; P = .002). These data suggest that in patients with type 1 diabetes without macular edema but with severe nonproliferative or proliferative diabetic retinopathy, decreased VA may be associated with the degree of capillary loss in the deep capillary complex.

  15. 40 CFR Appendix A to Part 97 - Final Section 126 Rule: EGU Allocations, 2004-2007

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... VA POSSUM POINT 3804 4 528 VA POSSUM POINT 3804 5 322 VA POTOMAC RIVER 3788 1 203 VA POTOMAC RIVER 3788 2 139 VA POTOMAC RIVER 3788 3 232 VA POTOMAC RIVER 3788 4 223 VA POTOMAC RIVER 3788 5 222 VA SEI...

  16. 40 CFR Appendix A to Part 97 - Final Section 126 Rule: EGU Allocations, 2004-2007

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... VA POSSUM POINT 3804 4 528 VA POSSUM POINT 3804 5 322 VA POTOMAC RIVER 3788 1 203 VA POTOMAC RIVER 3788 2 139 VA POTOMAC RIVER 3788 3 232 VA POTOMAC RIVER 3788 4 223 VA POTOMAC RIVER 3788 5 222 VA SEI...

  17. 40 CFR Appendix A to Part 97 - Final Section 126 Rule: EGU Allocations, 2004-2007

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... VA POSSUM POINT 3804 4 528 VA POSSUM POINT 3804 5 322 VA POTOMAC RIVER 3788 1 203 VA POTOMAC RIVER 3788 2 139 VA POTOMAC RIVER 3788 3 232 VA POTOMAC RIVER 3788 4 223 VA POTOMAC RIVER 3788 5 222 VA SEI...

  18. Vascular dementia: Cognitive, functional and behavioral assessment. Recommendations of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology. Part II

    PubMed Central

    Engelhardt, Eliasz; Tocquer, Carla; André, Charles; Moreira, Denise Madeira; Okamoto, Ivan Hideyo; Cavalcanti, José Luiz de Sá

    2011-01-01

    Vascular dementia (VaD) is the most prevalent form of secondary dementia and the second most common of all dementias. The present paper aims to define guidelines on the basic principles for treating patients with suspected VaD (and vascular cognitive impairment - no dementia) using an evidence-based approach. The material was retrieved and selected from searches of databases (Medline, Scielo, Lilacs), preferentially from the last 15 years, to propose a systematic way to assess cognition, function and behavior, and disease severity staging, with instruments adapted for our milieu, and diagnosis disclosure. The present proposal contributes to the definition of standard diagnostic criteria for VaD based on various levels of evidence. It is noteworthy that only around half of the population of patients with vascular cognitive impairment present with dementia, which calls for future proposals defining diagnostic criteria and procedures for this condition. PMID:29213753

  19. H2O2-responsive molecularly engineered polymer nanoparticles as ischemia/reperfusion-targeted nanotherapeutic agents

    NASA Astrophysics Data System (ADS)

    Lee, Dongwon; Bae, Soochan; Hong, Donghyun; Lim, Hyungsuk; Yoon, Joo Heung; Hwang, On; Park, Seunggyu; Ke, Qingen; Khang, Gilson; Kang, Peter M.

    2013-07-01

    The main culprit in the pathogenesis of ischemia/reperfusion (I/R) injury is the overproduction of reactive oxygen species (ROS). Hydrogen peroxide (H2O2), the most abundant form of ROS produced during I/R, causes inflammation, apoptosis and subsequent tissue damages. Here, we report H2O2-responsive antioxidant nanoparticles formulated from copolyoxalate containing vanillyl alcohol (VA) (PVAX) as a novel I/R-targeted nanotherapeutic agent. PVAX was designed to incorporate VA and H2O2-responsive peroxalate ester linkages covalently in its backbone. PVAX nanoparticles therefore degrade and release VA, which is able to reduce the generation of ROS, and exert anti-inflammatory and anti-apoptotic activity. In hind-limb I/R and liver I/R models in mice, PVAX nanoparticles specifically reacted with overproduced H2O2 and exerted highly potent anti-inflammatory and anti-apoptotic activities that reduced cellular damages. Therefore, PVAX nanoparticles have tremendous potential as nanotherapeutic agents for I/R injury and H2O2-associated diseases.

  20. A novel IMPDH1 mutation (Arg231Pro) in a family with a severe form of autosomal dominant retinitis pigmentosa.

    PubMed

    Grover, Sandeep; Fishman, Gerald A; Stone, Edwin M

    2004-10-01

    To define ophthalmic findings in a family with autosomal dominant retinitis pigmentosa and a novel IMPDH1 gene mutation. Genetic and observational family study. Sixteen affected members of a family with autosomal dominant retinitis pigmentosa. Ophthalmic examination, including best-corrected visual acuity (VA), slit-lamp biomicroscopy, direct and indirect ophthalmoscopy, Goldmann kinetic perimetry, and electroretinography were performed. Deoxyribonucleic acid single-strand conformation polymorphism (SSCP) analysis was done. Abnormal polymerase chain reaction products identified by SSCP analysis were sequenced bidirectionally. All affected patients had the onset of night blindness within the first decade of life. Ocular findings were characterized by diffuse retinal pigmentary degenerative changes, marked restriction of peripheral visual fields, severe loss of VA, nondetectable electroretinography amplitudes, and a high frequency of posterior subcapsular lens opacities. Affected members were observed to harbor a novel IMPDH1 gene mutation. A novel IMPDH1 gene mutation (Arg231Pro) was associated with a severe form of autosomal dominant retinitis pigmentosa. Families affected with a severe form of this genetic subtype should be investigated for a mutation in the IMPDH1 gene.

  1. Clinical Manifestations and Outcome of Syphilitic Uveitis.

    PubMed

    Bollemeijer, Jan G; Wieringa, Wietse G; Missotten, Tom O A R; Meenken, Ina; ten Dam-van Loon, Ninette H; Rothova, Aniki; Los, Leonoor I

    2016-02-01

    To analyze visual outcome, effectiveness of various modes of antibiotic treatment, and prognostic factors in patients with serologically proven syphilitic uveitis. The clinical records of 85 patients (139 eyes) diagnosed with syphilitic uveitis between 1984 and 2013 at tertiary centers in The Netherlands were retrospectively analyzed. Mean age was 47 years (range, 27-73 years), 82.4% were male. HIV positivity was found in 28 (35.9%) patients; 13 were newly diagnosed. Most patients had pan (45.9%) or posterior (31.8%) uveitis. On average, logMAR visual acuity (VA) improved significantly from 0.55 at the start of syphilis treatment to 0.34 at 1 month and to 0.27 at 6 months follow-up. Most patients (86.7%) reached disease remission. No differences in efficacy between the various treatment regimens were found. A high logMAR VA at the start of syphilis treatment and a treatment delay of more than 12 weeks were prognostic for a high logMAR VA at 6 months follow-up. Chronicity was not related to any form of treatment, HIV status, or Venereal Disease Research Laboratory test outcome. In this large cohort of 85 patients with syphilitic uveitis, visual outcomes were favorable in the majority of cases. Visual outcome was dependent on VA at the start of syphilis treatment and treatment delay.

  2. Erectile Dysfunction Medication Use in Veterans Eligible for Medicare Part D.

    PubMed

    Spencer, Samantha H; Suda, Katie J; Smith, Bridget M; Huo, Zhiping; Bailey, Lauren; Stroupe, Kevin T

    2016-07-01

    Erectile dysfunction (ED) medications are therapeutically effective and associated with satisfaction. Medicare Part D included ED medications on the formulary during 2006 and inadvertently in 2007-2008. To characterize phosphodiesterase-5 inhibitor (PDE-5) medication use among veterans who were dually eligible for Veterans Affairs (VA) and Medicare Part D benefits. Veterans aged > 66 years who received PDE-5 inhibitors between 2005 and 2009 were included. Veterans were categorized by PDE-5 inhibitor claims: VA-only, Part D-only, or dual users of VA and Part D-reimbursed pharmacies. T-tests and chi-square tests were applied as appropriate. From 2005 to 2009, the majority (85.2%) of veterans used VA benefits exclusively for their PDE-5 inhibitors; 11.4% used Medicare Part D exclusively; and 3.4% were dual users. The Part D-only group was older, more frequently not black, had a VA copay, and had a higher income (P < 0.03). The VA group was more likely to have comorbidities, smoke, and have a history of substance abuse (P < 0.001). With the inception of Medicare Part D in 2006, the number of patients filling prescriptions for PDE-5 inhibitors (-68%) and total number of PDE-5 inhibitor 30-day equivalents dispensed (-86.7%) from the VA decreased. Part D prescriptions increased through 2006 (full coverage period) and 2007 (accidental partial coverage) and decreased in 2008. While Part D accounted for only 10% of PDE-5 inhibitor 30-day equivalents, it equaled 29.2% of dispensed tablets. In October 2007, VA PDE-5 inhibitor use returned to 2005 levels. Implementation of Medicare Part D reduced VA PDE-5 inhibitor acquisition. However, after removal of PDE-5 inhibitors from the Part D formulary, use of VA pharmacies for PDE-5 inhibitors resumed. Medication policies outside the VA can affect medication use. Veterans with access to non-VA health care may obtain medications from the private sector because of VA restrictions. This may be especially true for nonformulary and lifestyle medications. The authors received funding support for this research project from the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service as grant IIR 07-165-2. The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs or Health Services Research and Development Service. Study concept and design were contributed by Smith and Stroupe, assisted by the other authors. Huo, Bailey, and Stroupe took the lead in data collection, assisted by the other authors. Data interpretation was performed by Spencer and Suda, along with Smith and Stroupe and assisted by Huo and Bailey. The manuscript was primarily written by Spencer and Suda, with assistance from the other authors, and revised by Spencer, along with the other authors.

  3. Pricing and Escalation Issues Weaken the Effectiveness of the Army Contract With Sikorsky to Support the Corpus Christi Army Depot

    DTIC Science & Technology

    2011-09-08

    General ,400 Army Navy Drive,Arlington,VA,22202 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10...contact the Office of the Deputy Inspector General for Auditing by phone (703) 604-9142 (DSN 664-9142), by fax (703) 604-8932, or by mail...ODIG-AUD (ATTN: Audit Suggestions) Department of Defense Inspector General 400 Army Navy Drive (Room 801) Arlington, VA 22202-4704

  4. Project VALOR: Trajectories of Change in PTSD in Combat-Exposed Veterans

    DTIC Science & Technology

    2017-10-01

    Implications for ICD–11. Journal Of Abnormal Psychology , 126(3), 355- 366. doi:10.1037/abn0000252 PRESENTATIONS Black, S.K., Harwell, A.M., Klein, A.B...mental health in a nationally representative sample of U.S. OEF/OIF veterans. Journal of Abnormal Psychology , 120, 797– 806. http://dx .doi.org...Marx, 150 South Huntington Avenue (116B-3), Boston, MA 02130. E-mail: Karen.Mitchell5@va.gov or Brian.Marx@va.gov Journal of Abnormal Psychology In

  5. Automated Logistics Support Analysis Tool, Version 1.0 User’s Manual, LSA Task 101, Early LSA Strategy

    DTIC Science & Technology

    1991-05-01

    US AMCCOM INTEGRATED LOGISTIC SUPPORT OFFICE AMSMC-LSP ROCK ISLAND, IL by AMERICAN POWER JET COMPANY RIDGEFIELD, NJ ARLINGTON, VA WILLIAMSBURG, VA ST...the American Power Jet (APJ) Company , under contract to HQs AMCCOM. A major goal of the project is to unify the military and contractor approach to...and should be addressed to: George Chernowitz AMERICAN POWER JET COMPANY 705 Grand Avenue Ridgefield, New Jersey 07657 Phone: (201) 945-8203 TABLE OF

  6. Ambient Noise Analysis from Selected CTBTO (Comprehensive Test Ban Treaty Organization) Sites

    DTIC Science & Technology

    2015-02-11

    AGENCY NAME(S) AND ADDRESS(ES) Robert H. Headrick Office of Naval Research 875 North Randolph Street Arlington, VA 22203-1995 10. SPONSOR/MONITOR’S...Canada HA03 Juan Fernandez Island Chile HA04 Crozet Islands France HA05 Guadeloupe France Co HA06 Socorro Island Mexico HA07 Flores Portugal...2), 61- 73 (1974). 8. W.J. Pierson, Jr ., and R.A. Stacy. NASA Report CR-2247, National Technical Information Service, Springfield, VA 22151 (1973

  7. Empirical-Based Typology of Health Care Utilization by Medicare Eligible Veterans.

    PubMed

    Vaughan Sarrazin, Mary; Rosenthal, Gary E; Turvey, Carolyn L

    2018-06-12

    Up to 70 percent of patients who receive care through Veterans Health Administration (VHA) facilities also receive care from non-VA providers. Using applied classification techniques, this study sought to improve understanding of how elderly VA patients use VA services and complementary use of non-VA care. The study included 1,721,900 veterans age 65 and older who were enrolled in VA and Medicare during 2013 with at least one VA encounter during 2013. Outpatient and inpatient encounters and medications received in VA were classified, and mutually exclusive patient subsets distinguished by patterns of VA service use were derived empirically using latent class analysis (LCA). Patient characteristics and complementary use of non-VA care were compared by patient subset. Five patterns of VA service use were identified that were distinguished by quantity of VA medical and specialty services, medication complexity, and mental health services. Low VA Medical users tend to be healthier and rely on non-VA services, while High VA users have multiple high cost illnesses and concentrate their care in the VA. VA patients distinguished by patterns of VA service use differ in illness burden and the use of non-VA services. This information may be useful for framing efforts to optimize access to care and care coordination for elderly VA patients. © Health Research and Educational Trust.

  8. 10. 1947 Tree Plan Jefferson's Academical Village, Bounded by ...

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

    10. 1947 Tree Plan - Jefferson's Academical Village, Bounded by University Avenue on the north, Jefferson Park Avenue on the south, Hospital Drive on the east, and McCormick Road on the west, Charlottesville, Independent City, VA

  9. Visual Function of Moderately Hyperopic 4- and 5-Year-Old Children in the Vision In Preschoolers - Hyperopia In Preschoolers Study

    PubMed Central

    Ciner, Elise B.; Kulp, Marjean Taylor; Maguire, Maureen; Pistilli, Maxwell; Candy, T. Rowan; Moore, Bruce; Ying, Gui-shuang; Quinn, Graham; Orlansky, Gale; Cyert, Lynn

    2016-01-01

    Purpose To compare visual performance between emmetropic and uncorrected moderately hyperopic preschool age children without strabismus or amblyopia. Design Cross-sectional study. Methods Setting Multicenter, institutional. Patient or Study Population Children aged 4 or 5 years. Intervention or Observation Procedures Visual functions were classified as normal or reduced for each child based on the 95% confidence interval for emmetropes. Hyperopic (≥3.0 diopters [D] to ≤6.0D in the most hyperopic meridian; astigmatism≤1.50D; anisometropia≤1.0D) and emmetropic status were determined by cycloplegic autorefraction. Main Outcome Measures Uncorrected monocular distance and binocular near visual acuity (VA); accommodative response; and near random dot stereoacuity. Results Mean (±SD) LogMAR distance VA among 248 emmetropes was better than among 244 hyperopes for the better (0.05±0.10 vs. 0.14±0.11, p<.001) and worse eyes (0.10±0.11 vs. 0.19±0.10, p<.001). Mean binocular LogMAR near VA was better in emmetropes than hyperopes (0.13±0.11 vs. 0.21±0.11, p<.001). Mean accommodative response for emmetropes was lower than for hyperopes for both Monocular Estimation Method (1.03±0.51D vs. 2.03±1.03D, p<0.001) and Grand Seiko (0.46±0.45D vs. 0.99±1.0D, p<0.001). Median near stereoacuity was better in emmetropes than hyperopes (40 sec arc vs.120 sec arc, p<0.001). The average number of reduced visual functions was lower in emmetropic than in hyperopic children (.19 vs.1.0 p<0.001). Conclusions VA, accommodative response, and stereoacuity were significantly reduced in moderate uncorrected hyperopic preschool children compared to emmetropes. Higher hyperopes (≥4 to ≤6D) were at greatest risk, although more than half of children with lower magnitudes (≥3 to <4D) demonstrated one or more reductions in function. PMID:27477769

  10. Superemission in vertically-aligned single-wall carbon nanotubes

    NASA Astrophysics Data System (ADS)

    Khmelinskii, Igor; Makarov, Vladimir

    2016-09-01

    Presently we used two samples of vertically aligned single-wall carbon nanotubes (VA SWCNTs) with parallelepiped geometry, sized 0.02 cm × 0.2 cm × 1.0 cm and 0.2 cm × 0.2 cm × 1.0 cm. We report absorption and emission properties of the VA SWCNTs, including strong anisotropy in both their absorption and emission spectra. We found that the emission spectra extend from the middle-IR range to the near-IR range, with such extended spectra being reported for the first time. Pumping the VA SWCNTs in the direction normal to their axis, superemission (SE) was observed in the direction along their axis. The SE band maximum is located at 7206 ± 0.4 cm-1. The energy and the power density of the superemission were estimated, along with the diffraction-limited divergence. At the pumping energy of 3 mJ/pulse, the SE energy measured by the detector was 0.74 mJ/pulse, corresponding to the total SE energy of 1.48 mJ/pulse, with the energy density of 18.5 mJ cm-2/pulse and the SE power density of 1.2 × 105 W cm-2/pulse. We report that a bundle of VA SWCNTs is an emitter with a relatively small divergence, not exceeding 3.9 × 10-3 rad. We developed a theoretical approach to explain such absorption and emission spectra. The developed theory is based on the earlier proposed SSH theory, which we extended to include the exchange interactions between the closest SWCNT neighbors. The developed theoretical ideas were implemented in a homemade FORTRAN code. This code was successfully used to calculate and reproduce the experimental spectra and to determine the SWCNT species that originate the respective absorption bands, with acceptable agreement between theory and experiment.

  11. High Prevalence of Malnutrition among Elderly Veterans in Home Based Primary Care.

    PubMed

    Win, A Z; Ceresa, C; Arnold, K; Allison, T A

    2017-01-01

    Elderly Veterans enrolled in VA Home Based Primary Care (HBPC) programs suffer from many diseases including malnutrition. Nutrition screening tools exist in the VA system but they are inconsistently utilized across ambulatory care programs and are neither research validated nor comparable with non-VA populations. The Mini-Nutritional Assessment short-form (MNA-SF) has been validated in international studies in a variety of settings. The primary aim of this study was to find the prevalence of malnutrition among Veterans enrolled in HBPC programs. The secondary objective was to determine the feasibility of adopting a validated nutrition screening tool (Mini-Nutritional Assessment short-form (MNA-SF)). 2252 veterans age 65 and older from 18 HBPC programs from across the country participated in the study. The study period was between April and September 2012. WinPepi (version 11.25) was used for descriptive analysis. We found that the prevalence of malnutrition was 15% (344/2252) and the prevalence of at risk for malnutrition was 40.3% (909/2252). The MNA-SF is an efficient nutrition screening tool and it can be successfully used for the elderly veterans. The prevalence of malnutrition among veterans was high compared to the community dwelling U.S. civilian elderly population. By preventing and treating malnutrition, health care systems should be able to reduce overall health care costs.

  12. 78 FR 66105 - Agency Information Collection Activities Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-04

    ... Health Benefits.'' SUPPLEMENTARY INFORMATION: Title: Application and Renewal for Health Benefits, VA Form... Activities Under OMB Review AGENCY: Veterans Health Administration, Department of Veterans Affairs. ACTION... notice announces that the Veterans Health Administration (VHA), Department of Veterans Affairs, has...

  13. 78 FR 36306 - Proposed Information Collection (Neck (Cervical Spine) Conditions Disability Benefits...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-17

    ... (Cervical Spine) Conditions Disability Benefits Questionnaire) Activity: Comment Request AGENCY: Veterans... ``OMB Control No. 2900--NEW (Neck (Cervical Spine) Conditions Disability Benefits Questionnaire)'' in... (Cervical Spine) Conditions Disability Benefits Questionnaire) Disability Benefits Questionnaire, VA Form 21...

  14. Fabrication and gas sensing properties of vertically aligned Si nanowires

    NASA Astrophysics Data System (ADS)

    Mirzaei, Ali; Kang, Sung Yong; Choi, Sun-Woo; Kwon, Yong Jung; Choi, Myung Sik; Bang, Jae Hoon; Kim, Sang Sub; Kim, Hyoun Woo

    2018-01-01

    In this study, a peculiar configuration for a gas sensor consisting of vertically aligned silicon nanowires (VA-Si NWs) synthesized by metal-assisted chemical etching (MACE) is reported. Si NWs were prepared via a facile MACE method and subsequent thermal annealing. Etching was performed by generation of silver nanoparticles (Ag NPs) and subsequent etching in HF/H2O2 aqueous solution; the growth conditions were optimized by changing the process parameters. Highly vertically oriented arrays of Si NWs with a straight-line morphology were obtained, and a top-top electrode configuration was applied. The VA-Si NW gas sensor showed good sensing performance, and the VA-Si NWs exhibited a remarkable response (Rg/Ra = 11.5 ∼ 17.1) to H2 gas (10-50 ppm) at 100 °C which was the optimal working temperature. The formation mechanism and gas sensing mechanism of VA-Si NWs are described. The obtained results can suggest new approaches to making inexpensive, versatile, and portable sensors based on Si NWs having a novel top-top electrode structure that are fully compatible with well-developed Si technologies.

  15. Prevalence and risk factors of vision impairment among children of employees of Telecom, Italy.

    PubMed

    Nucci, Carlo; Cofini, Vincenza; Mancino, Raffaele; Ricci, Federico; Martucci, Alessio; Cecilia, Maria Rosita; Ciciarelli, Vincenzo; Zazzara, Francesca; Cedrone, Claudio; di Orio, Ferdinando

    2016-06-10

    To define the prevalence, causes, and risk factors of vision impairment (VI) in children. In this study, relatives of Association for Supplemental Health Insurance to the Employees of Telecom members aged 5-16 years were examined in all Italian regions. A standardized record card was used to collect data on medical history; keratometry; objective refraction; uncorrected, presenting, and best-corrected visual acuity (VA); examination of the pupils, adnexa, and anterior segment; direct ophthalmoscopy; posterior segment and fundus examination; and assessment for ocular pathology. Binocular and monocular VI were defined by a VA <5/10 (or <20/40). The campaign included 17,508 children, 12,798 of whom (73.1%) were examined (and 12,740 on whom all VA data were gathered). The prevalence of uncorrected, presenting, and best-corrected VI in the better eye was 9.0%, 2.51%, and 0.10%, respectively. The following variables were associated with presenting VI: age 10-16 years, family history of myopia, female sex, family history of keratoconus, and hypertension. Myopia is the main cause of VI (82.6%). A total of 96% of children with presenting VI had correctable VI. Correctable VI because of myopia is an important public health problem in school-age children in Italy.

  16. The paradox of verbal autopsy in cause of death assignment: symptom question unreliability but predictive accuracy.

    PubMed

    Serina, Peter; Riley, Ian; Hernandez, Bernardo; Flaxman, Abraham D; Praveen, Devarsetty; Tallo, Veronica; Joshi, Rohina; Sanvictores, Diozele; Stewart, Andrea; Mooney, Meghan D; Murray, Christopher J L; Lopez, Alan D

    2016-01-01

    We believe that it is important that governments understand the reliability of the mortality data which they have at their disposable to guide policy debates. In many instances, verbal autopsy (VA) will be the only source of mortality data for populations, yet little is known about how the accuracy of VA diagnoses is affected by the reliability of the symptom responses. We previously described the effect of the duration of time between death and VA administration on VA validity. In this paper, using the same dataset, we assess the relationship between the reliability and completeness of symptom responses and the reliability and accuracy of cause of death (COD) prediction. The study was based on VAs in the Population Health Metrics Research Consortium (PHMRC) VA Validation Dataset from study sites in Bohol and Manila, Philippines and Andhra Pradesh, India. The initial interview was repeated within 3-52 months of death. Question responses were assessed for reliability and completeness between the two survey rounds. COD was predicted by Tariff Method. A sample of 4226 VAs was collected for 2113 decedents, including 1394 adults, 349 children, and 370 neonates. Mean question reliability was unexpectedly low ( kappa  = 0.447): 42.5 % of responses positive at the first interview were negative at the second, and 47.9 % of responses positive at the second had been negative at the first. Question reliability was greater for the short form of the PHMRC instrument ( kappa  = 0.497) and when analyzed at the level of the individual decedent ( kappa  = 0.610). Reliability at the level of the individual decedent was associated with COD predictive reliability and predictive accuracy. Families give coherent accounts of events leading to death but the details vary from interview to interview for the same case. Accounts are accurate but inconsistent; different subsets of symptoms are identified on each occasion. However, there are sufficient accurate and consistent subsets of symptoms to enable the Tariff Method to assign a COD. Questions which contributed most to COD prediction were also the most reliable and consistent across repeat interviews; these have been included in the short form VA questionnaire. Accuracy and reliability of diagnosis for an individual death depend on the quality of interview. This has considerable implications for the progressive roll out of VAs into civil registration and vital statistics (CRVS) systems.

  17. Comparison of outcomes for veterans receiving dialysis care from VA and non-VA providers

    PubMed Central

    2013-01-01

    Background Demand for dialysis treatment exceeds its supply within the Veterans Health Administration (VA), requiring VA to outsource dialysis care by purchasing private sector dialysis for veterans on a fee-for-service basis. It is unclear whether outcomes are similar for veterans receiving dialysis from VA versus non-VA providers. We assessed the extent of chronic dialysis treatment utilization and differences in all-cause hospitalizations and mortality between veterans receiving dialysis from VA versus VA-outsourced providers. Methods We constructed a retrospective cohort of veterans in 2 VA regions who received chronic dialysis treatment financed by VA between January 2007 and December 2008. From VA administrative data, we identified veterans who received outpatient dialysis in (1) VA, (2) VA-outsourced settings, or (3) both (“dual”) settings. In adjusted analyses, we used two-part and logistic regression to examine associations between dialysis setting and all-cause hospitalization and mortality one-year from veterans’ baseline dialysis date. Results Of 1,388 veterans, 27% received dialysis exclusively in VA, 47% in VA-outsourced settings, and 25% in dual settings. Overall, half (48%) were hospitalized and 12% died. In adjusted analysis, veterans in VA-outsourced settings incurred fewer hospitalizations and shorter hospital stays than users of VA due to favorable selection. Dual-system dialysis patients had lower one-year mortality than veterans receiving VA dialysis. Conclusions VA expenditures for “buying” outsourced dialysis are high and increasing relative to “making” dialysis treatment within its own system. Outcomes comparisons inform future make-or-buy decisions and suggest the need for VA to consider veterans’ access to care, long-term VA savings, and optimal patient outcomes in its placement decisions for dialysis services. PMID:23327632

  18. Comparison of outcomes for veterans receiving dialysis care from VA and non-VA providers.

    PubMed

    Wang, Virginia; Maciejewski, Matthew L; Patel, Uptal D; Stechuchak, Karen M; Hynes, Denise M; Weinberger, Morris

    2013-01-18

    Demand for dialysis treatment exceeds its supply within the Veterans Health Administration (VA), requiring VA to outsource dialysis care by purchasing private sector dialysis for veterans on a fee-for-service basis. It is unclear whether outcomes are similar for veterans receiving dialysis from VA versus non-VA providers. We assessed the extent of chronic dialysis treatment utilization and differences in all-cause hospitalizations and mortality between veterans receiving dialysis from VA versus VA-outsourced providers. We constructed a retrospective cohort of veterans in 2 VA regions who received chronic dialysis treatment financed by VA between January 2007 and December 2008. From VA administrative data, we identified veterans who received outpatient dialysis in (1) VA, (2) VA-outsourced settings, or (3) both ("dual") settings. In adjusted analyses, we used two-part and logistic regression to examine associations between dialysis setting and all-cause hospitalization and mortality one-year from veterans' baseline dialysis date. Of 1,388 veterans, 27% received dialysis exclusively in VA, 47% in VA-outsourced settings, and 25% in dual settings. Overall, half (48%) were hospitalized and 12% died. In adjusted analysis, veterans in VA-outsourced settings incurred fewer hospitalizations and shorter hospital stays than users of VA due to favorable selection. Dual-system dialysis patients had lower one-year mortality than veterans receiving VA dialysis. VA expenditures for "buying" outsourced dialysis are high and increasing relative to "making" dialysis treatment within its own system. Outcomes comparisons inform future make-or-buy decisions and suggest the need for VA to consider veterans' access to care, long-term VA savings, and optimal patient outcomes in its placement decisions for dialysis services.

  19. Transverse process anatomy as a guide to vertebral artery exposure during anterior cervical spine approach: A Cadaveric Study.

    PubMed

    Nourbakhsh, Ali; Yang, Jinping; Mcmahan, Howard; Garges, Kim

    2017-05-01

    Safe exposure of the vertebral artery (VA) is needed during resection of tumors close to the artery and during repair of lacerations. We defined the anatomy of the anterior root of each transverse process (TP) from C3 to C6 for identification and exposure of the VA during the anterior approach. We examined the anatomy of the TP and assessed two approaches for safe identification of the VA, lateral to medial and medial to lateral dissection of the TP, in 20 cadavers. The safe zone at each level of the cervical spine was defined as an area in which the surgeon can start to dissect at the midline of that level on the TP and safely cross the VA laterally. For the lateral to medial approach the surgical safe zone lies between the mid axis of the TPs and a line 2 mm parallel to and above it. The average TP angle was 11 ± 10.2 degrees. The mean distance of the lateral border of the VA from the TP tip was 3.78-5.28 mm. For the medial to lateral approach, staying at the level of the upper vertebral end plate will lead the surgeon to the tip of the TP. From that point, dissection can be carried out as described above. This study examined the anatomy of the TP and defined the approach to expose the VA safely during anterior cervical spine exposure. Clin. Anat. 30:492-497, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  20. Exercise sensitizes skeletal muscle to extracellular ATP for IL-6 expression in mice.

    PubMed

    Fernández-Verdejo, R; Casas, M; Galgani, J E; Jaimovich, E; Buvinic, S

    2014-04-01

    Active skeletal muscle synthesizes and releases interleukin-6 (IL-6), which plays important roles in the organism's adaptation to exercise. Autocrine/paracrine ATP signaling has been shown to modulate IL-6 expression. The aim of this study was to determine whether a period of physical activity modifies the ATP-induced IL-6 expression. BalbC mice were either subject to 5 weeks voluntary wheel running (VA) or kept sedentary (SED). Flexor digitorum brevis muscles were dissected, stimulated with different ATP concentrations (0-100 μM) and IL-6 mRNA levels were measured using qPCR. ATP evoked a concentration-dependent rise in IL-6 mRNA in both SED and VA mice. VA mice however, had significantly higher ATP sensitivity (pD2 pharmacological values: VA=5.58±0.02 vs. SED=4.95±0.04, p<0.05). Interestingly, in VA mice we observed a positive correlation between the level of physical activity and the IL-6 mRNA increase following fiber stimulation with 10 μM ATP. In addition, there were lower P2Y2- and higher P2Y14-receptor mRNA levels in skeletal muscles of VA compared to SED mice, showing plasticity of nucleotide receptors with exercise. These results suggest that exercise increases skeletal muscle ATP sensitivity, a response dependent on the level of physical activity performed. This could have an important role in the mechanisms controlling skeletal muscle adaptation to exercise and training. © Georg Thieme Verlag KG Stuttgart · New York.

  1. Sympathetic ophthalmia: incidence of ocular complications and vision loss in the sympathizing eye.

    PubMed

    Galor, Anat; Davis, Janet L; Flynn, Harry W; Feuer, William J; Dubovy, Sander R; Setlur, Vikram; Kesen, Muge R; Goldstein, Debra A; Tessler, Howard H; Ganelis, Irina Bykhovskaya; Jabs, Douglas A; Thorne, Jennifer E

    2009-11-01

    To report the frequency on presentation and subsequent incidence of ocular complications and vision loss in patients with sympathetic ophthalmia (SO) and to describe factors associated with decreased vision in the sympathizing eye. Multicenter retrospective case series. Three academic tertiary care uveitis clinics. Eighty-five patients with SO from 1976 to 2006. Review of existing medical records. Incident visual acuity (VA) loss to 20/50 or worse and 20/200 or worse and the median acuity over time. Twenty-six percent of patients with SO presented with a VA of 20/200 or worse in their sympathizing eye. Further development of vision loss to 20/200 or worse occurred at the rate of 10% per person-year (PY). Ocular complications were seen in the sympathizing eye in 47% of patients at presentation; further development of new complications occurred at the rate of 40%/PY. The ocular complications most often associated with decreased vision were cataract and optic nerve abnormality. Exudative retinal detachment and active intraocular inflammation were significantly associated with poorer VA in the sympathizing eye. The benefits of corticosteroids were indirectly demonstrated as their use led to more rapid disease inactivation. Fifty-nine percent of patients maintained a VA of better than 20/50 in their sympathizing eye; and 75% maintained a VA of better than 20/200. Although ocular complications were seen in many sympathizing eyes with SO, most patients maintained functional VA. The presence of an exudative retinal detachment and active intraocular inflammation correlated with poorer vision in the sympathizing eye.

  2. Research leadership and investigators: gender distribution in the federal government.

    PubMed

    McCarren, Madeline; Goldman, Steven

    2012-08-01

    The National Academies reported in Beyond Bias and Barriers: Fulfilling the Potential of Women in Academic Science and Engineering (2006) that "women are very likely to face discrimination." In academic medicine, gender distribution is becoming more balanced. In the federal government, women also have made progress, doubling their representation in professional positions to 44%. The Department of Veterans Affairs (VA) has a research program and a mission to train health care professionals; however, its gender distribution has not been described. We conducted a descriptive study using public data for positions in the VA, National Institutes of Health (NIH), and Agency for Healthcare Research and Quality (AHRQ). We followed with a case-control analysis of predictors of receipt of grant funding in the VA. Participants were 224 leadership positions and 132 principal investigators. Women comprised 33% (AHRQ), 27% (NIH), and 0% (VA) of the top research leadership. Across all VA research levels, women comprised 45% to 0%, depending on the service. In the case-control analysis of principal investigators, men had greater odds (odds ratio 8.0) of a Cooperative Studies Program (CSP) trial award. History of first, last, or any authorship on a clinical trial publication in the 10 years before the index trial was only weakly associated with award of a CSP trial. The gender imbalance was not explained by publication history. Marked gender disparities were seen in the VA, except in Health Services Research. Organizations must investigate their practices to reveal disparities, investigate underlying factors, and intervene as needed. Published by Elsevier Inc.

  3. 12 CFR Appendix A to Part 203 - Form and Instructions for Completion of HMDA Loan/Application Register

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 2 2011-01-01 2011-01-01 false Form and Instructions for Completion of HMDA..., numerals, or a combination of both. 2. Date Application Received a. Enter the date the loan application was... (any loan other than FHA, VA, FSA, or RHS loans) Code 2—FHA-insured (Federal Housing Administration...

  4. US-guided application of Nd:YAG laser in porcine pancreatic tissue: an ex vivo study and numerical simulation.

    PubMed

    Di Matteo, Francesco; Martino, Margareth; Rea, Roberta; Pandolfi, Monica; Panzera, Francesco; Stigliano, Egidio; Schena, Emiliano; Saccomandi, Paola; Silvestri, Sergio; Pacella, Claudio Maurizio; Breschi, Luca; Perrone, Giuseppe; Coppola, Roberto; Costamagna, Guido

    2013-11-01

    Laser ablation (LA) with a neodymium-doped yttrium aluminum garnet (Nd:YAG) laser is a minimally invasive approach able to achieve a high rate of complete tissue necrosis. In a previous study we described the feasibility of EUS-guided Nd:YAG pancreas LA performed in vivo in a porcine model. To establish the best laser setting of Nd:YAG lasers for pancreatic tissue ablation. A secondary aim was to investigate the prediction capability of a mathematical model on ablation volume. Ex vivo animal study. Hospital animal laboratory. Explanted pancreatic glands from 60 healthy farm pigs. Laser output powers (OP) of 1.5, 3, 6, 10, 15, and 20 W were supplied. Ten trials for each OP were performed under US guidance on ex vivo healthy porcine pancreatic tissue. Ablation volume (Va) and central carbonization volume (Vc) were measured on histologic specimens as the sum of the lesion areas multiplied by the thickness of each slide. The theoretical model of the laser-tissue interaction was based on the Pennes equation. A circumscribed ablation zone was observed in all histologic specimens. Va values grow with the increase of the OP up to 10 W and reach a plateau between 10 and 20 W. The trend of Vc values rises constantly until 20 W. The theoretical model shows a good agreement with experimental Va and Vc for OP between 1.5 and 10 W. Ex vivo study. Volumes recorded suggest that the best laser OP could be the lowest one to obtain similar Va with smaller Vc in order to avoid the risk of thermal injury to the surrounding tissue. The good agreement between the two models demonstrates the prediction capability of the theoretical model on laser-induced ablation volume in an ex vivo animal model and supports its potential use for estimating the ablation size at different laser OPs. Copyright © 2013 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

  5. Factors related to attrition from VA healthcare use: findings from the National Survey of Women Veterans.

    PubMed

    Hamilton, Alison B; Frayne, Susan M; Cordasco, Kristina M; Washington, Donna L

    2013-07-01

    While prior research characterizes women Veterans' barriers to accessing and using Veterans Health Administration (VA) care, there has been little attention to women who access VA and use services, but then discontinue use. Recent data suggest that among women Veterans, there is a 30 % attrition rate within 3 years of initial VA use. To compare individual characteristics and perceptions about VA care between women Veteran VA attriters (those who discontinue use) and non-attriters (those who continue use), and to compare recent versus remote attriters. Cross-sectional, population-based 2008-2009 national telephone survey. Six hundred twenty-six attriters and 2,065 non-attriters who responded to the National Survey of Women Veterans. Population weighted demographic, military and health characteristics; perceptions about VA healthcare; length of time since last VA use; among attriters, reasons for no longer using VA care. Fifty-four percent of the weighted VA ever user population reported that they no longer use VA. Forty-five percent of attrition was within the past ten years. Attriters had better overall health (p = 0.007), higher income (p < 0.001), and were more likely to have health insurance (p < 0.001) compared with non-attriters. Attriters had less positive perceptions of VA than non-attriters, with attriters having lower ratings of VA quality and of gender-specific features of VA care (p < 0.001). Women Veterans who discontinued VA use since 2001 did not differ from those with more remote VA use on most measures of VA perceptions. Overall, among attriters, distance to VA sites of care and having alternate insurance coverage were the most common reasons for discontinuing VA use. We found high VA attrition despite recent advances in VA care for women Veterans. Women's attrition from VA could reduce the critical mass of women Veterans in VA and affect current system-wide efforts to provide high-quality care for women Veterans. An understanding of reasons for attrition can inform organizational efforts to re-engage women who have attrited, to retain current users, and potentially to attract new VA patients.

  6. Hospital Distance and Readmissions Among VA-Medicare Dual-Enrolled Veterans.

    PubMed

    Wong, Edwin S; Rinne, Seppo T; Hebert, Paul L; Cook, Meredith A; Liu, Chuan-Fen

    2016-09-01

    Geographic access to inpatient care at the Veterans Affairs (VA) Health Care System is challenging for many veterans with chronic obstructive pulmonary disease (COPD) given relatively few VA hospitals nationwide. Veterans with lengthy travel distances may obtain non-VA care, particularly those dually enrolled in Medicare. Our primary objective was to assess whether distance from VA patients' residence to the nearest VA and non-VA hospitals was associated with 30-day all-cause readmission and the system where patients were readmitted (VA or Medicare). Using VA and Medicare administrative data, we identified 21,273 patients hospitalized for COPD between October 2008 and September 2011 and dually enrolled in VA and fee-for-service Medicare. Outcome variables were dichotomous measures denoting readmission for any cause within 30 days following discharge and whether the readmission occurred in a non-VA hospital through Medicare. Distance to the nearest hospital was defined as the number of miles between patients' residence ZIP code and the ZIP code of the nearest VA and non-VA hospital accepting Medicare, respectively. Probit models with sample selection were applied to examine the relationship between hospital distance and outcome measures. Respective distances to the nearest VA and non-VA hospital were not associated with 30-day all-cause readmission. Greater distance to the nearest VA hospital was associated with a greater conditional probability of choosing non-VA hospitals for readmission. COPD patients with poor geographic access to VA hospitals did not forgo subsequent inpatient care following their index hospitalization, but they were more likely to seek non-VA substitutes. © 2016 National Rural Health Association.

  7. A large-scale evaluation of the KiVa antibullying program: grades 4-6.

    PubMed

    Kärnä, Antti; Voeten, Marinus; Little, Todd D; Poskiparta, Elisa; Kaljonen, Anne; Salmivalli, Christina

    2011-01-01

    This study demonstrates the effectiveness of the KiVa antibullying program using a large sample of 8,237 youth from Grades 4-6 (10-12 years). Altogether, 78 schools were randomly assigned to intervention (39 schools, 4,207 students) and control conditions (39 schools, 4,030 students). Multilevel regression analyses revealed that after 9 months of implementation, the intervention had consistent beneficial effects on 7 of the 11 dependent variables, including self- and peer-reported victimization and self-reported bullying. The results indicate that the KiVa program is effective in reducing school bullying and victimization in Grades 4-6. Despite some evidence against school-based interventions, the results suggest that well-conceived school-based programs can reduce victimization. © 2011 The Authors. Child Development © 2011 Society for Research in Child Development, Inc.

  8. 78 FR 36829 - Proposed Information Collection (Veterans Mortgage Life Insurance Statement) Activity: Comment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-19

    ... (Veterans Mortgage Life Insurance Statement) Activity: Comment Request AGENCY: Veterans Benefits... to decline Veterans Mortgage Life Insurance. DATES: Written comments and recommendations on the... use of other forms of information technology. Title: Veterans Mortgage Life Insurance Statement, VA...

  9. 77 FR 70708 - VA Acquisition Regulation: Electronic Submission of Payment Requests

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-27

    ... payment requests in electronic form in order to enhance customer service, departmental productivity, and... to enhance customer service, departmental productivity, and adoption of innovative information... economy, a sector of the economy, productivity, competition, jobs, the environment, public health or...

  10. 78 FR 36308 - Proposed Information Collection: (Back (Thoracolumbar Spine) Conditions Disability Benefits...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-17

    ... (Thoracolumbar Spine) Conditions Disability Benefits Questionnaire) Activity: Comment Request AGENCY: Veterans...--NEW (Collection (Back (Thoracolumbar Spine) Conditions Disability Benefits Questionnaire)'' in any... (Thoracolumbar Spine) Conditions Disability Benefits Questionnaire, VA Form 21-0960M-14. OMB Control Number: 2900...

  11. 78 FR 48941 - Agency Information Collection (Marital Status Questionnaire) Activity Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-12

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0495] Agency Information Collection (Marital Status Questionnaire) Activity Under OMB Review AGENCY: Veterans Benefits Administration, Department of...-0495.'' SUPPLEMENTARY INFORMATION: Title: Marital Status Questionnaire, VA Form 21-0537. OMB Control...

  12. 78 FR 36643 - Proposed Information Collection (Wrist Conditions Disability Benefits Questionnaire) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-18

    ... Conditions Disability Benefits Questionnaire) Activity: Comment Request AGENCY: Veterans Benefits... ``OMB Control No. 2900--NEW (Wrist Conditions Disability Benefits Questionnaire)'' in any correspondence... Conditions Disability Benefits Questionnaire, VA Form 21-0960M-16. OMB Control Number: 2900-NEW (Wrist...

  13. 75 FR 10027 - Proposed Information Collection (Marital Status Questionnaire) Activity: Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-04

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0495] Proposed Information Collection (Marital Status Questionnaire) Activity: Comment Request AGENCY: Veterans Benefits Administration...: Marital Status Questionnaire, VA Form 21-0537. OMB Control Number: 2900-0495. Type of Review: Extension of...

  14. 78 FR 36307 - Proposed Information Collection (Wrist Conditions Disability Benefits Questionnaire) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-17

    ... Conditions Disability Benefits Questionnaire) Activity: Comment Request AGENCY: Veterans Benefits... Control No. 2900-NEW (Wrist Conditions Disability Benefits Questionnaire)'' in any correspondence. During... Disability Benefits Questionnaire, VA Form 21-0960M-16. OMB Control Number: 2900-NEW (Wrist Conditions...

  15. 75 FR 9277 - Proposed Information Collection (Nation-Wide Customer Satisfaction Surveys) Activity: Comment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-01

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0712] Proposed Information Collection (Nation-Wide Customer Satisfaction Surveys) Activity: Comment Request AGENCY: Veterans Health Administration... use of other forms of information technology. Title: Nation-wide Customer Satisfaction Surveys, VA...

  16. Productivity of Veterans Health Administration laboratories: a College of American Pathologists Laboratory Management Index Program (LMIP) study.

    PubMed

    Valenstein, Paul N; Wang, Edward; O'Donohue, Tom

    2003-12-01

    The Veterans Health Administration (VA) operates the largest integrated laboratory network in the United States. To assess whether the unique characteristics of VA laboratories impact efficiency of operations, we compared the productivity of VA and non-VA facilities. Financial and activity data were prospectively collected from 124 VA and 131 non-VA laboratories enrolled in the College of American Pathologists Laboratory Management Index Program (LMIP) during 2002. In addition, secular trends in 5 productivity ratios were calculated for VA and non-VA laboratories enrolled in LMIP from 1997 through 2002. Veterans Health Administration and non-VA facilities did not differ significantly in size. Inpatients accounted for a lower percentage of testing at VA facilities than non-VA facilities (21.7% vs 37.3%; P <.001). Technical staff at the median VA facility were paid more than at non-VA facilities (28.11/h dollars vs 22.60/h dollars, salaries plus benefits; P <.001), VA laboratories employed a smaller percentage of nontechnical staff (30.0% vs 41.9%; P <.001), and workers at VA laboratories worked less time per hour paid (85.5% vs 88.5%; P <.001). However, labor productivity was significantly higher at VA than at non-VA facilities (30 448 test results/total full-time equivalent (FTE)/y vs 19 260 results/total FTE; P <.001), resulting in lower labor expense per on-site test at VA sites than at non-VA sites (1.79 dollars/result vs 2.08 dollars/result; P <.001). Veterans Health Administration laboratories paid less per test for consumables (P =.003), depreciation, and maintenance than their non-VA counterparts (all P <.001), resulting in lower overall cost per on-site test result (2.64 dollars vs 3.40 dollars; P <.001). Cost per referred (sent-out) test did not differ significantly between the 2 groups. Analysis of 6-year trends showed significant increases in both VA (P <.001) and non-VA (P =.02) labor productivity (on-site tests/total FTE). Expenses at VA laboratories for labor per test, consumables per test, overall expense per test, and overall laboratory expense per discharge decreased significantly during the 6-year period (P <.001), while in non-VA facilities the corresponding ratios showed no significant change. Overall productivity of VA laboratories is superior to that of non-VA facilities enrolled in LMIP. The principal advantages enjoyed by the VA are higher-than-average labor productivity (tests/FTE) and lower-than-average consumable expenses.

  17. Successful Semi-Ambulatory Veno-Arterial Extracorporeal Membrane Oxygenation Bridge to Heart-Lung Transplantation in a Very Small Child.

    PubMed

    Wong, J Y W; Buchholz, H; Ryerson, L; Conradi, A; Adatia, I; Dyck, J; Rebeyka, I; Lien, D; Mullen, J

    2015-08-01

    Lung transplantation (LTx) may be denied for children on extracorporeal membrane oxygenation (ECMO) due to high risk of cerebral hemorrhage. Rarely has successful LTx been reported in children over 10 years of age receiving awake or ambulatory veno-venous ECMO. LTx following support with ambulatory veno-arterial ECMO (VA ECMO) in children has never been reported to our knowledge. We present the case of a 4-year-old, 12-kg child with heritable pulmonary artery hypertension and refractory right ventricular failure. She was successfully bridged to heart-lung transplantation (HLTx) using ambulatory VA ECMO. Initial resuscitation with standard VA ECMO was converted to an ambulatory circuit using Berlin heart cannulae. She was extubated and ambulating around her bed while on VA ECMO for 40 days. She received an HLTx from an oversized marginal lung donor. Despite a cardiac arrest and Grade 3 primary graft dysfunction, she made a full recovery without neurological deficits. She achieved 104% force expiratory volume in 1 s 33 months post-HLTx. Ambulatory VA ECMO may be a useful strategy to bridge very young children to LTx or HLTx. Patient tailored ECMO cannulation, minimization of hemorrhage, and thrombosis risks while on ECMO contributed to a successful HLTx in our patient. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

  18. Comparative proteomic analysis of two wasps venom, Vespa tropica and Vespa affinis.

    PubMed

    Rungsa, Prapenpuksiri; Incamnoi, Paroonkorn; Sukprasert, Sophida; Uawonggul, Nunthawun; Klaynongsruang, Sompong; Daduang, Jureerut; Patramanon, Rina; Roytrakul, Sittiruk; Daduang, Sakda

    2016-09-01

    Vespid venom is composed of many bioactive compounds. The venom of the banded tiger wasp (Vespa affinis, or VA) and the great banded wasp (Vespa tropica, or VT)-which are locally found in the northeastern part of Thailand and are well known for their life-threatening venom potency-were comparatively studied in terms of potency, composition and biological activity. Clinical studies that included word-of-mouth information shared by traditional healers in local areas noted that the venom of VT is more potent than that of VA. Our previous study showed that the venom of VA is lower in potency (PD50 = 12.5 μg/g body weight) than that of VT (PD50 = 3 μg/g body weight). Analysis with the PAGE technique showed that these two venoms showed similar patterns of active proteins. Most protein spots were basic proteins at an isoelectric point (pI) ranging from 5 to 10, with molecular weights between 27 and 50 kDa. These spots were identified as hyaluronidase, phospholipase, antigen 5, dipeptidyl peptidase and albumin-like protein. The proportion of hyaluronidase was 2.5 times higher in VT than in VA. VT also showed higher hyaluronidase, phospholipase and dipeptidyl peptidase activities, suggesting that these components made VT venom more potent than VA venom. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Population size is weakly related to quantitative genetic variation and trait differentiation in a stream fish.

    PubMed

    Wood, Jacquelyn L A; Tezel, Defne; Joyal, Destin; Fraser, Dylan J

    2015-09-01

    How population size influences quantitative genetic variation and differentiation among natural, fragmented populations remains unresolved. Small, isolated populations might occupy poor quality habitats and lose genetic variation more rapidly due to genetic drift than large populations. Genetic drift might furthermore overcome selection as population size decreases. Collectively, this might result in directional changes in additive genetic variation (VA ) and trait differentiation (QST ) from small to large population size. Alternatively, small populations might exhibit larger variation in VA and QST if habitat fragmentation increases variability in habitat types. We explored these alternatives by investigating VA and QST using nine fragmented populations of brook trout varying 50-fold in census size N (179-8416) and 10-fold in effective number of breeders, Nb (18-135). Across 15 traits, no evidence was found for consistent differences in VA and QST with population size and almost no evidence for increased variability of VA or QST estimates at small population size. This suggests that (i) small populations of some species may retain adaptive potential according to commonly adopted quantitative genetic measures and (ii) populations of varying sizes experience a variety of environmental conditions in nature, however extremely large studies are likely required before any firm conclusions can be made. © 2015 The Author(s). Evolution © 2015 The Society for the Study of Evolution.

  20. A simple and sensitive methodology for voltammetric determination of valproic acid in human blood plasma samples using 3-aminopropyletriethoxy silane coated magnetic nanoparticles modified pencil graphite electrode.

    PubMed

    Zabardasti, Abedin; Afrouzi, Hossein; Talemi, Rasoul Pourtaghavi

    2017-07-01

    In this work, we have prepared a nano-material modified pencil graphite electrode for the sensing of valproic acid (VA) by immobilization 3-aminopropyletriethoxy silane coated magnetic nanoparticles (APTES-MNPs) on the pencil graphite surface (PGE). Electrochemical studies indicated that the APTES-MNPs efficiently increased the electron transfer kinetics between VA and the electrode and the free NH 2 groups of the APTES on the outer surface of magnetic nanoparticles can interact with carboxyl groups of VA. Based on this, we have proposed a sensitive, rapid and convenient electrochemical method for VA determination. Under the optimized conditions, the reduction peak current of VA is found to be proportional to its concentration in the range of 1.0 (±0.2) to 100.0 (±0.3) ppm with a detection limit of 0.4 (±0.1) ppm. The whole sensor fabrication process was characterized by cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS) methods with using [Fe(CN) 6 ] 3-/4- as an electrochemical redox indicator. The prepared modified electrode showed several advantages such as high sensitivity, selectivity, ease of preparation and good repeatability, reproducibility and stability. The proposed method was applied to determination of valproic acid in blood plasma samples and the obtained results were satisfactory accurate. Copyright © 2017. Published by Elsevier B.V.

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