Critical Value Reporting in Transfusion Medicine

PubMed Central

Reese, Erika M.; Nelson, Randin C.; Flegel, Willy A.; Byrne, Karen M.; Booth, Garrett S.

2017-01-01

Abstract Objectives: While critical value procedures have been adopted in most areas of the clinical laboratory, their use in transfusion medicine has not been reviewed in detail. The results of this study present a comprehensive overview of critical value reporting and communication practices in transfusion medicine in the United States. Methods: A web-based survey was developed to collect data on the prevalence of critical value procedures and practices of communicating results. The survey was distributed via email to US hospital-based blood banks. Results: Of 123 facilities surveyed, 84 (68.3%) blood banks had a critical value procedure. From a panel of 23 common blood bank results, nine results were selected by more than 70% of facilities as either a critical value or requiring rapid communication as defined by an alternate procedure. Conclusions: There was overlap among results communicated by facilities with and without a critical value procedure. The most frequently communicated results, such as incompatible crossmatch for RBC units issued uncrossmatched, delay in finding compatible blood due to a clinically significant antibody, and transfusion reaction evaluation suggestive of a serious adverse event, addressed scenarios associated with the leading reported causes of transfusion-related fatalities. PMID:28371931

Traumatic Brain Injury History is Associated with Earlier Age of Onset of Alzheimer Disease

PubMed Central

LoBue, Christian; Wadsworth, Hannah; Wilmoth, Kristin; Clem, Matthew; Hart, John; Womack, Kyle B.; Didehbani, Nyaz; Lacritz, Laura H.; Rossetti, Heidi C.; Cullum, C. Munro

2016-01-01

Objective This study examined whether a history of traumatic brain injury (TBI) is associated with earlier onset of Alzheimer disease (AD), independent of apolipoprotein ε4 status (Apoe4) and gender. Method Participants with a clinical diagnosis of AD (n=7625) were obtained from the National Alzheimer’s Coordinating Center Uniform Data Set, and categorized based on self-reported lifetime TBI with loss of consciousness (LOC) (TBI+ vs TBI-) and presence of Apoe4. ANCOVAs, controlling for gender, race, and education were used to examine the association between history of TBI, presence of Apoe4, and an interaction of both risk factors on estimated age of AD onset. Results Estimated AD onset differed by TBI history and Apoe4 independently (p’s <.001). The TBI+ group had a mean age of onset 2.5 years earlier than the TBI- group. Likewise, Apoe4 carriers had a mean age of onset 2.3 years earlier than non-carriers. While the interaction was non-significant (p = .34), participants having both a history of TBI and Apoe4 had the earliest mean age of onset compared to those with a TBI history or Apoe4 alone (MDifference = 2.8 & 2.7 years, respectively). These results remained unchanged when stratified by gender. Conclusions History of self-reported TBI can be associated with an earlier onset of AD-related cognitive decline, regardless of Apoe4 status and gender. TBI may be related to an underlying neurodegenerative process in AD, but the implications of age at time of injury, severity, and repetitive injuries remain unclear. PMID:27855547

Later endogenous circadian temperature nadir relative to an earlier wake time in older people

NASA Technical Reports Server (NTRS)

Duffy, J. F.; Dijk, D. J.; Klerman, E. B.; Czeisler, C. A.

1998-01-01

The contribution of the circadian timing system to the age-related advance of sleep-wake timing was investigated in two experiments. In a constant routine protocol, we found that the average wake time and endogenous circadian phase of 44 older subjects were earlier than that of 101 young men. However, the earlier circadian phase of the older subjects actually occurred later relative to their habitual wake time than it did in young men. These results indicate that an age-related advance of circadian phase cannot fully account for the high prevalence of early morning awakening in healthy older people. In a second study, 13 older subjects and 10 young men were scheduled to a 28-h day, such that they were scheduled to sleep at many circadian phases. Self-reported awakening from scheduled sleep episodes and cognitive throughput during the second half of the wake episode varied markedly as a function of circadian phase in both groups. The rising phase of both rhythms was advanced in the older subjects, suggesting an age-related change in the circadian regulation of sleep-wake propensity. We hypothesize that under entrained conditions, these age-related changes in the relationship between circadian phase and wake time are likely associated with self-selected light exposure at an earlier circadian phase. This earlier exposure to light could account for the earlier clock hour to which the endogenous circadian pacemaker is entrained in older people and thereby further increase their propensity to awaken at an even earlier time.

Traumatic brain injury history is associated with an earlier age of dementia onset in autopsy-confirmed Alzheimer's disease.

PubMed

Schaffert, Jeff; LoBue, Christian; White, Charles L; Chiang, Hsueh-Sheng; Didehbani, Nyaz; Lacritz, Laura; Rossetti, Heidi; Dieppa, Marisara; Hart, John; Cullum, C Munro

2018-05-01

To evaluate whether a history of traumatic brain injury (TBI) with reported loss of consciousness (LOC) is a risk factor for earlier onset of Alzheimer's disease (AD) in an autopsy-confirmed sample. Data from 2,133 participants with autopsy-confirmed AD (i.e., at least Braak neurofibrillary tangle stages III to VI and CERAD neuritic plaque score moderate to frequent) were obtained from the National Alzheimer's Coordinating Center (NACC). Participants were categorized by presence/absence of self-reported remote (i.e., >1 year prior to their first Alzheimer's Disease Center visit) history of TBI with LOC (TBI+ vs. TBI-). Analyses of Covariance (ANCOVA) controlling for sex, education, and race compared groups on clinician-estimated age of symptom onset and age of diagnosis. Average age of onset was 2.34 years earlier (p = .01) for the TBI+ group (n = 194) versus the TBI- group (n = 1900). Dementia was diagnosed on average 2.83 years earlier (p = .002) in the TBI+ group (n = 197) versus the TBI- group (n = 1936). Using more stringent neuropathological criteria (i.e., Braak stages V-VI and CERAD frequent), both age of AD onset and diagnosis were 3.6 years earlier in the TBI+ group (both p's < .001). History of TBI with reported LOC appears to be a risk factor for earlier AD onset. This is the first study to use autopsy-confirmed cases, supporting previous investigations that used clinical criteria for the diagnosis of AD. Further investigation as to possible underlying mechanisms of association is needed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Identifying pneumonia outbreaks of public health importance: can emergency department data assist in earlier identification?

PubMed

Hope, Kirsty; Durrheim, David N; Muscatello, David; Merritt, Tony; Zheng, Wei; Massey, Peter; Cashman, Patrick; Eastwood, Keith

2008-08-01

To retrospectively review the performance of a near real-time Emergency Department (ED) Syndromic Surveillance System operating in New South Wales for identifying pneumonia outbreaks of public health importance. Retrospective data was obtained from the NSW Emergency Department data collection for a rural hospital that has experienced a cluster of pneumonia diagnoses among teenage males in August 2006. ED standard reports were examined for signals in the overall count for each respiratory syndrome, and for elevated counts in individual subgroups including; age, sex and admission to hospital status. Using the current thresholds, the ED syndromic surveillance system would have trigged a signal for pneumonia syndrome in children aged 5-16 years four days earlier than the notification by a paediatrician and this signal was maintained for 14 days. If the ED syndromic surveillance system had been operating it could have identified the outbreak earlier than the paediatrician's notification. This may have permitted an earlier public health response. By understanding the behaviour of syndromes during outbreaks of public health importance, response protocols could be developed to facilitate earlier implementation of control measures.

Scientific Knowledge Suppresses but Does Not Supplant Earlier Intuitions

ERIC Educational Resources Information Center

Shtulman, Andrew; Valcarcel, Joshua

2012-01-01

When students learn scientific theories that conflict with their earlier, naive theories, what happens to the earlier theories? Are they overwritten or merely suppressed? We investigated this question by devising and implementing a novel speeded-reasoning task. Adults with many years of science education verified two types of statements as quickly…

Tidal Wave II Revisited: A Review of Earlier Enrollment Projections for California Higher Education.

ERIC Educational Resources Information Center

Hayward, Gerald C.; Breneman, David W.; Estrada, Leobardo F.

This report examined enrollment projections for higher education institutions in California in relation to earlier projections conducted in the mid-1990s that forecasted steep declines in enrollment. It notes that California's remarkable economic recovery over the last several years has allowed it to fund higher education enrollment growth at a…

Toward Explaining Earlier Retirement after 1970.

ERIC Educational Resources Information Center

Ippolito, Richard A.

1990-01-01

Rule changes in the social security system and pension plans suggest that labor force participation rates for men aged 55 to 64 fell by 20 percent from 1970 through 1986 because of the increase in social security benefits and a change in private pension rules encouraging earlier retirement. (Author/JOW)

Learned value and object perception: Accelerated perception or biased decisions?

PubMed

Rajsic, Jason; Perera, Harendri; Pratt, Jay

2017-02-01

Learned value is known to bias visual search toward valued stimuli. However, some uncertainty exists regarding the stage of visual processing that is modulated by learned value. Here, we directly tested the effect of learned value on preattentive processing using temporal order judgments. Across four experiments, we imbued some stimuli with high value and some with low value, using a nonmonetary reward task. In Experiment 1, we replicated the value-driven distraction effect, validating our nonmonetary reward task. Experiment 2 showed that high-value stimuli, but not low-value stimuli, exhibit a prior-entry effect. Experiment 3, which reversed the temporal order judgment task (i.e., reporting which stimulus came second), showed no prior-entry effect, indicating that although a response bias may be present for high-value stimuli, they are still reported as appearing earlier. However, Experiment 4, using a simultaneity judgment task, showed no shift in temporal perception. Overall, our results support the conclusion that learned value biases perceptual decisions about valued stimuli without speeding preattentive stimulus processing.

Return of hunger following a relatively high carbohydrate breakfast is associated with earlier recorded glucose peak and nadir

PubMed Central

Chandler-Laney, Paula C.; Morrison, Shannon A.; Goree, Laura Lee T.; Ellis, Amy C.; Casazza, Krista; Desmond, Renee; Gower, Barbara A

2014-01-01

Objective To test the hypothesis that a breakfast meal with high carbohydrate/ low fat results in an earlier increase in postprandial glucose and insulin, a greater decrease below baseline in postprandial glucose, and an earlier return of appetite, compared to a low carbohydrate/high fat meal. Design Overweight but otherwise healthy adults (n=64) were maintained on one of two eucaloric diets: high carbohydrate/low fat (HC/LF; 55:27:18% kcals from carbohydrate: fat: protein) versus low carbohydrate/high fat (LC/HF; 43:39:18% kcals from carbohydrate: fat: protein). After 4 weeks of acclimation to the diets, participants underwent a meal test during which circulating glucose and insulin and self-reported hunger and fullness, were measured before and after consumption of breakfast from their assigned diets. Results The LC/HF meal resulted in a later time at the highest and lowest recorded glucose, higher glucose concentrations at 3 and 4 hours post-meal, and lower insulin incremental area under the curve. Participants consuming the LC/HF meal reported lower appetite 3 and 4 hours following the meal, a response that was associated with the timing of the highest and lowest recorded glucose. Conclusions Modest increases in meal carbohydrate content at the expense of fat content may facilitate weight gain over the long-term by contributing to an earlier rise and fall of postprandial glucose concentrations and an earlier return of appetite. PMID:24819342

Childhood hair product use and earlier age at menarche in a racially diverse study population: a pilot study.

PubMed

James-Todd, Tamarra; Terry, Mary Beth; Rich-Edwards, Janet; Deierlein, Andrea; Senie, Ruby

2011-06-01

Previous studies suggest that hair products containing endocrine disrupting chemicals could alter puberty. We evaluated the association between childhood hair product use and age at menarche in a racially diverse study population. We recruited 300 African-American, African-Caribbean, Hispanic, and white women from the New York City metropolitan area who were between 18-77 years of age. Data were collected retrospectively on hair oil, lotion, leave-in conditioner, perm, and other types of hair products used before age 13. Recalled age at menarche ranged from 8 to 19 years. We used multivariable binomial regression to evaluate the association between hair product use and age at menarche (<12 vs. ≥12), adjusting for potential confounders. African-Americans were more likely to use hair products and reached menarche earlier than other racial/ethnic groups. Women reporting childhood hair oil use had a risk ratio of 1.4 (95% confidence interval [CI]: 1.1-1.9) for earlier menarche, adjusting for race/ethnicity and year of birth. Hair perm users had an increased risk for earlier menarche (adjusted risk ratio = 1.4, 95% CI: 1.1-1.8). Other types of hair products assessed in this study were not associated with earlier menarche. Childhood hair oil and perm use were associated with earlier menarche. If replicated, these results suggest that hair product use may be important to measure in evaluating earlier age at menarche. Copyright © 2011 Elsevier Inc. All rights reserved.

National survey on current situation of critical value reporting in 973 laboratories in China.

PubMed

Fei, Yang; Zhao, Haijian; Wang, Wei; He, Falin; Zhong, Kun; Yuan, Shuai; Wang, Zhiguo

2017-10-15

The aim of the study was to investigate the state-of-the-art of the performance of critical value reporting and provide recommendations for laboratories setting critical value reporting time frames. The National Centre for Clinical Laboratories in China initiated a critical value reporting investigation in 2015. A questionnaire related to critical value reporting policy was sent to 1589 clinical laboratories in China online. The questionnaire consisted of a set of questions related to critical value reporting policy and a set of questions related to timeliness of critical value reporting. The survey data were collected between March and April 2015. A total survey response rate was 61.2%. The critical value unreported rate, unreported timely rate, and clinical unacknowledged rate of more than half of participants were all 0.0%. More than 75.0% of participants could report half of critical values to clinicians within 20 minutes and could report 90.0% of critical values to clinicians within 25 minutes (from result validation to result communication to the clinician). The median of target critical value reporting time was 15 minutes. "Reporting omission caused by laboratory staff", "communications equipment failure to connect", and "uncompleted application form without contact information of clinician" were the three major reasons for unreported critical value. The majority of laboratories can report critical values to responsible clinical staff within 25 minutes. Thus, this value could be recommended as suitable critical value reporting time frame for biochemistry laboratories in China. However, careful monitoring of the complete reporting process and improvement of information systems should ensure further improvement of critical value reporting timeliness.

Research promises earlier warning for grapevine canker diseases

USDA-ARS?s Scientific Manuscript database

When it comes to detecting and treating vineyards for grapevine canker diseases (also called trunk diseases), like Botryosphaeria dieback (Bot canker), Esca, Eutypa dieback and Phomopsis dieback, the earlier the better, says plant pathologist Kendra Baumgartner, with the USDA’s Agricultural Research...

Trends in P Value, Confidence Interval, and Power Analysis Reporting in Health Professions Education Research Reports: A Systematic Appraisal.

PubMed

Abbott, Eduardo F; Serrano, Valentina P; Rethlefsen, Melissa L; Pandian, T K; Naik, Nimesh D; West, Colin P; Pankratz, V Shane; Cook, David A

2018-02-01

To characterize reporting of P values, confidence intervals (CIs), and statistical power in health professions education research (HPER) through manual and computerized analysis of published research reports. The authors searched PubMed, Embase, and CINAHL in May 2016, for comparative research studies. For manual analysis of abstracts and main texts, they randomly sampled 250 HPER reports published in 1985, 1995, 2005, and 2015, and 100 biomedical research reports published in 1985 and 2015. Automated computerized analysis of abstracts included all HPER reports published 1970-2015. In the 2015 HPER sample, P values were reported in 69/100 abstracts and 94 main texts. CIs were reported in 6 abstracts and 22 main texts. Most P values (≥77%) were ≤.05. Across all years, 60/164 two-group HPER studies had ≥80% power to detect a between-group difference of 0.5 standard deviations. From 1985 to 2015, the proportion of HPER abstracts reporting a CI did not change significantly (odds ratio [OR] 2.87; 95% CI 1.04, 7.88) whereas that of main texts reporting a CI increased (OR 1.96; 95% CI 1.39, 2.78). Comparison with biomedical studies revealed similar reporting of P values, but more frequent use of CIs in biomedicine. Automated analysis of 56,440 HPER abstracts found 14,867 (26.3%) reporting a P value, 3,024 (5.4%) reporting a CI, and increased reporting of P values and CIs from 1970 to 2015. P values are ubiquitous in HPER, CIs are rarely reported, and most studies are underpowered. Most reported P values would be considered statistically significant.

An earlier de motu cordis.

PubMed Central

Daly, Walter J.

2004-01-01

Thirteenth century medical science, like medieval scholarship in general, was directed at reconciliation of Greek philosophy/science with prevailing medieval theology and philosophy. Peter of Spain [later Pope John XXI] was the leading medical scholar of his time. Peter wrote a long book on the soul. Imbedded in it was a chapter on the motion of the heart. Peter's De Motu was based on his own medical experience and Galen's De Usu Partium and De Usu Respirationis and De Usu Pulsuum. This earlier De Motu defines a point on the continuum of intellectual development leading to us and into the future. Thirteenth century scholarship relied on past authority to a degree that continues to puzzle and beg explanation. Images Fig. 1 PMID:17060956

Cardiac Complications, Earlier Treatment, and Initial Disease Severity in Kawasaki Disease.

PubMed

Abrams, Joseph Y; Belay, Ermias D; Uehara, Ritei; Maddox, Ryan A; Schonberger, Lawrence B; Nakamura, Yosikazu

2017-09-01

To assess if observed higher observed risks of cardiac complications for patients with Kawasaki disease (KD) treated earlier may reflect bias due to confounding from initial disease severity, as opposed to any negative effect of earlier treatment. We used data from Japanese nationwide KD surveys from 1997 to 2004. Receipt of additional intravenous immunoglobulin (IVIG) (data available all years) or any additional treatment (available for 2003-2004) were assessed as proxies for initial disease severity. We determined associations between earlier or later IVIG treatment (defined as receipt of IVIG on days 1-4 vs days 5-10 of illness) and cardiac complications by stratifying by receipt of additional treatment or by using logistic modeling to control for the effect of receiving additional treatment. A total of 48 310 patients with KD were included in the analysis. In unadjusted analysis, earlier IVIG treatment was associated with a higher risk for 4 categories of cardiac complications, including all major cardiac complications (risk ratio, 1.10; 95% CI, 1.06-1.15). Stratifying by receipt of additional treatment removed this association, and earlier IVIG treatment became protective against all major cardiac complications when controlling for any additional treatment in logistic regressions (OR, 0.90; 95% CI, 0.80-1.00). Observed higher risks of cardiac complications among patients with KD receiving IVIG treatment on days 1-4 of the illness are most likely due to underlying higher initial disease severity, and patients with KD should continue to be treated with IVIG as early as possible. Published by Elsevier Inc.

Travelling for earlier surgical treatment: the patient's view.

PubMed Central

Stewart, M; Donaldson, L J

1991-01-01

As part of the northern region's programme within the national waiting list initiative, schemes have been funded to test the feasibility and acceptability of offering patients the opportunity to travel further afield in order to receive earlier treatment. A total of 484 patients experiencing a long wait for routine surgical operations in the northern region were offered the opportunity to receive earlier treatment outside their local health district; 74% of the patients accepted the offer. The initiative was well received by the participating patients and the majority stated that if the need arose on a future occasion they would prefer to travel for treatment rather than have to wait for lengthy periods for treatment at their local hospital. These findings, interpreted in the light of the National Health Service reforms introduced in April 1991, suggest that for some types of care, patients would welcome greater flexibility in the placing of contracts, not merely reinforcement of historical patterns of referral. PMID:1823553

Spatial and Temporal Variation in Primary Productivity (NDVI) of Coastal Alaskan Tundra: Decreased Vegetation Growth Following Earlier Snowmelt

NASA Technical Reports Server (NTRS)

Gamon, John A.; Huemmrich, K. Fred; Stone, Robert S.; Tweedie, Craig E.

2015-01-01

In the Arctic, earlier snowmelt and longer growing seasons due to warming have been hypothesized to increase vegetation productivity. Using the Normalized Difference Vegetation Index (NDVI) from both field and satellite measurements as an indicator of vegetation phenology and productivity, we monitored spatial and temporal patterns of vegetation growth for a coastal wet sedge tundra site near Barrow, Alaska over three growing seasons (2000-2002). Contrary to expectation, earlier snowmelt did not lead to increased productivity. Instead, productivity was associated primarily with precipitation and soil moisture, and secondarily with growing degree days, which, during this period, led to reduced growth in years with earlier snowmelt. Additional moisture effects on productivity and species distribution, operating over a longer time scale, were evident in spatial NDVI patterns associated with microtopography. Lower, wetter regions dominated by graminoids were more productive than higher, drier locations having a higher percentage of lichens and mosses, despite the earlier snowmelt at the more elevated sites. These results call into question the oft-stated hypothesis that earlier arctic growing seasons will lead to greater vegetation productivity. Rather, they agree with an emerging body of evidence from recent field studies indicating that early-season, local environmental conditions, notably moisture and temperature, are primary factors determining arctic vegetation productivity. For this coastal arctic site, early growing season conditions are strongly influenced by microtopography, hydrology, and regional sea ice dynamics, and may not be easily predicted from snowmelt date or seasonal average air temperatures alone. Our comparison of field to satellite NDVI also highlights the value of in-situ monitoring of actual vegetation responses using field optical sampling to obtain detailed information on surface conditions not possible from satellite observations alone.

THE VALUE OF OVARIAN IRRADIATION IN THE MANAGEMENT OF BREAST CANCER

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

Cole, M.P.

1962-01-01

A report is given of a clinical trial to assess the value of ovarian radiation (x-ray artificial menopause) for breast cancer. There appeared to be a definite advantage to cases having ovarian irradiation prophylactically as judged on crude survival rate. This improvement was more apparent in the earlier case than the late, with a definite decrease in the incidence of metastases in the treated group at 5 years. (auth)

The value proposition of structured reporting in interventional radiology.

PubMed

Durack, Jeremy C

2014-10-01

The purposes of this article are to provide a brief overview of structured radiology reporting and to emphasize the anticipated benefits from a new generation of standardized interventional radiology procedure reports. Radiology reporting standards and tools have evolved to enable automated data integration from multiple institutions using structured templates. In interventional radiology, data aggregated into clinical, research and quality registries from enriched structured reports could firmly establish the interventional radiology value proposition.

A Hepatocellular Carcinoma Case in a Patient Who had Immunity to Hepatitis B Virus Earlier.

PubMed

Ates, Ihsan; Kaplan, Mustafa; Demirci, Selim; Altiparmak, Emin

2016-01-01

Hepatocellular carcinoma (HCC) is the most common malignant tumor of the liver. Hepatitis B virus infection is one of the most important etilogical factors of HCC. In this case report, a patient with HCC previously infected and having ongoing immunity against hepatitis B virus will be discussed. Ates I, Kaplan M, Demirci S, Altiparmak E. A Hepatocellular Carcinoma Case in a Patient Who had Immunity to Hepatitis B Virus Earlier. Euroasian J Hepato-Gastroenterol 2016;6(1):82-83.

32 CFR 644.353 - Determination of values for reporting.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 4 2011-07-01 2011-07-01 false Determination of values for reporting. 644.353 Section 644.353 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) REAL PROPERTY REAL ESTATE HANDBOOK Disposal Reports of Excess Real Property and Related Personal Property to...

32 CFR 644.353 - Determination of values for reporting.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 4 2013-07-01 2013-07-01 false Determination of values for reporting. 644.353 Section 644.353 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) REAL PROPERTY REAL ESTATE HANDBOOK Disposal Reports of Excess Real Property and Related Personal Property to...

32 CFR 644.353 - Determination of values for reporting.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Determination of values for reporting. 644.353 Section 644.353 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) REAL PROPERTY REAL ESTATE HANDBOOK Disposal Reports of Excess Real Property and Related Personal Property to...

32 CFR 644.353 - Determination of values for reporting.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 4 2014-07-01 2013-07-01 true Determination of values for reporting. 644.353 Section 644.353 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) REAL PROPERTY REAL ESTATE HANDBOOK Disposal Reports of Excess Real Property and Related Personal Property to...

32 CFR 644.353 - Determination of values for reporting.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 4 2012-07-01 2011-07-01 true Determination of values for reporting. 644.353 Section 644.353 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) REAL PROPERTY REAL ESTATE HANDBOOK Disposal Reports of Excess Real Property and Related Personal Property to...

Economic Costs Avoided by Diagnosing Melanoma Six Months Earlier Justify >100 Benign Biopsies.

PubMed

Aires, Daniel J; Wick, Jo; Shaath, Tarek S; Rajpara, Anand N; Patel, Vikas; Badawi, Ahmed H; Li, Cicy; Fraga, Garth R; Doolittle, Gary; Liu, Deede Y

2016-05-01

New melanoma drugs bring enormous benefits but do so at significant costs. Because melanoma grows deeper and deadlier over time, deeper lesions are costlier due to increased sentinel lymph node biopsy, chemotherapy, and disease-associated income loss. Prior studies have justified pigmented lesion biopsies on a "value per life" basis; by contrast we sought to assess how many biopsies are justified per melanoma found on a purely economic basis. We modeled how melanomas in the United States would behave if diagnosis were delayed by 6 months, eg, not biopsied, only observed until the next surveillance visit. Economic loss from delayed biopsy is the obverse of economic benefit of performing biopsy earlier. Growth rates were based on Liu et al. The results of this study can be applied to all patients presenting to dermatologists with pigmented skin lesions suspicious for melanoma. In-situ melanomas were excluded because no studies to date have modeled growth rates analogous to those for invasive melanoma. We assume conservatively that all melanomas not biopsied initially will be biopsied and treated 6 months later. Major modeled costs are (1) increased sentinel lymph node biopsy, (2) increased chemotherapy for metastatic lesions using increased 5-yr death as metastasis marker, and (3) income loss per melanoma death at $413,370 as previously published. Costs avoided by diagnosing melanoma earlier justify 170 biopsies per melanoma found. Efforts to penalize "unnecessary" biopsies may be economically counterproductive.

J Drugs Dermatol. 2016;15(5):527-532.

Disentangling neural representations of value and salience in the human brain

PubMed Central

Kahnt, Thorsten; Park, Soyoung Q; Haynes, John-Dylan; Tobler, Philippe N.

2014-01-01

A large body of evidence has implicated the posterior parietal and orbitofrontal cortex in the processing of value. However, value correlates perfectly with salience when appetitive stimuli are investigated in isolation. Accordingly, considerable uncertainty has remained about the precise nature of the previously identified signals. In particular, recent evidence suggests that neurons in the primate parietal cortex signal salience instead of value. To investigate neural signatures of value and salience, here we apply multivariate (pattern-based) analyses to human functional MRI data acquired during a noninstrumental outcome-prediction task involving appetitive and aversive outcomes. Reaction time data indicated additive and independent effects of value and salience. Critically, we show that multivoxel ensemble activity in the posterior parietal cortex encodes predicted value and salience in superior and inferior compartments, respectively. These findings reinforce the earlier reports of parietal value signals and reconcile them with the recent salience report. Moreover, we find that multivoxel patterns in the orbitofrontal cortex correlate with value. Importantly, the patterns coding for the predicted value of appetitive and aversive outcomes are similar, indicating a common neural scale for appetite and aversive values in the orbitofrontal cortex. Thus orbitofrontal activity patterns satisfy a basic requirement for a neural value signal. PMID:24639493

Mn and Btex Reference Value Arrays (Final Reports)

EPA Science Inventory

These final reports are a summary of reference value arrays with critical supporting documentation for the chemicals manganese, benzene, toluene, ethylbenzene, and xylene. Each chemical is covered in a separate document, and each is a statement of the status of the available inha...

Values: A Symposium Report.

ERIC Educational Resources Information Center

Ryan, T. A., Ed.

This publication brings together a set of four papers prepared for a symposium on values at the 1972 annual meeting of the American Educational Research Association. The first paper, by Fred N. Kerlinger, establishes a rationale for values research. The discussion focuses on the definition of values, relationship between values and attitudes,…

A Hepatocellular Carcinoma Case in a Patient Who had Immunity to Hepatitis B Virus Earlier

PubMed Central

Kaplan, Mustafa; Demirci, Selim; Altiparmak, Emin

2016-01-01

ABSTRACT Hepatocellular carcinoma (HCC) is the most common malignant tumor of the liver. Hepatitis B virus infection is one of the most important etilogical factors of HCC. In this case report, a patient with HCC previously infected and having ongoing immunity against hepatitis B virus will be discussed. How to cite this article Ates I, Kaplan M, Demirci S, Altiparmak E. A Hepatocellular Carcinoma Case in a Patient Who had Immunity to Hepatitis B Virus Earlier. Euroasian J Hepato-Gastroenterol 2016;6(1):82-83. PMID:29201732

Techniques for developing child dummy protection reference values : event report

DOT National Transportation Integrated Search

1996-10-01

The purpose of this report is to present background information and techniques for developing protection reference values (PRV) to use with child dummies in out-of-position (OOP) child/air bag interaction testing. This report summarizes the literatur...

Consistency errors in p-values reported in Spanish psychology journals.

PubMed

Caperos, José Manuel; Pardo, Antonio

2013-01-01

Recent reviews have drawn attention to frequent consistency errors when reporting statistical results. We have reviewed the statistical results reported in 186 articles published in four Spanish psychology journals. Of these articles, 102 contained at least one of the statistics selected for our study: Fisher-F , Student-t and Pearson-c 2 . Out of the 1,212 complete statistics reviewed, 12.2% presented a consistency error, meaning that the reported p-value did not correspond to the reported value of the statistic and its degrees of freedom. In 2.3% of the cases, the correct calculation would have led to a different conclusion than the reported one. In terms of articles, 48% included at least one consistency error, and 17.6% would have to change at least one conclusion. In meta-analytical terms, with a focus on effect size, consistency errors can be considered substantial in 9.5% of the cases. These results imply a need to improve the quality and precision with which statistical results are reported in Spanish psychology journals.

Value-based cleft lip-cleft palate care: a progress report.

PubMed

Abbott, Megan M; Meara, John G

2010-09-01

The health care debate in the United States centers on a concept that is fundamental to any service-based profession yet minimally integrated into the health care community: value creation. Value in health care has been defined as outcome achieved per dollar spent, and focuses on the patient. Many of the new strategies proposed to restructure health care delivery in the United States aim to study and improve both components of this equation. Indeed, it is a near guarantee that providers will soon be responsible for reporting their outcomes and resource use and will be benchmarked by these metrics. In addition, patients have a right to understand the value they receive from their care providers. In this report, the authors evaluate the current state of preparedness for the assessment of value in care delivery in the field of cleft lip-cleft palate based on literature review. There has been important progress in the definition and assessment of basic outcomes in cleft lip-cleft palate care, largely through formation of intercenter collaborations. However, many fundamental challenges face the cleft community, especially in North America. Standardization of data collection and outcomes measurement and reporting are particularly lacking. In addition, few data exist regarding the cost of cleft care. The weight of the evidence reveals that the cleft community is not prepared to assess, and thus improve, the value offered to patients. The authors address key challenges and outline future directions.

Measuring Value in Internal Medicine Residency Training Hospitals Using Publicly Reported Measures.

PubMed

Schickedanz, Adam; Gupta, Reshma; Arora, Vineet M; Braddock, Clarence H

2018-03-01

Graduate medical education (GME) lacks measures of resident preparation for high-quality, cost-conscious practice. The authors used publicly reported teaching hospital value measures to compare internal medicine residency programs on high-value care training and to validate these measures against program director perceptions of value. Program-level value training scores were constructed using Centers for Medicare & Medicaid Services Value-Based Purchasing (VBP) Program hospital quality and cost-efficiency data. Correlations with Association of Program Directors in Internal Medicine Annual Survey high-value care training measures were examined using logistic regression. For every point increase in program-level VBP score, residency directors were more likely to agree that GME programs have a responsibility to contain health care costs (adjusted odds ratio [aOR] 1.18, P = .04), their faculty model high-value care (aOR 1.07, P = .03), and residents are prepared to make high-value medical decisions (aOR 1.07, P = .09). Publicly reported clinical data offer valid measures of GME value training.

Values for Human-to-Human Reference.

ERIC Educational Resources Information Center

Gorman, Michael

2001-01-01

Defines "values" and lists the eight values (stewardship, service, intellectual freedom, rationalism, literacy and learning, equity of access, privacy, democracy) derived by the author in an earlier work. Gives a brief history of the evolution of human-to-human reference service and discusses its future. Relates each of the author's eight values…

Does Speech Emerge from Earlier Appearing Oral Motor Behaviors?.

ERIC Educational Resources Information Center

Moore, Christopher A.; Ruark, Jacki L.

1996-01-01

This study of the oral motor behaviors of seven toddlers (age 15 months) may be interpreted to indicate that: (1) mandibular coordination follows a developmental continuum from earlier emerging behaviors, such as chewing and sucking, through babbling, to speech, or (2) unique task demands give rise to distinct mandibular coordinative constraints…

Report of the ACR's Economics Committee on Value-Based Payment Models.

PubMed

Boland, Giles W; Glenn, Lucille; Goldberg-Stein, Shlomit; Jha, Saurabh; Mangano, Mark; Patel, Samir; Schoppe, Kurt A; Seidenwurm, David; Lohnes, John; Silva, Ezequiel; Abramson, Richard; Durand, Daniel J; Pattie, Laura; Kassing, Pamela; Heller, Richard E

2017-01-01

A major outcome of the current health care reform process is the move away from unrestricted fee-for-service payment models toward those that are based on the delivery of better patient value and outcomes. The authors' purpose, therefore, is to critically evaluate and define those components of the overall imaging enterprise that deliver meaningful value to both patients and referrers and to determine how these components might be measured and quantified. These metrics might then be used to lobby providers and payers for sustainable payment solutions for radiologists and radiology services. The authors evaluated radiology operations and services using the framework of the imaging value chain, which divides radiology service into a number of discrete value-added activities, which ultimately deliver the primary product, most often the actionable report for diagnostic imaging or an effective outcome for interventional radiology. These value activities include scheduling and imaging appropriateness and stewardship, patient preparation, protocol design, modality operations, reporting, report communication, and clinical follow-up (eg, mammography reminder letters). Two further categories are hospital or health care organization citizenship and examination outcome. Each is discussed in turn, with specific activities highlighted. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

The value of necropsy reports for animal health surveillance.

PubMed

Küker, Susanne; Faverjon, Celine; Furrer, Lenz; Berezowski, John; Posthaus, Horst; Rinaldi, Fabio; Vial, Flavie

2018-06-18

Animal health data recorded in free text, such as in necropsy reports, can have valuable information for national surveillance systems. However, these data are rarely utilized because the text format requires labor-intensive classification of records before they can be analyzed with using statistical or other software. In a previous study, we designed a text-mining tool to extract data from text in necropsy reports. In the current study, we used the tool to extract data from the reports from pig and cattle necropsies performed between 2000 and 2011 at the Institute of Animal Pathology (ITPA), University of Bern, Switzerland. We evaluated data quality in terms of credibility, completeness and representativeness of the Swiss pig and cattle populations. Data was easily extracted from necropsy reports. Data quality in terms of completeness and validity varied a lot depending on the type of data reported. Diseases of the gastrointestinal system were reported most frequently (54.6% of pig submissions and 40.8% of cattle submissions). Diseases affecting serous membranes were reported in 16.0% of necropsied pigs and 27.6% of cattle. Respiratory diseases were reported in 18.3% of pigs and 21.6% of cattle submissions. This study suggests that extracting data from necropsy reports can provide information of value for animal health surveillance. This data has potential value for monitoring endemic disease syndromes in different age and production groups, or for early detection of emerging or re-emerging diseases. The study identified data entry and other errors that could be corrected to improve the quality and validity of the data. Submissions to veterinary diagnostic laboratories have selection biases and these should be considered when designing surveillance systems that include necropsy reports.

The prognostic value of kidney transplant center report cards.

PubMed

Schold, J D; Buccini, L D; Heaphy, E L G; Goldfarb, D A; Sehgal, A R; Fung, J; Poggio, E D; Kattan, M W

2013-07-01

SRTR report cards provide the basis for quality measurement of US transplant centers. There is limited data evaluating the prognostic value of report cards, informing whether they are predictive of prospective patient outcomes. Using national SRTR data, we simulated report cards and calculated standardized mortality ratios (SMR) for kidney transplant centers over five distinct eras. We ranked centers based on SMR and evaluated outcomes for patients transplanted the year following reports. Recipients transplanted at the 50th, 100th and 200th ranked centers had 18% (AHR = 1.18, 1.13-1.22), 38% (AHR = 1.38, 1.28-1.49) and 91% (AHR = 1.91, 1.64-2.21) increased hazard for 1-year mortality relative to recipients at the top-ranked center. Risks were attenuated but remained significant for long-term outcomes. Patients transplanted at centers meeting low-performance criteria in the prior period had 40% (AHR = 1.40, 1.22-1.68) elevated hazard for 1-year mortality in the prospective period. Centers' SMR from the report card was highly predictive (c-statistics > 0.77) for prospective center SMRs and there was significant correlation between centers' SMR from the report card period and the year following (ρ = 0.57, p < 0.001). Although results do not mitigate potential biases of report cards for measuring quality, they do indicate strong prognostic value for future outcomes. Findings also highlight that outcomes are associated with center ranking across a continuum rather than solely at performance margins. © Copyright 2013 The American Society of Transplantation and the American Society of Transplant Surgeons.

Cultural values: can they explain self-reported health?

PubMed

Roudijk, Bram; Donders, Rogier; Stalmeier, Peep

2017-06-01

Self-reported health (SRH) is a measure widely used in health research and population studies. Differences in SRH have been observed between countries and cultural values have been hypothesized to partly explain such differences. Cultural values can be operationalized by two cultural dimensions using the World Values Survey (WVS), namely the traditional/rational-secular and the survival/self-expression dimension. We investigate whether there is an association between the WVS cultural dimensions and SRH, both within and between countries. Data from 51 countries in the WVS is used and combined with macroeconomic data from the Worldbank database. The association between SRH and the WVS cultural dimensions is tested within each of the 51 countries and multilevel mixed models are used to test differences between these countries. Socio-demographic and macroeconomic variables are used to correct for non-cultural variables related to SRH. Within countries, the survival/self-expression dimension was positively associated with SRH, while in most countries there was a negative association for the traditional/rational-secular dimension. Values range between 4 and 17% within countries. Further analyses show that the associations within countries and between countries are similar. Controlling for macroeconomic and socio-demographic factors did not change our results. The WVS cultural dimensions predict SRH within and between countries. Contrary to our expectations, traditional/rational-secular values were negatively associated with SRH. As SRH is associated with cultural values between countries, cultural values could be considered when interpreting SRH between countries.

Health and Well-Being Metrics in Business: The Value of Integrated Reporting.

PubMed

Pronk, Nicolaas P; Malan, Daniel; Christie, Gillian; Hajat, Cother; Yach, Derek

2018-01-01

Health and well-being (HWB) are material to sustainable business performance. Yet, corporate reporting largely lacks the intentional inclusion of HWB metrics. This brief report presents an argument for inclusion of HWB metrics into existing standards for corporate reporting. A Core Scorecard and a Comprehensive Scorecard, designed by a team of subject matter experts, based on available evidence of effectiveness, and organized around the categories of Governance, Management, and Evidence of Success, may be integrated into corporate reporting efforts. Pursuit of corporate integrated reporting requires corporate governance and ethical leadership and values that ultimately align with environmental, social, and economic performance. Agreement on metrics that intentionally include HWB may allow for integrated reporting that has the potential to yield significant value for business and society alike.

Reading-Related Skills in Earlier- and Later-Schooled Children

ERIC Educational Resources Information Center

Cunningham, Anna J.; Carroll, Julia M.

2011-01-01

We investigate the effects of age-related factors and formal instruction on the development of reading-related skills in children aged 4 and 7 years. Age effects were determined by comparing two groups of children at the onset of formal schooling; one aged 7 (later-schooled) and one aged 4 (earlier-schooled). Schooling effects were measured by…

Smoking is associated with earlier time to revision of total knee arthroplasty.

PubMed

Lim, Chin Tat; Goodman, Stuart B; Huddleston, James I; Harris, Alex H S; Bhowmick, Subhrojyoti; Maloney, William J; Amanatullah, Derek F

2017-10-01

Smoking is associated with early postoperative complications, increased length of hospital stay, and an increased risk of revision after total knee arthroplasty (TKA). However, the effect of smoking on time to revision TKA is unknown. A total of 619 primary TKAs referred to an academic tertiary center for revision TKA were retrospectively stratified according to the patient smoking status. Smoking status was then analyzed for associations with time to revision TKA using a Chi square test. The association was also analyzed according to the indication for revision TKA. Smokers (37/41, 90%) have an increased risk of earlier revision for any reason compared to non-smokers (274/357, 77%, p=0.031). Smokers (37/41, 90%) have an increased risk of earlier revision for any reason compared to ex-smokers (168/221, 76%, p=0.028). Subgroup analysis did not reveal a difference in indication for revision TKA (p>0.05). Smokers are at increased risk of earlier revision TKA when compared to non-smokers and ex-smokers. The risk for ex-smokers was similar to that of non-smokers. Smoking appears to have an all-or-none effect on earlier revision TKA as patients who smoked more did not have higher risk of early revision TKA. These results highlight the need for clinicians to urge patients not to begin smoking and encourage smokers to quit smoking prior to primary TKA. Copyright © 2017 Elsevier B.V. All rights reserved.

Floodplains within reservoirs promote earlier spawning of white crappies Pomoxis annularis

USGS Publications Warehouse

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

2015-01-01

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

View northeast, wharf A, portion AA, details showing earlier piers ...

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

View northeast, wharf A, portion AA, details showing earlier piers and braces sloping toward water, reused charred plates for existing decking - U.S. Coast Guard Sandy Hook Station, Western Docking Structure, West of intersection of Canfield Road & Hartshorne Drive, Highlands, Monmouth County, NJ

Digital Health Intervention for Asthma: Patient-Reported Value and Usability.

PubMed

Merchant, Rajan; Inamdar, Rubina; Henderson, Kelly; Barrett, Meredith; Su, Jason G; Riley, Jesika; Van Sickle, David; Stempel, David

2018-06-04

Although digital health tools are increasingly recognized as effective in improving clinical outcomes such as asthma control and medication adherence, few studies have assessed patient experiences and perception of value. The aim of this study was to evaluate patient satisfaction, perception of usability and value, and desire to continue after 12 months of using a digital health intervention to support asthma management. Participants were enrolled in a randomized controlled study evaluating the impact of a digital health platform for asthma management. Participants used electronic inhaler sensors to track medication use and accessed their information in a digital health platform. Electronic surveys were administered to intervention arm participants aged 12 years and older after 12 months of use. The survey assessed asthma control, patient satisfaction with the sensor device, and perception of the usability and value of the digital health platform through closed-ended and open-ended questions. Logistic regression models were used to assess the impact of participants' characteristics on survey completion, satisfaction, and perception of value. Of the 207 intervention arm participants aged 12 years and older, 89 submitted survey responses (42.9% response rate). Of these 89 participants, 70 reported being very satisfied (79%, 70/89) or somewhat satisfied (20%, 18/89) with the inhaler sensor device. Moreover, 93% (83/89) expressed satisfaction with the reports, and 90% (80/89) found the information from the reports useful for learning about their asthma. In addition, 72% (64/89) of the participants reported that they were interested in continuing to use the sensor and platform beyond the study. There were no significant differences in satisfaction with the device or the platform across participants' characteristics, including device type, age, sex, insurance type, asthma control, or syncing history; however, participants with smartphones and longer participation were

Earlier adolescent substance use onset predicts stronger connectivity between reward and cognitive control brain networks.

PubMed

Weissman, David G; Schriber, Roberta A; Fassbender, Catherine; Atherton, Olivia; Krafft, Cynthia; Robins, Richard W; Hastings, Paul D; Guyer, Amanda E

2015-12-01

Early adolescent onset of substance use is a robust predictor of future substance use disorders. We examined the relation between age of substance use initiation and resting state functional connectivity (RSFC) of the core reward processing (nucleus accumbens; NAcc) to cognitive control (prefrontal cortex; PFC) brain networks. Adolescents in a longitudinal study of Mexican-origin youth reported their substance use annually from ages 10 to 16 years. At age 16, 69 adolescents participated in a resting state functional magnetic resonance imaging scan. Seed-based correlational analyses were conducted using regions of interest in bilateral NAcc. The earlier that adolescents initiated substance use, the stronger the connectivity between bilateral NAcc and right dorsolateral PFC, right dorsomedial PFC, right pre-supplementary motor area, right inferior parietal lobule, and left medial temporal gyrus. The regions that demonstrated significant positive linear relationships between the number of adolescent years using substances and connectivity with NAcc are nodes in the right frontoparietal network, which is central to cognitive control. The coupling of reward and cognitive control networks may be a mechanism through which earlier onset of substance use is related to brain function over time, a trajectory that may be implicated in subsequent substance use disorders. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Can social media data lead to earlier detection of drug‐related adverse events?

PubMed Central

Cremieux, Pierre; Audenrode, Marc Van; Vekeman, Francis; Karner, Paul; Zhang, Haimin; Greenberg, Paul

2016-01-01

Abstract Purpose To compare the patient characteristics and the inter‐temporal reporting patterns of adverse events (AEs) for atorvastatin (Lipitor®) and sibutramine (Meridia®) in social media (AskaPatient.com) versus the FDA Adverse Event Reporting System (FAERS). Methods We identified clinically important AEs associated with atorvastatin (muscle pain) and sibutramine (cardiovascular AEs), compared their patterns in social media postings versus FAERS and used Granger causality tests to assess whether social media postings were useful in forecasting FAERS reports. Results We analyzed 998 and 270 social media postings between 2001 and 2014, 69 003 and 7383 FAERS reports between 1997 and 2014 for atorvastatin and sibutramine, respectively. Social media reporters were younger (atorvastatin: 53.9 vs. 64.0 years, p < 0.001; sibutramine: 36.8 vs. 43.8 years, p < 0.001). Social media reviews contained fewer serious AEs (atorvastatin, pain: 2.5% vs. 38.2%; sibutramine, cardiovascular issues: 7.9% vs. 63.0%; p < 0.001 for both) and concentrated on fewer types of AEs (proportion comprising the top 20 AEs: atorvastatin, 88.7% vs. 55.4%; sibutramine, 86.3% vs. 65.4%) compared with FAERS. While social media sibutramine reviews mentioning cardiac issues helped predict those in FAERS 11 months later (p < 0.001), social media atorvastatin reviews did not help predict FAERS reports. Conclusions Social media AE reporters were younger and focused on less‐serious and fewer types of AEs than FAERS reporters. The potential for social media to provide earlier indications of AEs compared with FAERS is uncertain. Our findings highlight some of the promises and limitations of online social media versus conventional pharmacovigilance sources and the need for careful interpretation of the results. © 2016 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons Ltd. PMID:27601271

Can social media data lead to earlier detection of drug-related adverse events?

PubMed

Duh, Mei Sheng; Cremieux, Pierre; Audenrode, Marc Van; Vekeman, Francis; Karner, Paul; Zhang, Haimin; Greenberg, Paul

2016-12-01

To compare the patient characteristics and the inter-temporal reporting patterns of adverse events (AEs) for atorvastatin (Lipitor ® ) and sibutramine (Meridia ® ) in social media (AskaPatient.com) versus the FDA Adverse Event Reporting System (FAERS). We identified clinically important AEs associated with atorvastatin (muscle pain) and sibutramine (cardiovascular AEs), compared their patterns in social media postings versus FAERS and used Granger causality tests to assess whether social media postings were useful in forecasting FAERS reports. We analyzed 998 and 270 social media postings between 2001 and 2014, 69 003 and 7383 FAERS reports between 1997 and 2014 for atorvastatin and sibutramine, respectively. Social media reporters were younger (atorvastatin: 53.9 vs. 64.0 years, p < 0.001; sibutramine: 36.8 vs. 43.8 years, p < 0.001). Social media reviews contained fewer serious AEs (atorvastatin, pain: 2.5% vs. 38.2%; sibutramine, cardiovascular issues: 7.9% vs. 63.0%; p < 0.001 for both) and concentrated on fewer types of AEs (proportion comprising the top 20 AEs: atorvastatin, 88.7% vs. 55.4%; sibutramine, 86.3% vs. 65.4%) compared with FAERS. While social media sibutramine reviews mentioning cardiac issues helped predict those in FAERS 11 months later (p < 0.001), social media atorvastatin reviews did not help predict FAERS reports. Social media AE reporters were younger and focused on less-serious and fewer types of AEs than FAERS reporters. The potential for social media to provide earlier indications of AEs compared with FAERS is uncertain. Our findings highlight some of the promises and limitations of online social media versus conventional pharmacovigilance sources and the need for careful interpretation of the results. © 2016 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons Ltd. © 2016 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons Ltd.

Extracting and analyzing ejection fraction values from electronic echocardiography reports in a large health maintenance organization.

PubMed

Xie, Fagen; Zheng, Chengyi; Yuh-Jer Shen, Albert; Chen, Wansu

2017-12-01

The left ventricular ejection fraction value is an important prognostic indicator of cardiovascular outcomes including morbidity and mortality and is often used clinically to indicate severity of heart disease. However, it is usually reported in free-text echocardiography reports. We developed and validated a computerized algorithm to extract ejection fraction values from echocardiography reports and applied the algorithm to a large volume of unstructured echocardiography reports between 1995 and 2011 in a large health maintenance organization. A total of 621,856 echocardiography reports with a description of ejection fraction values or systolic functions were identified, of which 70 percent contained numeric ejection fraction values and the rest (30%) were text descriptions explicitly indicating the systolic left ventricular function. The 12.1 percent (16.0% for male and 8.4% for female) of these extracted ejection fraction values are <45 percent. Validation conducted based on a random sample of 200 reports yielded 95.0 percent sensitivity and 96.9 percent positive predictive value.

Comprehensive methods for earlier detection and monitoring of forest decline

Treesearch

Jennifer Pontius; Richard Hallett

2014-01-01

Forested ecosystems are threatened by invasive pests, pathogens, and unusual climatic events brought about by climate change. Earlier detection of incipient forest health problems and a quantitatively rigorous assessment method is increasingly important. Here, we describe a method that is adaptable across tree species and stress agents and practical for use in the...

The association between cannabis use and earlier age at onset of schizophrenia and other psychoses: meta-analysis of possible confounding factors.

PubMed

Myles, Nicholas; Newall, Hannah; Nielssen, Olav; Large, Matthew

2012-01-01

A recent meta-analysis showed that the mean age of onset of psychosis among cannabis users was almost three years earlier than that of non-cannabis users. However, because cannabis users usually smoke tobacco, the use of tobacco might independently contribute to the earlier onset of psychosis. We aimed to use meta-analysis to compare the extent to which cannabis and tobacco use are each associated with an earlier age at onset of schizophrenia and other psychoses. We also examined other factors that might have contributed to the finding of an earlier age of onset among cannabis users, including the proportion of males in the samples, the diagnostic inclusion criteria and aspects of study quality. The electronic databases MEDLINE, EMBASE, PsycINFO and ISI Web of Science, were searched for English-language peer-reviewed publications that reported age at onset of schizophrenia and other psychoses separately for cannabis users and non-users, or for tobaccosmokers and non-smokers. Meta-analysis showed that the age at onset of psychosis for cannabis users was 32 months earlier than for cannabis non-users (SMD=- 0.399, 95%CI -0.493 - -0.306, z=-8.34, p < 0.001), and was two weeks later in tobacco smokers compared with non-smokers (SMD=0.002, 95%CI -0.094 - 0.097, z=0.03, p=0.974). The main results were not affected by subgroup analyses examining studies of a single sex, the methods for making psychiatric diagnoses and measures of study quality. The results suggest that the association between cannabis use and earlier onset of psychosis is robust and is not the result either of tobacco smoking by cannabis using patients or the other potentially confounding factors we examined. This supports the hypothesis that, in some patients, cannabis use plays a causal role in the development of schizophrenia and raises the possibility of treating schizophrenia with new pharmacological treatments that have an affinity for endo-cannabinoid receptors.

Earlier Violent Television Exposure and Later Drug Dependence

PubMed Central

Brook, David W.; Katten, Naomi S.; Ning, Yuming; Brook, Judith S.

2013-01-01

This research examined the longitudinal pathways from earlier violent television exposure to later drug dependence. African American and Puerto Rican adolescents were interviewed during three points in time (N = 463). Violent television exposure in late adolescence predicted violent television exposure in young adulthood, which in turn was related to tobacco/marijuana use, nicotine dependence, and later drug dependence. Some policy and clinical implications suggest: a) regulating the times when violent television is broadcast; b) creating developmentally targeted prevention/treatment programs; and c) recognizing that watching violent television may serve as a cue regarding increased susceptibility to nicotine and drug dependence. PMID:18612881

National survey on critical values reporting in a cohort of Italian laboratories.

PubMed

Lippi, Giuseppe; Giavarina, Davide; Montagnana, Martina; Luca Salvagno, Gian; Cappelletti, Piero; Plebani, Mario; Guidi, Gian Cesare

2007-01-01

Critical values' reporting is an essential requisite for clinical laboratories. Local policies were investigated within an indicative cohort of Italian laboratories to monitor the situation and establish a performance benchmark. A five-point questionnaire was administered to 150 laboratory specialists attending the SIMEL (Italian Society of Laboratory Medicine) National Meeting in June 2006. A total of 107 questionnaires (71.3%) were returned with a 100% individual question response rate. Only 55% of the participants acknowledge critical values reporting as an essential practice, 80% admit that a comprehensive list of critical values is unavailable in the laboratory and 4% do not promptly communicate critical values. The list of critical values is variable among laboratories, ranging from none to 20 analytes included. The requesting physician or his/her office staff receives the great majority (97%) of notifications by telephone for outpatients. Critical values for inpatients are notified directly by telephone (81%) and in a minority of cases by either fax or computer (19%). In the inpatient setting, the information is notified to physicians (77%), nurses (15%) or other healthcare staff in the clinic (8%). It was found that 49% of the participants adopt a standard (digital or written) policy for routine recording of notifications; in 32% of the cases the registration is left to individual attitudes, whereas in 20% of the cases the notification is not recorded. No laboratory has yet adopted a read-back verification of the complete test result by the person receiving the information. The importance of critical value reporting is still poorly recognized in Italy and uniform or internationally accredited practices for communication and recording are not currently implemented.

Trend of earlier spring in central Europe continued

NASA Astrophysics Data System (ADS)

Ungersböck, Markus; Jurkovic, Anita; Koch, Elisabeth; Lipa, Wolfgang; Scheifinger, Helfried; Zach-Hermann, Susanne

2013-04-01

Modern phenology is the study of the timing of recurring biological events in the animal and plant world, the causes of their timing with regard to biotic and abiotic forces, and the interrelation among phases of the same or different species. The relationship between phenology and climate explains the importance of plant phenology for Climate Change studies. Plants require light, water, oxygen mineral nutrients and suitable temperature to grow. In temperate zones the seasonal life cycle of plants is primarily controlled by temperature and day length. Higher spring air temperatures are resulting in an earlier onset of the phenological spring in temperate and cool climate. On the other hand changes in phenology due to climate change do have impact on the climate system itself. Vegetation is a dynamic factor in the earth - climate system and has positive and negative feedback mechanisms to the biogeochemical and biogeophysical fluxes to the atmosphere Since the mid of the 1980s spring springs earlier in Europe and autumn is shifting back to the end of the year resulting in a longer vegetation period. The advancement of spring can be clearly attributed to temperature increase in the months prior to leaf unfolding and flowering, the timing of autumn is more complex and cannot easily be attributed to one or some few parameters. To demonstrate that the observed advancement of spring since the mid of 1980s is pro-longed in 2001 to 2010 and the delay of fall and the lengthening of the growing season is confirmed in the last decade we picked out several indicator plants from the PEP725 database www.pep725.eu. The PEP725 database collects data from different European network operators and thus offers a unique compilation of phenological observations; the database is regularly updated. The data follow the same classification scheme, the so called BBCH coding system so they can be compared. Lilac Syringa vulgaris, birch Betula pendula, beech Fagus and horse chestnut Aesculus

Techniques for Developing Child Dummy Protection Reference Values. Event Report

DOT National Transportation Integrated Search

1996-10-01

The purpose of this report is to present background information and techniques : for developing protection reference values (PRV) to use with child dummies in : out-of-position (OOP) child/air bag interaction testing. Biomechanics experts : agree tha...

Duty Hour Reporting: Conflicting Values in Professionalism.

PubMed

Byrne, John M; Loo, Lawrence K; Giang, Dan W

2015-09-01

Duty hour limits challenge professional values, sometimes forcing residents to choose between patient care and regulatory compliance. This may affect truthfulness in duty hour reporting. We assessed residents' reasons for falsifying duty hour reports. We surveyed residents in 1 sponsoring institution to explore the reasons for noncompliance, frequency of violations, falsification of reports, and the residents' awareness of the option to extend hours to care for a single patient. The analysis used descriptive statistics. Linear regression was used to explore falsification of duty hour reports by year of training. The response rate was 88% (572 of 650). Primary reasons for duty hour violations were number of patients (19%) and individual patient acuity/complexity (19%). Junior residents were significantly more likely to falsify duty hours (R = -0.966). Of 124 residents who acknowledged falsification, 51 (41%) identified the primary reason as concern that the program will be in jeopardy of violating the Accreditation Council for Graduate Medical Education (ACGME) duty hour limits followed by fear of punishment (34, 27%). This accounted for more than two-thirds of the primary reasons for falsification. Residents' falsification of duty hour data appears to be motivated by concerns about adverse actions from the ACGME, and fear they might be punished. To foster professionalism, we recommend that sponsoring institutions educate residents about professionalism in duty hour reporting. The ACGME should also convey the message that duty hour limits be applied in a no-blame systems-based approach, and allow junior residents to extend duty hours for the care of individual patients.

Earlier vegetation green-up has reduced spring dust storms

PubMed Central

Fan, Bihang; Guo, Li; Li, Ning; Chen, Jin; Lin, Henry; Zhang, Xiaoyang; Shen, Miaogen; Rao, Yuhan; Wang, Cong; Ma, Lei

2014-01-01

The observed decline of spring dust storms in Northeast Asia since the 1950s has been attributed to surface wind stilling. However, spring vegetation growth could also restrain dust storms through accumulating aboveground biomass and increasing surface roughness. To investigate the impacts of vegetation spring growth on dust storms, we examine the relationships between recorded spring dust storm outbreaks and satellite-derived vegetation green-up date in Inner Mongolia, Northern China from 1982 to 2008. We find a significant dampening effect of advanced vegetation growth on spring dust storms (r = 0.49, p = 0.01), with a one-day earlier green-up date corresponding to a decrease in annual spring dust storm outbreaks by 3%. Moreover, the higher correlation (r = 0.55, p < 0.01) between green-up date and dust storm outbreak ratio (the ratio of dust storm outbreaks to times of strong wind events) indicates that such effect is independent of changes in surface wind. Spatially, a negative correlation is detected between areas with advanced green-up dates and regional annual spring dust storms (r = −0.49, p = 0.01). This new insight is valuable for understanding dust storms dynamics under the changing climate. Our findings suggest that dust storms in Inner Mongolia will be further mitigated by the projected earlier vegetation green-up in the warming world. PMID:25343265

Changes toward earlier streamflow timing across western North America

USGS Publications Warehouse

Stewart, I.T.; Cayan, D.R.; Dettinger, M.D.

2005-01-01

The highly variable timing of streamflow in snowmelt-dominated basins across western North America is an important consequence, and indicator, of climate fluctuations. Changes in the timing of snowmelt-derived streamflow from 1948 to 2002 were investigated in a network of 302 western North America gauges by examining the center of mass for flow, spring pulse onset dates, and seasonal fractional flows through trend and principal component analyses. Statistical analysis of the streamflow timing measures with Pacific climate indicators identified local and key large-scale processes that govern the regionally coherent parts of the changes and their relative importance. Widespread and regionally coherent trends toward earlier onsets of springtime snowmelt and streamflow have taken place across most of western North America, affecting an area that is much larger than previously recognized. These timing changes have resulted in increasing fractions of annual flow occurring earlier in the water year by 1-4 weeks. The immediate (or proximal) forcings for the spatially coherent parts of the year-to-year fluctuations and longer-term trends of streamflow timing have been higher winter and spring temperatures. Although these temperature changes are partly controlled by the decadal-scale Pacific climate mode [Pacific decadal oscillation (PDO)], a separate and significant part of the variance is associated with a springtime warming trend that spans the PDO phases. ?? 2005 American Meteorological Society.

Earlier vegetation green-up has reduced spring dust storms.

PubMed

Fan, Bihang; Guo, Li; Li, Ning; Chen, Jin; Lin, Henry; Zhang, Xiaoyang; Shen, Miaogen; Rao, Yuhan; Wang, Cong; Ma, Lei

2014-10-24

The observed decline of spring dust storms in Northeast Asia since the 1950s has been attributed to surface wind stilling. However, spring vegetation growth could also restrain dust storms through accumulating aboveground biomass and increasing surface roughness. To investigate the impacts of vegetation spring growth on dust storms, we examine the relationships between recorded spring dust storm outbreaks and satellite-derived vegetation green-up date in Inner Mongolia, Northern China from 1982 to 2008. We find a significant dampening effect of advanced vegetation growth on spring dust storms (r = 0.49, p = 0.01), with a one-day earlier green-up date corresponding to a decrease in annual spring dust storm outbreaks by 3%. Moreover, the higher correlation (r = 0.55, p < 0.01) between green-up date and dust storm outbreak ratio (the ratio of dust storm outbreaks to times of strong wind events) indicates that such effect is independent of changes in surface wind. Spatially, a negative correlation is detected between areas with advanced green-up dates and regional annual spring dust storms (r = -0.49, p = 0.01). This new insight is valuable for understanding dust storms dynamics under the changing climate. Our findings suggest that dust storms in Inner Mongolia will be further mitigated by the projected earlier vegetation green-up in the warming world.

Earlier tachycardia onset in right than left mesial temporal lobe seizures.

PubMed

Kato, Kazuhiro; Jin, Kazutaka; Itabashi, Hisashi; Iwasaki, Masaki; Kakisaka, Yosuke; Aoki, Masashi; Nakasato, Nobukazu

2014-10-07

To clarify whether the presence and timing of peri-ictal heart rate (HR) change is a seizure lateralizing sign in patients with mesial temporal lobe epilepsy (mTLE). Long-term video EEGs were retrospectively reviewed in 21 patients, 7 men and 14 women aged 13 to 67 years, diagnosed as mTLE with MRI lesions in the mesial temporal structures (hippocampal sclerosis in 20 cases, amygdala hypertrophy in 1 case). Seventy-seven partial seizures without secondary generalization were extracted. Peri-ictal HR change was compared between 29 right seizures (9 patients) and 48 left seizures (12 patients). HR abruptly increased in all 29 right seizures and 42 of 48 left seizures. Onset time of HR increase in relation to ictal EEG onset was significantly earlier in right seizures than in left seizures (mean ± SD, -11.5 ± 14.8 vs 9.2 ± 21.7 seconds; p < 0.0001). Time of maximum HR was also significantly earlier in right seizures than in left seizures (36.0 ± 18.1 vs 58.0 ± 28.7 seconds; p < 0.0001). Maximum HR changes from baseline showed no significant difference between right and left seizures (47.5 ± 19.1 vs 40.8 ± 20.0/min). Significantly earlier tachycardia in right than left mTLE seizures supports previous hypotheses that the right cerebral hemisphere is dominant in the sympathetic network. No HR change, or delayed tachycardia possibly due to seizure propagation to the right hemisphere, may be a useful lateralizing sign of left mTLE seizures. © 2014 American Academy of Neurology.

Diagramming Transactive Building Business Cases: Using Principles of e3 Value to Document Valuation Studies

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

Hammerstrom, Donald J.; Makhmalbaf, Atefe; Marinovici, Maria C.

Energy management in buildings is becoming more transactive. Pacific Northwest National Laboratory and the U.S. Department of Energy Building Technologies Office recently defined innovative use cases wherein market-like mechanisms are used to manage energy within buildings, between buildings, and between buildings and third-party entities, such as power utilities. A next step toward defining a set of transactive use cases in the buildings domain is to carefully diagram the corresponding business cases to capture details of transactions among all stakeholders and their economic value propositions. The principles of e3-value diagramming are applied in this report toward creating business value diagrams. Thesemore » principles are extended to be consistent with Universal Modeling Language use-case diagrams. Example diagrams are presented for a subset of buildings-domain use cases that were introduced in an earlier Pacific Northwest National Laboratory report. The diagrams are intended to clearly represent an understanding of the transactions through which individual entities accumulate value in their respective use cases, and the diagrams should therefore support economic valuation studies. The report reviews some of the foundational principles of e3 value and includes authors’ insights concerning the formulation of these diagrams using Universal Modeling Language as a more systematic modeling approach.« less

Duty Hour Reporting: Conflicting Values in Professionalism

PubMed Central

Byrne, John M.; Loo, Lawrence K.; Giang, Dan W.

2015-01-01

Background Duty hour limits challenge professional values, sometimes forcing residents to choose between patient care and regulatory compliance. This may affect truthfulness in duty hour reporting. Objective We assessed residents' reasons for falsifying duty hour reports. Methods We surveyed residents in 1 sponsoring institution to explore the reasons for noncompliance, frequency of violations, falsification of reports, and the residents' awareness of the option to extend hours to care for a single patient. The analysis used descriptive statistics. Linear regression was used to explore falsification of duty hour reports by year of training. Results The response rate was 88% (572 of 650). Primary reasons for duty hour violations were number of patients (19%) and individual patient acuity/complexity (19%). Junior residents were significantly more likely to falsify duty hours (R = −0.966). Of 124 residents who acknowledged falsification, 51 (41%) identified the primary reason as concern that the program will be in jeopardy of violating the Accreditation Council for Graduate Medical Education (ACGME) duty hour limits followed by fear of punishment (34, 27%). This accounted for more than two-thirds of the primary reasons for falsification. Conclusions Residents' falsification of duty hour data appears to be motivated by concerns about adverse actions from the ACGME, and fear they might be punished. To foster professionalism, we recommend that sponsoring institutions educate residents about professionalism in duty hour reporting. The ACGME should also convey the message that duty hour limits be applied in a no-blame systems-based approach, and allow junior residents to extend duty hours for the care of individual patients. PMID:26457145

Earlier Mother's Age at Menarche Predicts Rapid Infancy Growth and Childhood Obesity

PubMed Central

Ong, Ken K; Northstone, Kate; Wells, Jonathan CK; Rubin, Carol; Ness, Andy R; Golding, Jean; Dunger, David B

2007-01-01

Background Early menarche tends to be preceded by rapid infancy weight gain and is associated with increased childhood and adult obesity risk. As age at menarche is a heritable trait, we hypothesised that age at menarche in the mother may in turn predict her children's early growth and obesity risk. Methods and Findings We tested associations between mother's age at menarche, mother's adult body size and obesity risk, and her children's growth and obesity risk in 6,009 children from the UK population-based Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort who had growth and fat mass at age 9 y measured by dual-energy X-ray absorptiometry. A subgroup of 914 children also had detailed infancy and childhood growth data. In the mothers, earlier menarche was associated with shorter adult height (by 0.64 cm/y), increased weight (0.92 kg/y), and body mass index (BMI, 0.51 kg/m2/y; all p < 0.001). In contrast, in her children, earlier mother's menarche predicted taller height at 9 y (by 0.41 cm/y) and greater weight (0.80 kg/y), BMI (0.29 kg/m2/y), and fat mass index (0.22 kg/m2/year; all p < 0.001). Children in the earliest mother's menarche quintile (≤11 y) were more obese than the oldest quintile (≥15 y) (OR, 2.15, 95% CI 1.46 to 3.17; p < 0.001, adjusted for mother's education and BMI). In the subgroup, children in the earliest quintile showed faster gains in weight (p < 0.001) and height (p < 0.001) only from birth to 2 y, but not from 2 to 9 y (p = 0.3–0.8). Conclusions Earlier age at menarche may be a transgenerational marker of a faster growth tempo, characterised by rapid weight gain and growth, particularly during infancy, and leading to taller childhood stature, but likely earlier maturation and therefore shorter adult stature. This growth pattern confers increased childhood and adult obesity risks. PMID:17455989

Momentary Associations Between Reported Craving and Valuing Health in Daily Smokers.

PubMed

MacLean, Robert Ross; Martino, Steve; Carroll, Kathleen M; Smyth, Joshua M; Pincus, Aaron L; Wilson, Stephen J

2017-06-01

Research suggests that a blunted response to nondrug rewards, especially under conditions associated with strong cigarette cravings, is associated with reduced abstinence motivation in daily smokers. One limitation of previous studies is that they have largely focused on monetary rewards as broad representative of nondrug rewards. It remains unclear whether craving dampens responses to more abstract nondrug rewards, such as personal values. Personal values often have a positive valence and are frequently assumed to remain stable across time and situations. However, there may be time-varying and contextual influences on smokers' appraisal of values in daily life. Characterizing fluctuations in value importance in relation to relapse precipitants (eg, craving) may inform interventions that leverage personal values as motivation for cessation. Daily smokers (n = 18) completed ecological momentary assessment surveys measuring the importance of specific personal values and smoking-related variables during 8 days of monetarily reinforced cigarette abstinence. We hypothesized that value ratings would demonstrate adequate within-person heterogeneity for multilevel modeling and that within-person fluctuations in craving would be negatively related to valuing personal health. All values demonstrated adequate within-person variability for multilevel modeling. Within-person craving was negatively related to health valuation (p = .012) and a cross-level interaction (p > .0001) suggested this effect is stronger for individuals who report greater overall craving. Greater craving is associated with decreased importance of personal health in the moment, particularly for those with high average levels of craving. Timely interventions that bolster importance of health during moments of elevated craving can potentially improve cessation outcomes. This study builds on research highlighting the positive influence of personal values in motivating behavior change. Values are an often used

Adverse childhood experiences predict earlier age of drinking onset: results from a representative US sample of current or former drinkers.

PubMed

Rothman, Emily F; Edwards, Erika M; Heeren, Timothy; Hingson, Ralph W

2008-08-01

Our goal was to determine whether adverse childhood experiences predicted the age at which drinking was initiated and drinking motives in a representative sample of current or former drinkers in the United States. In 2006, a probability sample of 3592 US current or former drinkers aged 18 to 39 were surveyed. Multinomial logistic regression examined whether each of 10 adverse childhood experiences was associated with earlier ages of drinking onset, controlling for demographics, parental alcohol use, parental attitudes toward drinking, and peers' drinking in adolescence. We also examined whether there was a graded relationship between the number of adverse childhood experiences and age of drinking onset and whether adverse childhood experiences were related to self-reported motives for drinking during the first year that respondents drank. Sixty-six percent of respondents reported >or=1 adverse childhood experiences, and 19% reported experiencing >or=4. The most commonly reported adverse childhood experiences were parental separation/divorce (41.3%), living with a household member who was a problem drinker (28.7%), mental illness of a household member (24.8%), and sexual abuse (19.1%). Of the 10 specific adverse childhood experiences assessed, 5 were significantly associated with initiating drinking at or=21 years of age) after adjustment for confounders, including physical abuse, sexual abuse, having a mentally ill household member, substance abuse in the home, and parental discord or divorce. Compared with those without adverse childhood experiences, respondents with adverse childhood experiences were substantially more likely to report that they drank to cope during the first year that they used alcohol. Results suggest that children with particular adverse childhood experiences may initiate drinking earlier than their peers and that they may be more likely to drink to cope with problems (rather than for pleasure or to be

Number of Diverticulitis Episodes Before Resection and Factors Associated With Earlier Interventions

PubMed Central

Simianu, Vlad V.; Fichera, Alessandro; Bastawrous, Amir L.; Davidson, Giana H.; Florence, Michael G.; Thirlby, Richard C.; Flum, David R.

2016-01-01

claims only, in 80.5% (2459 of 3054) if counting inpatient and outpatient claims only, and in 56.3% (1720 of 3054) if counting all types of claims. Based on all types of claims, patients having surgery after fewer than 3 episodes were of similar mean age compared with patients having delayed surgery (both 47.7 years, P = .91), were less likely to undergo laparoscopy (65.1% [1120 of 1720] vs 70.8% [944 of 1334], P = .001), and had more time between the last 2 episodes preceding surgery (157 vs 96 days, P < .001). Patients with health maintenance organization or capitated insurance plans had lower rates of early surgery (50.1% [247 of 493] vs 57.4% [1429 of 2490], P = .01) than those with other insurance plan types. CONCLUSIONS AND RELEVANCE After considering all types of diverticulitis claims, 56.3% (1720 of 3054) of elective resections for uncomplicated diverticulitis occurred after fewer than 3 episodes. Earlier surgery was not explained by younger age, laparoscopy, time between the last 2 episodes preceding surgery, or financial risk-bearing for patients. In delivering value-added surgical care, factors driving early, elective resection for diverticulitis need to be determined. PMID:26864286

Stationary table CT dosimetry and anomalous scanner-reported values of CTDI{sub vol}

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

Dixon, Robert L., E-mail: rdixon@wfubmc.edu; Boone, John M.

2014-01-15

Purpose: Anomalous, scanner-reported values of CTDI{sub vol} for stationary phantom/table protocols (having elevated values of CTDI{sub vol} over 300% higher than the actual dose to the phantom) have been observed; which are well-beyond the typical accuracy expected of CTDI{sub vol} as a phantom dose. Recognition of these outliers as “bad data” is important to users of CT dose index tracking systems (e.g., ACR DIR), and a method for recognition and correction is provided. Methods: Rigorous methods and equations are presented which describe the dose distributions for stationary-table CT. A comparison with formulae for scanner-reported values of CTDI{sub vol} clearly identifiesmore » the source of these anomalies. Results: For the stationary table, use of the CTDI{sub 100} formula (applicable to a moving phantom only) overestimates the dose due to extra scatter and also includes an overbeaming correction, both of which are nonexistent when the phantom (or patient) is held stationary. The reported DLP remains robust for the stationary phantom. Conclusions: The CTDI-paradigm does not apply in the case of a stationary phantom and simpler nonintegral equations suffice. A method of correction of the currently reported CTDI{sub vol} using the approach-to-equilibrium formula H(a) and an overbeaming correction factor serves to scale the reported CTDI{sub vol} values to more accurate levels for stationary-table CT, as well as serving as an indicator in the detection of “bad data.”.« less

Re-evaluation of the reported experimental values of the heat of vaporization of N-methylacetamide

PubMed Central

MacKerell, Alexander D.; Shim, Ji Hyun; Anisimov, Victor M.

2010-01-01

The accuracy of empirical force fields is inherently related to the quality of the target data used for optimization of the model. With the heat of vaporization (ΔHvap) of N-methylacetamide (NMA), a range of values have been reported as target data for optimization of the nonbond parameters associated with the peptide bond in proteins. In the present work, the original experimental data and Antoine constants used for the determination of the ΔHvap of NMA are reanalyzed. Based on this analysis, the wide range of ΔHvap values reported in the literature are shown to be due to incorrect reporting of the temperatures at which the original values were extracted and limitations in the quality of experimental vapor pressure-temperature data over a wide range of temperatures. Taking these problems into account, a consistent ΔHvap value is extracted from three studies for which experimental data are available. This analysis suggests that the most reliable value for ΔHvap is 13.0±0.1 at 410 K for use in force field optimization studies. The present results also indicate that similar analyses, including analysis of Antoine constants alone, may be of utility when reported ΔHvap values are not consistent for a given neat liquid. PMID:20445813

The diagnostic value of earlier and later components of Vestibular Evoked Myogenic Potentials (VEMP) in multiple sclerosis.

PubMed

Eleftheriadou, A; Deftereos, S N; Zarikas, V; Panagopoulos, G; Sfetsos, S; Karageorgiou, C L; Ferekidou, E; Kandiloros, D; Korres, S

2009-01-01

To evaluate the ability of VEMP to disclose spatial dissemination of Multiple Sclerosis. Forty-six MS patients with auditory and/or vestibular symptoms were studied. Patients were divided in two groups. Group 1 included 24 patients with brainstem MRI findings, and Group 2 included 22 patients without MRI findings. VEMP and BAEP have been recorded and assessed. Abnormal p13n23 wave was observed in 50%, while unilateral absence or bilateral delay of the n34p44 in 43% of the patients. The overall diagnostic value considering abnormal cases suggested by both first and second VEMP waves was increased to 71%. Statistically significant differences revealed between patients and controls for p13 latency (p=0.018). The p13n23 was abnormal in 7 patients, although MRI scanning did not reveal brainstem lesions. In 9 out of 18 MS patients suffering from unilateral hearing loss, n34p44 was present in the unaffected ears and absent in the affected side, although p13n23 was normal. Abnormal VEMP imply the presence of lesions undetected by MRI neuroimaging, which verifies the diagnostic value of the method. Unilateral absence of n34p44 complex was related with sensorineural hearing loss, supporting the hypothesis that n34p44 is of cochlear origin.

Design a Fuzzy Rule-based Expert System to Aid Earlier Diagnosis of Gastric Cancer.

PubMed

Safdari, Reza; Arpanahi, Hadi Kazemi; Langarizadeh, Mostafa; Ghazisaiedi, Marjan; Dargahi, Hossein; Zendehdel, Kazem

2018-01-01

Screening and health check-up programs are most important sanitary priorities, that should be undertaken to control dangerous diseases such as gastric cancer that affected by different factors. More than 50% of gastric cancer diagnoses are made during the advanced stage. Currently, there is no systematic approach for early diagnosis of gastric cancer. to develop a fuzzy expert system that can identify gastric cancer risk levels in individuals. This system was implemented in MATLAB software, Mamdani inference technique applied to simulate reasoning of experts in the field, a total of 67 fuzzy rules extracted as a rule-base based on medical expert's opinion. 50 case scenarios were used to evaluate the system, the information of case reports is given to the system to find risk level of each case report then obtained results were compared with expert's diagnosis. Results revealed that sensitivity was 92.1% and the specificity was 83.1%. The results show that is possible to develop a system that can identify High risk individuals for gastric cancer. The system can lead to earlier diagnosis, this may facilitate early treatment and reduce gastric cancer mortality rate.

Discharging patients earlier in the day: a concept worth evaluating.

PubMed

Kravet, Steven J; Levine, Rachel B; Rubin, Haya R; Wright, Scott M

2007-01-01

Patient discharges from the hospital often occur late in the day and are frequently clustered after 4 PM. When inpatients leave earlier in the day, quality is improved because new admissions awaiting beds are able to leave the emergency department sooner and emergency department waiting room backlog is reduced. Nursing staff, whose work patterns traditionally result in high activity of discharge and admission between 5 PM and 8 PM, benefit by spreading out their work across a longer part of the day. Discharging patients earlier in the day also has the potential to increase patient satisfaction. Despite multiple stakeholders in the discharge planning process, physicians play the most important role. Getting physician buy-in requires an ability to teach physicians about the concept of early-in-the-day discharges and their impact on the process. We defined a new physician-centered discharge planning process and introduced it to an internal medicine team with an identical control team as a comparison. Discharge time of day was analyzed for 1 month. Mean time of day of discharge was 13:39 for the intervention group versus 15:45 for the control group (P<.001). If reproduced successfully, this process could improve quality at an important transition point in patient care.

ARM Climate Research Facility Quarterly Value-Added Product Report

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

Sivaraman, C.

The purpose of this report is to provide a concise status update for Value-Added Products (VAPs) implemented by the Atmospheric Radiation Measurement (ARM) Climate Research Facility. The report is divided into the following sections: (1) new VAPs for which development has begun; (2) progress on existing VAPs; (3) future VAPs that have been recently approved; (4) other work that leads to a VAP; (5) top requested VAPs from the ARM Data Archive; and (6) a summary of VAP and data releases to production and evaluation. New information is highlighted in blue text. New information about processed data by the developermore » is highlighted in red text. The upcoming milestones and dates are highlighted in green.« less

Revised values for the thermodynamic properties of boehmite, AlO(OH) , and related species and phases in the system Al-H-O

USGS Publications Warehouse

Hemingway, B.S.; Robie, R.A.; Apps, J.A.

1991-01-01

Heat capacity measurements are reported for a well-characterized boehmite that differ significantly from results reported earlier by Shomate and Cook (1946) for a monohydrate of alumina. It is suggested that the earlier measurements were made on a sample that was a mixture of phases and that use of that heat-capacity and derived thermodynamic data be discontinued. The entropy of boehmite derived in this study is 37.19 ?? 0.10 J/(mol.K) at 298.15 K. Based on our value for the entropy and accepting the recommended Gibbs free energy for Al(OH)-4, the Gibbs free energy and enthalpy of formation of boehmite are calculated to be -918.4 ?? 2.1 and -996.4 ?? 2.2 kJ/mol, respectively, from solubility data for boehmite. The Gibbs energy for boehmite is unchanged from that given by Hemingway et al. (1978). -from Authors

Attachment styles, earlier interpersonal relationships and schizotypy in a non-clinical sample.

PubMed

Berry, Katherine; Band, Rebecca; Corcoran, Rhiannon; Barrowclough, Christine; Wearden, Alison

2007-12-01

This paper investigates associations between adult attachment style, relationships with significant others during childhood, traumatic life-events and schizotypy. Relationships between attachment and hypothesized correlates were investigated in a cross-sectional design using an analogue sample. The reliability of the attachment and trauma measures was investigated using a test-retest design. Three hundred and four students completed the self-report version of the Psychosis Attachment Measure (PAM), maternal and paternal versions of the Parental Bonding Instrument, the Attachment History Questionnaire, a measure of trauma and the Oxford-Liverpool Inventory of Feelings and Experiences scale through an internet website. As predicted, there were statistically significant associations between insecure attachment in adult relationships and experiences of negative interpersonal events. Both earlier interpersonal experiences and adult attachment style predicted schizotypy, and adult attachment style emerged as an independent predictor of positive schizotypal characteristics. The findings support associations between adult attachment style and previous interpersonal experiences and between adult attachment and schizotypy. The PAM is a reliable and valid instrument that can be used to explore attachment styles in analogue samples and associations between attachment styles and psychotic symptoms in clinical samples.

The Role of Patient-Reported Outcome Measures in Value-Based Payment Reform.

PubMed

Squitieri, Lee; Bozic, Kevin J; Pusic, Andrea L

2017-06-01

The U.S. health care system is currently experiencing profound change. Pressure to improve the quality of patient care and control costs have caused a rapid shift from traditional volume-driven fee-for-service reimbursement to value-based payment models. Under the 2015 Medicare Access and Children's Health Insurance Program Reauthorization Act, providers will be evaluated on the basis of quality and cost efficiency and ultimately receive adjusted reimbursement as per their performance. Although current performance metrics do not incorporate patient-reported outcome measures (PROMs), many wonder whether and how PROMs will eventually fit into value-based payment reform. On November 17, 2016, the second annual Patient-Reported Outcomes in Healthcare Conference brought together international stakeholders across all health care disciplines to discuss the potential role of PROs in value-based health care reform. The purpose of this article was to summarize the findings from this conference in the context of recent literature and guidelines to inform implementation of PROs in value-based payment models. Recommendations for evaluating key perspectives and measurement goals are made to facilitate appropriate use of PROMs to best benefit and amplify the voice of our patients. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Institute on Human Values in Medicine. Reports of the Institute Fellows. 1973-74.

ERIC Educational Resources Information Center

Society for Health and Human Values, Philadelphia, PA.

This document is a compilation of reports of persons involved in the fellowship program offered by the Institute of Health and Human Values. The fellowship program centers around recognition of a need to support faculty development so that appropriately trained people can be available for emerging programs that teach human values as part of health…

An earlier age of breast cancer diagnosis related to more frequent use of antiperspirants/deodorants and underarm shaving.

PubMed

McGrath, K G

2003-12-01

Breast cancer incidence suggests a lifestyle cause. A lifestyle factor used near the breast is the application of antiperspirants/deodorants accompanied by axillary shaving. A previous study did not support a link with breast cancer. If these habits have a role in breast cancer development, women using antiperspirants/deodorants and shaving their underarms frequently would be expected to have an earlier age of diagnosis than those doing so less often. An earlier age of diagnosis would also be expected in those starting to use deodorants and shaving at an earlier age. This is the first study to investigate the intensity of underarm exposure in a cohort of breast cancer survivors. Four hundred and thirty-seven females diagnosed with breast cancer were surveyed. Once grouped by their frequency of underarm hygiene habits, the mean age of diagnosis was the primary end point. Secondary end points included the overall frequency of these habits, and potential usage group confounding variables were evaluated. All statistical tests were two-sided. Frequency and earlier onset of antiperspirant/deodorant usage with underarm shaving were associated with an earlier age of breast cancer diagnosis. Combined habits are likely for this earlier age of diagnosis. In conclusion, underarm shaving with antiperspirant/deodorant use may play a role in breast cancer. It is not clear which of these components are involved. Reviewed literature insinuates absorption of aluminium salts facilitated by dermal barrier disruption. Case-controlled investigations are needed before alternative underarm hygiene habits are suggested.

Cautionary Note on Reporting Eta-Squared Values from Multifactor ANOVA Designs

ERIC Educational Resources Information Center

Pierce, Charles A.; Block, Richard A.; Aguinis, Herman

2004-01-01

The authors provide a cautionary note on reporting accurate eta-squared values from multifactor analysis of variance (ANOVA) designs. They reinforce the distinction between classical and partial eta-squared as measures of strength of association. They provide examples from articles published in premier psychology journals in which the authors…

Bilingual Readiness for Achieving through Valued Opportunities (Project BRAVO) Final Evaluation Report, 1992-93. OREA Report.

ERIC Educational Resources Information Center

Choonoo, John

This report presents an evaluation of the Bilingual Readiness for Achieving through Valued Opportunities (Project BRAVO), an Elementary and Secondary Education Act Title VII-funded project in its first year of operation at Boys and Girls High School in Brooklyn (New York) and Louis D. Brandeis High School in Manhattan (New York). Participating…

Reported maternal tendencies predict the reward value of infant facial cuteness, but not cuteness detection

PubMed Central

Hahn, Amanda C.; DeBruine, Lisa M.; Jones, Benedict C.

2015-01-01

The factors that contribute to individual differences in the reward value of cute infant facial characteristics are poorly understood. Here we show that the effect of cuteness on a behavioural measure of the reward value of infant faces is greater among women reporting strong maternal tendencies. By contrast, maternal tendencies did not predict women's subjective ratings of the cuteness of these infant faces. These results show, for the first time, that the reward value of infant facial cuteness is greater among women who report being more interested in interacting with infants, implicating maternal tendencies in individual differences in the reward value of infant cuteness. Moreover, our results indicate that the relationship between maternal tendencies and the reward value of infant facial cuteness is not due to individual differences in women's ability to detect infant cuteness. This latter result suggests that individual differences in the reward value of infant cuteness are not simply a by-product of low-cost, functionless biases in the visual system. PMID:25740842

Diagnosis of varicoceles in men undergoing vasectomy may lead to earlier detection of hypogonadism.

PubMed

Liu, Joceline S; Jones, Madeline; Casey, Jessica T; Fuchs, Amanda B; Cashy, John; Lin, William W

2014-06-01

To determine the temporal relationship between vasectomy, varicocele, and hypogonadism diagnosis. Many young men undergo their first thorough genitourinary examination in their adult lives at the time of vasectomy consultation, providing a unique opportunity for diagnosis of asymptomatic varicoceles. Varicoceles have recently been implicated as a possible reversible contributor to hypogonadism. Hypogonadism may be associated with significant adverse effect, including decreased libido, impaired cognitive function, and increased cardiovascular events. Early diagnosis and treatment of hypogonadism may prevent these adverse sequelae. Data were collected from the Truven Health Analytics MarketScan database, a large outpatient claims database. We reviewed records between 2003 and 2010 for male patients between the ages of 25 and 50 years with International Classification of Diseases, Ninth Revision codes for hypogonadism, vasectomy, and varicocele, and queried dates of first claim. A total of 15,679 men undergoing vasectomies were matched with 156,790 men with nonvasectomy claims in the same year. Vasectomy patients were diagnosed with varicocele at an earlier age (40.9 vs 42.5 years; P=.009). We identified 224,817 men between the ages of 25 and 50 years with a claim of hypogonadism, of which 5883 (2.6%) also had a claim of varicocele. Men with hypogonadism alone were older at presentation compared with men with an accompanying varicocele (41.3 [standard deviation±6.5] vs 34.9 [standard deviation±6.1]; P<.001). Men undergoing vasectomies are diagnosed with varicoceles at a younger age than age-matched controls. Men with varicoceles present with hypogonadism earlier than men without varicoceles. Earlier diagnosis of varicocele at the time of vasectomy allows for earlier detection of hypogonadism. Copyright © 2014 Elsevier Inc. All rights reserved.

Compulsive Buying: Earlier Illicit Drug Use, Impulse Buying, Depression, and Adult ADHD Symptoms

PubMed Central

Brook, Judith S.; Zhang, Chenshu; Brook, David W.; Leukefeld, Carl G.

2015-01-01

This longitudinal study examined the association between psychosocial antecedents, including illicit drug use, and adult compulsive buying (CB) across a 29-year time period from mean age 14 to mean age 43. Participants originally came from a community-based random sample of residents in two upstate New York counties. Multivariate linear regression analysis was used to study the relationship between the participant’s earlier psychosocial antecedents and adult CB in the fifth decade of life. The results of the multivariate linear regression analyses showed that gender (female), earlier adult impulse buying (IB), depressive mood, illicit drug use, and concurrent ADHD symptoms were all significantly associated with adult CB at mean age 43. It is important that clinicians treating CB in adults should consider the role of drug use, symptoms of ADHD, IB, depression, and family factors in CB. PMID:26165963

Insight Into Illness and Cognition in Schizophrenia in Earlier and Later Life.

PubMed

Gerretsen, Philip; Voineskos, Aristotle N; Graff-Guerrero, Ariel; Menon, Mahesh; Pollock, Bruce G; Mamo, David C; Mulsant, Benoit H; Rajji, Tarek K

2017-04-01

Impaired insight into illness in schizophrenia is associated with illness severity and deficits in premorbid intellectual function, executive function, and memory. A previous study of patients aged 60 years and older found that illness severity and premorbid intellectual function accounted for variance in insight impairment. As such, we aimed to test whether similar relationships would be observed in earlier life. A retrospective analysis was performed on 1 large sample of participants (n = 171) with a DSM-IV-TR diagnosis of schizophrenia aged 19 to 79 years acquired from 2 studies: (1) a psychosocial intervention trial for older persons with schizophrenia (June 2008 to May 2014) and (2) a diffusion tensor imaging and genetics study of psychosis across the life span (February 2007 to December 2013). We assessed insight into illness using the Positive and Negative Syndrome Scale (PANSS) item G12 and explored its relationship to illness severity (PANSS total modified), premorbid intellectual function (Wechsler Test of Adult Reading [WTAR]), and cognition. Insight impairment was more severe in later life (≥ 60 years) than in earlier years (t = -3.75, P < .001). Across the whole sample, the variance of impaired insight was explained by PANSS total modified (Exp[B] = 1.070, P < .001) and WTAR scores (Exp[B] = 0.970, P = .028). Although age and cognition were correlated with impaired insight, they did not independently contribute to its variance. However, the relationships between impaired insight and illness severity and between impaired insight and cognition, particularly working memory, were stronger in later life than in earlier life. These results suggest an opportunity for intervention may exist with cognitive-enhancing neurostimulation or medications to improve insight into illness in schizophrenia across the life span. Original study registered on ClinicalTrials.gov (identifier: NCT00832845). © Copyright 2017 Physicians Postgraduate Press, Inc.

The Value Added National Project. Technical Report: Primary 4. Value-Added Key Stage 1 to Key Stage 2.

ERIC Educational Resources Information Center

Tymms, Peter

This is the fourth in a series of technical reports that have dealt with issues surrounding the possibility of national value-added systems for primary schools in England. The main focus has been on the relative progress made by students between the ends of Key Stage 1 (KS1) and Key Stage 2 (KS2). The analysis has indicated that the strength of…

Earlier Right Ventricular Pacing in Cardiac Resynchronization Therapy for a Patient with Right Axis Deviation.

PubMed

Hattori, Yusuke; Ishibashi, Kohei; Noda, Takashi; Okamura, Hideo; Kanzaki, Hideaki; Anzai, Toshihisa; Yasuda, Satoshi; Kusano, Kengo

2017-09-01

We describe the case of a 37-year-old woman who presented with complete right bundle branch block and right axis deviation. She was admitted to our hospital due to severe heart failure and was dependent on inotropic agents. Cardiac resynchronization therapy was initiated but did not improve her condition. After the optimization of the pacing timing, we performed earlier right ventricular pacing, which led to an improvement of her heart failure. Earlier right ventricular pacing should be considered in patients with complete right bundle branch block and right axis deviation when cardiac resynchronization therapy is not effective.

Compulsive buying: Earlier illicit drug use, impulse buying, depression, and adult ADHD symptoms.

PubMed

Brook, Judith S; Zhang, Chenshu; Brook, David W; Leukefeld, Carl G

2015-08-30

This longitudinal study examined the association between psychosocial antecedents, including illicit drug use, and adult compulsive buying (CB) across a 29-year time period from mean age 14 to mean age 43. Participants originally came from a community-based random sample of residents in two upstate New York counties. Multivariate linear regression analysis was used to study the relationship between the participant's earlier psychosocial antecedents and adult CB in the fifth decade of life. The results of the multivariate linear regression analyses showed that gender (female), earlier adult impulse buying (IB), depressive mood, illicit drug use, and concurrent ADHD symptoms were all significantly associated with adult CB at mean age 43. It is important that clinicians treating CB in adults should consider the role of drug use, symptoms of ADHD, IB, depression, and family factors in CB. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Critical Value Reporting in Transfusion Medicine: A Survey of Communication Practices in US Facilities.

PubMed

Reese, Erika M; Nelson, Randin C; Flegel, Willy A; Byrne, Karen M; Booth, Garrett S

2017-05-01

While critical value procedures have been adopted in most areas of the clinical laboratory, their use in transfusion medicine has not been reviewed in detail. The results of this study present a comprehensive overview of critical value reporting and communication practices in transfusion medicine in the United States. A web-based survey was developed to collect data on the prevalence of critical value procedures and practices of communicating results. The survey was distributed via email to US hospital-based blood banks. Of 123 facilities surveyed, 84 (68.3%) blood banks had a critical value procedure. From a panel of 23 common blood bank results, nine results were selected by more than 70% of facilities as either a critical value or requiring rapid communication as defined by an alternate procedure. There was overlap among results communicated by facilities with and without a critical value procedure. The most frequently communicated results, such as incompatible crossmatch for RBC units issued uncrossmatched, delay in finding compatible blood due to a clinically significant antibody, and transfusion reaction evaluation suggestive of a serious adverse event, addressed scenarios associated with the leading reported causes of transfusion-related fatalities. American Society for Clinical Pathology, 2017. This work is written by US Government employees and is in the public domain in the US.

The value of bedside shift reporting enhancing nurse surveillance, accountability, and patient safety.

PubMed

Jeffs, Lianne; Acott, Ashley; Simpson, Elisa; Campbell, Heather; Irwin, Terri; Lo, Joyce; Beswick, Susan; Cardoso, Roberta

2013-01-01

A study was undertaken to explore nurses' experiences and perceptions associated with implementation of bedside nurse-to-nurse shift handoff reporting. Interviews were conducted with nurses and analyzed using directed content analysis. Two themes emerged that illustrated the value of bedside shift reporting. These themes included clarifying information and intercepting errors and visualizing patients and prioritizing care. Nurse leaders can leverage study findings in their efforts to embed nurse-to-nurse bedside shift reporting in their respective organizations.

Earlier versus later continuous Kangaroo Mother Care (KMC) for stable low-birth-weight infants: a randomized controlled trial.

PubMed

Nagai, S; Andrianarimanana, D; Rabesandratana, N; Yonemoto, N; Nakayama, T; Mori, R

2010-06-01

The aim of this study was to examine the effectiveness of earlier continuous Kangaroo Mother Care (KMC) for relatively stable low-birth-weight (LBW) infants in a resource-limited country. A randomized controlled trial was performed in LBW infants at a referral hospital in Madagascar. Earlier continuous KMC (intervention) was begun as soon as possible, within 24 h postbirth, and later continuous KMC (control: conventional care) was begun after complete stabilization (generally after 24 h postbirth). Main outcome measure was mortality during the first 28 days postbirth. This trial was registered with ClinicalTrials.gov, NCT00531492. A total of 73 infants (intervention 37, control 36) were included. Earlier continuous KMC had higher but no statistically different mortality in the first 28 days postbirth (1 vs. 2; risk ratio, 1.95; 95% CIs, 0.18-20.53; p = 1.00). There were no differences in incidence of morbidities. Body weight loss from birth to 24 h postbirth was significantly less in earlier KMC infants compared with later KMC infants. (-34.81 g vs. -73.97 g; mean difference, 39.16 g; 95% CIs, 10.30-68.03; p = 0.01; adjusted p = 0.02). Adverse events and duration of hospitalization were not different between the two groups. Further evaluations of earlier continuous KMC including measurement of KMC dose, are needed in resource-limited countries.

Probing for the Multiplicative Term in Modern Expectancy-Value Theory: A Latent Interaction Modeling Study

ERIC Educational Resources Information Center

Trautwein, Ulrich; Marsh, Herbert W.; Nagengast, Benjamin; Ludtke, Oliver; Nagy, Gabriel; Jonkmann, Kathrin

2012-01-01

In modern expectancy-value theory (EVT) in educational psychology, expectancy and value beliefs additively predict performance, persistence, and task choice. In contrast to earlier formulations of EVT, the multiplicative term Expectancy x Value in regression-type models typically plays no major role in educational psychology. The present study…

Reporting numeric values of complete crowns. Part 1: Clinical preparation parameters.

PubMed

Tiu, Janine; Al-Amleh, Basil; Waddell, J Neil; Duncan, Warwick J

2015-07-01

An implemented objective measuring system for measuring clinical tooth preparations does not exist. The purpose of this study was to compare clinically achieved tooth preparations for ceramic crowns by general dentists with the recommended values in the literature with an objective measuring method. Two hundred thirty-six stone dies prepared for anterior and posterior complete ceramic crown restorations (IPS e.max Press; Ivoclar Vivadent) were collected from dental laboratories. The dies were scanned and analyzed using the coordinate geometry method. Cross-sectioned images were captured, and the average total occlusal convergence angle, margin width, and abutment height for each preparation was measured and presented with associated 95% confidence intervals. The average total occlusal convergence angles for each tooth type was above the recommended values reported in the literature. The average margin widths (0.40 to 0.83 mm) were below the minimum recommended values (1 to 1.5 mm). The tallest preparations were maxillary canines (5.25 mm), while the shortest preparations were mandibular molars (1.87 mm). Complete crown preparations produced in general practice do not achieve the recommended values found in the literature. However, these recommended values are not based on clinical trials, and the effects of observed shortfalls on the clinical longevity of these restorations are not predictable. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

From a declaration of values to the creation of value in global health: a report from Harvard University's Global Health Delivery Project.

PubMed

Kim, J Y; Rhatigan, J; Jain, S H; Weintraub, R; Porter, M E

2010-01-01

To make best use of the new dollars available for the treatment of disease in resource-poor settings, global health practice requires a strategic approach that emphasises value for patients. Practitioners and global health academics should seek to identify and elaborate the set of factors that drives value for patients through the detailed study of actual care delivery organisations in multiple settings. Several frameworks can facilitate this study, including the care delivery value chain. We report on our efforts to catalyse the study of health care delivery in resource-limited settings in the hope that this inquiry will lead to insights that can improve the health of the neediest worldwide.

Bilateral breast calciphylaxis in a patient who survived earlier extensive tissue necrosis 5 years previously: A case report.

PubMed

Verstappen, E M J; Maaskant-Braat, A J G; Scheltinga, M R

2018-05-07

Calciphylaxis is a rare condition including patchy dermal necrosis that mostly affects chronic hemodialysis patients. The syndrome usually heralds impending death although patients may survive following a set of measures including an adapted dialysis regimen. The present case is a unique patient who recovered from an earlier episode of upper leg calciphylaxis 5 years previously but developed fatal bilateral breast necrosis. A 69 year old Caucasian woman with a history of atrial fibrillation, hypertension, CVA, hyperparathyroidectomy for secondary hyperparathyroidism and end stage renal disease with hemodialysis recovered in 2012 from extensive symptomatic left upper leg necrosis due to calciphylaxis. In 2017, she developed painful, necrotic ulcers on both breasts, again due to calciphylaxis. She had no history of anticoagulants use but she did use prednisolone 5mg/day. She received adequate wound care, pain medication, antibiotics and dialysis frequency was increased with an addition of sodium thiosulfate. A bilateral ablation was discussed but she decided to stop all treatment following pulmonary aspiration and passed away one week later. Calciphylaxis is a rare diagnosis that should be considered in patients with renal insufficiency developing painful patches of skin necrosis. A multidisciplinary treatment approach including hyperparathyroidectomy, modified hemodialysis and wound treatment is recommended. There is limited evidence for surgical intervention. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Earlier Pulmonary Valve Replacement in Down Syndrome Patients Following Tetralogy of Fallot Repair.

PubMed

Sullivan, Rachel T; Frommelt, Peter C; Hill, Garick D

2017-08-01

The association between Down syndrome and pulmonary hypertension could contribute to more severe pulmonary regurgitation after tetralogy of Fallot repair and possibly earlier pulmonary valve replacement. We compared cardiac magnetic resonance measures of pulmonary regurgitation and right ventricular dilation as well as timing of pulmonary valve replacement between those with and without Down syndrome after tetralogy of Fallot repair. Review of our surgical database from 2000 to 2015 identified patients with tetralogy of Fallot with pulmonary stenosis. Those with Down syndrome were compared to those without. The primary outcome of interest was time from repair to pulmonary valve replacement. Secondary outcomes included pulmonary regurgitation and indexed right ventricular volume on cardiac magnetic resonance imaging. The cohort of 284 patients included 35 (12%) with Down syndrome. Transannular patch repair was performed in 210 (74%). Down syndrome showed greater degree of pulmonary regurgitation (55 ± 14 vs. 37 ± 16%, p = 0.01) without a significantly greater rate of right ventricular dilation (p = 0.09). In multivariable analysis, Down syndrome (HR 2.3, 95% CI 1.2-4.5, p = 0.02) and transannular patch repair (HR 5.5, 95% CI 1.7-17.6, p = 0.004) were significant risk factors for valve replacement. Those with Down syndrome had significantly lower freedom from valve replacement (p = 0.03). Down syndrome is associated with an increased degree of pulmonary regurgitation and earlier pulmonary valve replacement after tetralogy of Fallot repair. These patients require earlier assessment by cardiac magnetic resonance imaging to determine timing of pulmonary valve replacement and evaluation for and treatment of preventable causes of pulmonary hypertension.

Earlier Parental Set Bedtimes as a Protective Factor Against Depression and Suicidal Ideation

PubMed Central

Gangwisch, James E.; Babiss, Lindsay A.; Malaspina, Dolores; Turner, J. Blake; Zammit, Gary K.; Posner, Kelly

2010-01-01

Study Objectives: To examine the relationships between parental set bedtimes, sleep duration, and depression as a quasi-experiment to explore the potentially bidirectional relationship between short sleep duration and depression. Short sleep duration has been shown to precede depression, but this could be explained as a prodromal symptom of depression. Depression in an adolescent can affect his/her chosen bedtime, but it is less likely to affect a parent's chosen set bedtime which can establish a relatively stable upper limit that can directly affect sleep duration. Design: Multivariate cross-sectional analyses of the ADD Health using logistic regression. Setting: United States nationally representative, school-based, probability-based sample in 1994-96. Participants: Adolescents (n = 15,659) in grades 7 to 12. Measurements and Results: Adolescents with parental set bedtimes of midnight or later were 24% more likely to suffer from depression (OR = 1.24, 95% CI 1.04-1.49) and 20% more likely to have suicidal ideation (1.20, 1.01-1.41) than adolescents with parental set bedtimes of 10:00 PM or earlier, after controlling for covariates. Consistent with sleep duration and perception of getting enough sleep acting as mediators, the inclusion of these variables in the multivariate models appreciably attenuated the associations for depression (1.07, 0.88-1.30) and suicidal ideation (1.09, 0.92-1.29). Conclusions: The results from this study provide new evidence to strengthen the argument that short sleep duration could play a role in the etiology of depression. Earlier parental set bedtimes could therefore be protective against adolescent depression and suicidal ideation by lengthening sleep duration. Citation: Gangwisch JE; Babiss LA; Malaspina D; Turner JB; Zammit GK; Posner K. Earlier parental set bedtimes as a protective factor against depression and suicidal ideation. SLEEP 2010;33(1):97-106. PMID:20120626

40 CFR 87.21 - Exhaust emission standards for Tier 4 and earlier engines.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Emissions (New Aircraft Gas Turbine Engines) § 87.21 Exhaust emission standards for Tier 4 and earlier... standards. (a) Exhaust emissions of smoke from each new aircraft gas turbine engine of class T8 manufactured... from each new aircraft gas turbine engine of class TF and of rated output of 129 kilonewtons thrust or...

40 CFR 87.21 - Exhaust emission standards for Tier 4 and earlier engines.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Emissions (New Aircraft Gas Turbine Engines) § 87.21 Exhaust emission standards for Tier 4 and earlier... standards. (a) Exhaust emissions of smoke from each new aircraft gas turbine engine of class T8 manufactured... from each new aircraft gas turbine engine of class TF and of rated output of 129 kilonewtons thrust or...

AMCP Partnership Forum: Improving Quality, Value, and Outcomes with Patient-Reported Outcomes.

PubMed

2018-03-01

Patient-reported outcomes (PROs), which provide a direct measure of a patient's health status or treatment preferences, represent a key component of the shift toward patient-centered health care. PROs can measure the state of a patient's disease-specific and overall health throughout the care continuum, enabling them to have a variety of uses for key health care stakeholders. Currently, PROs are used in drug development, aligning patient and clinician goals in care, quality-of-care measures, and coverage and reimbursement decisions. While there have been significant strides by key health care stakeholders to further the development and use of PROs, there are a number of challenges limiting more widespread use. In light of these current challenges and the potential for PROs to improve health care quality and value, on October 19, 2017, the Academy of Managed Care Pharmacy convened a forum of key stakeholders representing patients, payers, providers, government, and pharmaceutical companies to discuss and identify solutions to the current challenges and barriers to further use of PROs. These discussions informed the development of participants' ideal future state in which PROs maximize the goals of all health care stakeholders and the actionable steps required to make the future state a reality. While stakeholders shared unique perspectives throughout the forum, they had consensus on 2 overarching issues: the importance of PROs in defining value, improving patient care, and implementing value-based payment models and the need for strong organizational and operational systems to achieve optimal adoption and use. Participants identified several key challenges in PRO use and adoption: achieving a representative patient population, inclusion of PRO data in medication labels, the necessity for both standardized and customizable PROs, and operational and organizational barriers to collecting and analyzing PROs. To overcome these challenges, participants recommended that

The current state of nursing performance measurement, public reporting, and value-based purchasing.

PubMed

Kurtzman, Ellen T; Dawson, Ellen M; Johnson, Jean E

2008-08-01

Over the last decade, there has been a substantial investment in holding health care providers accountable for the quality of care provided in hospitals and other settings of care. This investment has been realized through the proliferation of national policies that address performance measurement, public reporting, and value-based purchasing. Although nurses represent the largest segment of the health care workforce and despite their acknowledged role in patient safety and health care outcomes, they have been largely absent from policy setting in these areas. This article provides an analysis of current nursing performance measurement and public reporting initiatives and presents a summary of emerging trends in value-based purchasing, with an emphasis on activities in the United States. The article synthesizes issues of relevance to advancing the current climate for nursing quality and concludes with key issues for future policy setting.

Reducing Older Driver Motor Vehicle Collisions via Earlier Cataract Surgery

PubMed Central

Mennemeyer, Stephen T.; Owsley, Cynthia; McGwin, Gerald

2013-01-01

Older adults who undergo cataract extraction have roughly half the rate of motor vehicle collision (MVC) involvement per mile driven compared to cataract patients who do not elect cataract surgery. Currently in the U.S., most insurers do not allow payment for cataract surgery based upon the findings of a vision exam unless accompanied by an individual’s complaint of visual difficulties that seriously interfere with driving or other daily activities and individuals themselves may be slow or reluctant to complain and seek relief. As a consequence, surgery tends to occur after significant vision problems have emerged. We hypothesize that a proactive policy encouraging cataract surgery earlier for a lesser level of complaint would significantly reduce MVCs among older drivers. We used a Monte Carlo model to simulate the MVC experience of the U.S. population from age 60 to 89 under alternative protocols for the timing of cataract surgery which we call “Current Practice” (CP) and “Earlier Surgery” (ES). Our base model finds, from a societal perspective with undiscounted 2010 dollars, that switching to ES from CP reduces by about 21% the average number of MVCs, fatalities, and MVC cost per person. The net effect on total cost – all MVC costs plus cataract surgery expenditures -- is a reduction of about 16%. Quality Adjusted Life Years would increase by about 5%. From the perspective of payers for healthcare, the switch would increase cataract surgery expenditure for ages 65+ by about 8% and for ages 60 to 64 by about 47% but these expenditures are substantially offset after age 65 by reductions in the medical and emergency services component of MVC cost. Similar results occur with discounting at 3% and with various sensitivity analyses. We conclude that a policy of ES would significantly reduce MVCs and their associated consequences. PMID:23369786

Reanalysis of the occurrence of back pain among construction workers: modelling for the interdependent effects of heavy physical work, earlier back accidents, and aging.

PubMed

Nurminen, M

1997-11-01

To re-examine the relation between heavy physical work and the occurrence of sciatic pain among construction workers reported previously to be absent in an epidemiological study. METHODS-Poisson log linear regression was used to model for the frequency of sciatic pain among concrete reinforcement workers and maintenance house painters with adjustment for the interactive effects of earlier back accidents and aging that modified the relation. Concrete reinforcement work not only had a direct effect on the frequency of sciatic pain, but it also contributed significantly to the risk indirectly through earlier back accidents. The risk of sciatic pain increased from age 25 to 54 in a different manner for a worker depending on his occupational group and record of back accidents. Epidemiological studies on low back pain need to be analysed with sound methodology. This is important in view of future meta-analyses that will be performed for the purpose of providing guidelines on the prevention of back disorders in heavy physical work.

Daily Use, Especially of High-Potency Cannabis, Drives the Earlier Onset of Psychosis in Cannabis Users

PubMed Central

Di Forti, Marta; Sallis, Hannah; Allegri, Fabio; Trotta, Antonella; Ferraro, Laura; Stilo, Simona A.; Marconi, Arianna; La Cascia, Caterina; Reis Marques, Tiago; Pariante, Carmine; Dazzan, Paola; Mondelli, Valeria; Paparelli, Alessandra; Kolliakou, Anna; Prata, Diana; Gaughran, Fiona; David, Anthony S.; Morgan, Craig; Stahl, Daniel; Khondoker, Mizanur; MacCabe, James H.; Murray, Robin M.

2014-01-01

Cannabis use is associated with an earlier age of onset of psychosis (AOP). However, the reasons for this remain debated. Methods: We applied a Cox proportional hazards model to 410 first-episode psychosis patients to investigate the association between gender, patterns of cannabis use, and AOP. Results: Patients with a history of cannabis use presented with their first episode of psychosis at a younger age (mean years = 28.2, SD = 8.0; median years = 27.1) than those who never used cannabis (mean years = 31.4, SD = 9.9; median years = 30.0; hazard ratio [HR] = 1.42; 95% CI: 1.16–1.74; P < .001). This association remained significant after controlling for gender (HR = 1.39; 95% CI: 1.11–1.68; P < .001). Those who had started cannabis at age 15 or younger had an earlier onset of psychosis (mean years = 27.0, SD = 6.2; median years = 26.9) than those who had started after 15 years (mean years = 29.1, SD = 8.5; median years = 27.8; HR = 1.40; 95% CI: 1.06–1.84; P = .050). Importantly, subjects who had been using high-potency cannabis (skunk-type) every day had the earliest onset (mean years = 25.2, SD = 6.3; median years = 24.6) compared to never users among all the groups tested (HR = 1.99; 95% CI: 1.50- 2.65; P < .0001); these daily users of high-potency cannabis had an onset an average of 6 years earlier than that of non-cannabis users. Conclusions: Daily use, especially of high-potency cannabis, drives the earlier onset of psychosis in cannabis users. PMID:24345517

20 CFR 416.1246 - Disposal of resources at less than fair market value.

Code of Federal Regulations, 2013 CFR

2013-04-01

... the time of transfer or contract of sale, if earlier. See § 416.1101 for definition of current market... enforceable) agreement in effect at the time of transfer. Compensation also includes all money, real or...—General. The uncompensated value is the fair market value of a resource at the time of transfer minus the...

The role of attitudes about vaccine safety, efficacy, and value in explaining parents' reported vaccination behavior.

PubMed

Lavail, Katherine Hart; Kennedy, Allison Michelle

2013-10-01

To explain vaccine confidence as it related to parents' decisions to vaccinate their children with recommended vaccines, and to develop a confidence measure to efficiently and effectively predict parents' self-reported vaccine behaviors. A sample of parents with at least one child younger than 6 years (n = 376) was analyzed using data from the HealthStyles 2010 survey. Questions were grouped into block variables to create three confidence constructs: value, safety, and efficacy. Regression equations controlling for demographic characteristics were used to identify the confidence construct(s) that best predicted parents' self-reported vaccination decisions (accept all, some, or none of the recommended childhood vaccines). Among the three constructs evaluated, confidence in the value of vaccines, that is the belief that vaccines are important and vaccinating one's children is the right thing to do, was the best predictor of parents' vaccine decisions, F(2, 351) = 119.199, p < .001. When combined into a block variable for analysis, two survey items measuring confidence in the value of vaccines accounted for 40% of the variance in parents' self-reported vaccine decisions. Confidence in the safety or efficacy of vaccines failed to account for additional significant variance in parent-reported vaccination behavior. Confidence in the value of vaccines is a helpful predictor of parent-reported vaccination behavior. Attitudinal constructs of confidence in the safety and efficacy of vaccines failed to account for additional significant variance in parents' vaccination behaviors. Future research should assess the role of vaccine knowledge and tangible barriers, such as access and cost, to further explain parents' vaccination behaviors.

The incremental value of self-reported mental health measures in predicting functional outcomes of veterans.

PubMed

Eisen, Susan V; Bottonari, Kathryn A; Glickman, Mark E; Spiro, Avron; Schultz, Mark R; Herz, Lawrence; Rosenheck, Robert; Rofman, Ethan S

2011-04-01

Research on patient-centered care supports use of patient/consumer self-report measures in monitoring health outcomes. This study examined the incremental value of self-report mental health measures relative to a clinician-rated measure in predicting functional outcomes among mental health service recipients. Participants (n = 446) completed the Behavior and Symptom Identification Scale, the Brief Symptom Inventory, and the Veterans/Rand Short Form-36 at enrollment in the study (T1) and 3 months later (T2). Global Assessment of Functioning (GAF) ratings, mental health service utilization, and psychiatric diagnoses were obtained from administrative data files. Controlling for demographic and clinical variables, results indicated that improvement based on the self-report measures significantly predicted one or more functional outcomes (i.e., decreased likelihood of post-enrollment psychiatric hospitalization and increased likelihood of paid employment), above and beyond the predictive value of the GAF. Inclusion of self-report measures may be a useful addition to performance measurement efforts.

Nutrient reference value: non-communicable disease endpoints--a conference report.

PubMed

Lupton, J R; Blumberg, J B; L'Abbe, M; LeDoux, M; Rice, H B; von Schacky, C; Yaktine, A; Griffiths, J C

2016-03-01

Nutrition is complex-and seemingly getting more complicated. Most consumers are familiar with "essential nutrients," e.g., vitamins and minerals, and more recently protein and important amino acids. These essential nutrients have nutrient reference values, referred to as dietary reference intakes (DRIs) developed by consensus committees of scientific experts convened by the Institute of Medicine of the National Academy of Sciences, Engineering, and Medicine and carried out by the Food and Nutrition Board. The DRIs comprise a set of four nutrient-based reverence values, the estimated average requirements, the recommended dietary allowances (RDAs), the adequate intakes and the tolerable upper intake levels for micronutrient intakes and an acceptable macronutrient distribution range for macronutrient intakes. From the RDA, the US Food and Drug Administration (FDA) derives a labeling value called the daily value (DV), which appears on the nutrition label of all foods for sale in the US. The DRI reports do not make recommendations about whether the DV labeling values can be set only for what have been defined to date as "essential nutrients." For example, the FDA set a labeling value for "dietary fiber" without having the DV. Nutrient reference values-requirements are set by Codex Alimentarius for essential nutrients, and regulatory bodies in many countries use these Codex values in setting national policy for recommended dietary intakes. However, the focus of this conference is not on essential nutrients, but on the "nonessential nutrients," also termed dietary bioactive components. They can be defined as "Constituents in foods or dietary supplements, other than those needed to meet basic human nutritional needs, which are responsible for changes in health status (Office of Disease Prevention and Health Promotion, Office of Public Health and Science, Department of Health and Human Services in Fed Regist 69:55821-55822, 2004)." Substantial and often persuasive

Long-term effects of earlier initiated continuous Kangaroo Mother Care (KMC) for low-birth-weight (LBW) infants in Madagascar.

PubMed

Nagai, Shuko; Yonemoto, Naohiro; Rabesandratana, Norotiana; Andrianarimanana, Diavolana; Nakayama, Takeo; Mori, Rintaro

2011-12-01

To examine the long-term effects of earlier initiated continuous Kangaroo Mother Care (KMC) for relatively stable low-birth-weight (LBW) infants in a resource-limited country. A randomized controlled trial with long-term follow-up was performed in LBW infants in Madagascar. Earlier continuous KMC (intervention group) was initiated as soon as possible within 24 h postbirth, and later continuous KMC (control group: conventional care) was initiated after complete stabilization. Outcome measures were mortality or readmission, nutritional indicators at 6-12 months postbirth and feeding condition at 6 months postbirth (ClinicalTrials.gov, NCT00531492). A total of 72 infants were followed for mortality or readmission at 6-12 months postbirth. There was no difference between the two groups (7/36 vs. 7/36, Risk ratio (RR), 1.00; 95% CIs, 0.39-2.56; p = 1.00). The proportion of exclusive breast feeding (EBF) at 6 months postbirth was significantly higher with earlier KMC than later KMC (12/29 vs. 4/26; RR 2.69; 95% CIs, 1.00-7.31; p = 0.04). There were no differences in nutritional indicators between the two groups at 6-12 months postbirth. Earlier initiated continuous KMC results in a significantly higher proportion of EBF at 6 months postbirth. Further larger-scale long-term evaluations of earlier initiated continuous KMC for LBW infants are needed. © 2011 The Author(s)/Acta Paediatrica © 2011 Foundation Acta Paediatrica.

Facilitating earlier transfer of care from acute stroke services into the community.

PubMed

Robinson, Jennifer

This article outlines an initiative to reduce length of stay for stroke patients within an acute hospital and to facilitate earlier transfer of care. Existing care provision was remodelled and expanded to deliver stroke care to patients within a community bed-based intermediate care facility or intermediate care at home. This new model of care has improved the delivery of rehabilitation through alternative and innovative ways of addressing service delivery that meet the needs of the patients.

A vantage from space can detect earlier drought onset: an approach using relative humidity.

PubMed

Farahmand, Alireza; AghaKouchak, Amir; Teixeira, Joao

2015-02-25

Each year, droughts cause significant economic and agricultural losses across the world. The early warning and onset detection of drought is of particular importance for effective agriculture and water resource management. Previous studies show that the Standard Precipitation Index (SPI), a measure of precipitation deficit, detects drought onset earlier than other indicators. Here we show that satellite-based near surface air relative humidity data can further improve drought onset detection and early warning. This paper introduces the Standardized Relative Humidity Index (SRHI) based on the NASA Atmospheric Infrared Sounder (AIRS) observations. The results indicate that the SRHI typically detects the drought onset earlier than the SPI. While the AIRS mission was not originally designed for drought monitoring, we show that its relative humidity data offers a new and unique avenue for drought monitoring and early warning. We conclude that the early warning aspects of SRHI may have merit for integration into current drought monitoring systems.

A Vantage from Space Can Detect Earlier Drought Onset: An Approach Using Relative Humidity

PubMed Central

Farahmand, Alireza; AghaKouchak, Amir; Teixeira, Joao

2015-01-01

Each year, droughts cause significant economic and agricultural losses across the world. The early warning and onset detection of drought is of particular importance for effective agriculture and water resource management. Previous studies show that the Standard Precipitation Index (SPI), a measure of precipitation deficit, detects drought onset earlier than other indicators. Here we show that satellite-based near surface air relative humidity data can further improve drought onset detection and early warning. This paper introduces the Standardized Relative Humidity Index (SRHI) based on the NASA Atmospheric Infrared Sounder (AIRS) observations. The results indicate that the SRHI typically detects the drought onset earlier than the SPI. While the AIRS mission was not originally designed for drought monitoring, we show that its relative humidity data offers a new and unique avenue for drought monitoring and early warning. We conclude that the early warning aspects of SRHI may have merit for integration into current drought monitoring systems. PMID:25711500

76 FR 52539 - Federal Employees' Retirement System; Present Value Conversion Factors for Spouses of Deceased...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-23

... OFFICE OF PERSONNEL MANAGEMENT 5 CFR Part 843 RIN 3206-AM29 Federal Employees' Retirement System; Present Value Conversion Factors for Spouses of Deceased Separated Employees AGENCY: Office of Personnel... Subpart C of Part 843--Present Value Conversion Factors for Earlier Commencing Date of Annuities of...

Daily use, especially of high-potency cannabis, drives the earlier onset of psychosis in cannabis users.

PubMed

Di Forti, Marta; Sallis, Hannah; Allegri, Fabio; Trotta, Antonella; Ferraro, Laura; Stilo, Simona A; Marconi, Arianna; La Cascia, Caterina; Reis Marques, Tiago; Pariante, Carmine; Dazzan, Paola; Mondelli, Valeria; Paparelli, Alessandra; Kolliakou, Anna; Prata, Diana; Gaughran, Fiona; David, Anthony S; Morgan, Craig; Stahl, Daniel; Khondoker, Mizanur; MacCabe, James H; Murray, Robin M

2014-11-01

Cannabis use is associated with an earlier age of onset of psychosis (AOP). However, the reasons for this remain debated. We applied a Cox proportional hazards model to 410 first-episode psychosis patients to investigate the association between gender, patterns of cannabis use, and AOP. Patients with a history of cannabis use presented with their first episode of psychosis at a younger age (mean years = 28.2, SD = 8.0; median years = 27.1) than those who never used cannabis (mean years = 31.4, SD = 9.9; median years = 30.0; hazard ratio [HR] = 1.42; 95% CI: 1.16-1.74; P < .001). This association remained significant after controlling for gender (HR = 1.39; 95% CI: 1.11-1.68; P < .001). Those who had started cannabis at age 15 or younger had an earlier onset of psychosis (mean years = 27.0, SD = 6.2; median years = 26.9) than those who had started after 15 years (mean years = 29.1, SD = 8.5; median years = 27.8; HR = 1.40; 95% CI: 1.06-1.84; P = .050). Importantly, subjects who had been using high-potency cannabis (skunk-type) every day had the earliest onset (mean years = 25.2, SD = 6.3; median years = 24.6) compared to never users among all the groups tested (HR = 1.99; 95% CI: 1.50- 2.65; P < .0001); these daily users of high-potency cannabis had an onset an average of 6 years earlier than that of non-cannabis users. Daily use, especially of high-potency cannabis, drives the earlier onset of psychosis in cannabis users. © The Author 2013. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Light pollution is associated with earlier tree budburst across the United Kingdom.

PubMed

Ffrench-Constant, Richard H; Somers-Yeates, Robin; Bennie, Jonathan; Economou, Theodoros; Hodgson, David; Spalding, Adrian; McGregor, Peter K

2016-06-29

The ecological impact of night-time lighting is of concern because of its well-demonstrated effects on animal behaviour. However, the potential of light pollution to change plant phenology and its corresponding knock-on effects on associated herbivores are less clear. Here, we test if artificial lighting can advance the timing of budburst in trees. We took a UK-wide 13 year dataset of spatially referenced budburst data from four deciduous tree species and matched it with both satellite imagery of night-time lighting and average spring temperature. We find that budburst occurs up to 7.5 days earlier in brighter areas, with the relationship being more pronounced for later-budding species. Excluding large urban areas from the analysis showed an even more pronounced advance of budburst, confirming that the urban 'heat-island' effect is not the sole cause of earlier urban budburst. Similarly, the advance in budburst across all sites is too large to be explained by increases in temperature alone. This dramatic advance of budburst illustrates the need for further experimental investigation into the impact of artificial night-time lighting on plant phenology and subsequent species interactions. As light pollution is a growing global phenomenon, the findings of this study are likely to be applicable to a wide range of species interactions across the world. © 2016 The Authors.

Value engineering and cost effectiveness of various fiber reinforced polymer (FRP) repair systems : final report, June 2007.

DOT National Transportation Integrated Search

2007-06-01

This report is an extension to the final report for NCDOT project 2004-15 Value Engineering and Cost-Effectiveness of : Various Fiber Reinforced Polymers (FRP) Repair Systems, submitted in June 2005. In that report, seventeen 30-ft long : prest...

Trends of earlier palliative care consultation in advanced cancer patients receiving palliative radiation therapy.

PubMed

Chang, Sanders; Sigel, Keith; Goldstein, Nathan E; Wisnivesky, Juan; Dharmarajan, Kavita V

2018-06-06

The American Society of Clinical Oncology recommends that all patients with metastatic disease receive dedicated palliative care (PC) services early in their illness, ideally via interdisciplinary care teams. We investigated the time trends of specialty palliative care consultations from the date of metastatic cancer diagnosis among patients receiving palliative radiation therapy (PRT). A shorter time interval between metastatic diagnosis and first PC consultation suggests earlier involvement of palliative care in a patient's life with metastatic cancer. In this IRB-approved retrospective analysis, patients treated with PRT for solid tumors (bone and brain) at a single tertiary care hospital between 2010 and 2016 were included. Cohorts were arbitrarily established by metastatic diagnosis within approximately two-year intervals: (1) 1/1/2010-3/27/2012; (2) 3/28/2012-5/21/2014; and (3) 5/22/2014-12/31/2016. Cox-proportional hazards regression modelling was used to compare trends of PC consultation among cohorts. Of 284 patients identified, 184 patients received PC consultation, whereas 15 patients died before receiving a PC consult. Median follow-up time until an event or censor was 257 days (range: 1,900). Patients in the most recent cohort had a shorter median time to first PC consult (57 days) compared to those in the first (374 days) and second (186 days) cohorts. On multivariable analysis, patients in the third cohort were more likely to undergo a PC consultation earlier in their metastatic illness (HR: 1.8, 95% CI: 1.2,2.8). Over a six-year period, palliative care consultation occurred earlier for metastatic patients treated with PRT at our institution. Copyright © 2018. Published by Elsevier Inc.

Earlier time to aerobic exercise is associated with faster recovery following acute sport concussion.

PubMed

Lawrence, David Wyndham; Richards, Doug; Comper, Paul; Hutchison, Michael G

2018-01-01

To determine whether earlier time to initiation of aerobic exercise following acute concussion is associated with time to full return to (1) sport and (2) school or work. A retrospective stratified propensity score survival analysis of acute (≤14 days) concussion was used to determine whether time (days) to initiation of aerobic exercise post-concussion was associated with, both, time (days) to full return to (1) sport and (2) school or work. A total of 253 acute concussions [median (IQR) age, 17.0 (15.0-20.0) years; 148 (58.5%) males] were included in this study. Multivariate Cox regression models identified that earlier time to aerobic exercise was associated with faster return to sport and school/work adjusting for other covariates, including quintile propensity strata. For each successive day in delay to initiation of aerobic exercise, individuals had a less favourable recovery trajectory. Initiating aerobic exercise at 3 and 7 days following injury was associated with a respective 36.5% (HR, 0.63; 95% CI, 0.53-0.76) and 73.2% (HR, 0.27; 95% CI, 0.16-0.45) reduced probability of faster full return to sport compared to within 1 day; and a respective 45.9% (HR, 0.54; 95% CI, 0.44-0.66) and 83.1% (HR, 0.17; 95% CI, 0.10-0.30) reduced probability of faster full return to school/work. Additionally, concussion history, symptom severity, LOC deleteriously influenced concussion recovery. Earlier initiation of aerobic exercise was associated with faster full return to sport and school or work. This study provides greater insight into the benefits and safety of aerobic exercise within the first week of the injury.

The End of Education: Redefining the Value of School.

ERIC Educational Resources Information Center

Postman, Neil

Based on the belief that schooling is now too often a trivial pursuit or a mechanical exercise, this book argues that the inherent value and substance of learning has been lost and needs to be restored. The book begins by portraying the American education of an earlier part of this century when schools created a coherent, stable, unified culture…

Earlier nesting by generalist predatory bird is associated with human responses to climate change.

PubMed

Smith, Shawn H; Steenhof, Karen; McClure, Christopher J W; Heath, Julie A

2017-01-01

Warming temperatures cause temporal changes in growing seasons and prey abundance that drive earlier breeding by birds, especially dietary specialists within homogeneous habitat. Less is known about how generalists respond to climate-associated shifts in growing seasons or prey phenology, which may occur at different rates across land cover types. We studied whether breeding phenology of a generalist predator, the American kestrel (Falco sparverius), was associated with shifts in growing seasons and, presumably, prey abundance, in a mosaic of non-irrigated shrub/grasslands and irrigated crops/pastures. We examined the relationship between remotely-sensed normalized difference vegetation index (NDVI) and abundance of small mammals that, with insects, constitute approximately 93% of kestrel diet biomass. We used NDVI to estimate the start of the growing season (SoGS) in irrigated and non-irrigated lands from 1992 to 2015 and tested whether either estimate of annual SoGS predicted the timing of kestrel nesting. Finally, we examined relationships among irrigated SoGS, weather and crop planting. NDVI was a useful proxy for kestrel prey because it predicted small mammal abundance and past studies showed that NDVI predicts insect abundance. NDVI-estimated SoGS advanced significantly in irrigated lands (β = -1·09 ± 0·30 SE) but not in non-irrigated lands (β = -0·57 ± 0·53). Average date of kestrel nesting advanced 15 days in the past 24 years and was positively associated with the SoGS in irrigated lands, but not the SoGS in non-irrigated lands. Advanced SoGS in irrigated lands was related to earlier planting of crops after relatively warm winters, which were more common in recent years. Despite different patterns of SoGS change between land cover types, kestrel nesting phenology shifted with earlier prey availability in irrigated lands. Kestrels may preferentially track prey in irrigated lands over non-irrigated lands because of higher quality prey on

Recent gestational diabetes was associated with mothers stopping predominant breastfeeding earlier in a multi-ethnic population.

PubMed

Baerug, Anne; Sletner, Line; Laake, Petter; Fretheim, Atle; Løland, Beate Fossum; Waage, Christin W; Birkeland, Kåre I; Jenum, Anne Karen

2018-06-01

It has previously been shown that breastfeeding may reduce the risk of type 2 diabetes in mothers with recent gestational diabetes mellitus (GDM). This study compared the cessation of predominant breastfeeding in mothers with and without recent GDM in a multi-ethnic population. From May 2008 to May 2010, healthy pregnant women attending antenatal care provided by community health services in Eastern Oslo, Norway were recruited. We included 616 women-58% non-Western-and interviewed and examined them at a mean of 15 and 28 weeks of gestation and 14 weeks' postpartum. Cox regression models examined the association between GDM, as assessed by the 2013 World Health Organization criteria, and breastfeeding cessation. Overall, 190 of the 616 (31%) mothers had GDM and they ended predominant breastfeeding earlier than mothers without GDM, with an adjusted hazard ratio (aHR) of 1.33 and 95% confidence interval (95% CI) of 1.01-1.77. Mothers of South Asian origin ended predominant breastfeeding earlier than Western European mothers in the adjusted analysis (aHR 1.53, 95% CI: 1.04-2.25), but Middle Eastern mothers did not. Recent gestational diabetes was associated with earlier cessation of predominant breastfeeding in Western European and non-Western women. ©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Higher Childhood Red Meat Intake Frequency Is Associated with Earlier Age at Menarche.

PubMed

Jansen, Erica C; Marín, Constanza; Mora-Plazas, Mercedes; Villamor, Eduardo

2016-03-09

Early age at menarche is associated with increased breast cancer risk. Red meat consumption in adolescence predicts breast cancer risk, but it is unknown whether it is also related to earlier menarche. We studied the association between intake of red meat at ages 5-12 y and age at menarche in a prospective study. We assessed usual diets with a food-frequency questionnaire in a group of 456 girls aged 8.4 ± 1.7 y and followed them for a median 5.6 y in Bogotá, Colombia. Girls were asked periodically about the occurrence and date of menarche. Median age at menarche was estimated with use of Kaplan-Meier survival probabilities by categories of red meat intake frequency. Cox proportional hazards models were used to compare the incidence of menarche by red meat intake frequency, adjusting for potential sociodemographic and dietary confounders including total energy intake and intake frequency of other animal food groups (dairy, poultry, freshwater fish, tuna/sardines, eggs, and innards). Median age at menarche was 12.4 y. After adjustment for total energy intake, maternal parity, and socioeconomic status, red meat intake frequency was inversely associated with age at menarche. When compared with girls with red meat intake <4 times/wk, those consuming it ≥2 times/d had a significantly earlier age at menarche (HR: 1.64; 95% CI: 1.11, 2.41; P-trend = 0.0009). Incidentally, we found that girls with tuna/sardine intake >1 time/wk had a significantly later age at menarche (HR: 0.62; 95% CI: 0.42, 0.90; P = 0.01) than those with intake <1 time/mo. Intake frequency of other animal food groups was not significantly associated with age at menarche. Higher red meat intake frequency during childhood is associated with an earlier age at menarche, whereas greater fatty fish intake frequency is associated with a later menarcheal age. © 2016 American Society for Nutrition.

Addressing Current Criticism Regarding the Value of Self-Report Dietary Data.

PubMed

Subar, Amy F; Freedman, Laurence S; Tooze, Janet A; Kirkpatrick, Sharon I; Boushey, Carol; Neuhouser, Marian L; Thompson, Frances E; Potischman, Nancy; Guenther, Patricia M; Tarasuk, Valerie; Reedy, Jill; Krebs-Smith, Susan M

2015-12-01

Recent reports have asserted that, because of energy underreporting, dietary self-report data suffer from measurement error so great that findings that rely on them are of no value. This commentary considers the amassed evidence that shows that self-report dietary intake data can successfully be used to inform dietary guidance and public health policy. Topics discussed include what is known and what can be done about the measurement error inherent in data collected by using self-report dietary assessment instruments and the extent and magnitude of underreporting energy compared with other nutrients and food groups. Also discussed is the overall impact of energy underreporting on dietary surveillance and nutritional epidemiology. In conclusion, 7 specific recommendations for collecting, analyzing, and interpreting self-report dietary data are provided: (1) continue to collect self-report dietary intake data because they contain valuable, rich, and critical information about foods and beverages consumed by populations that can be used to inform nutrition policy and assess diet-disease associations; (2) do not use self-reported energy intake as a measure of true energy intake; (3) do use self-reported energy intake for energy adjustment of other self-reported dietary constituents to improve risk estimation in studies of diet-health associations; (4) acknowledge the limitations of self-report dietary data and analyze and interpret them appropriately; (5) design studies and conduct analyses that allow adjustment for measurement error; (6) design new epidemiologic studies to collect dietary data from both short-term (recalls or food records) and long-term (food-frequency questionnaires) instruments on the entire study population to allow for maximizing the strengths of each instrument; and (7) continue to develop, evaluate, and further expand methods of dietary assessment, including dietary biomarkers and methods using new technologies. © 2015 American Society for

Clinical presentation of retinoblastoma in Alexandria: A step toward earlier diagnosis.

PubMed

Soliman, Sameh E; Eldomiaty, Wesam; Goweida, Mohamed B; Dowidar, Amgad

2017-01-01

To evaluate the clinical presentation of retinoblastoma in Alexandria, Egypt, correlate the timing of accurate diagnosis with the presence of advanced disease and identify causes of delayed presentation. Retrospective noncomparative single institution study reviews demographic and clinical data of all new children with retinoblastoma presenting to Alexandria Main University ocular oncology clinic (OOC) from January 2012 to June 2014. Diagnosis time was from initial parental complaint to retinoblastoma diagnosis and referral time was from retinoblastoma diagnosis to presentation to the Alexandria OCC. Delayed Diagnosis and referral were counted if >2 weeks. Advanced presentation is defined as clinical TNMH (8th edition) staging of cT2 or cT3 (international intraocular retinoblastoma classification group D or E) in at least one eye or the presence of extra-ocular disease (cT4). Seventy eyes of 47 children were eligible: 52% unilateral, 7% with family history and 96% presented with leukocorea. Sixty-four percent of children had advanced intraocular disease and none had extra-ocular disease. Delayed presentation occurred in 58% of children and was significantly associated with advanced disease in both unilaterally and bilaterally affected children (p = 0.003, 0.002 respectively). The delay in diagnosis was more in unilateral cases while the delay in referral was more in bilateral cases. The main cause of delayed presentation in unilateral retinoblastoma was misdiagnosis (30%) while parental shopping for second medical opinion (30%) was the main cause in bilateral children. Delayed diagnosis is a problem affecting retinoblastoma management. Better medical education and training, health education and earlier screening are recommended to achieve earlier diagnosis.

Earlier time to aerobic exercise is associated with faster recovery following acute sport concussion

PubMed Central

Richards, Doug; Comper, Paul; Hutchison, Michael G.

2018-01-01

Objective To determine whether earlier time to initiation of aerobic exercise following acute concussion is associated with time to full return to (1) sport and (2) school or work. Methods A retrospective stratified propensity score survival analysis of acute (≤14 days) concussion was used to determine whether time (days) to initiation of aerobic exercise post-concussion was associated with, both, time (days) to full return to (1) sport and (2) school or work. Results A total of 253 acute concussions [median (IQR) age, 17.0 (15.0–20.0) years; 148 (58.5%) males] were included in this study. Multivariate Cox regression models identified that earlier time to aerobic exercise was associated with faster return to sport and school/work adjusting for other covariates, including quintile propensity strata. For each successive day in delay to initiation of aerobic exercise, individuals had a less favourable recovery trajectory. Initiating aerobic exercise at 3 and 7 days following injury was associated with a respective 36.5% (HR, 0.63; 95% CI, 0.53–0.76) and 73.2% (HR, 0.27; 95% CI, 0.16–0.45) reduced probability of faster full return to sport compared to within 1 day; and a respective 45.9% (HR, 0.54; 95% CI, 0.44–0.66) and 83.1% (HR, 0.17; 95% CI, 0.10–0.30) reduced probability of faster full return to school/work. Additionally, concussion history, symptom severity, LOC deleteriously influenced concussion recovery. Conclusion Earlier initiation of aerobic exercise was associated with faster full return to sport and school or work. This study provides greater insight into the benefits and safety of aerobic exercise within the first week of the injury. PMID:29668716

Factors associated with late diagnosis of HIV infection and missed opportunities for earlier testing.

PubMed

Gullón, Alejandra; Verdejo, José; de Miguel, Rosa; Gómez, Ana; Sanz, Jesús

2016-10-01

Late diagnosis (LD) of human immunodeficiency virus (HIV) infection continues to be a significant problem that increases disease burden both for patients and for the public health system. Guidelines have been updated in order to facilitate earlier HIV diagnosis, introducing "indicator condition-guided HIV testing". In this study, we analysed the frequency of LD and associated risk factors. We retrospectively identified those cases that could be considered missed opportunities for an earlier diagnosis. All patients newly diagnosed with HIV infection who attended Hospital La Princesa, Madrid (Spain) between 2007 and 2014 were analysed. We collected epidemiological, clinical and immunological data. We also reviewed electronic medical records from the year before the HIV diagnosis to search for medical consultations due to clinical indicators. HIV infection was diagnosed in 354 patients. The median CD4 count at presentation was 352 cells/mm(3). Overall, 158 patients (50%) met the definition of LD, and 97 (30.7%) the diagnosis of advanced disease. LD was associated with older age and was more frequent amongst immigrants. Heterosexual relations and injection drug use were more likely to be the reasons for LD than relations between men who have sex with men. During the year preceding the diagnosis, 46.6% of the patients had sought medical advice owing to the presence of clinical indicators that should have led to HIV testing. Of those, 24 cases (14.5%) were classified as missed opportunities for earlier HIV diagnosis because testing was not performed. According to these results, all health workers should pursue early HIV diagnosis through the proper implementation of HIV testing guidelines. Such an approach would prove directly beneficial to the patient and indirectly beneficial to the general population through the reduction in the risk of transmission.

Effects of site preparation on timber and non-timber values of loblolly pine plantations

Treesearch

Jianbang Gan; Stephen H. Kolison; James H. Miller; Tasha M. Hargrove

1998-01-01

This study evaluated the timber and non-timber values of the forest stands generated by four site preparation methods tested in the Tuskegee National Forest 15 yr earlier. The timber values of the forest stands were assessed with the timber yields predicted by the SE TWIGS model. Non-timber benefits were evaluated through the Contingent Valuation Method. Two hundred...

Classifying Cereal Data (Earlier Methods)

Cancer.gov

The DSQ includes questions about cereal intake and allows respondents up to two responses on which cereals they consume. We classified each cereal reported first by hot or cold, and then along four dimensions: density of added sugars, whole grains, fiber, and calcium.

The Creative Use of Companion Values in Environmental Education and Education for Sustainable Development: Exploring the Educative Moment

ERIC Educational Resources Information Center

Garrison, Jim; Östman, Leif; Håkansson, Michael

2015-01-01

Our paper addresses the emergence and evolution of values in educational settings. It builds upon and extends earlier work on companion meanings to develop a theory of the creative use of companion values and meanings in education. The recognition of companion values in educational practices highlight epistemological, ethical, and aesthetic…

Getting Value out of Value-Added: Report of a Workshop

ERIC Educational Resources Information Center

Braun, Henry, Ed.; Chudowsky, Naomi, Ed.; Koenig, Judith, Ed.

2010-01-01

Value-added methods refer to efforts to estimate the relative contributions of specific teachers, schools, or programs to student test performance. In recent years, these methods have attracted considerable attention because of their potential applicability for educational accountability, teacher pay-for-performance systems, school and teacher…

Assessment of risk factors for earlier onset of sporadic Alzheimer's disease dementia.

PubMed

de Oliveira, Fabricio Ferreira; Bertolucci, Paulo Henrique Ferreira; Chen, Elizabeth Suchi; Smith, Marilia Cardoso

2014-01-01

Pharmacological treatment has mild effects for patients with Alzheimer's disease dementia (AD); therefore, the search for modifiable risk factors is an important challenge. Though risk factors for AD are widely recognized, elements that influence the time of dementia onset have not been comprehensively reported. We aimed to investigate which risk factors might be related to the age of onset of AD in a sample of patients with highly variable educational levels, taking into account the Framingham risk scoring as the sole measure of vascular risk. We included 209 consecutive late-onset AD patients to find out which factors among educational levels, coronary heart disease risk estimated by way of Framingham risk scores, history of head trauma or depression, surgical procedures under general anesthesia, family history of neurodegenerative diseases, gender, marital status and APOE haplotypes might be related to the age of dementia onset in this sample of patients with low mean schooling. Mean age of AD onset was 73.38±6.5 years old, unaffected by schooling or family history of neurodegenerative diseases. Patients who were APOE-ε4 carriers, married, or with history of depression, had earlier onset of AD, particularly when they were women. Coronary heart disease risk was marginally significant for later onset of AD. APOE haplotypes, marital status and history of depression were the most important factors to influence the age of AD onset in this sample. While midlife cerebrovascular risk factors may increase incidence of AD, they may lead to later dementia onset when present in late life.

Quantitative Diagnosis of Continuous-Valued, Stead-State Systems

NASA Technical Reports Server (NTRS)

Rouquette, N.

1995-01-01

Quantitative diagnosis involves numerically estimating the values of unobservable parameters that best explain the observed parameter values. We consider quantitative diagnosis for continuous, lumped- parameter, steady-state physical systems because such models are easy to construct and the diagnosis problem is considerably simpler than that for corresponding dynamic models. To further tackle the difficulties of numerically inverting a simulation model to compute a diagnosis, we propose to decompose a physical system model in terms of feedback loops. This decomposition reduces the dimension of the problem and consequently decreases the diagnosis search space. We illustrate this approach on a model of thermal control system studied in earlier research.

The Chinese Visible Human (CVH) datasets incorporate technical and imaging advances on earlier digital humans

PubMed Central

Zhang, Shao-Xiang; Heng, Pheng-Ann; Liu, Zheng-Jin; Tan, Li-Wen; Qiu, Ming-Guo; Li, Qi-Yu; Liao, Rong-Xia; Li, Kai; Cui, Gao-Yu; Guo, Yan-Li; Yang, Xiao-Ping; Liu, Guang-Jiu; Shan, Jing-Lu; Liu, Ji-Jun; Zhang, Wei-Guo; Chen, Xian-Hong; Chen, Jin-Hua; Wang, Jian; Chen, Wei; Lu, Ming; You, Jian; Pang, Xue-Li; Xiao, Hong; Xie, Yong-Ming; Cheng, Jack Chun-Yiu

2004-01-01

We report the availability of a digitized Chinese male and a digitzed Chinese female typical of the population and with no obvious abnormalities. The embalming and milling procedures incorporate three technical improvements over earlier digitized cadavers. Vascular perfusion with coloured gelatin was performed to facilitate blood vessel identification. Embalmed cadavers were embedded in gelatin and cryosectioned whole so as to avoid section loss resulting from cutting the body into smaller pieces. Milling performed at −25 °C prevented small structures (e.g. teeth, concha nasalis and articular cartilage) from falling off from the milling surface. The male image set (.tiff images each of 36 Mb) has a section resolution of 3072 × 2048 pixels (∼170 μm, the accompanying magnetic resonance imaging and computer tomography data have a resolution of 512 × 512, i.e. ∼440 μm). The Chinese Visible Human male and female datasets are available at http://www.chinesevisiblehuman.com. (The male is 90.65 Gb and female 131.04 Gb). MPEG videos of direct records of real-time volume rendering are at: http://www.cse.cuhk.edu.hk/~crc PMID:15032906

Solar thermal repowering utility value analysis. Final report

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

Taylor, R.; Day, J.; Reed, B.

The retrofit of solar central receiver energy supply systems to existing steam-electric generating stations (repowering) is being considered as a major programmatic thrust by DOE. The determination of a government response appropriate to the opportunities of repowering is an important policy question, and is the major reason for the analysis. The study objective is to define a government role in repowering that constitutes an efficient program investment in pursuit of viable private markets for heliostat-based energy systems. In support of that objective, the study is designed to identify the scope and nature of the repowering opportunity within the larger contextmore » of its contributions to central receiver technology development and commercialization. The Supply and Integration Tasks are documented elsewhere. This report documents the Demand Task, determining and quantifying the sources of the value of repowering and of central receiver technology in general to electric utilities. The modeling tools and assumptions used in the Demand Task are described and the results are presented and interpreted. (MCW)« less

When do drilling alliances add value? The alliance value model

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

Brett, J.F.; Craig, V.B.; Wadsworth, D.B.

1996-12-31

A recent GRI report details three previously unstudied aspects of alliances: specific measurable factors that improve alliance success, how a successful alliance should be structured, and when an alliance makes economic sense. The most innovative tool to emerge from the report, the Alliance Value Model, addresses the third aspect. The theory behind the Alliance Value Model is that the long-term viability of any drilling relationship hinges on its ability to create real value and achieve stability. Based upon the report`s findings, the most effective way to form such an alliance is through a detailed description and integration of the technicalmore » processes involved. This new type of process-driven alliance is characterized by a value chain which links together a common set of technical processes, mutually defined bottomline goals, and shared benefits. Building a process-driven alliance requires time and people and therefore has an associated cost. The real value generated by an alliance must exceed this start-up cost. The Alliance Value Model computes the net present value (NPV) of the cash flows for four different operating arrangements: (1) Business As Usual (conventional competitive bidding process), (2) Process-Driven Alliance (linking technical processes to accelerate production and reduce expenses), (3) Incentivized Process-Driven Alliance (linked technical processes with performance incentives to promote stability), and (4) No Drill Case (primarily used to gauge the market value of services). These arrangements test different degrees of process integration between an operator and its suppliers. They can also help determine if the alliance can add enough value to exceed startup costs and if the relationship will be stable. Each partner can test the impact of the relational structure on its own profitability. When an alliance is warranted, all participants can benefit from real value generated in a stable relationship.« less

Values, Valuing, and Evaluation. Research on Evaluation Program, Paper and Report Series. Interim Draft.

ERIC Educational Resources Information Center

Gephart, William J.

The paper discusses the meaning of value and valuing, their roles in evaluation, and the potency of value systems in problem solving logic. Evaluation is defined as a process for facilitating decision making. A decision making situation occurs when there are options which are impossible to treat equivalently, and there is an impact in the…

Changing facial phenotype in Cohen syndrome: towards clues for an earlier diagnosis.

PubMed

El Chehadeh-Djebbar, Salima; Blair, Edward; Holder-Espinasse, Muriel; Moncla, Anne; Frances, Anne-Marie; Rio, Marlène; Debray, François-Guillaume; Rump, Patrick; Masurel-Paulet, Alice; Gigot, Nadège; Callier, Patrick; Duplomb, Laurence; Aral, Bernard; Huet, Frédéric; Thauvin-Robinet, Christel; Faivre, Laurence

2013-07-01

Cohen syndrome (CS) is a rare autosomal recessive condition caused by mutations and/or large rearrangements in the VPS13B gene. CS clinical features, including developmental delay, the typical facial gestalt, chorioretinal dystrophy (CRD) and neutropenia, are well described. CS diagnosis is generally raised after school age, when visual disturbances lead to CRD diagnosis and to VPS13B gene testing. This relatively late diagnosis precludes accurate genetic counselling. The aim of this study was to analyse the evolution of CS facial features in the early period of life, particularly before school age (6 years), to find clues for an earlier diagnosis. Photographs of 17 patients with molecularly confirmed CS were analysed, from birth to preschool age. By comparing their facial phenotype when growing, we show that there are no special facial characteristics before 1 year. However, between 2 and 6 years, CS children already share common facial features such as a short neck, a square face with micrognathia and full cheeks, a hypotonic facial appearance, epicanthic folds, long ears with an everted upper part of the auricle and/or a prominent lobe, a relatively short philtrum, a small and open mouth with downturned corners, a thick lower lip and abnormal eye shapes. These early transient facial features evolve to typical CS facial features with aging. These observations emphasize the importance of ophthalmological tests and neutrophil count in children in preschool age presenting with developmental delay, hypotonia and the facial features we described here, for an earlier CS diagnosis.

Identified research directions for using manufacturing knowledge earlier in the product lifecycle

PubMed Central

Hedberg, Thomas D.; Hartman, Nathan W.; Rosche, Phil; Fischer, Kevin

2016-01-01

Design for Manufacturing (DFM), especially the use of manufacturing knowledge to support design decisions, has received attention in the academic domain. However, industry practice has not been studied enough to provide solutions that are mature for industry. The current state of the art for DFM is often rule-based functionality within Computer-Aided Design (CAD) systems that enforce specific design requirements. That rule-based functionality may or may not dynamically affect geometry definition. And, if rule-based functionality exists in the CAD system, it is typically a customization on a case-by-case basis. Manufacturing knowledge is a phrase with vast meanings, which may include knowledge on the effects of material properties decisions, machine and process capabilities, or understanding the unintended consequences of design decisions on manufacturing. One of the DFM questions to answer is how can manufacturing knowledge, depending on its definition, be used earlier in the product lifecycle to enable a more collaborative development environment? This paper will discuss the results of a workshop on manufacturing knowledge that highlights several research questions needing more study. This paper proposes recommendations for investigating the relationship of manufacturing knowledge with shape, behavior, and context characteristics of product to produce a better understanding of what knowledge is most important. In addition, the proposal includes recommendations for investigating the system-level barriers to reusing manufacturing knowledge and how model-based manufacturing may ease the burden of knowledge sharing. Lastly, the proposal addresses the direction of future research for holistic solutions of using manufacturing knowledge earlier in the product lifecycle. PMID:27990027

Identified research directions for using manufacturing knowledge earlier in the product lifecycle.

PubMed

Hedberg, Thomas D; Hartman, Nathan W; Rosche, Phil; Fischer, Kevin

2017-01-01

Design for Manufacturing (DFM), especially the use of manufacturing knowledge to support design decisions, has received attention in the academic domain. However, industry practice has not been studied enough to provide solutions that are mature for industry. The current state of the art for DFM is often rule-based functionality within Computer-Aided Design (CAD) systems that enforce specific design requirements. That rule-based functionality may or may not dynamically affect geometry definition. And, if rule-based functionality exists in the CAD system, it is typically a customization on a case-by-case basis. Manufacturing knowledge is a phrase with vast meanings, which may include knowledge on the effects of material properties decisions, machine and process capabilities, or understanding the unintended consequences of design decisions on manufacturing. One of the DFM questions to answer is how can manufacturing knowledge, depending on its definition, be used earlier in the product lifecycle to enable a more collaborative development environment? This paper will discuss the results of a workshop on manufacturing knowledge that highlights several research questions needing more study. This paper proposes recommendations for investigating the relationship of manufacturing knowledge with shape, behavior, and context characteristics of product to produce a better understanding of what knowledge is most important. In addition, the proposal includes recommendations for investigating the system-level barriers to reusing manufacturing knowledge and how model-based manufacturing may ease the burden of knowledge sharing. Lastly, the proposal addresses the direction of future research for holistic solutions of using manufacturing knowledge earlier in the product lifecycle.

Inevitable end-of-21st-century trends toward earlier surface runoff timing in California's Sierra Nevada Mountains

NASA Astrophysics Data System (ADS)

Schwartz, M. A.; Hall, A. D.; Sun, F.; Walton, D.; Berg, N.

2015-12-01

Hybrid dynamical-statistical downscaling is used to produce surface runoff timing projections for California's Sierra Nevada, a high-elevation mountain range with significant seasonal snow cover. First, future climate change projections (RCP8.5 forcing scenario, 2081-2100 period) from five CMIP5 global climate models (GCMs) are dynamically downscaled. These projections reveal that future warming leads to a shift toward earlier snowmelt and surface runoff timing throughout the Sierra Nevada region. Relationships between warming and surface runoff timing from the dynamical simulations are used to build a simple statistical model that mimics the dynamical model's projected surface runoff timing changes given GCM input or other statistically-downscaled input. This statistical model can be used to produce surface runoff timing projections for other GCMs, periods, and forcing scenarios to quantify ensemble-mean changes, uncertainty due to intermodel variability and consequences stemming from choice of forcing scenario. For all CMIP5 GCMs and forcing scenarios, significant trends toward earlier surface runoff timing occur at elevations below 2500m. Thus, we conclude that trends toward earlier surface runoff timing by the end-of-the-21st century are inevitable. The changes to surface runoff timing diagnosed in this study have implications for many dimensions of climate change, including impacts on surface hydrology, water resources, and ecosystems.

The distribution of P-values in medical research articles suggested selective reporting associated with statistical significance.

PubMed

Perneger, Thomas V; Combescure, Christophe

2017-07-01

Published P-values provide a window into the global enterprise of medical research. The aim of this study was to use the distribution of published P-values to estimate the relative frequencies of null and alternative hypotheses and to seek irregularities suggestive of publication bias. This cross-sectional study included P-values published in 120 medical research articles in 2016 (30 each from the BMJ, JAMA, Lancet, and New England Journal of Medicine). The observed distribution of P-values was compared with expected distributions under the null hypothesis (i.e., uniform between 0 and 1) and the alternative hypothesis (strictly decreasing from 0 to 1). P-values were categorized according to conventional levels of statistical significance and in one-percent intervals. Among 4,158 recorded P-values, 26.1% were highly significant (P < 0.001), 9.1% were moderately significant (P ≥ 0.001 to < 0.01), 11.7% were weakly significant (P ≥ 0.01 to < 0.05), and 53.2% were nonsignificant (P ≥ 0.05). We noted three irregularities: (1) high proportion of P-values <0.001, especially in observational studies, (2) excess of P-values equal to 1, and (3) about twice as many P-values less than 0.05 compared with those more than 0.05. The latter finding was seen in both randomized trials and observational studies, and in most types of analyses, excepting heterogeneity tests and interaction tests. Under plausible assumptions, we estimate that about half of the tested hypotheses were null and the other half were alternative. This analysis suggests that statistical tests published in medical journals are not a random sample of null and alternative hypotheses but that selective reporting is prevalent. In particular, significant results are about twice as likely to be reported as nonsignificant results. Copyright © 2017 Elsevier Inc. All rights reserved.

Studying the Cost and Value of Library Services: Final Report. Technical Report APLAB/94-3/1,2,3,4.

ERIC Educational Resources Information Center

Kantor, Paul B.; And Others

This is the final technical report (in three parts) of a 15-month long project to study the costs and value of library functions at five major research libraries. Twenty-one services or service aspects were studied, and numerous measures of the importance or benefit of the service to the users were made. These measures were studied together to lay…

Value of evidence from syndromic surveillance with cumulative evidence from multiple data streams with delayed reporting.

PubMed

Struchen, R; Vial, F; Andersson, M G

2017-04-26

Delayed reporting of health data may hamper the early detection of infectious diseases in surveillance systems. Furthermore, combining multiple data streams, e.g. aiming at improving a system's sensitivity, can be challenging. In this study, we used a Bayesian framework where the result is presented as the value of evidence, i.e. the likelihood ratio for the evidence under outbreak versus baseline conditions. Based on a historical data set of routinely collected cattle mortality events, we evaluated outbreak detection performance (sensitivity, time to detection, in-control run length) under the Bayesian approach among three scenarios: presence of delayed data reporting, but not accounting for it; presence of delayed data reporting accounted for; and absence of delayed data reporting (i.e. an ideal system). Performance on larger and smaller outbreaks was compared with a classical approach, considering syndromes separately or combined. We found that the Bayesian approach performed better than the classical approach, especially for the smaller outbreaks. Furthermore, the Bayesian approach performed similarly well in the scenario where delayed reporting was accounted for to the scenario where it was absent. We argue that the value of evidence framework may be suitable for surveillance systems with multiple syndromes and delayed reporting of data.

Education for Humanistic, Ethical/Moral and Cultural Values: Final Report of a Regional Meeting.

ERIC Educational Resources Information Center

National Inst. for Educational Research, Tokyo (Japan).

This report stems from a meeting of representatives of countries in the Asia Pacific region concerned with the development of strategies for strengthening content relating to humanistic, ethical, and cultural values in formal and non-formal education. The following countries were represented: Australia, Bangladesh, China, India, Indonesia, Japan,…

Epicormic branches affect lumber grade and value in willow oak

Treesearch

James S. Meadows; E.C. Burkhardt

2001-01-01

A case study was conducted in a 50-yr-old bottomland oak stand in central Alabama to investigate the relationship between epicormic branches and lumber grade and value in willow oak (Quercus phellos L.). The stand had been thinned from below 7–10 yr earlier, resulting in a wide variety of epicormic branch conditions on the residual trees. A...

Advanced seasonal reproductive development in a male urban bird is reflected in earlier plasma luteinizing hormone rise but not energetic status.

PubMed

Davies, Scott; Behbahaninia, Hirbod; Giraudeau, Mathieu; Meddle, Simone L; Waites, Kyle; Deviche, Pierre

2015-12-01

Urban animals inhabit an environment considerably different than do their non-urban conspecifics, and to persist urban animals must adjust to these novel environments. The timing of seasonal reproductive development (i.e., growth of gonads and secondary sex organs) is a fundamental determinant of the breeding period and is frequently advanced in urban bird populations. However, the underlying mechanism(s) by which birds adjust the timing of reproductive development to urban areas remain(s) largely unknown. Here, we compared the timing of vernal reproductive development in free-ranging urban and non-urban male Abert's Towhees, Melozone aberti, in Phoenix, Arizona, USA, and tested the non-mutually exclusive hypotheses that earlier reproductive development is due to improved energetic status and/or earlier increase in endocrine activity of the reproductive system. We found that urban birds initiated testicular development earlier than non-urban birds, but this disparity was not associated with differences in body condition, fat stores, or innate immune performance. These results provide no support for the hypothesis that energetic constraints are responsible for delayed reproductive development of non-urban relative to urban male Abert's Towhees. Urban birds did, however, increase their plasma luteinizing hormone, but not plasma testosterone, earlier than non-urban birds. These findings suggest that adjustment to urban areas by Abert's Towhees involves increases in the endocrine activity of the anterior pituitary gland and/or hypothalamus earlier than non-urban towhees. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Professional values and reported behaviours of doctors in the USA and UK: quantitative survey

PubMed Central

Rao, Sowmya R; Sibbald, Bonnie; Hann, Mark; Harrison, Stephen; Walter, Alex; Guthrie, Bruce; Desroches, Catherine; Ferris, Timothy G; Campbell, Eric G

2011-01-01

Background The authors aimed to determine US and UK doctors' professional values and reported behaviours, and the extent to which these vary with the context of care. Method 1891 US and 1078 UK doctors completed the survey (64.4% and 40.3% response rate respectively). Multivariate logistic regression was used to compare responses to identical questions in the two surveys. Results UK doctors were more likely to have developed practice guidelines (82.8% UK vs 49.6% US, p<0.001) and to have taken part in a formal medical error-reduction programme (70.9% UK vs 55.7% US, p<0.001). US doctors were more likely to agree about the need for periodic recertification (completely agree 23.4% UK vs 53.9% US, p<0.001). Nearly a fifth of doctors had direct experience of an impaired or incompetent colleague in the previous 3 years. Where the doctor had not reported the colleague to relevant authorities, reasons included thinking that someone else was taking care of the problem, believing that nothing would happen as a result, or fear of retribution. UK doctors were more likely than US doctors to agree that significant medical errors should always be disclosed to patients. More US doctors reported that they had not disclosed an error to a patient because they were afraid of being sued. Discussion The context of care may influence both how professional values are expressed and the extent to which behaviours are in line with stated values. Doctors have an important responsibility to develop their healthcare systems in ways which will support good professional behaviour. PMID:21383386

Professional values and reported behaviours of doctors in the USA and UK: quantitative survey.

PubMed

Roland, Martin; Rao, Sowmya R; Sibbald, Bonnie; Hann, Mark; Harrison, Stephen; Walter, Alex; Guthrie, Bruce; Desroches, Catherine; Ferris, Timothy G; Campbell, Eric G

2011-06-01

BACKGROUND The authors aimed to determine US and UK doctors' professional values and reported behaviours, and the extent to which these vary with the context of care. METHOD 1891 US and 1078 UK doctors completed the survey (64.4% and 40.3% response rate respectively). Multivariate logistic regression was used to compare responses to identical questions in the two surveys. RESULTS UK doctors were more likely to have developed practice guidelines (82.8% UK vs 49.6% US, p<0.001) and to have taken part in a formal medical error-reduction programme (70.9% UK vs 55.7% US, p<0.001). US doctors were more likely to agree about the need for periodic recertification (completely agree 23.4% UK vs 53.9% US, p<0.001). Nearly a fifth of doctors had direct experience of an impaired or incompetent colleague in the previous 3 years. Where the doctor had not reported the colleague to relevant authorities, reasons included thinking that someone else was taking care of the problem, believing that nothing would happen as a result, or fear of retribution. UK doctors were more likely than US doctors to agree that significant medical errors should always be disclosed to patients. More US doctors reported that they had not disclosed an error to a patient because they were afraid of being sued. DISCUSSION The context of care may influence both how professional values are expressed and the extent to which behaviours are in line with stated values. Doctors have an important responsibility to develop their healthcare systems in ways which will support good professional behaviour.

The Value-Added Achievement Gains of NBPTS-Certified Teachers in Tennessee: A Brief Report.

ERIC Educational Resources Information Center

Stone, J. E.

This study investigated whether National Board for Professional Teaching Standards (NBPTS)-certified teachers in Tennessee were exceptionally effective in bringing about objectively measured student achievement gains. Tennessee has over 40 NBPTS-certified teachers, 16 of whom teach in grades 3-8 and have value-added teacher reports in the state…

Value Analysis of Digital Breast Tomosynthesis for Breast Cancer Screening in a US Medicaid Population.

PubMed

Miller, Jeffrey D; Bonafede, Machaon M; Herschorn, Sally D; Pohlman, Scott K; Troeger, Kathleen A; Fajardo, Laurie L

2017-04-01

Better understanding regarding the clinical-economic value of digital breast tomosynthesis (DBT) for breast cancer screening for Medicaid enrollees is needed to help inform sound, value-based decision making. The objective of this study was to conduct a clinical-economic value analysis of DBT for breast cancer screening among women enrolled in Medicaid to assess the potential clinical benefits, associated expenditures, and net budget impact of DBT. Two annual screening mammography scenarios were evaluated with an economic model: (1) full-field digital mammography and (2) combined full-field digital mammography and DBT. The model focused on two main drivers of DBT value: (1) capacity for DBT to reduce the number of women recalled for additional follow-up imaging and diagnostic services and (2) capacity of DBT to facilitate earlier diagnosis of cancer at earlier stages, when treatment costs are lower. Model analysis results showed that the use of DBT as a mammographic screening modality by Medicaid enrollees potentially reduces the need for follow-up diagnostic services and improves the detection of invasive cancers, allowing earlier, less costly treatment. With the modest incremental reimbursement of $37 for DBT expected for a typical Medicaid claim, annual cost savings from DBT predicted by the model amounts to $8.14 per patient, potentially translating into more than $12,000 savings per year for an average-sized Medicaid plan and as much as $207,000 savings per year for a typical state Medicaid program. Wider adoption of DBT presents an opportunity to deliver value-based care to Medicaid programs and to help address disparities and barriers to accessing preventive care by some of the nation's most vulnerable citizens. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Organized screening detects breast cancer at earlier stage regardless of molecular phenotype.

PubMed

Holloway, Claire M B; Jiang, Li; Whitehead, Marlo; Racz, Jennifer M; Groome, Patti A

2018-06-16

Mortality reduction attributable to organized breast screening is modest. Screening may be less effective at detecting more aggressive cancers at an earlier stage. This study was conducted to determine the relative efficacy of screening mammography to detect cancers at an earlier stage by molecular phenotype. We identified 2882 women with primary invasive breast cancer diagnosed between January 1, 2008 and December 31, 2012 and who had a mammogram through the Ontario Breast Screening Program in the 28 months before diagnosis. Five tumor phenotypes were defined by expression of estrogen (ER) and progesterone (PR) receptors and HER2/neu oncogene. We conducted univariable and multivariable analyses to describe the predictors of detection as an interval cancer. Additional analyses identified predictors of detection at stages II, III, or IV compared with stage I, by phenotype. Analyses were adjusted for the effects of age, grade, and breast density. ER negative and HER2 positive tumors were over-represented among interval cancers, and triple negative cancers were more likely than ER +/HER2 - cancers to be detected as interval cancers OR 2.5 (95% CI 2.0-3.2, p < 0.0001). Method of detection (interval vs. screen) and molecular phenotype were independently associated with stage at diagnosis (p < 0.0001), but there was no interaction between method of detection and phenotype (p = 0.44). In a screened population, triple negative and HER2 + breast cancers are diagnosed at a higher stage but this appears to be due to higher growth rates of these tumors rather than a relative inability of screening to detect them.

A primary care Web-based Intervention Modeling Experiment replicated behavior changes seen in earlier paper-based experiment.

PubMed

Treweek, Shaun; Francis, Jill J; Bonetti, Debbie; Barnett, Karen; Eccles, Martin P; Hudson, Jemma; Jones, Claire; Pitts, Nigel B; Ricketts, Ian W; Sullivan, Frank; Weal, Mark; MacLennan, Graeme

2016-12-01

Intervention Modeling Experiments (IMEs) are a way of developing and testing behavior change interventions before a trial. We aimed to test this methodology in a Web-based IME that replicated the trial component of an earlier, paper-based IME. Three-arm, Web-based randomized evaluation of two interventions (persuasive communication and action plan) and a "no intervention" comparator. The interventions were designed to reduce the number of antibiotic prescriptions in the management of uncomplicated upper respiratory tract infection. General practitioners (GPs) were invited to complete an online questionnaire and eight clinical scenarios where an antibiotic might be considered. One hundred twenty-nine GPs completed the questionnaire. GPs receiving the persuasive communication did not prescribe an antibiotic in 0.70 more scenarios (95% confidence interval [CI] = 0.17-1.24) than those in the control arm. For the action plan, GPs did not prescribe an antibiotic in 0.63 (95% CI = 0.11-1.15) more scenarios than those in the control arm. Unlike the earlier IME, behavioral intention was unaffected by the interventions; this may be due to a smaller sample size than intended. A Web-based IME largely replicated the findings of an earlier paper-based study, providing some grounds for confidence in the IME methodology. Copyright © 2016 Elsevier Inc. All rights reserved.

Robustness of Value-Added Analysis of School Effectiveness. Research Report. ETS RR-08-22

ERIC Educational Resources Information Center

Braun, Henry; Qu, Yanxuan

2008-01-01

This paper reports on a study conducted to investigate the consistency of the results between 2 approaches to estimating school effectiveness through value-added modeling. Estimates of school effects from the layered model employing item response theory (IRT) scaled data are compared to estimates derived from a discrete growth model based on the…

Estimating Teacher and School Effectiveness in Pittsburgh: Value-Added Modeling and Results. Final Report

ERIC Educational Resources Information Center

Lipscomb, Stephen; Gill, Brian; Booker, Kevin; Johnson, Matthew

2010-01-01

At the request of Pittsburgh Public Schools (PPS) and the Pittsburgh Federation of Teachers (PFT), Mathematica is developing value-added models (VAMs) that aim to estimate the contributions of individual teachers, teams of teachers, and schools to the achievement growth of their students. The analyses described in this report are intended as an…

29 CFR 99.320 - Report submission.

Code of Federal Regulations, 2014 CFR

2014-07-01

... completed and the data collection form and reporting package shall be submitted within the earlier of 30... the data elements prescribed by OMB. (c) Reporting package. The reporting package shall include the... data collection form described in paragraph (b) of this section and one copy of the reporting package...

29 CFR 99.320 - Report submission.

Code of Federal Regulations, 2010 CFR

2010-07-01

... completed and the data collection form and reporting package shall be submitted within the earlier of 30... the data elements prescribed by OMB. (c) Reporting package. The reporting package shall include the... data collection form described in paragraph (b) of this section and one copy of the reporting package...

Delusions and underlying needs in older adults with Alzheimer's disease: influence of earlier life experiences and the current environment.

PubMed

Wang, Jing-Jy; Cheng, Wen-Yun; Lai, Pei-Ru; Pai, Ming-Chyi

2014-12-01

Delusions are one of the most severe psychiatric symptoms of individuals with Alzheimer's disease (AD), which often increase the stress experienced by caregivers. The purpose of this study was to understand the influences of earlier life experiences and the current environment on delusions, as well as the underlying needs of older adults with AD who experience delusions. Using an exploratory research design with a qualitative approach and purposive sampling, 20 family caregivers were interviewed. Two psychosocial types of attributes of delusion were categorized: Type A, the influence of earlier life experiences; and Type B, current environmental influences. The underlying needs of those with delusions include physical comfort, a desire to be secure, and a sense of belonging. The contents of delusions are easily influenced by patients' earlier negative experiences and responsibilities, whereas the current environment exerts a crucial influence on the occurrence, frequency, and severity of specific delusions. These results can facilitate planning for patient-centered care by enhancing health care providers' understanding of the psychosocial and environmental attributes and needs behind delusions. Copyright 2014, SLACK Incorporated.

Systemwide Report on Value of Supplemental Pension Obligations and Cost of Post-Employment Benefits Other Than Pensions.

ERIC Educational Resources Information Center

Oklahoma State Regents for Higher Education, Oklahoma City.

This report provides financial data on the value of obligations of any supplemental pension plans and the annual cost of any post-employment benefits for employees of state universities, colleges, and community colleges in Oklahoma. Attachment 1 summarizes information on supplemental pension plans that have been reported by state system…

A test of the reward-value hypothesis.

PubMed

Smith, Alexandra E; Dalecki, Stefan J; Crystal, Jonathon D

2017-03-01

Rats retain source memory (memory for the origin of information) over a retention interval of at least 1 week, whereas their spatial working memory (radial maze locations) decays within approximately 1 day. We have argued that different forgetting functions dissociate memory systems. However, the two tasks, in our previous work, used different reward values. The source memory task used multiple pellets of a preferred food flavor (chocolate), whereas the spatial working memory task provided access to a single pellet of standard chow-flavored food at each location. Thus, according to the reward-value hypothesis, enhanced performance in the source memory task stems from enhanced encoding/memory of a preferred reward. We tested the reward-value hypothesis by using a standard 8-arm radial maze task to compare spatial working memory accuracy of rats rewarded with either multiple chocolate or chow pellets at each location using a between-subjects design. The reward-value hypothesis predicts superior accuracy for high-valued rewards. We documented equivalent spatial memory accuracy for high- and low-value rewards. Importantly, a 24-h retention interval produced equivalent spatial working memory accuracy for both flavors. These data are inconsistent with the reward-value hypothesis and suggest that reward value does not explain our earlier findings that source memory survives unusually long retention intervals.

Oppositional Defiance, Moral Reasoning and Moral Value Evaluation as Predictors of Self-Reported Juvenile Delinquency

ERIC Educational Resources Information Center

Beerthuizen, Marinus G. C. J.; Brugman, Daniel; Basinger, Karen S.

2013-01-01

This study investigated the relationships among oppositional defiant attitudes, moral reasoning, moral value evaluation and self-reported delinquent behaviour in adolescents ("N" = 351, "M"[subscript AGE] = 13.8 years, "SD"[subscript AGE] = 1.1). Of particular interest were the moderating effects of age, educational…

37 CFR 1.78 - Claiming benefit of earlier filing date and cross-references to other applications.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 37 Patents, Trademarks, and Copyrights 1 2014-07-01 2014-07-01 false Claiming benefit of earlier filing date and cross-references to other applications. 1.78 Section 1.78 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE GENERAL RULES OF PRACTICE IN...

37 CFR 1.78 - Claiming benefit of earlier filing date and cross-references to other applications.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 37 Patents, Trademarks, and Copyrights 1 2011-07-01 2011-07-01 false Claiming benefit of earlier filing date and cross-references to other applications. 1.78 Section 1.78 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE GENERAL RULES OF PRACTICE IN...

Low protein content of drainage fluid is a good predictor for earlier chest tube removal after lobectomy.

PubMed

Olgac, Guven; Cosgun, Tugba; Vayvada, Mustafa; Ozdemir, Atilla; Kutlu, Cemal Asim

2014-10-01

postoperative day versus second and third days; P < 0.002). Eleven of 38 (29%) and 16 of 27 (59%) patients' chest tubes were, respectively, removed on the first and second postoperative days in Group S, but only two of 34 (6%) and ten of 32 (31%) patients, respectively, had their chest tubes removed in Group C (two-tailed Fisher's exact test, P = 0.02 and 0.005 for the first and the second postoperative days, respectively). On the third postoperative day, daily drainage remained ≥250 ml in 22 (65%) patients, among whom, 17 (77%) would have their chest tubes removed on the PrRPl/B value in Group C. However, drains could not be removed due to the high protein content of draining fluid despite the acceptable volume of daily drainage in only three (27%) of 11 cases in Group S (McNemar's paired proportions test, P = 0.009). The mean chest tube removal time (2.1 ± 0.9 vs 2.9 ± 1.0 days; P < 0.001) and the median hospital stay [3 days (IQR: 1-3) vs 4 days (IQR: 2-4), P < 0.003] were significantly shorter in Group S. None of the patients required a redrainage procedure due to a persistent and symptomatic pleural effusion. Regardless of the daily drainage, chest tubes can safely be removed earlier than anticipated in most patients after lobectomy if the protein content of the draining fluid is low. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Earlier Vegetation Activity Onset Enhances Springtime Water-use Efficiency in Temperate and Boreal Ecosystems

NASA Astrophysics Data System (ADS)

Jin, J.; Wang, Y.

2017-12-01

Ecosystem-scale water-use efficiency (EWUE), defined as the ratio of gross primary productivity (GPP) to evapotranspiration (ET), is an important indicator for understanding how water couples with the carbon cycle under global change. Relationships between EWUE and abiotic environmental factors (e.g. climatic factors, atmospheric CO2concentration and nitrogen deposition) have been widely investigated, but the variations in EWUE in response to biotic controls remain little understood. Here, we argue that phenology plays an important role in the regulation of EWUE by analyzing springtime EWUE responses to variability of the GPP-based vegetation activity onset (VAO) in temperate and boreal ecosystems using both satellite and flux-tower observations. Based on MODIS productions during 2000-2014, we found that spring EWUE widely significantly increased with the earlier VAO mainly in the mid- and high latitudes (over 50°N), southwestern China and mid-western North America. When AVO advanced a 10-day, the spring EWUE would increase on average by 0.17±0.09 g C kg-1 H2O in temperate and continental climates after removing the effect of environmental factors. The main response patterns of EWUE to phenology suggest that an increase in spring EWUE with an earlier VAO are mainly because the increase in GPP is relatively larger in magnitude compared to that of ET, or due to an increase in GPP accompanied by a decrease in ET, resulting from an advanced VAO. The credibility of the results is also supported by the local-scale observations. By analyzing 66 site-years of flux and meteorological data obtained from 8 temperate deciduous broadleaf forest sites across North America and Europe, spring EWUE increased 0.42±0.08 g C kg-1 H2O with a 10-day advance of VAO across all sites after controlling for environmental factors, mainly because an earlier VAO could lead to a steeper increase in GPP than in ET. Our results and conclusions highlight that phenological factors cannot be

The Classroom Observations of Vietnamese Teachers: Mediating Underlying Values to Understand Student Learning

ERIC Educational Resources Information Center

Tsukui, Atsushi; Saito, Eisuke; Sato, Masaaki; Michiyama, Megumi; Murase, Masatsugu

2017-01-01

This study uses the grounded theory approach (GTA) to investigate the value and characteristics of teacher observations, when used to understand student learning. Earlier studies have analysed the act of observation, defining it as a combination of joint observation and interpretation activities. By contrast, this analysis of 28 primary school…

mHealth and big data will bring meaning and value to patient-reported outcomes.

PubMed

Weiler, Anne

2016-01-01

The intersection of widespread mobile adoption, cloud computing and healthcare will enable patient-reported outcomes to be used to personalize care, draw insights and shorten the cycle from research to clinical implementation. Today, patient-reported outcomes are largely collected as part of a regulatory shift to value-based or bundled care. When patients are able to record their experiences in real-time and combine them with passive data collection from sensors and mobile devices, this information can inform better care for each patient and contribute to the growing body of health data that can be used to draw insights for all patients. This paper explores the current limitations of patient reported outcomes and how mobile health and big data analysis unlocks their potential as a valuable tool to deliver care.

Do BRCA1/2 mutation carriers have an earlier onset of natural menopause?

PubMed

van Tilborg, Theodora C; Broekmans, Frank J; Pijpe, Anouk; Schrijver, Lieske H; Mooij, Thea M; Oosterwijk, Jan C; Verhoef, Senno; Gómez Garcia, Encarna B; van Zelst-Stams, Wendy A; Adank, Muriel A; van Asperen, Christi J; van Doorn, Helena C; van Os, Theo A; Bos, Anna M; Rookus, Matti A; Ausems, Margreet G

2016-08-01

It has been hypothesized that BRCA1/2 mutation carriers have an earlier age at natural menopause (ANM), although to date findings are inconclusive. This study assessed the influence of BRCA mutation status on ANM, and aimed to explore the reasons of inconsistency in the literature. Cross-sectional assessment from an ongoing nationwide cohort study among members of BRCA1/2 mutated families. Information was obtained by a standardized questionnaire. Kaplan-Meier curves were constructed, and Cox regression was used to assess the association between BRCA1/2 mutation status and ANM. Adjustments were made for birth cohort, family, smoking, use of hormonal contraceptives, and parity. A total of 1,208 BRCA1/2 mutation carriers and 2,211 proven noncarriers were included. Overall, no association was found between BRCA1/2 mutation status and ANM (adjusted hazard ratio [HR] = 1.06 [95% CI, 0.87-1.30]). We examined if the null finding was due to informative censoring by uptake of risk-reducing salpingo-oophorectomy. Indeed, within the oldest birth cohort, in which the percentage of surgical menopause events was lowest and comparable between carriers and noncarriers, the HR for earlier natural menopause in carriers was 1.45 (95% CI, 1.09-1.94). The second oldest birth cohort, however, demonstrated a decreased HR (0.67 [95% CI, 0.46-0.98]), and thus no trend over birth cohorts was found. Various types of selection bias hamper the comparison of ANM between BRCA1/2 mutation carriers and noncarriers, genetically tested in the clinic.

Earlier parental set bedtimes as a protective factor against depression and suicidal ideation.

PubMed

Gangwisch, James E; Babiss, Lindsay A; Malaspina, Dolores; Turner, J Blake; Zammit, Gary K; Posner, Kelly

2010-01-01

To examine the relationships between parental set bedtimes, sleep duration, and depression as a quasi-experiment to explore the potentially bidirectional relationship between short sleep duration and depression. Short sleep duration has been shown to precede depression, but this could be explained as a prodromal symptom of depression. Depression in an adolescent can affect his/her chosen bedtime, but it is less likely to affect a parent's chosen set bedtime which can establish a relatively stable upper limit that can directly affect sleep duration. Multivariate cross-sectional analyses of the ADD Health using logistic regression. United States nationally representative, school-based, probability-based sample in 1994-96. Adolescents (n = 15,659) in grades 7 to 12. Adolescents with parental set bedtimes of midnight or later were 24% more likely to suffer from depression (OR = 1.24, 95% CI 1.04-1.49) and 20% more likely to have suicidal ideation (1.20, 1.01-1.41) than adolescents with parental set bedtimes of 10:00 PM or earlier, after controlling for covariates. Consistent with sleep duration and perception of getting enough sleep acting as mediators, the inclusion of these variables in the multivariate models appreciably attenuated the associations for depression (1.07, 0.88-1.30) and suicidal ideation (1.09, 0.92-1.29). The results from this study provide new evidence to strengthen the argument that short sleep duration could play a role in the etiology of depression. Earlier parental set bedtimes could therefore be protective against adolescent depression and suicidal ideation by lengthening sleep duration.

Traditional text-only versus multimedia-enhanced radiology reporting: referring physicians' perceptions of value.

PubMed

Sadigh, Gelareh; Hertweck, Timothy; Kao, Cristine; Wood, Paul; Hughes, Danny; Henry, Travis S; Duszak, Richard

2015-05-01

The aim of this study was to evaluate referring physicians' perceptions of multimedia-enhanced radiology reporting (MERR) as an alternative to traditional text-only radiology reporting. MERR supplements text-only reports by embedding user-friendly interactive hyperlinks to key images and graphically plotting target lesion size longitudinally over time. Of 402 physicians responding to a web-based survey, 200 (50 each medical oncologists, radiation oncologists, neurosurgeons, and pulmonologists) practicing in the United States fulfilled criteria to complete an online survey with questions focusing on satisfaction with current text-only reports and the perceived value of image- and data-enriched reporting. The mean respondent age was 46 years, with a mean of 15 years in posttraining clinical practice (85% men; 47% from academic medical centers). Although 80% were satisfied with the format of their current text-only radiology reports, 80% believed that MERR would represent an improvement. The most commonly reported advantages of MERR were "improved understanding of radiology findings by correlating images to text reports" (86%) and "easier access to images while monitoring progression of a disease/condition" (79%). Of the 28% of physicians with concerns about MERR implementation, the most common were that it was "too time intensive" (53%) and "the clinic workflow does not allow itself to view reports in such a fashion" (42%). Physicians indicated a strong increased likelihood of preferentially referring patients to (80%) and recommending peers to (79%) facilities that offer MERR. Most specialist referring physicians believe that interactive image- and data-embedded MERR represents an improvement over current text-only radiology reporting. Compared with current report formatting, most would preferentially refer patients and peers to facilities offering more meaningful image- and graphically enriched reporting platforms. Copyright © 2015 American College of Radiology

The case for earlier cochlear implantation in postlingually deaf adults.

PubMed

Dowell, Richard C

2016-01-01

This paper aimed to estimate the difference in speech perception outcomes that may occur due to timing of cochlear implantation in relation to the progression of hearing loss. Data from a large population-based sample of adults with acquired hearing loss using cochlear implants (CIs) was used to estimate the effects of duration of hearing loss, age, and pre-implant auditory skills on outcomes for a hypothetical standard patient. A total of 310 adults with acquired severe/profound bilateral hearing loss who received a CI in Melbourne, Australia between 1994 and 2006 provided the speech perception data and demographic information to derive regression equations for estimating CI outcomes. For a hypothetical CI candidate with progressive sensorineural hearing loss, the estimates of speech perception scores following cochlear implantation are significantly better if implantation occurs relatively soon after onset of severe hearing loss and before the loss of all functional auditory skills. Improved CI outcomes and quality of life benefit may be achieved for adults with progressive severe hearing loss if they are implanted earlier in the progression of the pathology.

Integrated Tree-Ring-Radiocarbon High-Resolution Timeframe to Resolve Earlier Second Millennium BCE Mesopotamian Chronology.

PubMed

Manning, Sturt W; Griggs, Carol B; Lorentzen, Brita; Barjamovic, Gojko; Ramsey, Christopher Bronk; Kromer, Bernd; Wild, Eva Maria

2016-01-01

500 years of ancient Near Eastern history from the earlier second millennium BCE, including such pivotal figures as Hammurabi of Babylon, Šamši-Adad I (who conquered Aššur) and Zimrilim of Mari, has long floated in calendar time subject to rival chronological schemes up to 150+ years apart. Texts preserved on clay tablets provide much information, including some astronomical references, but despite 100+ years of scholarly effort, chronological resolution has proved impossible. Documents linked with specific Assyrian officials and rulers have been found and associated with archaeological wood samples at Kültepe and Acemhöyük in Turkey, and offer the potential to resolve this long-running problem. Here we show that previous work using tree-ring dating to place these timbers in absolute time has fundamental problems with key dendrochronological crossdates due to small sample numbers in overlapping years and insufficient critical assessment. To address, we have integrated secure dendrochronological sequences directly with radiocarbon (14C) measurements to achieve tightly resolved absolute (calendar) chronological associations and identify the secure links of this tree-ring chronology with the archaeological-historical evidence. The revised tree-ring-sequenced 14C time-series for Kültepe and Acemhöyük is compatible only with the so-called Middle Chronology and not with the rival High, Low or New Chronologies. This finding provides a robust resolution to a century of uncertainty in Mesopotamian chronology and scholarship, and a secure basis for construction of a coherent timeframe and history across the Near East and East Mediterranean in the earlier second millennium BCE. Our re-dating also affects an unusual tree-ring growth anomaly in wood from Porsuk, Turkey, previously tentatively associated with the Minoan eruption of the Santorini volcano. This tree-ring growth anomaly is now directly dated ~1681-1673 BCE (68.2% highest posterior density range), ~20

Integrated Tree-Ring-Radiocarbon High-Resolution Timeframe to Resolve Earlier Second Millennium BCE Mesopotamian Chronology

PubMed Central

Griggs, Carol B.; Lorentzen, Brita; Barjamovic, Gojko; Ramsey, Christopher Bronk; Kromer, Bernd; Wild, Eva Maria

2016-01-01

500 years of ancient Near Eastern history from the earlier second millennium BCE, including such pivotal figures as Hammurabi of Babylon, Šamši-Adad I (who conquered Aššur) and Zimrilim of Mari, has long floated in calendar time subject to rival chronological schemes up to 150+ years apart. Texts preserved on clay tablets provide much information, including some astronomical references, but despite 100+ years of scholarly effort, chronological resolution has proved impossible. Documents linked with specific Assyrian officials and rulers have been found and associated with archaeological wood samples at Kültepe and Acemhöyük in Turkey, and offer the potential to resolve this long-running problem. Here we show that previous work using tree-ring dating to place these timbers in absolute time has fundamental problems with key dendrochronological crossdates due to small sample numbers in overlapping years and insufficient critical assessment. To address, we have integrated secure dendrochronological sequences directly with radiocarbon (14C) measurements to achieve tightly resolved absolute (calendar) chronological associations and identify the secure links of this tree-ring chronology with the archaeological-historical evidence. The revised tree-ring-sequenced 14C time-series for Kültepe and Acemhöyük is compatible only with the so-called Middle Chronology and not with the rival High, Low or New Chronologies. This finding provides a robust resolution to a century of uncertainty in Mesopotamian chronology and scholarship, and a secure basis for construction of a coherent timeframe and history across the Near East and East Mediterranean in the earlier second millennium BCE. Our re-dating also affects an unusual tree-ring growth anomaly in wood from Porsuk, Turkey, previously tentatively associated with the Minoan eruption of the Santorini volcano. This tree-ring growth anomaly is now directly dated ~1681–1673 BCE (68.2% highest posterior density range), ~20

Understanding Violence in Contemporary and Earlier Gangs: An Exploratory Application of the Theory of Reasoned Action.

ERIC Educational Resources Information Center

Evans, Judy P.; Taylor, Jerome

1995-01-01

Reviews the theory of reasoned action to demonstrate how it can be applied to understanding gang violence, and illustrates its potential applicability to a pilot sample of 30 contemporary and 18 earlier gangs living in a large metropolitan community. Results indicate this theory has been helpful in explaining higher levels of violence in…

The composition, heating value and renewable share of the energy content of mixed municipal solid waste in Finland

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

Horttanainen, M., E-mail: mika.horttanainen@lut.fi; Teirasvuo, N.; Kapustina, V.

Highlights: • New experimental data of mixed MSW properties in a Finnish case region. • The share of renewable energy of mixed MSW. • The results were compared with earlier international studies. • The average share of renewable energy was 30% and the average LHVar 19 MJ/kg. • Well operating source separation decreases the renewable energy content of MSW. - Abstract: For the estimation of greenhouse gas emissions from waste incineration it is essential to know the share of the renewable energy content of the combusted waste. The composition and heating value information is generally available, but the renewable energymore » share or heating values of different fractions of waste have rarely been determined. In this study, data from Finnish studies concerning the composition and energy content of mixed MSW were collected, new experimental data on the compositions, heating values and renewable share of energy were presented and the results were compared to the estimations concluded from earlier international studies. In the town of Lappeenranta in south-eastern Finland, the share of renewable energy ranged between 25% and 34% in the energy content tests implemented for two sample trucks. The heating values of the waste and fractions of plastic waste were high in the samples compared to the earlier studies in Finland. These high values were caused by good source separation and led to a low share of renewable energy content in the waste. The results showed that in mixed municipal solid waste the renewable share of the energy content can be significantly lower than the general assumptions (50–60%) when the source separation of organic waste, paper and cardboard is carried out successfully. The number of samples was however small for making extensive conclusions on the results concerning the heating values and renewable share of energy and additional research is needed for this purpose.« less

Seroepidemiology of Varicella and value of self-reported history of Varicella infection in Iranian medical students.

PubMed

Allami, Abbas; Mohammadi, Navid; Najar, Azade

2014-04-01

We conducted this study to assess the seroprevalence of Varicella zoster virus (VZV) antibodies in a group of Iranian medical sciences students that were at risk of Varicella and the value of self-reported history as a predictor of immunity. 255 medical, nursing and obstetrics students who had not entered as a student or worked in a hospital from 3 different schools were enrolled in the study in 2012 (Qazvin province, Iran). Demographics and other information as well as the history of Varicella were obtained through a self-administered questionnaire. Blood samples were collected to determine the Varicella IgG levels via an enzyme-linked immunosorbent assay. A statistical analysis was performed by calculating prevalences and their 95% confidence intervals. Sensitivity, specificity, positive and negative predictive values, Cohen's kappa and positive and negative likelihood ratios of recalled history were determined. p < 0.05 was considered statistically significant. The mean age of participants was 21.3 ± 4.3 years. Seropositivity rate was 74.5%. The relationships between marital status, number of family members, and acquired VZV history with immunity against the virus were statistically significant. The overall rate of reported history was 57%. The positive and negative predictive values of self-reported history of Varicella were 91% and 47.3%, respectively. Immunization of students of Iranian medical sciences seems logical in the near future. Also, they should be tested for Varicella immunity regardless of the history of previous infection.

Congruence and functions of personal and cultural values: do my values reflect my culture's values?

PubMed

Fischer, Ronald

2006-11-01

Two studies are described examining the correlation between self- and culture-referenced values at a culture level (Study 1) and correlation between self- and culture-referenced values and self-reported behavior at an individual level (Study 2). It is found that values related to individual-group relationships (embeddedness) and expression and experience of affective feelings and emotions (affective autonomy) are significantly correlated at a culture level. In Study 2, culture-referenced values are shown to correlate with behaviors attached to social norms, whereas self-rated values are found to correlate with behaviors that are not norm-governed. Implications for measurement of cultural values and cultural and cross-cultural research designs are discussed.

Selection of children to provide care: the effect of earlier parental transfers.

PubMed

Henretta, J C; Hill, M S; Li, W; Soldo, B J; Wolf, D A

1997-05-01

We use the first wave of data from the Asset and Health Dynamics Among the Oldest Old (AHEAD) study to examine the effects of past parent-to-child financial transfers on selection of a child to provide assistance with basic personal care for unmarried parents. We estimate a fixed-effects conditional logit model and find a positive and significant association between past financial transfers and a child's current helping behavior. The coefficient of past financial transfers is in the direction hypothesized, and its magnitude is 80% as large as that of gender, a well-documented powerful predictor of parental caregiving. There appears to be substantial evidence that earlier parent-to-child financial gifts play a role in determining which child in the family will provide assistance.

Don't judge a book by its cover, revisited: perceived and reported traits and values of attractive women.

PubMed

Segal-Caspi, Lihi; Roccas, Sonia; Sagiv, Lilach

2012-10-01

Research has documented a robust stereotype regarding personality attributes related to physical attractiveness (the "what is beautiful is good" stereotype). But do physically attractive women indeed possess particularly attractive inner attributes? Studying traits and values, we investigated two complementary questions: how perceived attractiveness relates to perceived personality, and how it relates to actual personality. First, 118 women reported their traits and values and were videotaped reading the weather forecast. Then, 118 judges rated the traits, values, and attractiveness of the women. As hypothesized, attractiveness correlated with attribution of desirable traits, but not with attribution of values. By contrast, attractiveness correlated with actual values, but not actual traits: Attractiveness correlated with tradition and conformity values (which were contrasted with self-direction values) and with self-enhancement values (which were contrasted with universalism values). Thus, despite the widely accepted "what is beautiful is good" stereotype, our findings suggest that the beautiful strive for conformity rather than independence and for self-promotion rather than tolerance.

The irreducibility of value-freedom to theory assessment.

PubMed

Bueter, Anke

2015-02-01

The current ideal of value-freedom holds non-cognitive values to be illegitimate in theory appraisal but legitimate in earlier stages of the research process, for example, when affecting the selection of topics or the generation of hypotheses. Respective decisions are often considered as part of a context of discovery and as irrelevant for the justification and assessment of theories. I will argue that this premise of an epistemic independence of theory appraisal, though often taken for granted, is false. Due to the possibility of value-laden blind spots, decisions in discovery can have an indirect impact on theory assessment that the value-free ideal cannot deal with. This argument is illustrated by a case study from women's health research, namely the assessment of hormone replacement therapy as a prevention of coronary heart diseases. In consequence, the epistemic trustworthiness of science is promoted more by a pluralism of non-cognitive values than by their exclusion; and a normative philosophy of science needs to enlarge its focus to include the context of discovery as well as the social conditions of science. Copyright © 2014 Elsevier Ltd. All rights reserved.

Signatures of Value Comparison in Ventral Striatum Neurons

PubMed Central

Strait, Caleb E.; Sleezer, Brianna J.; Hayden, Benjamin Y.

2015-01-01

The ventral striatum (VS), like its cortical afferents, is closely associated with processing of rewards, but the relative contributions of striatal and cortical reward systems remains unclear. Most theories posit distinct roles for these structures, despite their similarities. We compared responses of VS neurons to those of ventromedial prefrontal cortex (vmPFC) Area 14 neurons, recorded in a risky choice task. Five major response patterns observed in vmPFC were also observed in VS: (1) offer value encoding, (2) value difference encoding, (3) preferential encoding of chosen relative to unchosen value, (4) a correlation between residual variance in responses and choices, and (5) prominent encoding of outcomes. We did observe some differences as well; in particular, preferential encoding of the chosen option was stronger and started earlier in VS than in vmPFC. Nonetheless, the close match between vmPFC and VS suggests that cortex and its striatal targets make overlapping contributions to economic choice. PMID:26086735

Implementation of a closed-loop reporting system for critical values and clinical communication in compliance with goals of the joint commission.

PubMed

Parl, Fritz F; O'Leary, Mandy F; Kaiser, Allen B; Paulett, John M; Statnikova, Kristina; Shultz, Edward K

2010-03-01

Current practices of reporting critical laboratory values make it challenging to measure and assess the timeliness of receipt by the treating physician as required by The Joint Commission's 2008 National Patient Safety Goals. A multidisciplinary team of laboratorians, clinicians, and information technology experts developed an electronic ALERTS system that reports critical values via the laboratory and hospital information systems to alphanumeric pagers of clinicians and ensures failsafe notification, instant documentation, automatic tracking, escalation, and reporting of critical value alerts. A method for automated acknowledgment of message receipt was incorporated into the system design. The ALERTS system has been applied to inpatients and eliminated approximately 9000 phone calls a year made by medical technologists. Although a small number of phone calls were still made as a result of pages not acknowledged by clinicians within 10 min, they were made by telephone operators, who either contacted the same physician who was initially paged by the automated system or identified and contacted alternate physicians or the patient's nurse. Overall, documentation of physician acknowledgment of receipt in the electronic medical record increased to 95% of critical values over 9 months, while the median time decreased to <3 min. We improved laboratory efficiency and physician communication by developing an electronic system for reporting of critical values that is in compliance with The Joint Commission's goals.

Combined circulating tumor DNA and protein biomarker-based liquid biopsy for the earlier detection of pancreatic cancers.

PubMed

Cohen, Joshua D; Javed, Ammar A; Thoburn, Christopher; Wong, Fay; Tie, Jeanne; Gibbs, Peter; Schmidt, C Max; Yip-Schneider, Michele T; Allen, Peter J; Schattner, Mark; Brand, Randall E; Singhi, Aatur D; Petersen, Gloria M; Hong, Seung-Mo; Kim, Song Cheol; Falconi, Massimo; Doglioni, Claudio; Weiss, Matthew J; Ahuja, Nita; He, Jin; Makary, Martin A; Maitra, Anirban; Hanash, Samir M; Dal Molin, Marco; Wang, Yuxuan; Li, Lu; Ptak, Janine; Dobbyn, Lisa; Schaefer, Joy; Silliman, Natalie; Popoli, Maria; Goggins, Michael G; Hruban, Ralph H; Wolfgang, Christopher L; Klein, Alison P; Tomasetti, Cristian; Papadopoulos, Nickolas; Kinzler, Kenneth W; Vogelstein, Bert; Lennon, Anne Marie

2017-09-19

The earlier diagnosis of cancer is one of the keys to reducing cancer deaths in the future. Here we describe our efforts to develop a noninvasive blood test for the detection of pancreatic ductal adenocarcinoma. We combined blood tests for KRAS gene mutations with carefully thresholded protein biomarkers to determine whether the combination of these markers was superior to any single marker. The cohort tested included 221 patients with resectable pancreatic ductal adenocarcinomas and 182 control patients without known cancer. KRAS mutations were detected in the plasma of 66 patients (30%), and every mutation found in the plasma was identical to that subsequently found in the patient's primary tumor (100% concordance). The use of KRAS in conjunction with four thresholded protein biomarkers increased the sensitivity to 64%. Only one of the 182 plasma samples from the control cohort was positive for any of the DNA or protein biomarkers (99.5% specificity). This combinatorial approach may prove useful for the earlier detection of many cancer types.

To achieve an earlier IFN-γ response is not sufficient to control Mycobacterium tuberculosis infection in mice.

PubMed

Vilaplana, Cristina; Prats, Clara; Marzo, Elena; Barril, Carles; Vegué, Marina; Diaz, Jorge; Valls, Joaquim; López, Daniel; Cardona, Pere-Joan

2014-01-01

The temporo-spatial relationship between the three organs (lung, spleen and lymph node) involved during the initial stages of Mycobacterium tuberculosis infection has been poorly studied. As such, we performed an experimental study to evaluate the bacillary load in each organ after aerosol or intravenous infection and developed a mathematical approach using the data obtained in order to extract conclusions. The results showed that higher bacillary doses result in an earlier IFN-γ response, that a certain bacillary load (BL) needs to be reached to trigger the IFN-γ response, and that control of the BL is not immediate after onset of the IFN-γ response, which might be a consequence of the spatial dimension. This study may have an important impact when it comes to designing new vaccine candidates as it suggests that triggering an earlier IFN-γ response might not guarantee good infection control, and therefore that additional properties should be considered for these candidates.

To Achieve an Earlier IFN-γ Response Is Not Sufficient to Control Mycobacterium tuberculosis Infection in Mice

PubMed Central

Marzo, Elena; Barril, Carles; Vegué, Marina; Diaz, Jorge; Valls, Joaquim; López, Daniel; Cardona, Pere-Joan

2014-01-01

The temporo-spatial relationship between the three organs (lung, spleen and lymph node) involved during the initial stages of Mycobacterium tuberculosis infection has been poorly studied. As such, we performed an experimental study to evaluate the bacillary load in each organ after aerosol or intravenous infection and developed a mathematical approach using the data obtained in order to extract conclusions. The results showed that higher bacillary doses result in an earlier IFN-γ response, that a certain bacillary load (BL) needs to be reached to trigger the IFN-γ response, and that control of the BL is not immediate after onset of the IFN-γ response, which might be a consequence of the spatial dimension. This study may have an important impact when it comes to designing new vaccine candidates as it suggests that triggering an earlier IFN-γ response might not guarantee good infection control, and therefore that additional properties should be considered for these candidates. PMID:24959669

Sunscreen tests: correspondence between in vitro data and values reported by the manufacturers.

PubMed

Garoli, Denis; Pelizzo, Maria Guglielmina; Bernardini, Bianca; Nicolosi, Piergiorgio; Alaibac, Mauro

2008-12-01

In vitro sunscreen tests are diffusively used to test both the sun protection factor (SPF) and the photo-stability of filters. Spectrophotometric measurements of the absorbance of ultraviolet radiations through a sunscreen applied on a suitable substrate allow a rapid evaluation of its protection factor both at short and long wavelength ultraviolet radiation (UVB and UVA). The objective of this study has been to demonstrate if Teflon can be adopted as substrate both for SPF evaluation and photo-stability tests. Moreover, we have investigated if there is a correspondence between in vitro SPF measurements and values reported by manufacturers on sunscreens. Teflon has been used to perform several photo-stability tests by irradiating the filters with different wavebands and analyzing the combined effect of UV and infrared (IR) light. Similar analyses have been carried out using PMMA Plates, which is the standard substrate for UVA in vitro test. We have demonstrated that it is possible to establish a good correspondence between in vitro SPF and values reported by manufacturers on sunscreens. We have also verified that the in vitro/label SPF correlation curve depends on the quantity of product applied while this does not seem to be true for other parameters like Critical Wavelength and UVA ratio. With regard to photo-stability studies, our results indicate for the first time that IR irradiation may have a role on photo-degradation. The results show that there is a good correlation between the in vitro SPF determined by the present method and the SPF reported by the manufacturer. The compatibility of the results obtained using Teflon and PMMA Plates demonstrates that Teflon can be utilized for both SPF determination and photo-stability tests.

Progress Reports-HDSC/OWP

Science.gov Websites

- March 2017 October - December 2016 If you would like to subscribe to the HDSC List-Server and receive future announcements of progress report on current projects click here. If you would like earlier

Earlier Age of Onset of Chronic Hypertension and Type 2 Diabetes Mellitus After a Hypertensive Disorder of Pregnancy or Gestational Diabetes Mellitus.

PubMed

Heida, Karst Y; Franx, Arie; van Rijn, Bas B; Eijkemans, Marinus J C; Boer, Jolanda M A; Verschuren, Monique W M; Oudijk, Martijn A; Bots, Michiel L; van der Schouw, Yvonne T

2015-12-01

A prospective cohort study was conducted to assess the impact of a history of hypertensive disorder of pregnancy (HDP) or gestational diabetes mellitus (GDM) on the risk and age of onset of hypertension, type 2 diabetes mellitus (T2D), and cardiovascular disease (CVD) later in life, independent of hypertension and T2D. Between 1993 and 1997, 22 265 ever-pregnant women were included from the European Prospective Investigation into Cancer and Nutrition-NL study, aged 20 to 70 years at baseline. Details on complications of pregnancy and known hypertension were obtained by questionnaire. Blood pressure was measured at enrollment. Participants were followed for the occurrence of CVD events. Data were analyzed using ANCOVA, multivariable logistic regression, and Cox proportional hazard (with HDP and GDM as time-dependent variables for T2D and CVD) models. At enrollment, women with a HDP reported diagnosis of hypertension 7.7 years earlier (95% confidence interval [CI] 6.9-8.5) and women with GDM reported diagnosis of T2D 7.7 years earlier (95% CI 5.8-9.6) than women without pregnancy complications. After adjustment for potential confounders, HDP was associated with presence of hypertension at enrollment (odds ratio 2.12, 95% CI 1.98-2.28) and onset of CVD later in life (hazard ratio 1.21, 95% CI 1.10-1.32). After including the intermediates hypertension and T2D in the model, the risk of CVD later in life decreased (hazard ratio 1.09, 95% CI 1.00-1.20). GDM was associated with an increased risk of developing T2D later in life (hazard ratio 3.68, 95% CI 2.77-4.90), but not with risk of CVD. HDP and GDM have a substantial impact on the risk of CVD and are potentially important indicators for preventive cardiovascular risk management. © 2015 American Heart Association, Inc.

Report: CSB Needs to Improve Its Acquisition Approvals and Other Processes to Ensure Best Value for Taxpayers

EPA Pesticide Factsheets

Report #15-P-0245, July 31, 2015. CSB's acquisition process is at risk and may have ineffective operations without a strategy to implement controls. Further, CSB has limited evidence it contracted at the best value.

What Is the Value of @*#? Deepening Teachers' Understanding of Place Value

ERIC Educational Resources Information Center

Hopkins, Theresa M.; Cady, Jo Ann

2007-01-01

This article reports on the use of a unique number system to facilitate teachers' understanding of the concepts of place value. Teachers' mastery of base-ten may hinder their recognition of the difficulties students have with place value, so the authors created a number system that used five symbols to represent values. Using this system, teachers…

Value-cell bar charts for visualizing large transaction data sets.

PubMed

Keim, Daniel A; Hao, Ming C; Dayal, Umeshwar; Lyons, Martha

2007-01-01

One of the common problems businesses need to solve is how to use large volumes of sales histories, Web transactions, and other data to understand the behavior of their customers and increase their revenues. Bar charts are widely used for daily analysis, but only show highly aggregated data. Users often need to visualize detailed multidimensional information reflecting the health of their businesses. In this paper, we propose an innovative visualization solution based on the use of value cells within bar charts to represent business metrics. The value of a transaction can be discretized into one or multiple cells: high-value transactions are mapped to multiple value cells, whereas many small-value transactions are combined into one cell. With value-cell bar charts, users can 1) visualize transaction value distributions and correlations, 2) identify high-value transactions and outliers at a glance, and 3) instantly display values at the transaction record level. Value-Cell Bar Charts have been applied with success to different sales and IT service usage applications, demonstrating the benefits of the technique over traditional charting techniques. A comparison with two variants of the well-known Treemap technique and our earlier work on Pixel Bar Charts is also included.

Recommended Values of the Fundamental Physical Constants: A Status Report

PubMed Central

Taylor, Barry N.; Cohen, E. Richard

1990-01-01

We summarize the principal advances made in the fundamental physical constants field since the completion of the 1986 CODATA least-squares adjustment of the constants and discuss their implications for both the 1986 set of recommended values and the next least-squares adjustment. In general, the new results lead to values of the constants with uncertainties 5 to 7 times smaller than the uncertainties assigned the 1986 values. However, the changes in the values themselves are less than twice the 1986 assigned one-standard-deviation uncertainties and thus are not highly significant. Although much new data has become available since 1986, three new results dominate the analysis: a value of the Planck constant obtained from a realization of the watt; a value of the fine-structure constant obtained from the magnetic moment anomaly of the electron; and a value of the molar gas constant obtained from the speed of sound in argon. Because of their dominant role in determining the values and uncertainties of many of the constants, it is highly desirable that additional results of comparable uncertainty that corroborate these three data items be obtained before the next adjustment is carried out. Until then, the 1986 CODATA set of recommended values will remain the set of choice. PMID:28179787

When Can Subscores Be Expected to Have Added Value? Results from Operational and Simulated Data. Research Report. ETS RR-10-16

ERIC Educational Resources Information Center

Sinharay, Sandip

2010-01-01

Recently, there has been an increasing level of interest in subscores for their potential diagnostic value. Haberman (2008) suggested a method based on classical test theory to determine whether subscores have added value over total scores. This paper provides a literature review and reports when subscores were found to have added value for…

Association between severe dorsolateral prefrontal dysfunction during random number generation and earlier onset in schizophrenia.

PubMed

Koike, Shinsuke; Takizawa, Ryu; Nishimura, Yukika; Marumo, Kohei; Kinou, Masaru; Kawakubo, Yuki; Rogers, Mark A; Kasai, Kiyoto

2011-08-01

Schizophrenia involves impairment in attention, working memory and executive processes associated with prefrontal cortical function, an essential contributor of social functioning. Age at onset is a major factor for predicting social outcome in schizophrenia. In clinical settings, we need an objective assessment tool for evaluating prefrontal function and social outcome. Participants included 22 right-handed patients with schizophrenia and 40 gender- and age-matched healthy controls. We used a 52-channel near-infrared spectroscopy (NIRS) instrument to measure oxygenated haemoglobin ([oxy-Hb]) changes over the prefrontal cortex during a random number generation (RNG) task. In healthy controls, we found significant [oxy-Hb] increase in the bilateral dorsolateral (DLPFC; BA9 and BA46) and ventrolateral prefrontal cortex (VLPFC; BA44, 45 and 47). The patients with schizophrenia showed significantly smaller activation than the healthy controls in the same approximate regions. In the patient group, a smaller [oxy-Hb] increase in the right DLPFC region (BA9) was significantly correlated with earlier age at onset. NIRS can detect prefrontal cortical dysfunction associated with an executive task, which was coupled with earlier age at onset in schizophrenia. Multichannel NIRS, a non-invasive and user-friendly instrument, may be useful in evaluating cognitive function and social outcome in clinical settings in psychiatry. Copyright © 2011 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Earlier disability of the patients followed in Multiple Sclerosis centers compared to outpatients.

PubMed

Debouverie, M; Laforest, L; Van Ganse, E; Guillemin, F

2009-02-01

The currently published works regarding the multiple sclerosis (MS) natural history report data were collected most often on population of patients recruited in MS centers. The aim was to compare the natural history of a population of patients followed in a MS centre (MSC) with patients followed outside a MS centre (NMSC). Cases were identified through the LORSEP cohort, a network of neurologists (private ambulatory practice, hospitals, and MS centers) in France. A total of 3602 patients had been analyzed: 1036 MSC patients and 2566 NMSC patients. No difference was observed regarding gender and initial symptoms. Conversely, MSC patients were younger at MS onset and were more likely to have a primary progressive initial form. Median times (years) to the EDSS scores of 3, 4, and 6 were 5.8 (5.0-6.8), 8.4 (7.9-9.0), 16.0 (14.8-18.1) in the MSC group, respectively, whereas corresponding times were 8.4 (7.9-9.0), 12.3 (11.4-13.4), 19.1 (18.0-20.2) in the NMSC group. These differences according to the type of MS supervision were statistically significant for EDSS3 (P < 0.0001), EDSS4 (P < 0.0001), and EDSS6 (P = 0.01), respectively. These findings were confirmed in Cox multivariate models. The patients followed in a MS centre had earlier disability than patients managed otherwise. Analyses exclusively conducted in patients with MS supervised in specialized centers may falsely misestimate the times needed to reach major disability landmarks. Before using registries to study the natural history of MS, efforts should be performed to verify in how far data are exhaustive and to understand the local health care system.

Health significance and statistical uncertainty. The value of P-value.

PubMed

Consonni, Dario; Bertazzi, Pier Alberto

2017-10-27

The P-value is widely used as a summary statistics of scientific results. Unfortunately, there is a widespread tendency to dichotomize its value in "P<0.05" (defined as "statistically significant") and "P>0.05" ("statistically not significant"), with the former implying a "positive" result and the latter a "negative" one. To show the unsuitability of such an approach when evaluating the effects of environmental and occupational risk factors. We provide examples of distorted use of P-value and of the negative consequences for science and public health of such a black-and-white vision. The rigid interpretation of P-value as a dichotomy favors the confusion between health relevance and statistical significance, discourages thoughtful thinking, and distorts attention from what really matters, the health significance. A much better way to express and communicate scientific results involves reporting effect estimates (e.g., risks, risks ratios or risk differences) and their confidence intervals (CI), which summarize and convey both health significance and statistical uncertainty. Unfortunately, many researchers do not usually consider the whole interval of CI but only examine if it includes the null-value, therefore degrading this procedure to the same P-value dichotomy (statistical significance or not). In reporting statistical results of scientific research present effects estimates with their confidence intervals and do not qualify the P-value as "significant" or "not significant".

Do emotional support and classroom organization earlier in the year set the stage for higher quality instruction?

PubMed

Curby, Timothy W; Rimm-Kaufman, Sara E; Abry, Tashia

2013-10-01

Many teachers believe that providing greater emotional and organizational supports in the beginning of the year strengthens their ability to teach effectively as the year progresses. Some interventions, such as the Responsive Classroom (RC) approach, explicitly embed this sequence into professional development efforts. We tested the hypothesis that earlier emotional and organizational supports set the stage for improved instruction later in the year in a sample of third- and fourth-grade teachers enrolled in a randomized controlled trial of the RC approach. Further, we examined the extent to which the model generalized for teachers using varying levels of RC practices as well as whether or not teachers were in the intervention or control groups. Teachers' emotional, organizational, and instructional interactions were observed using the Classroom Assessment Scoring System (Pianta, La Paro, & Hamre, 2008) on five occasions throughout the year. Results indicated a reciprocal relation between emotional and instructional supports. Specifically, higher levels of emotional support earlier in the year predicted higher instructional support later in the year. Also, higher levels of instructional support earlier in the year predicted higher emotional support later in the year. Classroom organization was not found to have longitudinal associations with the other domains across a year. This pattern was robust when controlling for the use of RC practices as well as across intervention and control groups. Further, teachers' use of RC practices predicted higher emotional support and classroom organization throughout the year, suggesting the malleability of this teacher characteristic. Discussion highlights the connection between teachers' emotional and instructional supports and how the use of RC practices improves teachers' emotionally supportive interactions with students. Copyright © 2013 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights

Emerging Good Practices for Transforming Value Assessment: Patients' Voices, Patients' Values.

PubMed

Perfetto, Eleanor M; Harris, Jason; Mullins, C Daniel; dosReis, Susan

2018-04-01

Patient engagement is a transformative strategy for improving value assessment. US value framework developers have increased engagement activities, but more needs to be learned about how to best achieve meaningful patient engagement in value assessment. The objective was to glean good practices in patient engagement emerging from patient community experiences, to be used in value assessment. The National Health Council Value Workgroup conducted a survey and held a focus group with its member advocacy organizations to gather experiences with value framework developers and views on emerging good practices. Ten of 13 organizations completed the survey; reporting 13 interactions with four framework developers. Most rated experiences as "good" to "very good." Emerging good practices included (1) engage early; (2) engage a range of patients; (3) leverage patient-provided information, data resources, and outreach mechanisms; (4) be transparent; and (5) appreciate and accommodate resource constraints. Twelve of 13 organizations participated in the focus group, and this produced 30 emerging good practices in four areas: (1) timing; (2) methodology and data; (3) partnering; and (4) characterizing engagement. Patient engagement was limited in early development of value frameworks but has increased in the past few years. Patient groups report positive experiences that can serve as emerging good practices. These groups also reported experienced challenges in their interactions and recommended good practices to mitigate those challenges. The growing pool of patient engagement experiences can be translated into good practices to advance a patient-centered, value-driven health care ecosystem. Lessons learned from these early experiences can help establish recommend emerging good practices that can eventually result in best practices and standards in the field. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc

Combined circulating tumor DNA and protein biomarker-based liquid biopsy for the earlier detection of pancreatic cancers

PubMed Central

Cohen, Joshua D.; Javed, Ammar A.; Thoburn, Christopher; Wong, Fay; Tie, Jeanne; Gibbs, Peter; Schmidt, C. Max; Yip-Schneider, Michele T.; Allen, Peter J.; Schattner, Mark; Brand, Randall E.; Singhi, Aatur D.; Petersen, Gloria M.; Hong, Seung-Mo; Kim, Song Cheol; Falconi, Massimo; Doglioni, Claudio; Weiss, Matthew J.; Ahuja, Nita; He, Jin; Makary, Martin A.; Maitra, Anirban; Hanash, Samir M.; Dal Molin, Marco; Wang, Yuxuan; Li, Lu; Ptak, Janine; Dobbyn, Lisa; Schaefer, Joy; Silliman, Natalie; Popoli, Maria; Goggins, Michael G.; Hruban, Ralph H.; Wolfgang, Christopher L.; Klein, Alison P.; Tomasetti, Cristian; Papadopoulos, Nickolas; Kinzler, Kenneth W.; Vogelstein, Bert; Lennon, Anne Marie

2017-01-01

The earlier diagnosis of cancer is one of the keys to reducing cancer deaths in the future. Here we describe our efforts to develop a noninvasive blood test for the detection of pancreatic ductal adenocarcinoma. We combined blood tests for KRAS gene mutations with carefully thresholded protein biomarkers to determine whether the combination of these markers was superior to any single marker. The cohort tested included 221 patients with resectable pancreatic ductal adenocarcinomas and 182 control patients without known cancer. KRAS mutations were detected in the plasma of 66 patients (30%), and every mutation found in the plasma was identical to that subsequently found in the patient’s primary tumor (100% concordance). The use of KRAS in conjunction with four thresholded protein biomarkers increased the sensitivity to 64%. Only one of the 182 plasma samples from the control cohort was positive for any of the DNA or protein biomarkers (99.5% specificity). This combinatorial approach may prove useful for the earlier detection of many cancer types. PMID:28874546

Accounting for Co-Teaching: A Guide for Policymakers and Developers of Value-Added Models

ERIC Educational Resources Information Center

Isenberg, Eric; Walsh, Elias

2015-01-01

We outline the options available to policymakers for addressing co-teaching in a value-added model. Building on earlier work, we propose an improvement to a method of accounting for co-teaching that treats co-teachers as teams, with each teacher receiving equal credit for co-taught students. Hock and Isenberg (2012) described a method known as the…

Computing Evans functions numerically via boundary-value problems

NASA Astrophysics Data System (ADS)

Barker, Blake; Nguyen, Rose; Sandstede, Björn; Ventura, Nathaniel; Wahl, Colin

2018-03-01

The Evans function has been used extensively to study spectral stability of travelling-wave solutions in spatially extended partial differential equations. To compute Evans functions numerically, several shooting methods have been developed. In this paper, an alternative scheme for the numerical computation of Evans functions is presented that relies on an appropriate boundary-value problem formulation. Convergence of the algorithm is proved, and several examples, including the computation of eigenvalues for a multi-dimensional problem, are given. The main advantage of the scheme proposed here compared with earlier methods is that the scheme is linear and scalable to large problems.

Critical values in hematology of 862 institutions in China.

PubMed

Ye, Y Y; Zhao, H J; Fei, Y; Wang, W; He, F L; Zhong, K; Yuan, S; Wang, Z G

2017-10-01

A national survey on critical values in hematology of China laboratories was conducted to determine the current practice and assess the quality indicators so as to obtain a quality improvement. Laboratories participating were asked to submit the general information, the practice of critical value reporting, and the status of timeliness of critical value reporting. A total of 862 laboratories submitted the results. The majority of participants have included white blood cell count, blood platelet count, hemoglobin, prothrombin time, and activated partial thromboplastin time in their critical value lists. Many sources are used for establishing a critical value policy, and some of the laboratories consult with clinicians. The unreported critical value rate, late critical value reporting rate, and clinically unacknowledged rate in China are relatively low, and the median of critical value reporting time is 8-9 minutes. There exists a wide variety for critical value reporting in hematology in China. Laboratories should establish a policy of critical value reporting suited for their own situations and consult with clinicians to set critical value lists. Critical values are generally reported in a timely manner in China, but some measures should be taken to further improve the timeliness of critical value reporting. © 2017 John Wiley & Sons Ltd.

Empirical corroboration of an earlier theoretical resolution to the UV paradox of insect polarized skylight orientation.

PubMed

Wang, Xin; Gao, Jun; Fan, Zhiguo

2014-02-01

It is surprising that many insect species use only the ultraviolet (UV) component of the polarized skylight for orientation and navigation purposes, while both the intensity and the degree of polarization of light from the clear sky are lower in the UV than at longer (blue, green, red) wavelengths. Why have these insects chosen the UV part of the polarized skylight? This strange phenomenon is called the "UV-sky-pol paradox". Although earlier several speculations tried to resolve this paradox, they did this without any quantitative data. A theoretical and computational model has convincingly explained why it is advantageous for certain animals to detect celestial polarization in the UV. We performed a sky-polarimetric approach and built a polarized skylight sensor that models the processing of polarization signals by insect photoreceptors. Using this model sensor, we carried out measurements under clear and cloudy sky conditions. Our results showed that light from the cloudy sky has maximal degree of polarization in the UV. Furthermore, under both clear and cloudy skies the angle of polarization of skylight can be detected with a higher accuracy. By this, we corroborated empirically the soundness of the earlier computational resolution of the UV-sky-pol paradox.

Empirical corroboration of an earlier theoretical resolution to the UV paradox of insect polarized skylight orientation

NASA Astrophysics Data System (ADS)

Wang, Xin; Gao, Jun; Fan, Zhiguo

2014-02-01

It is surprising that many insect species use only the ultraviolet (UV) component of the polarized skylight for orientation and navigation purposes, while both the intensity and the degree of polarization of light from the clear sky are lower in the UV than at longer (blue, green, red) wavelengths. Why have these insects chosen the UV part of the polarized skylight? This strange phenomenon is called the "UV-sky-pol paradox". Although earlier several speculations tried to resolve this paradox, they did this without any quantitative data. A theoretical and computational model has convincingly explained why it is advantageous for certain animals to detect celestial polarization in the UV. We performed a sky-polarimetric approach and built a polarized skylight sensor that models the processing of polarization signals by insect photoreceptors. Using this model sensor, we carried out measurements under clear and cloudy sky conditions. Our results showed that light from the cloudy sky has maximal degree of polarization in the UV. Furthermore, under both clear and cloudy skies the angle of polarization of skylight can be detected with a higher accuracy. By this, we corroborated empirically the soundness of the earlier computational resolution of the UV-sky-pol paradox.

Reconstruction of finite-valued sparse signals

NASA Astrophysics Data System (ADS)

Keiper, Sandra; Kutyniok, Gitta; Lee, Dae Gwan; Pfander, Götz

2017-08-01

The need of reconstructing discrete-valued sparse signals from few measurements, that is solving an undetermined system of linear equations, appears frequently in science and engineering. Those signals appear, for example, in error correcting codes as well as massive Multiple-Input Multiple-Output (MIMO) channel and wideband spectrum sensing. A particular example is given by wireless communications, where the transmitted signals are sequences of bits, i.e., with entries in f0; 1g. Whereas classical compressed sensing algorithms do not incorporate the additional knowledge of the discrete nature of the signal, classical lattice decoding approaches do not utilize sparsity constraints. In this talk, we present an approach that incorporates a discrete values prior into basis pursuit. In particular, we address finite-valued sparse signals, i.e., sparse signals with entries in a finite alphabet. We will introduce an equivalent null space characterization and show that phase transition takes place earlier than when using the classical basis pursuit approach. We will further discuss robustness of the algorithm and show that the nonnegative case is very different from the bipolar one. One of our findings is that the positioning of the zero in the alphabet - i.e., whether it is a boundary element or not - is crucial.

A reversal of the shift towards earlier spring phenology in several Mediterranean reptiles and amphibians during the 1998-2013 warming slowdown.

PubMed

Prodon, Roger; Geniez, Philippe; Cheylan, Marc; Devers, Florence; Chuine, Isabelle; Besnard, Aurelien

2017-12-01

Herps, especially amphibians, are particularly susceptible to climate change, as temperature tightly controls many parameters of their biological cycle-above all, their phenology. The timing of herps' activity or migration period-in particular the dates of their first appearance in spring and first breeding-and the shift to earlier dates in response to warming since the last quarter of the 20 th century has often been described up to now as a nearly monotonic trend towards earlier phenological events. In this study, we used citizen science data opportunistically collected on reptiles and amphibians in the northern Mediterranean basin over a period of 32 years to explore temporal variations in herp phenology. For 17 common species, we measured shifts in the date of the species' first spring appearance-which may be the result of current changes in climate-and regressed the first appearance date against temperatures and precipitations. Our results confirmed the expected overall trend towards earlier first spring appearances from 1983 to 1997, and show that the first appearance date of both reptiles and amphibians fits well with the temperature in late winter. However, the trend towards earlier dates was stopped or even reversed in most species between 1998 and 2013. We interpret this reversal as a response to cooling related to the North Atlantic Oscillation (NAO) in the late winter and early spring. During the positive NAO episodes, for certain species only (mainly amphibians), the effect of a warm weather, which tends to advance the phenology, seems to be counterbalanced by the adverse effects of the relative dryness. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

NMR-based fecal metabolomics fingerprinting as predictors of earlier diagnosis in patients with colorectal cancer.

PubMed

Lin, Yan; Ma, Changchun; Liu, Chengkang; Wang, Zhening; Yang, Jurong; Liu, Xinmu; Shen, Zhiwei; Wu, Renhua

2016-05-17

Colorectal cancer (CRC) is a growing cause of mortality in developing countries, warranting investigation into its earlier detection for optimal disease management. A metabolomics based approach provides potential for noninvasive identification of biomarkers of colorectal carcinogenesis, as well as dissection of molecular pathways of pathophysiological conditions. Here, proton nuclear magnetic resonance spectroscopy (1HNMR) -based metabolomic approach was used to profile fecal metabolites of 68 CRC patients (stage I/II=20; stage III=25 and stage IV=23) and 32 healthy controls (HC). Pattern recognition through principal component analysis (PCA) and orthogonal partial least squares-discriminant analysis (OPLS-DA) was applied on 1H-NMR processed data for dimension reduction. OPLS-DA revealed that each stage of CRC could be clearly distinguished from HC based on their metabolomic profiles. Successive analyses identified distinct disturbances to fecal metabolites of CRC patients at various stages, compared with those in cancer free controls, including reduced levels of acetate, butyrate, propionate, glucose, glutamine, and elevated quantities of succinate, proline, alanine, dimethylglycine, valine, glutamate, leucine, isoleucine and lactate. These altered fecal metabolites potentially involved in the disruption of normal bacterial ecology, malabsorption of nutrients, increased glycolysis and glutaminolysis. Our findings revealed that the fecal metabolic profiles of healthy controls can be distinguished from CRC patients, even in the early stage (stage I/II), highlighting the potential utility of NMR-based fecal metabolomics fingerprinting as predictors of earlier diagnosis in CRC patients.

NMR-based fecal metabolomics fingerprinting as predictors of earlier diagnosis in patients with colorectal cancer

PubMed Central

Lin, Yan; Ma, Changchun; Liu, Chengkang; Wang, Zhening; Yang, Jurong; Liu, Xinmu; Shen, Zhiwei; Wu, Renhua

2016-01-01

Colorectal cancer (CRC) is a growing cause of mortality in developing countries, warranting investigation into its earlier detection for optimal disease management. A metabolomics based approach provides potential for noninvasive identification of biomarkers of colorectal carcinogenesis, as well as dissection of molecular pathways of pathophysiological conditions. Here, proton nuclear magnetic resonance spectroscopy (1HNMR) -based metabolomic approach was used to profile fecal metabolites of 68 CRC patients (stage I/II=20; stage III=25 and stage IV=23) and 32 healthy controls (HC). Pattern recognition through principal component analysis (PCA) and orthogonal partial least squares-discriminant analysis (OPLS-DA) was applied on 1H-NMR processed data for dimension reduction. OPLS-DA revealed that each stage of CRC could be clearly distinguished from HC based on their metabolomic profiles. Successive analyses identified distinct disturbances to fecal metabolites of CRC patients at various stages, compared with those in cancer free controls, including reduced levels of acetate, butyrate, propionate, glucose, glutamine, and elevated quantities of succinate, proline, alanine, dimethylglycine, valine, glutamate, leucine, isoleucine and lactate. These altered fecal metabolites potentially involved in the disruption of normal bacterial ecology, malabsorption of nutrients, increased glycolysis and glutaminolysis. Our findings revealed that the fecal metabolic profiles of healthy controls can be distinguished from CRC patients, even in the early stage (stage I/II), highlighting the potential utility of NMR-based fecal metabolomics fingerprinting as predictors of earlier diagnosis in CRC patients. PMID:27107423

Development of a Values Inventory for Grades 1 Through 3 in Five Ethnic Groups. Progress Report.

ERIC Educational Resources Information Center

Guilford, Joan S.

The bulk of the report was an outline of the steps taken to accomplish stated project tasks. These tasks included: (1) identifying the dimensions of value, which involved reviewing the literature and formulating a model based on Maslow's hierarchy of needs; (2) constructing the item pool, all of which were to be pictorial; (3) developing a test…

Value of antirabies vaccine with and without serum against severe challenges.

PubMed

VEERARAGHAVAN, N; SUBRAHMANYAN, T P

1960-01-01

Earlier studies with antirabies serum and vaccine have been extended to determine the value of serum, vaccine, or serum and vaccine combined against rabies challenges of increasing degrees of severity. While serum alone was not found to have any protective effect, vaccine alone was sufficient against mild challenges, the superiority of combined therapy with both serum and vaccine becoming evident at a challenge of about 50 LD(50). With challenges of over 300 LD(50) no treatment was of any value. It was also found that with a recommended optimum dose of serum, the usual vaccine dose could be halved-a matter of importance in countries with a high incidence of neuroparalytic accidents following administration of nervous tissue vaccine.

Addressing Cancer Drug Costs and Value

Cancer.gov

The President’s Cancer Panel has released its latest report, Promoting Value, Affordability, and Innovation in Cancer Drug Treatment. The report recommends six actions to maximize the value and affordability of cancer drug treatment.

Investigating the value of time and value of reliability for managed lanes.

DOT National Transportation Integrated Search

2015-12-01

This report presents a comprehensive study in Value of Time (VOT) and Value of Reliability (VOR) analysis in : the context of managed lane (ML) facilities. Combined Revealed Preference (RP) and Stated Preference (SP) : data were used to understand tr...

An Overview of Value, Perspective, and Decision Context-A Health Economics Approach: An ISPOR Special Task Force Report [2].

PubMed

Garrison, Louis P; Pauly, Mark V; Willke, Richard J; Neumann, Peter J

2018-02-01

The second section of our Special Task Force builds on the discussion of value and perspective in the previous article of the report by 1) defining a health economics approach to the concept of value in health care systems; 2) discussing the relationship of value to perspective and decision context, that is, how recently proposed value frameworks vary by the types of decisions being made and by the stakeholders involved; 3) describing the patient perspective on value because the patient is a key stakeholder, but one also wearing the hat of a health insurance purchaser; and 4) discussing how value is relevant in the market-based US system of mixed private and public insurance, and differs from its use in single-payer systems. The five recent value frameworks that motivated this report vary in the types of decisions they intend to inform, ranging from coverage, access, and pricing decisions to those defining appropriate clinical pathways and to supporting provider-clinician shared decision making. Each of these value frameworks must be evaluated in its own decision context for its own objectives. Existing guidelines for cost-effectiveness analysis emphasize the importance of clearly specifying the perspective from which the analysis is undertaken. Relevant perspectives may include, among others, 1) the health plan enrollee, 2) the patient, 3) the health plan manager, 4) the provider, 5) the technology manufacturer, 6) the specialty society, 7) government regulators, or 8) society as a whole. A valid and informative cost-effectiveness analysis could be conducted from the perspective of any of these stakeholders, depending on the decision context. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Rangeland ecosystem goods and services: Values and evaluation of opportunities for ranchers and land managers

Treesearch

Kristie Maczko; John A. Tanaka; Robert Breckenridge; Lori Hidinger; H. Theodore Heintz; William E. Fox; Urs P. Kreuter; Clifford S. Duke; John E. Mitchell; Daniel W. McCollum

2011-01-01

Although the US Department of Agriculture's 2005 public commitment to use market-based incentives for environmental stewardship and cooperative conservation focused land managers' attention on the concept of ecosystem goods and services (EGS), this was not a new idea. Much earlier in the 20th century, Aldo Leopold embraced the value of open space, calling for...

Onset of rigor mortis is earlier in red muscle than in white muscle.

PubMed

Kobayashi, M; Takatori, T; Nakajima, M; Sakurada, K; Hatanaka, K; Ikegaya, H; Matsuda, Y; Iwase, H

2000-01-01

Rigor mortis is thought to be related to falling ATP levels in muscles postmortem. We measured rigor mortis as tension determined isometrically in three rat leg muscles in liquid paraffin kept at 37 degrees C or 25 degrees C--two red muscles, red gastrocnemius (RG) and soleus (SO) and one white muscle, white gastrocnemius (WG). Onset, half and full rigor mortis occurred earlier in RG and SO than in WG both at 37 degrees C and at 25 degrees C even though RG and WG were portions of the same muscle. This suggests that rigor mortis directly reflects the postmortem intramuscular ATP level, which decreases more rapidly in red muscle than in white muscle after death. Rigor mortis was more retarded at 25 degrees C than at 37 degrees C in each type of muscle.

Clear cell variant of follicular thyroid carcinoma with normal thyroid-stimulating hormone value: a case report

PubMed Central

2014-01-01

Introduction Clear cell carcinomas of the thyroid gland with normal thyroid-stimulating hormone value are very rare, but clear cell changes are described in most reported cases of thyroidal lesions. Case presentation In this report, we describe the case of a 50-year-old Caucasian woman with a normal thyroid-stimulating hormone level who underwent surgery to treat a multi-nodular goiter. The pathology was a clear cell variant of follicular thyroid carcinoma. The tumor was 1cm in diameter and consisted of pure clear cells. Conclusion Clear cell variants of follicular thyroid carcinoma are rarely seen, especially it is misdiagnosed with metastatic renal cell carcinoma. In this report, we describe the case of a patient with a clear cell variant of follicular thyroid carcinoma with an interesting pathology. PMID:24884725

Earlier anal sexarche and co-occurring sexual risk are associated with current HIV-related risk behaviors among an online sample of men who have sex with men in Asia

PubMed Central

Cheung, Doug H.; Suharlim, Christian; Guadamuz, Thomas E.; Lim, Sin How; Koe, Stuart; Wei, Chongyi

2014-01-01

Studies of heterosexual populations across the globe and men who have sex with men (MSM) in a few developed countries showed that earlier sexual debut (sexarche) was associated with higher levels of co-occurring and subsequent HIV risk behaviors. We examined the relationships between earlier anal sexarche, unprotected earlier anal sexarche and current HIV risks among MSM from Asia. A cross-sectional online survey was conducted among MSM (N = 10,826) in Asia in 2010. Bivariate and multivariable logistic regressions were used to identify co-occurring (i.e., sexual experiences during sexarche) and current HIV-related risk factors (i.e., past six months) associated with earlier anal sexarche (before the age of 18) and unprotected earlier anal sexarche, respectively. Earlier anal sexarche was significantly associated with lack of condom use, being anal receptive or both receptive and insertive, and having a partner who were older during sexarche. It was also associated with current HIV-related risk behaviors including having multiple male sexual partners, having been paid for sex, and increased frequencies of recreational drug use. Unprotected earlier anal sexarche was significantly associated with inconsistent condom use in the past the six months. Improved and culturally sensitive sex education at schools should be included in national and regional HIV/AIDS prevention programming and policies in Asia. Such sex education programs should incorporate curriculum that address sexuality, sexual orientation, and sexual behaviors beyond those related to reproductive health. PMID:24920344

Earlier anal sexarche and co-occurring sexual risk are associated with current HIV-related risk behaviors among an online sample of men who have sex with men in Asia.

PubMed

Cheung, Doug H; Suharlim, Christian; Guadamuz, Thomas E; Lim, Sin How; Koe, Stuart; Wei, Chongyi

2014-12-01

Studies of heterosexual populations across the globe and men who have sex with men (MSM) in a few developed countries showed that earlier sexual debut (sexarche) was associated with higher levels of co-occurring and subsequent HIV risk behaviors. We examined the relationships between earlier anal sexarche, unprotected earlier anal sexarche and current HIV risks among MSM from Asia. A cross-sectional online survey was conducted among MSM (N = 10,826) in Asia in 2010. Bivariate and multivariable logistic regressions were used to identify co-occurring (i.e., sexual experiences during sexarche) and current HIV-related risk factors (i.e., past 6 months) associated with earlier anal sexarche (before the age of 18) and unprotected earlier anal sexarche, respectively. Earlier anal sexarche was significantly associated with lack of condom use, being anal receptive or both receptive and insertive, and having a partner who were older during sexarche. It was also associated with current HIV-related risk behaviors including having multiple male sexual partners, having been paid for sex, and increased frequencies of recreational drug use. Unprotected earlier anal sexarche was significantly associated with inconsistent condom use in the past the 6 months. Improved and culturally sensitive sex education at schools should be included in national and regional HIV/AIDS prevention programming and policies in Asia. Such sex education programs should incorporate curriculum that address sexuality, sexual orientation, and sexual behaviors beyond those related to reproductive health.

Trainees May Add Value to Patient Care by Decreasing Addendum Utilization in Radiology Reports.

PubMed

Balthazar, Patricia; Konstantopoulos, Christina; Wick, Carson A; DeSimone, Ariadne K; Tridandapani, Srini; Simoneaux, Stephen; Applegate, Kimberly E

2017-11-01

The purpose of this study was to evaluate the impact of trainee involvement and other factors on addendum rates in radiology reports. This retrospective study was performed in a tertiary care pediatric hospital. From the institutional radiology data repository, we extracted all radiology reports from January 1 to June 30, 2016, as well as trainee (resident or fellow) involvement, imaging modality, patient setting (emergency, inpatient, or outpatient), order status (routine vs immediate), time of interpretation (regular work hours vs off-hours), radiologist's years of experience, and sex. We grouped imaging modalities as advanced (CT, MRI, and PET) or nonadvanced (any modality that was not CT, MRI, or PET) and radiologist experience level as ≤ 20 years or > 20 years. Our outcome measure was the rate of addenda in radiology reports. Statistical analysis was performed using multivariate logistic regression. From 129,033 reports finalized during the study period, 418 (0.3%) had addenda. Reports generated without trainees were 12 times more likely than reports with trainee involvement to have addenda (odds ratio [OR] = 12.2, p < 0.001). Advanced imaging studies were more likely than nonadvanced studies to be associated with addendum use (OR = 4.7, p < 0.001). Reports generated for patients in emergency or outpatient settings had a slightly higher likelihood of addendum use than those in an inpatient setting (OR = 1.5, p = 0.04; and OR = 1.3, p = 0.04, respectively). Routine orders had a slightly higher likelihood of addendum use compared with immediate orders (OR = 1.3, p = 0.01). We found no difference in addendum use by radiologist's sex, radiologist's years of experience, emergency versus outpatient setting, or time of interpretation. Trainees may add value to patient care by decreasing addendum rates in radiology reports.

Age of diagnosis of breast cancer in china: almost 10 years earlier than in the United States and the European union.

PubMed

Song, Qing-Kun; Li, Jing; Huang, Rong; Fan, Jin-Hu; Zheng, Rong-Shou; Zhang, Bao-Ning; Zhang, Bin; Tang, Zhong-Hua; Xie, Xiao-Ming; Yang, Hong-Jian; He, Jian-Jun; Li, Hui; Li, Jia-Yuan; Qiao, You-Lin; Chen, Wan-Qing

2014-01-01

The study aimed to describe the age distribution of breast cancer diagnosis among Chinese females for comparison with the United States and the European Union, and provide evidence for the screening target population in China. Median age was estimated from hospital databases from 7 tertiary hospitals in China. Population-based data in China, United States and European Union was extracted from the National Central Cancer Registry, SEER program and GLOBOCAN 2008, respectively. Age-standardized distribution of breast cancer at diagnosis in the 3 areas was estimated based on the World Standard Population 2000. The median age of breast cancer at diagnosis was around 50 in China, nearly 10 years earlier than United States and European Union. The diagnosis age in China did not vary between subgroups of calendar year, region and pathological characteristics. With adjustment for population structure, median age of breast cancer at diagnosis was 50~54 in China, but 55~59 in United States and European Union. The median diagnosis age of female breast cancer is much earlier in China than in the United States and the European Union pointing to racial differences in genetics and lifestyle. Screening programs should start at an earlier age for Chinese women and age disparities between Chinese and Western women warrant further studies.

Decreased length of stay and earlier oral feeding associated with standardized postoperative clinical care for total gastrectomies at a cancer center.

PubMed

Selby, Luke V; Rifkin, Marissa B; Yoon, Sam S; Ariyan, Charlotte E; Strong, Vivian E

2016-09-01

Standardization of postoperative care has been shown to decrease postoperative length of stay. In June 2009, we standardized postoperative care for all gastrectomies at our institution. Four years' worth of total gastrectomies (2 years prior to standardization and 2 years after standardization) were reviewed to determine the effect of standardization on postoperative care, length of stay, complications, and readmissions. Between June 2007 and July 2011, 99 patients underwent curative intent open total gastrectomy: 51 patients prior to standardization, and 48 patients poststandardization. Patients were predominantly male (70%); median age was 63; and median body mass index was 26. Standardization of postoperative care was associated with a decrease in median time to beginning both clear liquids and a postgastrectomy diet, earlier removal of epidural catheters, earlier use of oral pain medication, less time receiving intravenous fluids, and decreased length of stay (all P < .01). Groups showed no differences in complication rates, complication severity, diet intolerance, return to our Urgent Care Center, or readmission. Institution of standardized postoperative orders for total gastrectomy was associated with a significantly decreased length of stay and earlier oral feeding without increasing postoperative complications, early postoperative outpatient visits, or readmissions. Copyright © 2016 Elsevier Inc. All rights reserved.

The value of case reports in human teratology.

PubMed

Goldberg, J D; Golbus, M S

1986-03-01

Birth defects caused by human teratogens are an important and potentially preventable cause of perinatal morbidity and mortality. Case reports provide an initial suggestion that a specific agent may be a human teratogen and provide the basis for further study. This review discusses the importance of case reports in human teratology and provides guidance in evaluating new case reports.

Understanding Place Value

ERIC Educational Resources Information Center

Cooper, Linda L.; Tomayko, Ming C.

2011-01-01

Developing an understanding of place value and the base-ten number system is considered a fundamental goal of the early primary grades. For years, teachers have anecdotally reported that students struggle with place-value concepts. Among the common errors cited are misreading such numbers as 26 and 62 by seeing them as identical in meaning,…

Measuring and predicting Delta(vap)H298 values of ionic liquids.

PubMed

Deyko, Alexey; Lovelock, Kevin R J; Corfield, Jo-Anne; Taylor, Alasdair W; Gooden, Peter N; Villar-Garcia, Ignacio J; Licence, Peter; Jones, Robert G; Krasovskiy, Vladimir G; Chernikova, Elena A; Kustov, Leonid M

2009-10-14

We report the enthalpies of vaporisation (measured using temperature programmed desorption by mass spectrometry) of twelve ionic liquids (ILs), covering four imidazolium, [C(m)C(n)Im]+, five pyrrolidinium, [C(n)C(m)Pyrr]+, two pyridinium, [C(n)Py]+, and a dication, [C3(C1Im)2]2+ based IL. These cations were paired with a range of anions: [BF4]-, [FeCl4]-, [N(CN)2]-, [PF3(C2F5)3]- ([FAP]-), [(CF3SO2)2N]- ([Tf2N]-) and [SCN]-. Using these results, plus those for a further eight imidazolium based ILs published earlier (which include the anions [CF3SO3]- ([TfO]-), [PF6]- and [EtSO4]-), we show that the enthalpies of vaporisation can be decomposed into three components. The first component is the Coulombic interaction between the ions, DeltaU(Cou,R), which is a function of the IL molar volume, V(m), and a parameter R(r) which quantifies the relative change in anion-cation distance on evaporation from the liquid phase to the ion pair in the gas phase. The second and third components are the van der Waals contributions from the anion, DeltaH(vdw,A), and the cation, DeltaH(vdw,C). We derive a universal value for R(r), and individual values of DeltaH(vdw,A) and DeltaH(vdw,C) for each of the anions and cations considered in this study. Given the molar volume, it is possible to estimate the enthalpies of vaporisation of ILs composed of any combination of the ions considered here; values for fourteen ILs which have not yet been studied experimentally are given.

Gender influencers on work values of black adolescents.

PubMed

Thomas, V G; Shields, L C

1987-01-01

Work values and key influencers of a sample of black male and female adolescents were examined. Results indicated that boys and girls valued both the intrinsic and extrinsic rewards of work; however, girls reported slighter stronger extrinsic values than did boys. In addition, the sexes reported differences in the importance of specific work values such as "making lots of money," and "doing important things." When naming a key influencer, respondents tended to cite a same-sex and race individual. Sex of one's key influencer was related to certain work values, with subjects reporting a male key influencer valuing "trying out one's own ideas" and "having a secure future" more than those reporting a female key influencer. The interaction of sex of subject and sex of key influencer was significant on one of the work value outcomes. Implications of these findings are considered.

Numerical analysis of the asymptotic two-point boundary value solution for N-body trajectories.

NASA Technical Reports Server (NTRS)

Lancaster, J. E.; Allemann, R. A.

1972-01-01

Previously published asymptotic solutions for lunar and interplanetary trajectories have been modified and combined to formulate a general analytical boundary value solution applicable to a broad class of trajectory problems. In addition, the earlier first-order solutions have been extended to second-order to determine if improved accuracy is possible. Comparisons between the asymptotic solution and numerical integration for several lunar and interplanetary trajectories show that the asymptotic solution is generally quite accurate. Also, since no iterations are required, a solution to the boundary value problem is obtained in a fraction of the time required for numerically integrated solutions.

Value of antirabies vaccine with and without serum against severe challenges

PubMed Central

Veeraraghavan, N.; Subrahmanyan, T. P.

1960-01-01

Earlier studies with antirabies serum and vaccine have been extended to determine the value of serum, vaccine, or serum and vaccine combined against rabies challenges of increasing degrees of severity. While serum alone was not found to have any protective effect, vaccine alone was sufficient against mild challenges, the superiority of combined therapy with both serum and vaccine becoming evident at a challenge of about 50 LD50. With challenges of over 300 LD50 no treatment was of any value. It was also found that with a recommended optimum dose of serum, the usual vaccine dose could be halved—a matter of importance in countries with a high incidence of neuroparalytic accidents following administration of nervous tissue vaccine. PMID:13841546

A reformulation of the Cost Plus Net Value Change (C+NVC) model of wildfire economics

Treesearch

Geoffrey H. Donovan; Douglas B. Rideout

2003-01-01

The Cost plus Net Value Change (C+NVC) model provides the theoretical foundation for wildland fire economics and provides the basis for the National Fire Management Analysis System (NFMAS). The C+NVC model is based on the earlier least Cost plus Loss model (LC+L) expressed by Sparhawk (1925). Mathematical and graphical analysis of the LC+L model illustrates two errors...

Electrostatic potential calculation for biomolecules--creating a database of pre-calculated values reported on a per residue basis for all PDB protein structures.

PubMed

Rocchia, W; Neshich, G

2007-10-05

STING and Java Protein Dossier provide a collection of physical-chemical parameters, describing protein structure, stability, function, and interaction, considered one of the most comprehensive among the available protein databases of similar type. Particular attention in STING is paid to the electrostatic potential. It makes use of DelPhi, a well-known tool that calculates this physical-chemical quantity for biomolecules by solving the Poisson Boltzmann equation. In this paper, we describe a modification to the DelPhi program aimed at integrating it within the STING environment. We also outline how the "amino acid electrostatic potential" and the "surface amino acid electrostatic potential" are calculated (over all Protein Data Bank (PDB) content) and how the corresponding values are made searchable in STING_DB. In addition, we show that the STING and Java Protein Dossier are also capable of providing these particular parameter values for the analysis of protein structures modeled in computers or being experimentally solved, but not yet deposited in the PDB. Furthermore, we compare the calculated electrostatic potential values obtained by using the earlier version of DelPhi and those by STING, for the biologically relevant case of lysozyme-antibody interaction. Finally, we describe the STING capacity to make queries (at both residue and atomic levels) across the whole PDB, by looking at a specific case where the electrostatic potential parameter plays a crucial role in terms of a particular protein function, such as ligand binding. BlueStar STING is available at http://www.cbi.cnptia.embrapa.br.

Accessing Real-Life Episodic Information from Minutes versus Hours Earlier Modulates Hippocampal and High-Order Cortical Dynamics

PubMed Central

Chen, J.; Honey, C. J.; Simony, E.; Arcaro, M. J.; Norman, K. A.; Hasson, U.

2016-01-01

It is well known that formation of new episodic memories depends on hippocampus, but in real-life settings (e.g., conversation), hippocampal amnesics can utilize information from several minutes earlier. What neural systems outside hippocampus might support this minutes-long retention? In this study, subjects viewed an audiovisual movie continuously for 25 min; another group viewed the movie in 2 parts separated by a 1-day delay. Understanding Part 2 depended on retrieving information from Part 1, and thus hippocampus was required in the day-delay condition. But is hippocampus equally recruited to access the same information from minutes earlier? We show that accessing memories from a few minutes prior elicited less interaction between hippocampus and default mode network (DMN) cortical regions than accessing day-old memories of identical events, suggesting that recent information was available with less reliance on hippocampal retrieval. Moreover, the 2 groups evinced reliable but distinct DMN activity timecourses, reflecting differences in information carried in these regions when Part 1 was recent versus distant. The timecourses converged after 4 min, suggesting a time frame over which the continuous-viewing group may have relied less on hippocampal retrieval. We propose that cortical default mode regions can intrinsically retain real-life episodic information for several minutes. PMID:26240179

Inference of equatorial field-line-integrated electron density values using whistlers

NASA Technical Reports Server (NTRS)

Anderson, D. N.; Kintner, P. M.; Kelley, M. C.

1985-01-01

The nighttime electron density integrated along a magnetic field line at very small L-values (about 1.06) is inferred by comparing whistler dispersions, measured from a sounding rocket, with model ionospheric calculations. At a local time of 0500 LT, the electron density in the F-layer valley was found to be about 1000 per cu cm. It is suggested that this technique can be applied to earlier times in the local evening to determine ionospheric conditions which benefit the growth of low-latitude plasma instabilities.

Deformation strain is the main physical driver for skeletal precursors to undergo osteogenesis in earlier stages of osteogenic cell maturation.

PubMed

Ramani-Mohan, Ram-Kumar; Schwedhelm, Ivo; Finne-Wistrand, Anna; Krug, Melanie; Schwarz, Thomas; Jakob, Franz; Walles, Heike; Hansmann, Jan

2018-03-01

Mesenchymal stem cells play a major role during bone remodelling and are thus of high interest for tissue engineering and regenerative medicine applications. Mechanical stimuli, that is, deformation strain and interstitial fluid-flow-induced shear stress, promote osteogenic lineage commitment. However, the predominant physical stimulus that drives early osteogenic cell maturation is not clearly identified. The evaluation of each stimulus is challenging, as deformation and fluid-flow-induced shear stress interdepend. In this study, we developed a bioreactor that was used to culture mesenchymal stem cells harbouring a strain-responsive AP-1 luciferase reporter construct, on porous scaffolds. In addition to the reporter, mineralization and vitality of the cells was investigated by alizarin red staining and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide. Quantification of the expression of genes associated to bone regeneration and bone remodelling was used to confirm alizarin red measurements. Controlled perfusion and deformation of the 3-dimensional scaffold facilitated the alteration of the expression of osteogenic markers, luciferase activity, and calcification. To isolate the specific impact of scaffold deformation, a computational model was developed to derive a perfusion flow profile that results in dynamic shear stress conditions present in periodically loaded scaffolds. In comparison to actually deformed scaffolds, a lower expression of all measured readout parameters indicated that deformation strain is the predominant stimulus for skeletal precursors to undergo osteogenesis in earlier stages of osteogenic cell maturation. Copyright © 2017 John Wiley & Sons, Ltd.

Defining Value in Cancer Care: AVBCC 2013 Steering Committee Report

PubMed Central

Zweigenhaft, Burt; Bosserman, Linda; Kenney, James T.; Lawless, Grant D.; Marsland, Thomas A.; Deligdish, Craig K.; Burgoyne, Douglas S.; Knopf, Kevin B.; Long, Douglas M.; McKercher, Patrick; Owens, Gary M.; Hennessy, John E.; Lang, James R.; Malin, Jennifer; Natelson, Leonard; Palmgren, Matthew C.; Slotnik, Jayson; Shockney, Lillie D.; Vogenberg, F. Randy

2013-01-01

The AVBCC Annual Meeting experiences exponential growth in attendance and participation as oncologists, payers, employers, managed care executives, patient advocates, and drug manufacturers convened in Hollywood, FL, on May 2–5, 2013, for the Third Annual Conference of the Association for Value-Based Cancer Care (AVBCC). The conference presented an all-inclusive open forum for stakeholder dialogue and integration across the cancer care continuum, facilitating an open dialogue among the various healthcare stakeholders to align their perspectives around the urgent need to address value in cancer care, costs, patient education, safety, outcomes, and quality. The AVBCC 2013 Steering Committee was held on the first day of the conference to define value in cancer care. The committee was divided into 7 groups, each representing a key stakeholder in oncology. The goal of the Steering Committee was to define value from the particular point of view of each of the stakeholder groups and to suggest how that particular perspective can contribute to the value proposition in oncology, by balancing cost, quality, and access to care to improve overall patient outcomes. The following summary highlights the major points addressed by each group. PMID:24991360

Defining Value in Cancer Care: AVBCC 2013 Steering Committee Report.

PubMed

Zweigenhaft, Burt; Bosserman, Linda; Kenney, James T; Lawless, Grant D; Marsland, Thomas A; Deligdish, Craig K; Burgoyne, Douglas S; Knopf, Kevin B; Long, Douglas M; McKercher, Patrick; Owens, Gary M; Hennessy, John E; Lang, James R; Malin, Jennifer; Natelson, Leonard; Palmgren, Matthew C; Slotnik, Jayson; Shockney, Lillie D; Vogenberg, F Randy

2013-07-01

The AVBCC Annual Meeting experiences exponential growth in attendance and participation as oncologists, payers, employers, managed care executives, patient advocates, and drug manufacturers convened in Hollywood, FL, on May 2-5, 2013, for the Third Annual Conference of the Association for Value-Based Cancer Care (AVBCC). The conference presented an all-inclusive open forum for stakeholder dialogue and integration across the cancer care continuum, facilitating an open dialogue among the various healthcare stakeholders to align their perspectives around the urgent need to address value in cancer care, costs, patient education, safety, outcomes, and quality. The AVBCC 2013 Steering Committee was held on the first day of the conference to define value in cancer care. The committee was divided into 7 groups, each representing a key stakeholder in oncology. The goal of the Steering Committee was to define value from the particular point of view of each of the stakeholder groups and to suggest how that particular perspective can contribute to the value proposition in oncology, by balancing cost, quality, and access to care to improve overall patient outcomes. The following summary highlights the major points addressed by each group.

The composition, heating value and renewable share of the energy content of mixed municipal solid waste in Finland.

PubMed

Horttanainen, M; Teirasvuo, N; Kapustina, V; Hupponen, M; Luoranen, M

2013-12-01

For the estimation of greenhouse gas emissions from waste incineration it is essential to know the share of the renewable energy content of the combusted waste. The composition and heating value information is generally available, but the renewable energy share or heating values of different fractions of waste have rarely been determined. In this study, data from Finnish studies concerning the composition and energy content of mixed MSW were collected, new experimental data on the compositions, heating values and renewable share of energy were presented and the results were compared to the estimations concluded from earlier international studies. In the town of Lappeenranta in south-eastern Finland, the share of renewable energy ranged between 25% and 34% in the energy content tests implemented for two sample trucks. The heating values of the waste and fractions of plastic waste were high in the samples compared to the earlier studies in Finland. These high values were caused by good source separation and led to a low share of renewable energy content in the waste. The results showed that in mixed municipal solid waste the renewable share of the energy content can be significantly lower than the general assumptions (50-60%) when the source separation of organic waste, paper and cardboard is carried out successfully. The number of samples was however small for making extensive conclusions on the results concerning the heating values and renewable share of energy and additional research is needed for this purpose. Copyright © 2013 Elsevier Ltd. All rights reserved.

U.S. Dental School Deans' Views on the Value of Patient-Reported Outcome Measures in Dentistry.

PubMed

Rosen, Evan B; Donoff, R Bruce; Riedy, Christine A

2016-06-01

There has historically been limited development and utilization of patient-reported outcome measures (PROMs) in clinical dentistry. However, in recent years PROMs have been recognized by other health care fields as valuable in the comprehensive assessment of patient outcomes. The aim of this study was to survey deans of U.S. dental schools to better understand their vision for the role of PROMs in the field of dentistry. A 13-question online survey was emailed to the deans of the 64 accredited U.S. dental schools at the time to gather their opinions about the value of patient-reported outcomes in dentistry. The survey consisted of questions in 12 domains such as treatment planning, perceived success/complications of surgery, identification/management of dental pain, psychological and oral function, and insurance payment/reimbursement. Of the 64 deans, 33 responses were received (51.5% response rate), but three surveys were excluded due to incomplete answers, resulting in a final response rate of 46.8%. All respondents reported there was value in utilization of PROMs for understanding a patient's satisfaction of a procedure, a patient's perceived success of dental surgery, identifying dental pain, and managing dental pain. However, there was disagreement among the respondents about utilization of PROMs for the purpose of determining insurance payment and/or reimbursement. Additional steps should be taken to develop clinically appropriate PROMs for dentistry and to determine the appropriate situations in which to use dental PROMs. This study suggests that PROMs should be incorporated into dental school curricula as they will likely play a role in future comprehensive treatment assessment.

Radiology's value chain.

PubMed

Enzmann, Dieter R

2012-04-01

A diagnostic radiology value chain is constructed to define its main components, all of which are vulnerable to change, because digitization has caused disaggregation of the chain. Some components afford opportunities to improve productivity, some add value, while some face outsourcing to lower labor cost and to information technology substitutes, raising commoditization risks. Digital image information, because it can be competitive at smaller economies of scale, allows faster, differential rates of technological innovation of components, initiating a centralization-to-decentralization technology trend. Digitization, having triggered disaggregation of radiology's professional service model, may soon usher in an information business model. This means moving from a mind-set of "reading images" to an orientation of creating and organizing information for greater accuracy, faster speed, and lower cost in medical decision making. Information businesses view value chain investments differently than do small professional services. In the former model, producing a better business product will extend image interpretation beyond a radiologist's personal fund of knowledge to encompass expanding external imaging databases. A follow-on expansion with integration of image and molecular information into a report will offer new value in medical decision making. Improved interpretation plus new integration will enrich and diversify radiology's key service products, the report and consultation. A more robust, information-rich report derived from a "systems" and "computational" radiology approach will be facilitated by a transition from a professional service to an information business. Under health care reform, radiology will transition its emphasis from volume to greater value. Radiology's future brightens with the adoption of a philosophy of offering information rather than "reads" for decision making. Staunchly defending the status quo via turf wars is unlikely to constitute a

Informative value of Patient Reported Outcomes (PRO) in Health Technology Assessment (HTA).

PubMed

Brettschneider, Christian; Lühmann, Dagmar; Raspe, Heiner

2011-02-02

"Patient-Reported Outcome" (PRO) is used as an umbrella term for different concepts for measuring subjectively perceived health status e. g. as treatment effects. Their common characteristic is, that the appraisal of the health status is reported by the patient himself. In order to describe the informative value of PRO in Health Technology Assessment (HTA) first an overview of concepts, classifications and methods of measurement is given. The overview is complemented by an empirical analysis of clinical trials and HTA-reports on rheumatoid arthritis and breast cancer in order to report on type, frequency and consequences of PRO used in these documents. For both issues systematic reviews of the literature have been performed. The search for methodological literature covers the publication period from 1990 to 2009, the search for clinical trials of rheumatoid arthritis and breast cancer covers the period 2005 to 2009. Both searches were performed in the medical databases of the German Institute of Medical Documentation and Information (DIMDI). The search for HTA-reports and methodological papers of HTA-agencies was performed in the CRD-Databases (CRD = Centre for Reviews and Dissemination) and by handsearching the websites of INAHTA member agencies (INAHTA = International Network of Agencies for Health Technology Assessment). For all issues specific inclusion and exclusion criteria were defined. The methodological quality of randomized controlled trials (RCT) was assessed by a modified version of the Cochrane Risk of Bias Tool. For the methodological part information extraction from the literature is structured by the report's chapters, for the empirical part data extraction sheets were constructed. All information is summarized in a qualitative manner. Concerning the methodological issues the literature search retrieved 158 documents (87 documents related to definition or classification, 125 documents related to operationalisation of PRO). For the empirical analyses

Existence Values for Groundwater (1989)

EPA Pesticide Factsheets

This study reports the findings of a preliminary investigation into the existence (nonuse) values people hold for groundwater resources and how these values can be measured for use in benefit/cost analysis.

Defining Value in Cancer Care: AVBCC 2012 Steering Committee Report

PubMed Central

Beed, Gene; Owens, Gary M.; Benson, Al B.; Klein, Ira M.; Silver, Samuel M.; Beveridge, Roy A.; Malin, Jennifer; Sprandio, John D.; Deligdish, Craig K.; Mitchell, Matthew; Vogenberg, F. Randy; Fox, John; Newcomer, Lee N.

2012-01-01

Approximately 200 oncologists, payers, employers, managed care executives, pharmacy benefit managers, and other healthcare stakeholders convened in Houston, TX, on March 28–31, 2012, for the Second Annual Conference of the Association for Value-Based Cancer Care (AVBCC). The mission of the conference was to align the various perspectives around the growing need of defining value in cancer care and developing strategies to enhance patient outcomes. The AVBCC conference presented a forum for the various viewpoints from all the stakeholders across the cancer care continuum, featuring more than 20 sessions and symposia led by nearly 30 oncology leaders. The discussions focused on current trends and challenges in optimizing value in oncology by reducing or controlling cost while improving care quality and patient outcomes, introducing emerging approaches to management and tools that providers and payers are using to enhance cancer care collaboratively. The AVBCC Second Annual Conference was opened by a Steering Committee discussion of 11 panel members who attempted to define value in cancer care and articulated action steps that can help to implement value into cancer care delivery. The following summary represents highlights from the Steering Committee discussion, which was moderated by Gene Beed, MD, and Gary M. Owens, MD. PMID:24991320

Defining Value in Cancer Care: AVBCC 2012 Steering Committee Report.

PubMed

Beed, Gene; Owens, Gary M; Benson, Al B; Klein, Ira M; Silver, Samuel M; Beveridge, Roy A; Malin, Jennifer; Sprandio, John D; Deligdish, Craig K; Mitchell, Matthew; Vogenberg, F Randy; Fox, John; Newcomer, Lee N

2012-07-01

Approximately 200 oncologists, payers, employers, managed care executives, pharmacy benefit managers, and other healthcare stakeholders convened in Houston, TX, on March 28-31, 2012, for the Second Annual Conference of the Association for Value-Based Cancer Care (AVBCC). The mission of the conference was to align the various perspectives around the growing need of defining value in cancer care and developing strategies to enhance patient outcomes. The AVBCC conference presented a forum for the various viewpoints from all the stakeholders across the cancer care continuum, featuring more than 20 sessions and symposia led by nearly 30 oncology leaders. The discussions focused on current trends and challenges in optimizing value in oncology by reducing or controlling cost while improving care quality and patient outcomes, introducing emerging approaches to management and tools that providers and payers are using to enhance cancer care collaboratively. The AVBCC Second Annual Conference was opened by a Steering Committee discussion of 11 panel members who attempted to define value in cancer care and articulated action steps that can help to implement value into cancer care delivery. The following summary represents highlights from the Steering Committee discussion, which was moderated by Gene Beed, MD, and Gary M. Owens, MD.

Effects of earlier sea ice breakup on survival and population size of polar bears in western Hudson Bay

USGS Publications Warehouse

Regehr, E.V.; Lunn, N.J.; Amstrup, Steven C.; Stirling, I.

2007-01-01

Some of the most pronounced ecological responses to climatic warming are expected to occur in polar marine regions, where temperature increases have been the greatest and sea ice provides a sensitive mechanism by which climatic conditions affect sympagic (i.e., with ice) species. Population-level effects of climatic change, however, remain difficult to quantify. We used a flexible extension of Cormack-Jolly-Seber capture-recapture models to estimate population size and survival for polar bears (Ursus maritimus), one of the most ice-dependent of Arctic marine mammals. We analyzed data for polar bears captured from 1984 to 2004 along the western coast of Hudson Bay and in the community of Churchill, Manitoba, Canada. The Western Hudson Bay polar bear population declined from 1,194 (95% CI = 1,020-1,368) in 1987 to 935 (95% CI = 794-1,076) in 2004. Total apparent survival of prime-adult polar bears (5-19 yr) was stable for females (0.93; 95% CI = 0.91-0.94) and males (0.90; 95% CI = 0.88-0.91). Survival of juvenile, subadult, and senescent-adult polar bears was correlated with spring sea ice breakup date, which was variable among years and occurred approximately 3 weeks earlier in 2004 than in 1984. We propose that this correlation provides evidence for a causal association between earlier sea ice breakup (due to climatic warming) and decreased polar bear survival. It may also explain why Churchill, like other communities along the western coast of Hudson Bay, has experienced an increase in human-polar bear interactions in recent years. Earlier sea ice breakup may have resulted in a larger number of nutritionally stressed polar bears, which are encroaching on human habitations in search of supplemental food. Because western Hudson Bay is near the southern limit of the species' range, our findings may foreshadow the demographic responses and management challenges that more northerly polar bear populations will experience if climatic warming in the Arctic continues as

M-Mode Ultrasound Reveals Earlier Gluteus Minimus Activity in Individuals With Chronic Hip Pain During a Step-down Task.

PubMed

Dieterich, Angela V; Deshon, Louise; Strauss, Geoffrey R; McKay, Jan; Pickard, Christine M

2016-04-01

Controlled laboratory study. The hip abductor muscles are important hip joint stabilizers. Hip joint pain may alter muscle recruitment. Motion-mode (M-mode) ultrasound enables noninvasive measurements of the onset of deep and superficial muscle motion, which is associated with activation onset. To compare (1) the onset of superficial and deep gluteus medius and gluteus minimus muscle motion relative to the instant of peak ground reaction force and (2) the level of swing-phase muscle motion during step-down between subjects with chronic hip pain and controls using M-mode ultrasound. Thirty-five subjects with anterior, nontraumatic hip pain for more than 6 months (mean ± SD age, 54 ± 9 years) and 35 controls (age, 57 ± 7 years) were scanned on the lateral hip of the leading leg during frontal step-down onto a force platform using M-mode ultrasound. Computerized motion detection with the Teager-Kaiser energy operator was applied on the gluteus minimus and the deep and superficial gluteus medius to determine the time lag between muscle motion onset and instant of peak ground reaction force and the level of gluteus minimus motion during the swing phase. Time lags and motion levels were averaged per subject, and t tests were used to determine between-group differences. In participants with hip pain, gluteus minimus motion onset was 103 milliseconds earlier (P = .002) and superficial gluteus medius motion was 70 milliseconds earlier (P = .047) than those in healthy control participants. The level of gluteus minimus swing-phase motion was higher with pain (P = .006). Increased gluteus minimus motion during the swing phase and earlier gluteus minimus and superficial gluteus medius motion in individuals with hip pain suggest an overall increase of muscle activity, possibly a protective behavior.

Entrepreneurship Education at School in Europe. Eurydice Report

ERIC Educational Resources Information Center

Bourgeois, Ania; Balcon, Marie-Pascale; Riiheläinen, Jari Matti

2016-01-01

Entrepreneurship education is essential not only to shape the mind-sets of young people but also to provide the skills, knowledge and attitudes that are central to developing an entrepreneurial culture. This report captures all the latest developments in this regard in European countries, following earlier Eurydice reports (2006, 2012). It covers…

Transcriptional analysis of micronutrient zinc-associated response for enhanced carbohydrate utilization and earlier solventogenesis in Clostridium acetobutylicum.

PubMed

Wu, You-Duo; Xue, Chuang; Chen, Li-Jie; Wan, Hui-Hui; Bai, Feng-Wu

2015-11-20

The micronutrient zinc plays vital roles in ABE fermentation by Clostridium acetobutylicum. In order to elucidate the zinc-associated response for enhanced glucose utilization and earlier solventogenesis, transcriptional analysis was performed on cells grown in glucose medium at the exponential growth phase of 16 h without/with supplementary zinc. Correspondingly, the gene glcG (CAC0570) encoding a glucose-specific PTS was significantly upregulated accompanied with the other two genes CAC1353 and CAC1354 for glucose transport in the presence of zinc. Additionally, genes involved in the metabolisms of six other carbohydrates (maltose, cellobiose, fructose, mannose, xylose and arabinose) were differentially expressed, indicating that the regulatory effect of micronutrient zinc is carbohydrate-specific with respects to the improved/inhibited carbohydrate utilization. More importantly, multiple genes responsible for glycolysis (glcK and pykA), acidogenesis (thlA, crt, etfA, etfB and bcd) and solventogenesis (ctfB and bdhA) of C. acetobutylicum prominently responded to the supplementary zinc at differential expression levels. Comparative analysis of intracellular metabolites revealed that the branch node intermediates such as acetyl-CoA, acetoacetyl-CoA, butyl-CoA, and reducing power NADH remained relatively lower whereas more ATP was generated due to enhanced glycolysis pathway and earlier initiation of solventogenesis, suggesting that the micronutrient zinc-associated response for the selected intracellular metabolisms is significantly pleiotropic.

The utility of a Personal Values Report for medical decision-making.

PubMed

Henderson, W; Corke, C

2015-09-01

Our aim was to determine if a patient's Personal Values Report (PVR) has a positive impact on a doctor's decisions regarding treatment. We conducted a prospective cohort study delivering a short, web-based hypothetical case-centred questionnaire to intensive care doctors practising in Australia and New Zealand. One hundred and twenty-four intensive care consultants and registrars agreed to participate in an online questionnaire in two routine mailings between November 2013 and February 2014. We evaluated the effect of a PVR on clinical decision-making in a case-based scenario. In addition, participants rated the utility of the PVR on their decision-making process. Participants were presented with a difficult scenario in a frail elderly man where death was almost inevitable without aggressive support but survival with severe disability was possible with significant intervention. Most doctors (52.4%) elected to continue ventilation and admit to ICU. After the PVR was made available, only 8.1% of doctors continued to choose to admit the patient to the ICU. In all cases where admission to the ICU was chosen after seeing the PVR, the admission to the ICU was stated to be to permit family to arrive before withdrawing support (an approach which was consistent with the values stated in the PVR). One hundred and twenty-one of the 124 participants (97.6%) agreed or strongly agreed that the PVR helped them get an understanding of the patient's wishes, whereas none of the participants (0%) were unsure, disagreed or strongly disagreed with this statement. The remaining 2.4% did not answer the question. It is surmised that PVRs pre-written by patients are potentially an effective and valuable tool for use in helping doctors make decisions regarding patient care.

Informative value of Patient Reported Outcomes (PRO) in Health Technology Assessment (HTA)

PubMed Central

Brettschneider, Christian; Lühmann, Dagmar; Raspe, Heiner

2011-01-01

Background “Patient-Reported Outcome” (PRO) is used as an umbrella term for different concepts for measuring subjectively perceived health status e. g. as treatment effects. Their common characteristic is, that the appraisal of the health status is reported by the patient himself. In order to describe the informative value of PRO in Health Technology Assessment (HTA) first an overview of concepts, classifications and methods of measurement is given. The overview is complemented by an empirical analysis of clinical trials and HTA-reports on rheumatoid arthritis and breast cancer in order to report on type, frequency and consequences of PRO used in these documents. Methods For both issues systematic reviews of the literature have been performed. The search for methodological literature covers the publication period from 1990 to 2009, the search for clinical trials of rheumatoid arthritis and breast cancer covers the period 2005 to 2009. Both searches were performed in the medical databases of the German Institute of Medical Documentation and Information (DIMDI). The search for HTA-reports and methodological papers of HTA-agencies was performed in the CRD-Databases (CRD = Centre for Reviews and Dissemination) and by handsearching the websites of INAHTA member agencies (INAHTA = International Network of Agencies for Health Technology Assessment). For all issues specific inclusion and exclusion criteria were defined. The methodological quality of randomized controlled trials (RCT) was assessed by a modified version of the Cochrane Risk of Bias Tool. For the methodological part information extraction from the literature is structured by the report’s chapters, for the empirical part data extraction sheets were constructed. All information is summarized in a qualitative manner. Results Concerning the methodological issues the literature search retrieved 158 documents (87 documents related to definition or classification, 125 documents related to operationalisation of

Smoking, health behavior, and value priorities.

PubMed

Kristiansen, C M

1985-01-01

In a postal survey, 113 respondents completed the Rokeach terminal value survey with the additional value, health, and questions regarding their preventive health behavior. Analyses showed that lighter nonsmokers displayed better preventive behavior than heavier smokers. Lighter nonsmokers also reported valuing health more than heavier smokers reported, and were oriented toward safety and inner-directedness compared with heavier smokers who were oriented toward satisfaction and outer-directedness. The preventive behavior of lighter nonsmokers increased with the value of social goals while the preventive behavior of heavier smokers was related to personal goals. These results are considered in the context of previous research which suggested that smokers and nonsmokers may have different value priorities. The implications of these findings for health education are discussed.

Young Women's Work Value Preferences.

ERIC Educational Resources Information Center

Peterson, Karen L.; Roscoe, Bruce

A study examined the work value preferences of young women in their late teens and early twenties. A descriptive self-report instrument was administered to 496 female undergraduate students at a midwestern university. Respondents were asked to rate the importance of 30 work values that were organized into two groups--work values that directly…

Psychological health in siblings who lost a brother or sister to cancer 2 to 9 years earlier.

PubMed

Eilegård, Alexandra; Steineck, Gunnar; Nyberg, Tommy; Kreicbergs, Ulrika

2013-03-01

The objective of this study was to assess long-term psychological distress in siblings who lost a brother or sister to cancer 2 to 9 years earlier, as compared with a control group of non-bereaved siblings from the general population. During 2009, we conducted a nationwide follow-up study in Sweden by using an anonymous study-specific questionnaire. Siblings who had lost a brother or sister to cancer between the years 2000 and 2007 and also a control group of non-bereaved siblings from the general population were invited to participate. The Hospital Anxiety and Depression Scale (HADS) was used to measure psychological distress, and to test for differences in the ordinal outcome responses between the groups, we used Wilcoxon-Mann-Whitney rank-sum test. Among the bereaved siblings, 174/240 (73%) participated and 219/293 (75%) among the non-bereaved. Self-assessed low self-esteem (p = 0.002), difficulties falling asleep (p = 0.005), and low level of personal maturity (p = 0.007) at follow-up were more prevalent among bereaved siblings. However, anxiety (p = 0.298) and depression (p = 0.946), according to HADS, were similar. Bereaved siblings are at increased risk of low self-esteem, low level of personal maturity and difficulties falling asleep as compared with non-bereaved peers. Yet, the bereaved were not more likely to report anxiety or depression. Copyright © 2012 John Wiley & Sons, Ltd.

Brief report: Into the wild? How a film can change adolescents' values.

PubMed

Döring, Anna K; Hillbrink, Alessa

2015-04-01

In adolescence, behavior and attitudes are constantly rethought and value priorities are established. Still, there is hardly any research addressing how values are shaped throughout this sensitive period. We employed an experimental design, testing whether adolescents' values can be influenced by exposure to a film. In our study, 154 German adolescents (80 females, ages 13-15) were randomly assigned to an experimental group that watched excerpts from the film "Into the wild" or to a control group. Value change was assessed in a pre-post-test design with a one-week interval. As hypothesized, values changed in the direction of those displayed by the film's protagonist: Universalism values increased significantly and conformity values decreased significantly as compared to the control group. Our findings suggest that single exposure to a film may initiate value change, indicating that not only major live events, but also everyday experiences significantly affect adolescents' values. Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Instructor Apathy and the Malaise of Listless Colleges. Part 1: A Pathologist's Report on the Fact-Value Distinction.

ERIC Educational Resources Information Center

Williams, Richard L.

The reported "malaise" of college instructors of the social sciences, particularly in political science, has its roots in the attempt to model the social sciences after the natural sciences and thus to separate fact from value. Scientific method requires that politics be redefined as an activity involving relationships of power, rule, and…

Antiretroviral treatment-based cost saving interventions may offset expenses for new patients and earlier treatment start.

PubMed

Angeletti, C; Pezzotti, P; Antinori, A; Mammone, A; Navarra, A; Orchi, N; Lorenzini, P; Mecozzi, A; Ammassari, A; Murachelli, S; Ippolito, G; Girardi, E

2014-03-01

Combination antiretroviral therapy (cART) has become the main driver of total costs of caring for persons living with HIV (PLHIV). The present study estimated the short/medium-term cost trends in response to the recent evolution of national guidelines and regional therapeutic protocols for cART in Italy. We developed a deterministic mathematical model that was calibrated using epidemic data for Lazio, a region located in central Italy with about six million inhabitants. In the Base Case Scenario, the estimated number of PLHIV in the Lazio region increased over the period 2012-2016 from 14 414 to 17 179. Over the same period, the average projected annual cost for treating the HIV-infected population was €147.0 million. An earlier cART initiation resulted in a rise of 2.3% in the average estimated annual cost, whereas an increase from 27% to 50% in the proportion of naïve subjects starting cART with a nonnucleoside reverse transcriptase inhibitor (NNRTI)-based regimen resulted in a reduction of 0.3%. Simplification strategies based on NNRTIs co-formulated in a single tablet regimen and protease inhibitor/ritonavir-boosted monotherapy produced an overall reduction in average annual costs of 1.5%. A further average saving of 3.3% resulted from the introduction of generic antiretroviral drugs. In the medium term, cost saving interventions could finance the increase in costs resulting from the inertial growth in the number of patients requiring treatment and from the earlier treatment initiation recommended in recent guidelines. © 2013 British HIV Association.

Valuing Flexibility

DTIC Science & Technology

2010-11-09

SERC  RT  18   Valuing  Flexibility   Sponsors   Steve  Welby  /  Kristen  Baldwin  /  Sco<  Lucero,  DDR&E/SE   Team...Kevin  Sullivan     11/9/2010   1  RT-­‐18   SERC  ASRR  Review   Report Documentation Page Form ApprovedOMB No. 0704-0188...Research Center ( SERC ),1 Castle Point on Hudson,Hoboken,NJ,07030 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S) AND

Coping and emotional distress during acute hospitalization in older persons with earlier trauma: the case of Holocaust survivors.

PubMed

Kimron, Lee; Cohen, Miri

2012-06-01

Older persons with earlier trauma are often more vulnerable to stresses of old age. To examine the levels of emotional distress in relation to cognitive appraisal of acute hospitalization and coping strategies in Holocaust survivors compared with an age- and education-matched group of elderly persons without Holocaust experience. This is a cross-sectional study of 63 Holocaust survivors, 65 years and older, hospitalized for an acute illness, and 57 age-, education- and hospital unit-matched people without Holocaust experience. Participants completed appraisal and coping strategies (COPE) questionnaires, and the brief symptoms inventory (BSI-18). Holocaust survivors reported higher levels of emotional distress, appraised the hospitalization higher as a threat and lower as a challenge, and used more emotion-focused and less problem-focused or support-seeking coping strategies than the comparison group. Study variables explained 65% of the variance of emotional distress; significant predictors of emotional distress in the final regression model were not having a partner and more use of emotion-focused coping. The latter mediated the relation of group variable and challenge appraisal to emotional distress. Health professionals must be aware of the potential impact of the hospital environment on the survivors of Holocaust as well as survivors of other trauma. Being sensitive to their specific needs may reduce the negative impact of hospitalization.

Filarial parasites develop faster and reproduce earlier in response to host immune effectors that determine filarial life expectancy.

PubMed

Babayan, Simon A; Read, Andrew F; Lawrence, Rachel A; Bain, Odile; Allen, Judith E

2010-10-19

Humans and other mammals mount vigorous immune assaults against helminth parasites, yet there are intriguing reports that the immune response can enhance rather than impair parasite development. It has been hypothesized that helminths, like many free-living organisms, should optimize their development and reproduction in response to cues predicting future life expectancy. However, immune-dependent development by helminth parasites has so far eluded such evolutionary explanation. By manipulating various arms of the immune response of experimental hosts, we show that filarial nematodes, the parasites responsible for debilitating diseases in humans like river blindness and elephantiasis, accelerate their development in response to the IL-5 driven eosinophilia they encounter when infecting a host. Consequently they produce microfilariae, their transmission stages, earlier and in greater numbers. Eosinophilia is a primary host determinant of filarial life expectancy, operating both at larval and at late adult stages in anatomically and temporally separate locations, and is implicated in vaccine-mediated protection. Filarial nematodes are therefore able to adjust their reproductive schedules in response to an environmental predictor of their probability of survival, as proposed by evolutionary theory, thereby mitigating the effects of the immune attack to which helminths are most susceptible. Enhancing protective immunity against filarial nematodes, for example through vaccination, may be less effective at reducing transmission than would be expected and may, at worst, lead to increased transmission and, hence, pathology.

Revisiting the Benefits of Higher Education. A Report by the Bedford Group for Lifecourse and Statistical Studies, Institute of Education.

ERIC Educational Resources Information Center

Bynner, John; Dolton, Peter; Feinstein, Leon; Makepeace, Gerry; Malmberg, Lars; Woods, Laura

An earlier report presented preliminary findings on the wider benefits of higher education in England, drawing on data collected at age 33 from the National Child Development Study, based on a cohort born in 1958 and a sample of more than 16,000. This report updates the earlier conclusions through new findings from a more extensive analysis…

The value of 'life at any cost': Talk about stopping kidney dialysis

PubMed Central

Russ, Ann J.; Shim, Janet K.; Kaufman, Sharon R.

2007-01-01

With the trend toward an older, sicker dialysis population in the USA, discussions of ethical issues surrounding dialysis have shifted from concerns about access to and availability of the therapy, to growing unease about non-initiation and treatment discontinuation. Recent studies report treatment withdrawal as the leading cause of death among elderly dialysis patients. Yet, the actual activities that move patients toward stopping treatment often remain obscure, even to clinicians and patients themselves. This paper explores that paradox, drawing on anthropological research among patients over age 70, their families, and clinicians in two California renal dialysis units. It concludes that many older patients sacrifice a sense of choice about dialysis in the present to maintain “choice” as both value and possibility for the future. Yet, patients desire more information and communication, provided earlier in their illness, about prognosis, how long they can expect to be on dialysis, and what the impact of the treatment will be on their daily lives. That, with time, there is a transition to be made from dialysis as “treatment” to end of life care could be better explained and managed to alleviate patients’ confusion and unneeded isolation. PMID:17418924

Daily Report Supplement, East Europe

DTIC Science & Technology

1993-03-30

they have played a major role in the diversion of Hungarian business into Western Euro- pean markets. 14 HUNGARY JPRS-EER-93-025-S 30 March...value of Hungarian foreign trade to Central Europe. Last year also played an important role in the elimina- tion of quotas and tariffs on...cooperatives which they dreamed up, the contradictions which were stressful enough earlier were only supplemented with new ones. The author of the

Defining Elements of Value in Health Care-A Health Economics Approach: An ISPOR Special Task Force Report [3].

PubMed

Lakdawalla, Darius N; Doshi, Jalpa A; Garrison, Louis P; Phelps, Charles E; Basu, Anirban; Danzon, Patricia M

2018-02-01

The third section of our Special Task Force report identifies and defines a series of elements that warrant consideration in value assessments of medical technologies. We aim to broaden the view of what constitutes value in health care and to spur new research on incorporating additional elements of value into cost-effectiveness analysis (CEA). Twelve potential elements of value are considered. Four of them-quality-adjusted life-years, net costs, productivity, and adherence-improving factors-are conventionally included or considered in value assessments. Eight others, which would be more novel in economic assessments, are defined and discussed: reduction in uncertainty, fear of contagion, insurance value, severity of disease, value of hope, real option value, equity, and scientific spillovers. Most of these are theoretically well understood and available for inclusion in value assessments. The two exceptions are equity and scientific spillover effects, which require more theoretical development and consensus. A number of regulatory authorities around the globe have shown interest in some of these novel elements. Augmenting CEA to consider these additional elements would result in a more comprehensive CEA in line with the "impact inventory" of the Second Panel on Cost-Effectiveness in Health and Medicine. Possible approaches for valuation and inclusion of these elements include integrating them as part of a net monetary benefit calculation, including elements as attributes in health state descriptions, or using them as criteria in a multicriteria decision analysis. Further research is needed on how best to measure and include them in decision making. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Provider perceptions of the value of same-day, electronic patient-reported measures for use in clinical HIV care

PubMed Central

Fredericksen, RJ; Tufano, J; Ralston, J; McReynolds, J; Stewart, M; Lober, WB; Mayer, K; Mathews, WC; Mugavero, M; Crane, PK; Crane, HM

2016-01-01

Strong evidence suggests that patient-reported outcomes (PROs) aid in managing chronic conditions, reduce omissions in care, and improve patient-provider communication. However, provider acceptability of PROs and their use in clinical HIV care is not well known. We interviewed providers (n=27) from four geographically diverse HIV and community care clinics in the U.S. that have integrated PROs into routine HIV care, querying perceived value, challenges, and use of PRO data. Perceived benefits included the ability of PROs to identify less-observable behaviors and conditions, particularly suicidal ideation, depression, and substance use; usefulness in agenda-setting prior to a visit; and reduction of social desirability bias in patient-provider communication. Challenges included initial flow integration issues and ease of interpretation of PRO feedback. Providers value same-day, electronic patient-reported measures for use in clinical HIV care with the condition that PROs are 1) tailored to be the most clinically relevant to their population; 2) well-integrated into clinic flow; 3) easy to interpret, highlighting chief patient concerns and changes over time. PMID:27237187

User Values in the Selection of Information Services. Final Report.

ERIC Educational Resources Information Center

Hall, Homer J.

The value systems by which the users of purchased information services select which one to use or buy are found to differ sharply among different user populations, but the variable found to control them is a function of use, not of the user as an individual. Selection variables are summarized in a matrix of user values and interaction effects. The…

Hemodynamic parameters change earlier than tissue oxygen tension in hemorrhage.

PubMed

Pestel, Gunther J; Fukui, Kimiko; Kimberger, Oliver; Hager, Helmut; Kurz, Andrea; Hiltebrand, Luzius B

2010-05-15

Untreated hypovolemia results in impaired outcome. This study tests our hypothesis whether general hemodynamic parameters detect acute blood loss earlier than monitoring parameters of regional tissue beds. Eight pigs (23-25 kg) were anesthetized and mechanically ventilated. A pulmonary artery catheter and an arterial catheter were inserted. Tissue oxygen tension was measured with Clark-type electrodes in the jejunal and colonic wall, in the liver, and subcutaneously. Jejunal microcirculation was assessed by laser Doppler flowmetry (LDF). Intravascular volume was optimized using difference in pulse pressure (dPP) to keep dPP below 13%. Sixty minutes after preparation, baseline measurements were taken. At first, 5% of total blood volume was withdrawn, followed by another 5% increment, and then in 10% increments until death. After withdrawal of 5% of estimated blood volume, dPP increased from 6.1% +/- 3.0% to 20.8% +/- 2.7% (P < 0.01). Mean arterial pressure (MAP), mean pulmonary artery pressure (PAP) and pulmonary artery occlusion pressure (PAOP) decreased with a blood loss of 10% (P < 0.01). Cardiac output (CO) changed after a blood loss of 20% (P < 0.05). Tissue oxygen tension in central organs, and blood flow in the jejunal muscularis decreased (P < 0.05) after a blood loss of 20%. Tissue oxygen tension in the skin, and jejunal mucosa blood flow decreased (P < 0.05) after a blood loss of 40% and 50%, respectively. In this hemorrhagic pig model systemic hemodynamic parameters were more sensitive to detect acute hypovolemia than tissue oxygen tension measurements or jejunal LDF measurements. Acute blood loss was detected first by dPP. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Screening for Colorectal Cancer in African Americans: Determinants and Rationale for an Earlier Age to Commence Screening

PubMed Central

Carethers, John M.

2014-01-01

Colorectal cancer (CRC) screening is a highly cost-effective approach to reduce morbidity and mortality of patients, as well as reduce the prevalence of CRC in populations. Current recommendations for CRC screening for the asymptomatic general population begin at age 50 years, an age after which ~95% of cancers occur. Determinants that modify the timing and frequency for screening include a personal or family history of adenomatous polyps or CRC, the age of onset of these colonic lesions, and the presence or potential for a patient to harbor a higher-risk syndrome such as inflammatory bowel disease (IBD), familial adenomatous polyposis (FAP), or Lynch syndrome.. Although race, like family history, is a heritable factor, it has not engendered inclusion in the same broad systematic screening recommendations despite multiple studies demonstrating a disparity in the incidence and mortality from CRC, and the potential for targeted screening to reduce the disparity. In particular, African Americans, when compared to Caucasians, (a) have lower CRC screening utilization rates, (b) have an earlier presentation of CRC (0-8 years younger than Caucasians) and, more often have aggressive biological features more prone to metastasis, (c) have a higher CRC prevalence at all ages and a higher proportion of CRCs before 50 years of age (~11% vs 5% in Caucasians), (d) are less likely to know or transmit personal or family history of adenomas or CRC that might change their screening to an earlier age, (e) present with 7-15% excess right-sided CRCs that are not microsatellite unstable, (f) show higher frequencies of high-risk adenomas at every decile of age, and an excess of high-risk proximal adenomas that mirror the excess of proximal CRCs, (g) have cancers that demonstrate lower proportions of good prognostic biomarkers such as MSI and higher proportions of bad prognosticators such as EMAST, (h) may possess gut microbiota more conducive to initiating and/or propagating colonic

Bowel cancer screening is safe, detects earlier stage cancer and adenomas in 50% of cases: experience of the prevalent round of screening from two first wave centres in the North East of England.

PubMed

Rajasekhar, P T; Clifford, G M; Lee, T J W; Rutter, M D; Waddup, G; Ritchie, M; Nylander, D; Painter, J; Singh, J; Ward, I; Dempsey, N; Bowes, J; Handley, G; Henry, J; Rees, C J

2012-01-01

The NHS Bowel Cancer Screening Programme (BCSP) began roll-out in 2006 aiming to reduce cancer mortality through detection at an earlier stage. We report results from the prevalent round of screening at two first wave centres and compare with the UK pilot study. This is a service evaluation study. Data were collected prospectively for all individuals undergoing faecal occult blood testing (FOBt) and colonoscopy including: uptake and outcomes of FOBt, colonoscopic performance, findings, histological data and complications. Continuous data were compared using a two-tailed test of two proportions. The South of Tyne and Tees Bowel Cancer Screening centres. Participants of the BCSP. 1) Colonoscopy Quality Assurance and 2) Cancer stage shift. 195,772 individuals were invited to participate. Uptake was 54% and FOBt positivity 1.7%. 1524 underwent colonoscopy with caecal intubation in 1485 (97%). 180 (12%) cancers were detected. Dukes stages were: 76 (42%) A; 47 (26%) B; 47 (26%) C; 8 (4%) D and 2 (1%) unknown. This demonstrates a significantly earlier stage at diagnosis compared with data from 2867 non-screening detected cancers (p<0.001). Adenomas were detected in 758 (50%). One perforation occurred (0.07%) and two intermediate bleeds requiring transfusion only (0.12%). Both caecal intubation and adenoma detection were significantly higher than in the UK pilot study (p<0.001). The prevalent round of screening demonstrates a high adenoma and cancer detection rate and significantly earlier stage at diagnosis. Complications were few providing reassurance regarding safety. Efforts are required to improve uptake.

Bowel cancer screening is safe, detects earlier stage cancer and adenomas in 50% of cases: experience of the prevalent round of screening from two first wave centres in the North East of England

PubMed Central

Rajasekhar, P T; Clifford, G M; Lee, T J W; Rutter, M D; Waddup, G; Ritchie, M; Nylander, D; Painter, J; Singh, J; Ward, I; Dempsey, N; Bowes, J; Handley, G; Henry, J; Rees, C J

2012-01-01

Objective The NHS Bowel Cancer Screening Programme (BCSP) began roll-out in 2006 aiming to reduce cancer mortality through detection at an earlier stage. We report results from the prevalent round of screening at two first wave centres and compare with the UK pilot study. Design This is a service evaluation study. Data were collected prospectively for all individuals undergoing faecal occult blood testing (FOBt) and colonoscopy including: uptake and outcomes of FOBt, colonoscopic performance, findings, histological data and complications. Continuous data were compared using a two-tailed test of two proportions. Setting The South of Tyne and Tees Bowel Cancer Screening centres. Patients Participants of the BCSP. Main Outcome Measures 1) Colonoscopy Quality Assurance and 2) Cancer stage shift. Results 195,772 individuals were invited to participate. Uptake was 54% and FOBt positivity 1.7%. 1524 underwent colonoscopy with caecal intubation in 1485 (97%). 180 (12%) cancers were detected. Dukes stages were: 76 (42%) A; 47 (26%) B; 47 (26%) C; 8 (4%) D and 2 (1%) unknown. This demonstrates a significantly earlier stage at diagnosis compared with data from 2867 non-screening detected cancers (p<0.001). Adenomas were detected in 758 (50%). One perforation occurred (0.07%) and two intermediate bleeds requiring transfusion only (0.12%). Both caecal intubation and adenoma detection were significantly higher than in the UK pilot study (p<0.001). Conclusions The prevalent round of screening demonstrates a high adenoma and cancer detection rate and significantly earlier stage at diagnosis. Complications were few providing reassurance regarding safety. Efforts are required to improve uptake. PMID:28839624

A Health Economics Approach to US Value Assessment Frameworks-Summary and Recommendations of the ISPOR Special Task Force Report [7].

PubMed

Garrison, Louis P; Neumann, Peter J; Willke, Richard J; Basu, Anirban; Danzon, Patricia M; Doshi, Jalpa A; Drummond, Michael F; Lakdawalla, Darius N; Pauly, Mark V; Phelps, Charles E; Ramsey, Scott D; Towse, Adrian; Weinstein, Milton C

2018-02-01

This summary section first lists key points from each of the six sections of the report, followed by six key recommendations. The Special Task Force chose to take a health economics approach to the question of whether a health plan should cover and reimburse a specific technology, beginning with the view that the conventional cost-per-quality-adjusted life-year metric has both strengths as a starting point and recognized limitations. This report calls for the development of a more comprehensive economic evaluation that could include novel elements of value (e.g., insurance value and equity) as part of either an "augmented" cost-effectiveness analysis or a multicriteria decision analysis. Given an aggregation of elements to a measure of value, consistent use of a cost-effectiveness threshold can help ensure the maximization of health gain and well-being for a given budget. These decisions can benefit from the use of deliberative processes. The six recommendations are to: 1) be explicit about decision context and perspective in value assessment frameworks; 2) base health plan coverage and reimbursement decisions on an evaluation of the incremental costs and benefits of health care technologies as is provided by cost-effectiveness analysis; 3) develop value thresholds to serve as one important input to help guide coverage and reimbursement decisions; 4) manage budget constraints and affordability on the basis of cost-effectiveness principles; 5) test and consider using structured deliberative processes for health plan coverage and reimbursement decisions; and 6) explore and test novel elements of benefit to improve value measures that reflect the perspectives of both plan members and patients. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Does earlier arrival of the retrieval team improve short-term outcomes in outborn extremely premature infants?

PubMed

Sharpe, Janet B; Davies, Mark W

2018-05-31

The risk of mortality and morbidity is increased in outborn, extremely premature infants. We aim to determine whether earlier arrival of the retrieval team after the birth of infants less than 29 weeks gestation improves short-term mortality and morbidity. This is a retrospective analysis of a cohort of infants less than 29 weeks gestation who were retrieved to the Royal Brisbane and Women's Hospital (RBWH) over a 5-year period. Demographic information regarding the infant and mother, retrieval team arrival time and outcome data was collected. Primary outcomes investigated were mortality prior to discharge from hospital or a composite of mortality or severe intraventricular haemorrhage (IVH). Data on 105 infants were analysed; 88 infants (83.8%) survived to discharge home, and 79 (75.2%) survived to discharge without severe IVH. On univariate analysis, there was no significant association between age at arrival of the retrieval team and death prior to discharge (P = 0.94) or death prior to discharge or severe IVH (P = 0.83). On logistic regression analysis, age at arrival of retrieval team remained non-significant for a reduction in death prior to discharge and composite of death or severe IVH (P = 0.70 and P = 0.99, respectively). The earlier arrival of the retrieval team is not associated with improved short-term outcomes in outborn, extremely preterm infants who are retrieved and admitted to a tertiary neonatal intensive care unit - for infants where the retrieval team arrived within about 8 h of birth. © 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

Reporting the national antimicrobial consumption in Danish pigs: influence of assigned daily dosage values and population measurement.

PubMed

Dupont, Nana; Fertner, Mette; Kristensen, Charlotte Sonne; Toft, Nils; Stege, Helle

2016-05-03

Transparent calculation methods are crucial when investigating trends in antimicrobial consumption over time and between populations. Until 2011, one single standardized method was applied when quantifying the Danish pig antimicrobial consumption with the unit "Animal Daily Dose" (ADD). However, two new methods for assigning values for ADDs have recently emerged, one implemented by DANMAP, responsible for publishing annual reports on antimicrobial consumption, and one by the Danish Veterinary and Food Administration (DVFA), responsible for the Yellow Card initiative. In addition to new ADD assignment methods, Denmark has also experienced a shift in the production pattern, towards a larger export of live pigs. The aims of this paper were to (1) describe previous and current ADD assignment methods used by the major Danish institutions and (2) to illustrate how ADD assignment method and choice of population and population measurement affect the calculated national antimicrobial consumption in pigs (2007-2013). The old VetStat ADD-values were based on SPCs in contrast to the new ADD-values, which were based on active compound, concentration and administration route. The new ADD-values stated by both DANMAP and DVFA were only identical for 48 % of antimicrobial products approved for use in pigs. From 2007 to 2013, the total number of ADDs per year increased by 9 % when using the new DVFA ADD-values, but decreased by 2 and 7 % when using the new DANMAP ADD-values or the old VetStat ADD-values, respectively. Through 2007 to 2013, the production of pigs increased from 26.1 million pigs per year with 18 % exported live to 28.7 million with 34 % exported live. In the same time span, the annual pig antimicrobial consumption increased by 22.2 %, when calculated using the new DVFA ADD-values and pigs slaughtered per year as population measurement (13.0 ADDs/pig/year to 15.9 ADDs/pig/year). However, when based on the old VetStat ADD values and pigs produced per year

Nontimber values of Louisiana's timberland

Treesearch

Victor A. Rudis

1988-01-01

As a companion publication to the Louisiana timber report (Rosson and others 1988), this document presents information about the other forest values associated with Louisiana's timberland. These "nontimber" values include water quality, soils, livestock potential, wildlife habitat, aesthetics, and dispersed recreation opportunities in timberland areas....

On solvability of boundary value problems for hyperbolic fourth-order equations with nonlocal boundary conditions of integral type

NASA Astrophysics Data System (ADS)

Popov, Nikolay S.

2017-11-01

Solvability of some initial-boundary value problems for linear hyperbolic equations of the fourth order is studied. A condition on the lateral boundary in these problems relates the values of a solution or the conormal derivative of a solution to the values of some integral operator applied to a solution. Nonlocal boundary-value problems for one-dimensional hyperbolic second-order equations with integral conditions on the lateral boundary were considered in the articles by A.I. Kozhanov. Higher-dimensional hyperbolic equations of higher order with integral conditions on the lateral boundary were not studied earlier. The existence and uniqueness theorems of regular solutions are proven. The method of regularization and the method of continuation in a parameter are employed to establish solvability.

An inhibitor of polyamine synthesis arrests cells at an earlier stage of G1 than does calcium deprivation.

PubMed Central

Cheetham, B F

1983-01-01

Methylglyoxal bis(guanylhydrazone) completely inhibits the induction of thymidine kinase after serum stimulation of quiescent fibroblasts only if added within 3 h after serum, whereas calcium deprivation blocks this induction up to 12 h after serum stimulation. Experiments in which one of these blocks was imposed as the other was released confirmed that cells blocked by methylglyoxal bis(guanylhydrazone) are arrested at an earlier stage in G1 than cells blocked by calcium deprivation. PMID:6843551

Field testing existence values for riparian ecosystems

Treesearch

John W. Duffield; Chris J. Neher; David A. Patterson; Patricia A. Champ

2007-01-01

This paper presents preliminary findings on a cash and contingent valuation (cv) experiment. The study replicates major elements of an earlier (1990) experiment, which solicited hypothetical and actual donations to benefit instream flows for Montana fisheries. Extensions of the earlier work include: repeat contacts to increase response rate, follow-up of the contingent...

Final report on COOMET.AUV.A-S1: Technical report on supplementary comparison 'Comparison of national standards of the sound pressure unit in air through calibration of working reference microphones'

NASA Astrophysics Data System (ADS)

Pozdeeva, Valentina; Chalyy, Vladimir

2014-01-01

The supplementary comparison COOMET.AUV.A-S1 for secondary calibration methods using WS1 and WS2 measurement microphones was carried out from 2009 to 2010. The results were submitted to and approved by CCAUV in April 2014. Four National Metrology Institutes took part in this comparison and are as follows: BelGIM (Belarus), VNIIFTRI (Russia), SMU (Slovakia) and DP NDI 'Sistema' (Ukraine). Three of the above NMIs (VNIIFTRI, SMU and DP NDI 'Sistema') had earlier participated in COOMET key comparisons and one NMI (VNIIFTRI) had also participated in CCAUV key comparisons. The Comparison Reference Values were calculated as the weighted mean values from results obtained by three institutes. The comparison results show agreement for all participants in the frequency range from 20 Hz to 12.5 kHz for WS1 microphones, and in the frequency range from 20 Hz to 16 kHz for WS2 microphones. Main text. To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCAUV, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

Exact finite volume expectation values of local operators in excited states

NASA Astrophysics Data System (ADS)

Pozsgay, B.; Szécsényi, I. M.; Takács, G.

2015-04-01

We present a conjecture for the exact expression of finite volume expectation values in excited states in integrable quantum field theories, which is an extension of an earlier conjecture to the case of general diagonal factorized scattering with bound states and a nontrivial bootstrap structure. The conjectured expression is a spectral expansion which uses the exact form factors and the excited state thermodynamic Bethe Ansatz as building blocks. The conjecture is proven for the case of the trace of the energy-moment tensor. Concerning its validity for more general operators, we provide numerical evidence using the truncated conformal space approach. It is found that the expansion fails to be well-defined for small values of the volume in cases when the singularity structure of the TBA equations undergoes a non-trivial rearrangement under some critical value of the volume. Despite these shortcomings, the conjectured expression is expected to be valid for all volumes for most of the excited states, and as an expansion above the critical volume for the rest.

Presetting ECG electrodes for earlier heart rate detection in the delivery room.

PubMed

Gulati, Rashmi; Zayek, Michael; Eyal, Fabien

2018-07-01

To determine whether heart rate (HR) could be detected earlier than by pulse oximeter (POX), using a novel method of application of electrocardiogram (ECG) electrodes during neonatal resuscitation in the delivery room. ECG electrodes were set before delivery to be applied to the back of infants' thorax. Time to detect HR was recorded as soon as a numerical HR along with a recognizable and persistent QRS complex was observed on ECG monitor (HRECG) and a plethysmographic waveform was seen on POX monitor (HRPOX). Out of 334 infants, 49 were <31 weeks of gestational age. Overall, the median (interquartile range, IQR) time to detect HRECG was significantly shorter [29 (5, 60) seconds] than time by POX [60 (45,120) seconds], (p < 0.001). Similarly, in <31-week infants, the median (IQR) time to detect HRECG was 10 (2, 40) seconds compared to 60 (30,120) seconds by POX, (p < 0.001). Failure to have HR detected by 1 minute occurred in 30%, 54% and 20% of infants by ECG, POX and either of the devices, respectively. In the delivery room, electrodes applied by the study method are more effective than pulse oximetry in providing the neonatal team with timely HR information that is necessary for proper resuscitative actions. Published by Elsevier B.V.

Earlier Snowmelt Changes the Ratio Between Early and Late Season Forest Productivity

NASA Astrophysics Data System (ADS)

Knowles, J. F.; Molotch, N. P.; Trujillo, E.; Litvak, M. E.

2017-12-01

Future projections of declining snowpack and increasing potential evaporation associated with climate warming are predicted to advance the timing of snowmelt in mountain ecosystems globally. This scenario has direct implications for snowmelt-driven forest productivity, but the net effect of temporally shifting moisture dynamics is unknown with respect to the annual carbon balance. Accordingly, this study uses both satellite- and tower-based observations to document the forest productivity response to snowpack and potential evaporation variability between 1989 and 2012 throughout the southern Rocky Mountain ecoregion, USA. These results show that a combination of low snow accumulation and record high potential evaporation in 2012 resulted in the 34-year minimum ecosystem productivity that could be indicative of future conditions. Moreover, early and late season productivity were significantly and inversely related, suggesting that future shifts toward earlier or reduced snowmelt could increase late-season moisture stress to vegetation and thus restrict productivity despite a longer growing season. This relationship was further subject to modification by summer precipitation, and the controls on the early/late season productivity ratio are explored within the context of ecosystem carbon storage in the future. Any perturbation to the carbon cycle at this scale represents a potential feedback to climate change since snow-covered forests represent an important global carbon sink.

Predictive value of autoantibody testing for validating self-reported diagnoses of rheumatoid arthritis in the Women's Health Initiative.

PubMed

Walitt, Brian; Mackey, Rachel; Kuller, Lewis; Deane, Kevin D; Robinson, William; Holers, V Michael; Chang, Yue-Fang; Moreland, Larry

2013-05-01

Rheumatoid arthritis (RA) research using large databases is limited by insufficient case validity. Of 161,808 postmenopausal women in the Women's Health Initiative, 15,691 (10.2%) reported having RA, far higher than the expected 1% population prevalence. Since chart review for confirmation of an RA diagnosis is impractical in large cohort studies, the current study (2009-2011) tested the ability of baseline serum measurements of rheumatoid factor and anti-cyclic citrullinated peptide antibodies, second-generation assay (anti-CCP2), to identify physician-validated RA among the chart-review study participants with self-reported RA (n = 286). Anti-CCP2 positivity had the highest positive predictive value (PPV) (80.0%), and rheumatoid factor positivity the lowest (44.6%). Together, use of disease-modifying antirheumatic drugs and anti-CCP2 positivity increased PPV to 100% but excluded all seronegative cases (approximately 15% of all RA cases). Case definitions inclusive of seronegative cases had PPVs between 59.6% and 63.6%. False-negative results were minimized in these test definitions, as evidenced by negative predictive values of approximately 90%. Serological measurements, particularly measurement of anti-CCP2, improved the test characteristics of RA case definitions in the Women's Health Initiative.

Potential value of satellite cloud pictures in weather modification projects

NASA Technical Reports Server (NTRS)

Biswas, K. R.

1972-01-01

Satellite imagery for one project season of cloud seeding programs in the northern Great Plains has been surveyed for its probable usefulness in weather modification programs. The research projects and the meteorological information available are described. A few illustrative examples of satellite imagery analysis are cited and discussed, along with local observations of weather and the seeding decisions made in the research program. This analysis indicates a definite correlation between satellite-observed cloud patterns and the types of cloud seeding activity undertaken, and suggests a high probability of better and/or earlier decisions if the imagery is available in real time. Infrared imagery provides better estimates of cloud height which can be useful in assessing the possibility of a hail threat. The satellite imagery appears to be of more value to area-seeding projects than to single-cloud seeding experiments where the imagery is of little value except as an aid in local forecasting and analysis.

Value-Focused Objectives Model for Community Resilience

DTIC Science & Technology

2014-04-01

Value-focused objectives model for community resilience : Final report Prepared by: Jay Adamsson CAE Integrated Enterprise Solutions...2014 Value-Focused Objectives Model for Community Resilience Final Report 24 March 2014 – iv – 5606-002 Version 01 T A B L E O F C O N T E... Community Resilience ......................................................... 13 APPENDIX A LIST OF ACRONYMS

Report on Allegation of Unsatisfactory Conditions Regarding Actions by the Defense Contract Management Agency, Earned Value Management Center

DTIC Science & Technology

2010-07-28

object ivity of Defen se Contract Management Agency to carry ou t its ea rn ed va lue managemen t oversight responsibilities; and DCMA Response: Non...Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302...Earned Value Management Center Director advised us that the 2-week time frame was “standard operating procedure” for performing compliance reviews at

76 FR 53057 - Change to the Reporting Date for Certain Data Elements Required Under the Mandatory Reporting of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-25

..., blast furnaces, basic oxygen process furnace shops. Lead Production 331419 Primary lead smelting and.... Chapter 5, generally provides that rules may not take effect earlier than 30 days after they are published... behavior and prepare before the final rule takes effect. Because this final rule defers a reporting...

Analysis of arrhythmic events is useful to detect lead failure earlier in patients followed by remote monitoring.

PubMed

Nishii, Nobuhiro; Miyoshi, Akihito; Kubo, Motoki; Miyamoto, Masakazu; Morimoto, Yoshimasa; Kawada, Satoshi; Nakagawa, Koji; Watanabe, Atsuyuki; Nakamura, Kazufumi; Morita, Hiroshi; Ito, Hiroshi

2018-03-01

Remote monitoring (RM) has been advocated as the new standard of care for patients with cardiovascular implantable electronic devices (CIEDs). RM has allowed the early detection of adverse clinical events, such as arrhythmia, lead failure, and battery depletion. However, lead failure was often identified only by arrhythmic events, but not impedance abnormalities. To compare the usefulness of arrhythmic events with conventional impedance abnormalities for identifying lead failure in CIED patients followed by RM. CIED patients in 12 hospitals have been followed by the RM center in Okayama University Hospital. All transmitted data have been analyzed and summarized. From April 2009 to March 2016, 1,873 patients have been followed by the RM center. During the mean follow-up period of 775 days, 42 lead failure events (atrial lead 22, right ventricular pacemaker lead 5, implantable cardioverter defibrillator [ICD] lead 15) were detected. The proportion of lead failures detected only by arrhythmic events, which were not detected by conventional impedance abnormalities, was significantly higher than that detected by impedance abnormalities (arrhythmic event 76.2%, 95% CI: 60.5-87.9%; impedance abnormalities 23.8%, 95% CI: 12.1-39.5%). Twenty-seven events (64.7%) were detected without any alert. Of 15 patients with ICD lead failure, none has experienced inappropriate therapy. RM can detect lead failure earlier, before clinical adverse events. However, CIEDs often diagnose lead failure as just arrhythmic events without any warning. Thus, to detect lead failure earlier, careful human analysis of arrhythmic events is useful. © 2017 Wiley Periodicals, Inc.

[Evaluation of serum total carnitine values in persons with severe motor and intellectual disabilities with enteral (tube) feeding].

PubMed

Ohtaki, Ushio; Ozawa, Hiroshi; Ishizuka, Takehiro; Kamiishi, Akiko; Sasaki, Kyoko; Nakajima, Suemi; Katayama, Ayako; Arimoto, Kiyoshi; Yagihashi, Tatsuhiko; Kimiya, Satoshi

2012-09-01

The nutritive evaluation and the serum carnitine values were measured for persons with severe motor and intellectual disabilities with enteral (tube) feeding. In Shimada Rehabilitation Center, twenty one people who had serum albumin levels of 3.4 g/dl or less, and were taking nutrition with enteral (tube) feeding, were tested. Body weight, blood samples, and serum carnitine levels were measured. The total carnitine value was less than the standard value in 19 patients. The total carnitine value decreased in the group taking valporate sodium (VPA), compared to the values from the group non-taking VPA. From our evaluation, we think that daily carnitine supplements is essential for persons with sever motor and intellectual disabilities taking VPA to maintain carnitine levels in the blood, and regular urine test should be done for earlier detection secondary lack complications from the secondary lack of carnitine.

Measuring Up 2002: The State-By-State Report Card for Higher Education.

ERIC Educational Resources Information Center

National Center for Public Policy and Higher Education, CA.

This report is the second in a series of biennial, state-by-state 50-state report cards. As in the earlier report, state higher education systems are evaluated, compared, and graded in five categories of performance: preparation, participation, affordability, completion, and benefits. All states are given an "incomplete" in the sixth category,…

Adjusting Quality index Log Values to Represent Local and Regional Commercial Sawlog Product Values

Treesearch

Orris D. McCauley; Joseph J. Mendel; Joseph J. Mendel

1969-01-01

The primary purpose of this paper is not only to report the results of a comparative analysis as to how well the Q.I. method predicts log product values when compared to commercial sawmill log output values, but also to develop a methodology which will facilitate the comparison and provide the adjustments needed by the sawmill operator.

The problem with value

PubMed Central

O’Doherty, John P.

2015-01-01

Neural correlates of value have been extensively reported in a diverse set of brain regions. However, in many cases it is difficult to determine whether a particular neural response pattern corresponds to a value-signal per se as opposed to an array of alternative non-value related processes, such as outcome-identity coding, informational coding, encoding of autonomic and skeletomotor consequences, alongside previously described “salience” or “attentional” effects. Here, I review a number of experimental manipulations that can be used to test for value, and I identify the challenges in ascertaining whether a particular neural response is or is not a value signal. Finally, I emphasize that some non-value related signals may be especially informative as a means of providing insight into the nature of the decision-making related computations that are being implemented in a particular brain region. PMID:24726573

Missed opportunities for earlier diagnosis of HIV in patients who presented with advanced HIV disease: a retrospective cohort study

PubMed Central

Levy, Itzchak; Maor, Yasmin; Mahroum, Naim; Olmer, Liraz; Wieder, Anat; Litchevski, Vladislav; Mor, Orna; Rahav, Galia

2016-01-01

Objective To quantify and characterise missed opportunities for earlier HIV diagnosis in patients diagnosed with advanced HIV. Design A retrospective observational cohort study. Setting A central tertiary medical centre in Israel. Measures The proportion of patients with advanced HIV, the proportion of missed opportunities to diagnose them earlier, and the rate of clinical indicator diseases (CIDs) in those patients. Results Between 2010 and 2015, 356 patients were diagnosed with HIV, 118 (33.4%) were diagnosed late, 57 (16%) with advanced HIV disease. Old age (OR=1.45 (95% CI 1.16 to 1.74)) and being heterosexual (OR=2.65 (95% CI 1.21 to 5.78)) were significant risk factors for being diagnosed late. All patients with advanced disease had at least one CID that did not lead to an HIV test in the 5 years prior to AIDS diagnosis. The median time between CID and AIDS diagnosis was 24 months (IQR 10–30). 60% of CIDs were missed by a general practitioner and 40% by a specialist. Conclusions Missed opportunities to early diagnosis of HIV occur in primary and secondary care. Lack of national guidelines, lack of knowledge regarding CIDs and communication barriers with patients may contribute to a late diagnosis of HIV. PMID:28186940

Earlier predictors of eating disorder symptoms in 9-year-old children. A longitudinal study.

PubMed

Parkinson, Kathryn N; Drewett, Robert F; Le Couteur, Ann S; Adamson, Ashley J

2012-08-01

The aim of the study was to examine predictors of eating disorder symptoms in a population based sample at the earliest age at which they can be measured using the Children's Eating Attitudes Test. Data were collected from the longitudinal Gateshead Millennium Study cohort; 609 children participated in the 7 year data sweep (and their mothers and teachers), and 589 children participated in the 9 year data sweep. Eating disorder symptoms at 9 years were higher in boys, and in children from more deprived families. Higher eating disorder symptoms were associated with more body dissatisfaction at 9 years. Higher symptoms were predicted by higher levels of dietary restraint and of emotional symptoms, but not greater body dissatisfaction, 2 years earlier. The study showed that some correlates of high eating disorder symptoms found in adolescents and adults are also found in children, before the rise in diagnosable eating disorders over the pubertal period. Copyright © 2012 Elsevier Ltd. All rights reserved.

Preoperative left ventricular internal dimension in end-diastole as earlier identification of early patent ductus arteriosus operation and postoperative intensive care in very low birth weight infants.

PubMed

Saida, Ken; Nakamura, Tomohiko; Hiroma, Takehiko; Takigiku, Kiyohiro; Yasukochi, Satoshi

2013-10-01

Patent ductus arteriosus (PDA) is common in premature infants. In very low birth weight infants (VLBWI), PDA requires surgical therapy in many cases. It is unclear to know at-risk infants showing cardio-dysfunction after PDA surgery. The purpose of this study was to identify at-risk infants showing cardio-dysfunction after surgery for patent ductus arteriosus (PDA). We examined the relationship between left ventricular (LV) performance before and after PDA ligation in a retrospective observational cohort study. We studied 64 preterm neonates with symptomatic PDA before and after surgical ligation. Echocardiographic examinations were performed pre- and postoperatively. M-mode measurements included left ventricular internal dimension in end-diastole (LVIDd) and LV fractional shortening (FS). All cases showed decreased LVFS after PDA closure. Most cases (49/64, 77%) showed postoperative FS decreased to below normal (<28%). Preoperative relative LVIDd was significantly larger in abnormal FS infants (137 ± 18%) than in normal FS infants (118 ± 11%; p<0.01). A cut-off value of preoperative relative LVIDd (absolute LVIDd/normal value) for predicting postoperative cardio-dysfunction was 127.4% (sensitivity, 0.735; specificity, 0.933; area under curve, 0.817). Determination of preoperative LVIDd might facilitate earlier identification of infants needing early PDA surgery and postoperative intensive care. © 2013 Elsevier Ireland Ltd. All rights reserved.

Comments on 'Kinetic Study on the Hexacelsian-Celsian Phase Transformation'

NASA Technical Reports Server (NTRS)

Bansal, Narottam P.; Drummond, Charles H., III

1992-01-01

A value of 20.1 +/- 4 kcal/mole for the activation energy (E) for the hexacelsian to celsian phase transformation in BaAl2Si2O8 was reported in an earlier work. In the present work, the earlier experimental data were reanalyzed and a much higher value of E was obtained. This revised E value is consistent with the transformation mechanism of a layered hexacelsian structure into a three-dimensional feldspar structure of celsian which would necessitate the breaking of the Si-O and/or the Al-O bonds.

Effectiveness of automated notification and customer service call centers for timely and accurate reporting of critical values: a laboratory medicine best practices systematic review and meta-analysis.

PubMed

Liebow, Edward B; Derzon, James H; Fontanesi, John; Favoretto, Alessandra M; Baetz, Rich Ann; Shaw, Colleen; Thompson, Pamela; Mass, Diana; Christenson, Robert; Epner, Paul; Snyder, Susan R

2012-09-01

To conduct a systematic review of the evidence available in support of automated notification methods and call centers and to acknowledge other considerations in making evidence-based recommendations for best practices in improving the timeliness and accuracy of critical value reporting. This review followed the Laboratory Medicine Best Practices (LMBP) review methods (Christenson, et al. 2011). A broad literature search and call for unpublished submissions returned 196 bibliographic records which were screened for eligibility. 41 studies were retrieved. Of these, 4 contained credible evidence for the timeliness and accuracy of automatic notification systems and 5 provided credible evidence for call centers for communicating critical value information in in-patient care settings. Studies reporting improvement from implementing automated notification findings report mean differences and were standardized using the standard difference in means (d=0.42; 95% CI=0.2-0.62) while studies reporting improvement from implementing call centers generally reported criterion referenced findings and were standardized using odds ratios (OR=22.1; 95% CI=17.1-28.6). The evidence, although suggestive, is not sufficient to make an LMBP recommendation for or against using automated notification systems as a best practice to improve the timeliness of critical value reporting in an in-patient care setting. Call centers, however, are effective in improving the timeliness of critical value reporting in an in-patient care setting, and meet LMBP criteria to be recommended as an "evidence-based best practice." Copyright © 2012 The Canadian Society of Clinical Chemists. All rights reserved.

Value-based resource management: a model for best value nursing care.

PubMed

Caspers, Barbara A; Pickard, Beth

2013-01-01

With the health care environment shifting to a value-based payment system, Catholic Health Initiatives nursing leadership spearheaded an initiative with 14 hospitals to establish best nursing care at a lower cost. The implementation of technology-enabled business processes at point of care led to a new model for best value nursing care: Value-Based Resource Management. The new model integrates clinical patient data from the electronic medical record and embeds the new information in care team workflows for actionable real-time decision support and predictive forecasting. The participating hospitals reported increased patient satisfaction and cost savings in the reduction of overtime and improvement in length of stay management. New data generated by the initiative on nursing hours and cost by patient and by population (Medicare severity diagnosis-related groups), and patient health status outcomes across the acute care continuum expanded business intelligence for a value-based population health system.

Unresolved grief and its consequences. A nationwide follow-up of teenage loss of a parent to cancer 6-9 years earlier.

PubMed

Bylund-Grenklo, T; Fürst, C J; Nyberg, T; Steineck, G; Kreicbergs, U

2016-07-01

The early loss of a parent is a tragedy and a serious life event. This study investigated grief resolution and morbidity in cancer-bereaved teenagers 6 to 9 years after the loss of a parent to cancer. In a nationwide population-based study of 622 of 851 (73 %) youths who as teenagers 6 to 9 years earlier had lost a parent to cancer, we explored the magnitude of unresolved grief and its association with psychological and physiological morbidity. Participants answered a study-specific anonymous questionnaire including questions about if they had worked through their grief and about their current health. Six to nine years post-loss 49 % reported unresolved grief (8 % no and 41 % a little grief resolution). They had, in comparison with youths reporting resolved grief, statistically significantly elevated risks, e.g. for insomnia (sons' relative risk (RR) 2.3, 95 % CI 1.3-4.0; daughters' RR 1.7, 95 % CI 1.1-2.7), fatigue (sons' RR 1.8, 95 % CI 1.3-2.5; daughters' RR 1.4, 95 % CI 1.1-1.7) and moderate to severe depression, i.e. score >9, PHQ-9 (sons' RR 3.6, 95 % CI 1.4-8.8; daughters' RR 1.8, 95 % CI 1.1-3.1). Associations remained for insomnia in sons, exhaustion in daughters and fatigue in both sons and daughters when depression, negative intrusive thoughts and avoiding reminders of the parents' disease or death were included in a model. Approximately half of cancer-bereaved youth report no or little grief resolution 6 to 9 years post-loss, which is associated with fatigue, sleeping problems and depressive symptoms.

Depletions in winter total ozone values over southern England

NASA Technical Reports Server (NTRS)

Lapworth, A.

1994-01-01

A study has been made of the recently re-evaluated time series of daily total ozone values for the period 1979 to 1992 for southern England. The series consists of measurements made at two stations, Bracknell and Camborne. The series shows a steady decline in ozone values in the spring months over the period, and this is consistent with data from an earlier decade that has been published but not re-evaluated. Of exceptional note is the monthly mean for January 1992 which was very significantly reduced from the normal value, and was the lowest so far measured for this month. This winter was also noteworthy for a prolonged period during which a blocking anticyclone dominated the region, and the possibility existed that this was related to the ozone anomaly. It was possible to determine whether the origin of the low ozone value lay in ascending stratospheric motions. A linear regression analysis of ozone value deviation against 100hPa temperature deviations was used to reduce ozone values to those expected in the absence of high pressure. The assumption was made that the normal regression relation was not affected by atmospheric anomalies during the winter. This showed that vertical motions in the stratosphere only accounted for part of the ozone anomaly and that the main cause of the ozone deficit lay either in a reduced stratospheric circulation to which the anticyclone may be related or in chemical effects in the reduced stratospheric temperatures above the high pressure area. A study of the ozone time series adjusted to remove variations correlated with meteorological quantities, showed that during the period since 1979, one other winter, that of 1982/3, showed a similar although less well defined deficit in total ozone values.

How to Develop Critical Thinking Skills Within the Armys Officer Education System (OES) Earlier in an Officer’s Career

DTIC Science & Technology

2016-02-13

thinking emerges.”31 Military leaders should minimize bureaucracy when possible in an attempt to facilitate creative thinking . Consequently, a...AIR WAR COLLEGE AIR UNIVERSITY HOW TO DEVELOP CRITICAL THINKING SKILLS WITHIN THE ARMY’S OFFICER EDUCTION SYSTEM (OES) EARLIER IN AN...Force Dragon’s Heart.” iv Abstract Critical thinking skills are required by strategic leaders to solve complex problems in an environment

Health care strategies to promote earlier presentation of symptomatic breast cancer: perspectives of women and family physicians

PubMed Central

Heisey, R.; Clemons, M.; Granek, L.; Fergus, K.; Hum, S.; Lord, B.; McCready, D.R.; Fitzgerald, B.

2011-01-01

Background Many women with symptoms suggestive of a breast cancer diagnosis delay presentation to their family physician. Although factors associated with delay have been well described, there is a paucity of data on strategies to mitigate delay. Objectives We conducted a qualitative research project to examine factors related to delay and to identify health care system changes that might encourage earlier presentation. Methods Individual semi-structured interviews were conducted with women who sought care 12 weeks or more after self-detection of breast cancer symptoms and with family physicians whose practices included patients meeting that criterion. Results The women and physicians both suggested a need for clearer screening mammography guidelines for women 40–49 years of age and for better messaging concerning breast awareness. The use of additional hopeful testimonials from breast cancer survivors were suggested to help dispel the notion of cancer as a “death sentence.” Educational initiatives were proposed, aimed at both increasing awareness of “non-lump” breast cancer symptoms and advising women that a previous benign diagnosis does not ensure that future symptoms are not cancer. Women wanted empathic nonjudgmental access to care. Improved methods to track compliance with screening mammography and with periodic health exams and access to a rapid diagnostic process were suggested. Conclusions A list of “at-risk situations for delay” in diagnosis of breast cancer was developed for physicians to assist in identifying women who might delay. Health care system changes actionable both at the health policy level and in the family physician’s office were identified to encourage earlier presentation of women with symptomatic breast cancer. PMID:21980254

Earlier Visual N1 Latencies in Expert Video-Game Players: A Temporal Basis of Enhanced Visuospatial Performance?

PubMed Central

Latham, Andrew J.; Patston, Lucy L. M.; Westermann, Christine; Kirk, Ian J.; Tippett, Lynette J.

2013-01-01

Increasing behavioural evidence suggests that expert video game players (VGPs) show enhanced visual attention and visuospatial abilities, but what underlies these enhancements remains unclear. We administered the Poffenberger paradigm with concurrent electroencephalogram (EEG) recording to assess occipital N1 latencies and interhemispheric transfer time (IHTT) in expert VGPs. Participants comprised 15 right-handed male expert VGPs and 16 non-VGP controls matched for age, handedness, IQ and years of education. Expert VGPs began playing before age 10, had a minimum 8 years experience, and maintained playtime of at least 20 hours per week over the last 6 months. Non-VGPs had little-to-no game play experience (maximum 1.5 years). Participants responded to checkerboard stimuli presented to the left and right visual fields while 128-channel EEG was recorded. Expert VGPs responded significantly more quickly than non-VGPs. Expert VGPs also had significantly earlier occipital N1s in direct visual pathways (the hemisphere contralateral to the visual field in which the stimulus was presented). IHTT was calculated by comparing the latencies of occipital N1 components between hemispheres. No significant between-group differences in electrophysiological estimates of IHTT were found. Shorter N1 latencies may enable expert VGPs to discriminate attended visual stimuli significantly earlier than non-VGPs and contribute to faster responding in visual tasks. As successful video-game play requires precise, time pressured, bimanual motor movements in response to complex visual stimuli, which in this sample began during early childhood, these differences may reflect the experience and training involved during the development of video-game expertise, but training studies are needed to test this prediction. PMID:24058667

Earlier visual N1 latencies in expert video-game players: a temporal basis of enhanced visuospatial performance?

PubMed

Latham, Andrew J; Patston, Lucy L M; Westermann, Christine; Kirk, Ian J; Tippett, Lynette J

2013-01-01

Increasing behavioural evidence suggests that expert video game players (VGPs) show enhanced visual attention and visuospatial abilities, but what underlies these enhancements remains unclear. We administered the Poffenberger paradigm with concurrent electroencephalogram (EEG) recording to assess occipital N1 latencies and interhemispheric transfer time (IHTT) in expert VGPs. Participants comprised 15 right-handed male expert VGPs and 16 non-VGP controls matched for age, handedness, IQ and years of education. Expert VGPs began playing before age 10, had a minimum 8 years experience, and maintained playtime of at least 20 hours per week over the last 6 months. Non-VGPs had little-to-no game play experience (maximum 1.5 years). Participants responded to checkerboard stimuli presented to the left and right visual fields while 128-channel EEG was recorded. Expert VGPs responded significantly more quickly than non-VGPs. Expert VGPs also had significantly earlier occipital N1s in direct visual pathways (the hemisphere contralateral to the visual field in which the stimulus was presented). IHTT was calculated by comparing the latencies of occipital N1 components between hemispheres. No significant between-group differences in electrophysiological estimates of IHTT were found. Shorter N1 latencies may enable expert VGPs to discriminate attended visual stimuli significantly earlier than non-VGPs and contribute to faster responding in visual tasks. As successful video-game play requires precise, time pressured, bimanual motor movements in response to complex visual stimuli, which in this sample began during early childhood, these differences may reflect the experience and training involved during the development of video-game expertise, but training studies are needed to test this prediction.

An earlier origin for the Acheulian.

PubMed

Lepre, Christopher J; Roche, Hélène; Kent, Dennis V; Harmand, Sonia; Quinn, Rhonda L; Brugal, Jean-Philippe; Texier, Pierre-Jean; Lenoble, Arnaud; Feibel, Craig S

2011-08-31

The Acheulian is one of the first defined prehistoric techno-complexes and is characterized by shaped bifacial stone tools. It probably originated in Africa, spreading to Europe and Asia perhaps as early as ∼1 million years (Myr) ago. The origin of the Acheulian is thought to have closely coincided with major changes in human brain evolution, allowing for further technological developments. Nonetheless, the emergence of the Acheulian remains unclear because well-dated sites older than 1.4 Myr ago are scarce. Here we report on the lithic assemblage and geological context for the Kokiselei 4 archaeological site from the Nachukui formation (West Turkana, Kenya) that bears characteristic early Acheulian tools and pushes the first appearance datum for this stone-age technology back to 1.76 Myr ago. Moreover, co-occurrence of Oldowan and Acheulian artefacts at the Kokiselei site complex indicates that the two technologies are not mutually exclusive time-successive components of an evolving cultural lineage, and suggests that the Acheulian was either imported from another location yet to be identified or originated from Oldowan hominins at this vicinity. In either case, the Acheulian did not accompany the first human dispersal from Africa despite being available at the time. This may indicate that multiple groups of hominins distinguished by separate stone-tool-making behaviours and dispersal strategies coexisted in Africa at 1.76 Myr ago.

A historical study to understand students’ current difficulties about RMS values

NASA Astrophysics Data System (ADS)

Khantine-Langlois, Françoise; Munier, Valérie

2016-07-01

Several studies show that students experience more and more difficulties managing the measurements of electrical values in alternating current and that they have trouble making links between theory and practice. They find it difficult to give meaning to root mean square (RMS; or effective) values, which are not understood as average values and are confused with instantaneous values. This shows that students do not clearly differentiate variable and direct currents. In this paper we try, with a historical study and a study of teaching the concept of RMS values, to understand students’ difficulties with this concept. In the first part we present an epistemological analysis of the concept of RMS values, showing that it is multifaceted and can be approached from different points of view. In the second part we analyse the evolution of French secondary school curricula and textbooks from the explicit introduction of variable currents to today, questioning the links between the evolution of the curricula and the evolution of the place of science and technology in our societies. We point out that the evolution of the curricula is linked to the social context and to the connections between science, technology and society, and also to the relationship with mathematics curricula. We show that alternating current is introduced earlier in the curriculum but has gradually lost all phenomenological description. This study allows us to better understand students’ difficulties and to discuss some implications for teaching.

Radioactive materials released from nuclear power plants. Annual report, 1980

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

Tichler, J.; Benkovitz, C.

Releases of radioactive materials in airborne and liquid effluents from commercial light water reactors during 1980 have been compiled and reported. Data on solid waste shipments as well as selected operating information have been included. This report supplements earlier annual reports issued by the former Atomic Energy Commission and the Nuclear Regulatory Commission. The 1980 release data are summarized in tabular form. Data covering specific radionuclides are summarized.

Radioactive materials released from nuclear power plants: Annual report, 1984

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

Tichler, J.; Norden, K.; Congemi, J.

Releases of radioactive materials in airborne and liquid effluents from commercial light water reactors during 1984 have been compiled and reported. Data on solid waste shipments as well as selected operating information have been included. This report supplements earlier annual reports issued by the former Atomic Energy Commission and the Nuclear Regulatory Commission. The 1984 release data are summarized in tabular form. Data covering specific radionuclides are summarized.

Radioactive materials released from nuclear power plants. Annual report 1978

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

Tichler, J.; Benkovitz, C.

Releases of radioactive materials in airborne and liquid effluents from commerical light water reactors during 1978 have been compiled and reported. Data on soild waste shipments as well as selected operating information have been included. This report supplements earlier annual reports by the former Atomic Energy Commission and the Nuclear Regulatory Commission. The 1978 release data are compared with previous years releases in tabular form. Data covering specific radionuclides are summarized.

Radioactive materials released from nuclear power plants: Annual report, 1985

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

Tichler, J.; Norden, K.; Congemi, J.

Releases of radioactive materials in airborne and liquid effluents from commercial light water reactors during 1985 have been compiled and reported. Data on solid waste shipments as well as selected operating information have been included. This report supplements earlier annual reports issued by the former Atomic Energy Commission and the Nuclear Regulatory Commission. The 1985 release data are summarized in tabular form. Data covering specific radionuclides are summarized.

An earlier explosion date for the Crab Nebula supernova

NASA Astrophysics Data System (ADS)

Abt, Helmut A.; Fountain, John W.

2018-04-01

The Chinese first reported the Crab Nebula supernova on 1054 July 5. Ecclesiastical documents from the near east reported it in April and May of 1054. More than 33 petroglyphs made by Native Americans in the US and Mexico are consistent with sightings both before and after conjunction with the Sun on 1054 May 27. We found a petroglyph showing the new star close to Venus and the Moon, which occurred on 1054 April 12 and April 13, respectively. Collins et al., using the four historical dates, derived a light curve that is like that of a Type Ia supernova. The only remaining problem with this identification is that this supernova was near maximum light for 85 d, which is unlike the behavior of any known supernova.

An Action Research Study in an Icelandic Preschool: Developing Consensus about Values and Values Education

ERIC Educational Resources Information Center

Sigurdardottir, Ingibjorg; Einarsdottir, Johanna

2016-01-01

Values education is embedded in the curricula of all the Nordic countries. However, values education remains a neglected area for research and practice in early childhood education and care. This article reports on the aspects of an action research project conducted in a preschool in Iceland, across a period of 18 months. The study focused on the…

Value management program: performance, quantification, and presentation of imaging value-added actions.

PubMed

Patel, Samir

2015-03-01

Health care is in a state of transition, shifting from volume-based success to value-based success. Hospital executives and referring physicians often do not understand the total value a radiology group provides. A template for easy, cost-effective implementation in clinical practice for most radiology groups to demonstrate the value they provide to their clients (patients, physicians, health care executives) has not been well described. A value management program was developed to document all of the value-added activities performed by on-site radiologists, quantify them in terms of time spent on each activity (investment), and present the benefits to internal and external stakeholders (outcomes). The radiology value-added matrix is the platform from which value-added activities are categorized and synthesized into a template for defining investments and outcomes. The value management program was first implemented systemwide in 2013. Across all serviced locations, 9,931.75 hours were invested. An annual executive summary report template demonstrating outcomes is given to clients. The mean and median individual value-added hours per radiologist were 134.52 and 113.33, respectively. If this program were extrapolated to the entire field of radiology, approximately 30,000 radiologists, this would have resulted in 10,641,161 uncompensated value-added hours documented in 2013, with an estimated economic value of $2.21 billion. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Moderately premature infants at Kaiser Permanente Medical Care Program in California are discharged home earlier than their peers in Massachusetts and the United Kingdom

PubMed Central

Profit, J; Zupancic, J A F; McCormick, M C; Richardson, D K; Escobar, G J; Tucker, J; Tarnow‐Mordi, W; Parry, G

2006-01-01

Objective To compare gestational age at discharge between infants born at 30–34+6 weeks gestational age who were admitted to neonatal intensive care units (NICUs) in California, Massachusetts, and the United Kingdom. Design Prospective observational cohort study. Setting Fifty four United Kingdom, five California, and five Massachusetts NICUs. Subjects A total of 4359 infants who survived to discharge home after admission to an NICU. Main outcome measures Gestational age at discharge home. Results The mean (SD) postmenstrual age at discharge of the infants in California, Massachusetts, and the United Kingdom were 35.9 (1.3), 36.3 (1.3), and 36.3 (1.9) weeks respectively (p  =  0.001). Compared with the United Kingdom, adjusted discharge of infants occurred 3.9 (95% confidence interval (CI) 1.4 to 6.5) days earlier in California, and 0.9 (95% CI −1.2 to 3.0) days earlier in Massachusetts. Conclusions Infants of 30–34+6 weeks gestation at birth admitted and cared for in hospitals in California have a shorter length of stay than those in the United Kingdom. Certain characteristics of the integrated healthcare approach pursued by the health maintenance organisation of the NICUs in California may foster earlier discharge. The California system may provide opportunities for identifying practices for reducing the length of stay of moderately premature infants. PMID:16449257

40 CFR 35.926 - Value engineering (VE).

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 1 2013-07-01 2013-07-01 false Value engineering (VE). 35.926 Section... engineering (VE). (a) Value engineering proposal. All step 2 grant applications for projects having a... completion of VE analysis and submittal of VE summary reports). (b) Value engineering analysis. For projects...

40 CFR 35.926 - Value engineering (VE).

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Value engineering (VE). 35.926 Section... engineering (VE). (a) Value engineering proposal. All step 2 grant applications for projects having a... completion of VE analysis and submittal of VE summary reports). (b) Value engineering analysis. For projects...

40 CFR 35.926 - Value engineering (VE).

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 1 2012-07-01 2012-07-01 false Value engineering (VE). 35.926 Section... engineering (VE). (a) Value engineering proposal. All step 2 grant applications for projects having a... completion of VE analysis and submittal of VE summary reports). (b) Value engineering analysis. For projects...

40 CFR 35.926 - Value engineering (VE).

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Value engineering (VE). 35.926 Section... engineering (VE). (a) Value engineering proposal. All step 2 grant applications for projects having a... completion of VE analysis and submittal of VE summary reports). (b) Value engineering analysis. For projects...

40 CFR 35.926 - Value engineering (VE).

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 1 2014-07-01 2014-07-01 false Value engineering (VE). 35.926 Section... engineering (VE). (a) Value engineering proposal. All step 2 grant applications for projects having a... completion of VE analysis and submittal of VE summary reports). (b) Value engineering analysis. For projects...

Arctic National Wildlife Refuge, Alaska, Coastal Plain Resource Assessment: Report and recommendation to the Congress of the United States and final legislative environmental impact statement

USGS Publications Warehouse

,

1987-01-01

The Arctic National Wildlife Refuge, in the northeastern corner of Alaska, was first established as the Arctic National Wildlife Range by Public Land Order 2214 in 1960, for the purpose of preserving unique wildlife, wilderness, and recreational values. The original 8.9-millionacre Range was withdrawn from all forms of appropriation under the public land laws, including mining laws but not including mineral leasing laws. This order culminated extensive efforts begun more than a decade earlier to preserve this unique part of Alaska. The following report analyzes the potential environmental consequences of five management alternatives for the coastal plain, ranging from opening for lease of the entire area for oil and gas development, to wilderness designation. A legislative environmental impact statement has been integrated into the report.

Expensing stock options: a fair-value approach.

PubMed

Kaplan, Robert S; Palepu, Krishna G

2003-12-01

Now that companies such as General Electric and Citigroup have accepted the premise that employee stock options are an expense, the debate is shifting from whether to report options on income statements to how to report them. The authors present a new accounting mechanism that maintains the rationale underlying stock option expensing while addressing critics' concerns about measurement error and the lack of reconciliation to actual experience. A procedure they call fair-value expensing adjusts and eventually reconciles cost estimates made at grant date with subsequent changes in the value of the options, and it does so in a way that eliminates forecasting and measurement errors over time. The method captures the chief characteristic of stock option compensation--that employees receive part of their compensation in the form of a contingent claim on the value they are helping to produce. The mechanism involves creating entries on both the asset and equity sides of the balance sheet. On the asset side, companies create a prepaid-compensation account equal to the estimated cost of the options granted; on the owners'-equity side, they create a paid-in capital stock-option account for the same amount. The prepaid-compensation account is then expensed through the income statement, and the stock option account is adjusted on the balance sheet to reflect changes in the estimated fair value of the granted options. The amortization of prepaid compensation is added to the change in the option grant's value to provide the total reported expense of the options grant for the year. At the end of the vesting period, the company uses the fair value of the vested option to make a final adjustment on the income statement to reconcile any difference between that fair value and the total of the amounts already reported.

Correlation between polar values and vector analysis.

PubMed

Naeser, K; Behrens, J K

1997-01-01

To evaluate the possible correlation between polar value and vector analysis assessment of surgically induced astigmatism. Department of Ophthalmology, Aalborg Sygehus Syd, Denmark. The correlation between polar values and vector analysis was evaluated by simple mathematical and optical methods using accepted principles of trigonometry and first-order optics. Vector analysis and polar values report different aspects of surgically induced astigmatism. Vector analysis describes the total astigmatic change, characterized by both astigmatic magnitude and direction, while the polar value method produces a single, reduced figure that reports flattening or steepening in preselected directions, usually the plane of the surgical meridian. There is a simple Pythagorean correlation between vector analysis and two polar values separated by an arch of 45 degrees. The polar value calculated in the surgical meridian indicates the power or the efficacy of the surgical procedure. The polar value calculated in a plane inclined 45 degrees to the surgical meridian indicates the degree of cylinder rotation induced by surgery. These two polar values can be used to obtain other relevant data such as magnitude, direction, and sphere of an induced cylinder. Consistent use of these methods will enable surgeons to control and in many cases reduce preoperative astigmatism.

Valuing improved wetland quality using choice modeling

NASA Astrophysics Data System (ADS)

Morrison, Mark; Bennett, Jeff; Blamey, Russell

1999-09-01

The main stated preference technique used for estimating environmental values is the contingent valuation method. In this paper the results of an application of an alternative technique, choice modeling, are reported. Choice modeling has been developed in the marketing and transport applications but has only been used in a handful of environmental applications, most of which have focused on use values. The case study presented here involves the estimation of the nonuse environmental values provided by the Macquarie Marshes, a major wetland in New South Wales, Australia. Estimates of the nonuse value the community places on preventing job losses are also presented. The reported models are robust, having high explanatory power and variables that are statistically significant and consistent with expectations. These results provide support for the hypothesis that choice modeling can be used to estimate nonuse values for both environmental and social consequences of resource use changes.

The Ph.D. in English and Foreign Languages: A Conference Report.

ERIC Educational Resources Information Center

Association of Departments of English, New York, NY.

This special issue presents the speeches, surveys, and workshop reports of the University of Texas Conference on the Research Component of the Ph.D. in English and Foreign Languages held in Austin in December 1972. Also included are updated papers and reports from the Purdue University Conference on Graduate Education held earlier in 1972.…

Investigating the Value of Section Scores for the "TOEFL iBT"® Test. "TOEFL iBT"® Research Report. TOEFL iBT-21. ETS Research Report RR-13-35

ERIC Educational Resources Information Center

Sawaki, Yasuyo; Sinharay, Sandip

2013-01-01

This study investigates the value of reporting the reading, listening, speaking, and writing section scores for the "TOEFL iBT"® test, focusing on 4 related aspects of the psychometric quality of the TOEFL iBT section scores: reliability of the section scores, dimensionality of the test, presence of distinct score profiles, and the…

Imbalance p values for baseline covariates in randomized controlled trials: a last resort for the use of p values? A pro and contra debate.

PubMed

Stang, Andreas; Baethge, Christopher

2018-01-01

Results of randomized controlled trials (RCTs) are usually accompanied by a table that compares covariates between the study groups at baseline. Sometimes, the investigators report p values for imbalanced covariates. The aim of this debate is to illustrate the pro and contra of the use of these p values in RCTs. Low p values can be a sign of biased or fraudulent randomization and can be used as a warning sign. They can be considered as a screening tool with low positive-predictive value. Low p values should prompt us to ask for the reasons and for potential consequences, especially in combination with hints of methodological problems. A fair randomization produces the expectation that the distribution of p values follows a flat distribution. It does not produce an expectation related to a single p value. The distribution of p values in RCTs can be influenced by the correlation among covariates, differential misclassification or differential mismeasurement of baseline covariates. Given only a small number of reported p values in the reports of RCTs, judging whether the realized p value distribution is, indeed, a flat distribution becomes difficult. If p values ≤0.005 or ≥0.995 were used as a sign of alarm, the false-positive rate would be 5.0% if randomization was done correctly, and five p values per RCT were reported. Use of a low p value as a warning sign that randomization is potentially biased can be considered a vague heuristic. The authors of this debate are obviously more or less enthusiastic with this heuristic and differ in the consequences they propose.

Verification of Self-Report Temperament Factors.

ERIC Educational Resources Information Center

Dermen, Diran; And Others

In an earlier report, one of the authors describes 28 temperament factors for which there is sufficient consensus in the literature to call them "established". From 1 to 5 distinct bipolar subscales were suggested to mark each factor; 12 or 16 item subscales were written, each balanced in terms of the two defined poles and in terms of numbers of…

Facilitating the inclusion of nonmarket values in Bureau of Land Management planning and project assessments—Final report

USGS Publications Warehouse

Huber, Chris; Richardson, Leslie

2016-11-23

Executive SummaryThis report summarizes the results of a series of field-based case studies conducted by the U.S. Geological Survey (USGS) to (1) evaluate the use of nonmarket values in Bureau of Land Management (BLM) planning and project assessments, (2) update existing technical resources for measuring those values, and (3) provide guidance to field staff on the use of nonmarket values. Four BLM pilot sites participated in this effort: Canyons of the Ancients National Monument in Colorado, Red Cliffs and Beaver Dam Wash National Conservation Areas in Utah, BLM’s Taos Field Office in New Mexico, and BLM's Tuscarora Field Office in Nevada. The focus of the case studies was on practical applications of nonmarket valuation. USGS worked directly with BLM field staff at the pilot sites to demonstrate the process of considering nonmarket values in BLM decisionmaking and document the questions, challenges, and opportunities that arise when tying economic language to projects.As part of this effort, a Web-based toolkit, available at https://my.usgs.gov/benefit-transfer/, was updated and expanded to help facilitate benefit transfers (that is, the use of existing economic data to quantify nonmarket values) and qualitative discussions of nonmarket values. A total of 53 new or overlooked nonmarket valuation studies comprising 494 nonmarket value estimates for various recreational activities and the preservation of threatened, endangered, and rare species were added to existing databases within this Benefit Transfer Toolkit. In addition, four meta-regression functions focused on hunting, wildlife viewing, fishing, and trail use recreation were developed and added to the Benefit Transfer Toolkit.Results of this effort demonstrate that there are two main roles for nonmarket valuation in BLM planning. The first is to improve the decisionmaking process by contributing to a more comprehensive comparison of economic benefits and cost when evaluating resource tradeoffs for National

Influence of the way of reporting alpha-Amylase values in saliva in different naturalistic situations: A pilot study

PubMed Central

Contreras-Aguilar, María Dolores; Escribano, Damián; Martínez-Subiela, Silvia; Martínez-Miró, Silvia; Rubio, Mónica; Tvarijonaviciute, Asta; Tecles, Fernando; Cerón, Jose J.

2017-01-01

The objective of this pilot study was to compare the different ways of measuring salivary alpha-amylase (sAA, enzymatic vs. concentration) and to evaluate the influence that the different ways of reporting the results can have in sAA interpretation. For this purpose, sAA was measured by direct quantification and also by an enzymatic assay in three different naturalistic situations, a physical stressor (situation 1) and two mental stressors of different intensity (situations 2 and 3). The results were expressed in three different ways (without correction, multiplied by flow rate and divided by protein concentration). sAA concentration and activity increased just after situations 1 and 3. When values were multiplied by the flow rate, significant changes after situation 1 were detected only for sAA activity but not for sAA concentration, being these changes of lower significance and magnitude that those observed for sAA activity without any correction. In addition, a significant increase in sAA activity was found at T+15 in situation 2. In situation 3 the significant decrease in sAA at T+15 disappeared. When values were divided by protein concentration, there were no significant changes in situations 1 or 3, but a decrease in situation 2 at T+0 and an increase at T+15. sAA activity and concentration showed a significant correlation in all situations. This pilot study points out that the way of expressing sAA can influence the results obtained in different stress models and also their interpretation. Therefore, how sAA is reported and the factors involved in the different ways of expressing sAA, should be taken into consideration for an objective interpretation of sAA values. PMID:28654668

Influence of the way of reporting alpha-Amylase values in saliva in different naturalistic situations: A pilot study.

PubMed

Contreras-Aguilar, María Dolores; Escribano, Damián; Martínez-Subiela, Silvia; Martínez-Miró, Silvia; Rubio, Mónica; Tvarijonaviciute, Asta; Tecles, Fernando; Cerón, Jose J

2017-01-01

The objective of this pilot study was to compare the different ways of measuring salivary alpha-amylase (sAA, enzymatic vs. concentration) and to evaluate the influence that the different ways of reporting the results can have in sAA interpretation. For this purpose, sAA was measured by direct quantification and also by an enzymatic assay in three different naturalistic situations, a physical stressor (situation 1) and two mental stressors of different intensity (situations 2 and 3). The results were expressed in three different ways (without correction, multiplied by flow rate and divided by protein concentration). sAA concentration and activity increased just after situations 1 and 3. When values were multiplied by the flow rate, significant changes after situation 1 were detected only for sAA activity but not for sAA concentration, being these changes of lower significance and magnitude that those observed for sAA activity without any correction. In addition, a significant increase in sAA activity was found at T+15 in situation 2. In situation 3 the significant decrease in sAA at T+15 disappeared. When values were divided by protein concentration, there were no significant changes in situations 1 or 3, but a decrease in situation 2 at T+0 and an increase at T+15. sAA activity and concentration showed a significant correlation in all situations. This pilot study points out that the way of expressing sAA can influence the results obtained in different stress models and also their interpretation. Therefore, how sAA is reported and the factors involved in the different ways of expressing sAA, should be taken into consideration for an objective interpretation of sAA values.

Cost-Effectiveness of Earlier Initiation of Antiretroviral Therapy for Uninsured HIV-Infected Adults

PubMed Central

Schackman, Bruce R.; Goldie, Sue J.; Weinstein, Milton C.; Losina, Elena; Zhang, Hong; Freedberg, Kenneth A.

2001-01-01

Objectives. This study was designed to examine the societal cost-effectiveness and the impact on government payers of earlier initiation of antiretroviral therapy for uninsured HIV-infected adults. Methods. A state-transition simulation model of HIV disease was used. Data were derived from the Multicenter AIDS Cohort Study, published randomized trials, and medical care cost estimates for all government payers and for Massachusetts, New York, and Florida. Results. Quality-adjusted life expectancy increased from 7.64 years with therapy initiated at 200 CD4 cells/μL to 8.21 years with therapy initiated at 500 CD4 cells/μL. Initiating therapy at 500 CD4/μL was a more efficient use of resources than initiating therapy at 200 CD4/μL and had an incremental cost-effectiveness ratio of $17 300 per quality-adjusted life-year gained, compared with no therapy. Costs to state payers in the first 5 years ranged from $5500 to $24 900 because of differences among the states in the availability of federal funds for AIDS drug assistance programs. Conclusions. Antiretroviral therapy initiated at 500 CD4 cells/μL is cost-effective from a societal perspective compared with therapy initiated later. States should consider Medicaid waivers to expand access to early therapy. PMID:11527782

Solvability of a fourth-order boundary value problem with periodic boundary conditions II

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

Gupta, Chaitan P.

1991-01-01

Lemore » t f : [ 0 , 1 ] × R 4 → R be a function satisfying Caratheodory's conditions and e ( x ) ∈ L 1 [ 0 , 1 ] . This paper is concerned with the solvability of the fourth-order fully quasilinear boundary value problem d 4 u d x 4 + f ( x , u ( x ) , u ′ ( x ) , u ″ ( x ) , u ‴ ( x ) ) = e ( x ) ,    0 < x < 1 , with u ( 0 ) − u ( 1 ) = u ′ ( 0 ) − u ′ ( 1 ) = u ″ ( 0 ) - u ″ ( 1 ) = u ‴ ( 0 ) - u ‴ ( 1 ) = 0 . This problem was studied earlier by the author in the special case when f was of the form f ( x , u ( x ) ) , i.e., independent of u ′ ( x ) , u ″ ( x ) , u ‴ ( x ) . It turns out that the earlier methods do not apply in this general case. The conditions need to be related to both of the linear eigenvalue problems d 4 u d x 4 = λ 4 u and d 4 u d x 4 = − λ 2 d 2 u d x 2 with periodic boundary conditions.« less

Mean lives of some astrophysically important excited levels in carbon, nitrogen and oxygen

NASA Technical Reports Server (NTRS)

Chang, M. W.; Bickel, W. S.

1976-01-01

A number of astrophysically important mean lives of levels in carbon, nitrogen and oxygen were measured with the beam-foil technique. New values are reported and compared with earlier theoretical and experimental values. Direct references to astrophysical applications are listed.

Value-Based Assessment of Radiology Reporting Using Radiologist-Referring Physician Two-Way Feedback System-a Design Thinking-Based Approach.

PubMed

Shaikh, Faiq; Hendrata, Kenneth; Kolowitz, Brian; Awan, Omer; Shrestha, Rasu; Deible, Christopher

2017-06-01

In the era of value-based healthcare, many aspects of medical care are being measured and assessed to improve quality and reduce costs. Radiology adds enormously to health care costs and is under pressure to adopt a more efficient system that incorporates essential metrics to assess its value and impact on outcomes. Most current systems tie radiologists' incentives and evaluations to RVU-based productivity metrics and peer-review-based quality metrics. In a new potential model, a radiologist's performance will have to increasingly depend on a number of parameters that define "value," beginning with peer review metrics that include referrer satisfaction and feedback from radiologists to the referring physician that evaluates the potency and validity of clinical information provided for a given study. These new dimensions of value measurement will directly impact the cascade of further medical management. We share our continued experience with this project that had two components: RESP (Referrer Evaluation System Pilot) and FRACI (Feedback from Radiologist Addressing Confounding Issues), which were introduced to the clinical radiology workflow in order to capture referrer-based and radiologist-based feedback on radiology reporting. We also share our insight into the principles of design thinking as applied in its planning and execution.

Self-reported smoking effects and comparative value between cigarettes and high dose e-cigarettes in nicotine-dependent cigarette smokers.

PubMed

McPherson, Sterling; Howell, Donelle; Lewis, Jennifer; Barbosa-Leiker, Celestina; Bertotti Metoyer, Patrick; Roll, John

2016-04-01

The objective of this experiment was to evaluate the comparative value of cigarettes versus high dose e-cigarettes among nicotine-dependent cigarette smokers when compared with money or use of their usual cigarette brand. The experiment used a within-subject design with four sessions. After baseline assessment, participants attended two 15-min unrestricted smoking sessions: one cigarette smoking session and one e-cigarette smoking session. Participants then attended two multiple-choice procedure (MCP) sessions: a session comparing cigarettes and money and a session comparing e-cigarettes and money. Participants (n=27) had used cigarettes regularly, had never used e-cigarettes, and were not currently attempting to quit smoking. The sample consisted primarily of males (72%), with a mean age of 34 years. When given the opportunity to choose between smoking a cigarette or an e-cigarette, participants chose the cigarette 73.9% of the time. Findings from the MCP demonstrated that after the first e-cigarette exposure sessions, the crossover value for cigarettes ($3.45) was significantly higher compared with the crossover value for e-cigarettes ($2.73). The higher participant preference, self-reported smoking effects, and higher MCP crossover points indicate that cigarettes have a higher comparative value than high dose e-cigarettes among e-cigarette naive smokers.

Empathy, values, morality and Asperger's syndrome.

PubMed

Hirvelä, Shari; Helkama, Klaus

2011-12-01

The aims of this study were, first, to re-address the issue of empathy among people with autism conditions; second, to explore the relationships between empathy and values among autistic populations and controls; and third, to explore the capacity for moral agency among those affected by autism. We compared responses of an Asperger group (N = 41) and a control group (N = 139) to measures of self-reported empathy (Davis's IRI) and value priorities (Schwartz's PVQ). Control group results were largely in line with previous studies, such that empathy subscales of perspective taking and empathic concern showed their strongest positive and negative relations to the Schwartz self-transcendence/self-enhancement dimensions. Results for the Asperger group showed that although on the one hand there were self-reported difficulties in perspective taking and the cognitive recognition of affect, and that on the other hand there were less connections between the empathy and value measures, there was nevertheless a comparable prioritization of moral values. Conclusions suggest that different people may acquire moral values through different mechanisms. © 2011 The Authors. Scandinavian Journal of Psychology © 2011 The Scandinavian Psychological Associations.

What We Have Learned about Class Size Reduction in California. Capstone Report.

ERIC Educational Resources Information Center

Bohrnstedt, George W., Ed.; Stecher, Brian M., Ed.

This final report on the California Class Size Reduction (CSR) initiative summarizes findings from three earlier reports dating back to 1997. Chapter 1 recaps the history of California's CSR initiative and includes a discussion of what state leaders' expectations were when CSR was passed. The chapter also describes research on class-size reduction…

Giant-Magnetoresistance(GMR) Siegel KEY FIRST Experimental Discovery Decade-Earlier PRE-``Fert"-``Gruenberg" in Nuc"el"ar ``Super"alloys: Science?;``SEANCE!!!; Ethics?; SHMETHICS!!!

NASA Astrophysics Data System (ADS)

Hoffman, R.; Siegel, E.

2010-03-01

(So MIScalled) ``Fert"-``Grunberg"[PRL(1988;1989)] GMR 2007 physics Nobel/Wolf/Japan-Prizes VS. decade-earlier(1973-1977) KEY FIRST Siegel at:Westin"kl"ouse/PSEG/IAEA/ABB[google:``Martin Ebner"(94-04) in financial media]/Vattenfall/Wallenbergs/nuc"el"ar-DoE Labs[at flickr.com, search on ``Giant- Magnotoresistance''; find: Intl.Conf.Mag.Alloys & Oxides(ICMAO), Haifa(Aug./1977); J.Mag.Mag.Mtls,(JMMM)7,312(1978)``unavailable: not yet scanned''/modified(last R(H) GMR Figs(7;8) deleted!!!) on JMMM/Reed-Elsevier website until 7/29/08 conveniently one- half-year after last (Nobel)award(12/2007); conveniently effectively deleted!!!; google: ``If Leaks Could Kill''; many APS/MRS Mtgs(1970s)<<<1988/1989] decade-earlier GMR: (1978)<<< (1988); 1988-1978 =10 years = one full decadeprecedence!!!] first experimental discovery in (so MIScalled) ``super''alloys [182/82, Hastelloy-X, 600, 690(!!!), Stainless-Steels: ANY/ALL!!!] generic endemic Wigner's[JAP,17,857(1946)]- disease/Ostwald-ripening/spinodal-decomposition/overageing- embrittlement/ thermo-mechanical-INstability!

Field evidence for earlier leaf-out dates in alpine grassland on the eastern Tibetan Plateau from 1990 to 2006.

PubMed

Zhou, H K; Yao, B Q; Xu, W X; Ye, X; Fu, J J; Jin, Y X; Zhao, X Q

2014-08-01

Worldwide, many plant species are experiencing an earlier onset of spring phenophases due to climate warming. Rapid recent temperature increases on the Tibetan Plateau (TP) have triggered changes in the spring phenology of the local vegetation. However, remote sensing studies of the land surface phenology have reached conflicting interpretations about green-up patterns observed on the TP since the mid-1990s. We investigated this issue using field phenological observations from 1990 to 2006, for 11 dominant plants on the TP at the levels of species, families (Gramineae-grasses and Cyperaceae-sedges) and vegetation communities (alpine meadow and alpine steppe). We found a significant trend of earlier leaf-out dates for one species (Koeleria cristata). The leaf-out dates of both Gramineae and Cyperaceae had advanced (the latter significantly, starting an average of 9 days later per year than the former), but the correlation between them was significant. The leaf-out dates of both vegetation communities also advanced, but the pattern was only significant in the alpine meadow. This study provides the first field evidence of advancement in spring leaf phenology on the TP and suggests that the phenology of the alpine steppe can differ from that of the alpine meadow. These findings will be useful for understanding ecosystem responses to climate change and for grassland management on the TP. © 2014 The Author(s) Published by the Royal Society. All rights reserved.

Attitude and Empowerment as Predictors Of Self-Reported Self-Care and A1C Values among African Americans With Diabetes Mellitus.

PubMed

Kleier, Jo Ann; Dittman, Patricia Welch

2014-01-01

Diabetes mellitus is a leading cause of end stage renal disease among African Americans. The complications associated with diabetes can largely be reduced with effective diabetes self-management. Selected variables were tested as predictors of self-reported self-care, and self-reported self-care was tested as a predictor of A1C among 100 African-American individuals with diabetes. Participants scored high on their understanding of diabetes, its treatment, and engagement in self-care activities, but this was not reflected in their body mass index levels or A IC values.

White shrimp Litopenaeus vannamei that had received the hot-water extract of Spirulina platensis showed earlier recovery in immunity and up-regulation of gene expressions after pH stress.

PubMed

Lin, Yong-Chin; Tayag, Carina Miranda; Huang, Chien-Lun; Tsui, Wen-Ching; Chen, Jiann-Chu

2010-12-01

White shrimp Litopenaeus vannamei which had been immersed in seawater (35‰, pH 8.2) containing the hot-water extract of Spirulina platensis at 0 (control), 200, 400, and 600 mg L(-1) for 3 h, were transferred to seawater at pH 6.8, and the immune parameters and transcripts of the lipopolysaccharide- and β-glucan-binding protein (LGBP), peroxinectin (PX), and integrin β (IB) were examined 6-96 h post-transfer. Shrimp with no exposure to the hot-water extract and no pH change served as the background control. Results indicated that the hyaline cells, granular cells (including semi-granular cells), total haemocyte count, phenoloxidase activity, respiratory burst, superoxide dismutase activity, glutathione peroxidase activity, and lysozyme activity of shrimp transferred to seawater at pH 6.8 significantly decreased to the lowest at 6 h post-transfer. These immune parameters of shrimp immersed in 600 mg L(-1) of the extract were significantly higher than those of control shrimp at 24-96 h post-transfer, and had returned to the background values earlier at 48-72 h post-transfer with significant transcripts of LGBP, PX, and IB at 24, 6, and 24 h, respectively, whereas these parameters of control shrimp returned to the original values at ≥96 h post-transfer. Copyright © 2010 Elsevier Ltd. All rights reserved.

School Enrollment--Social and Economic Characteristics of Students: October 1977 (Advance Report). Current Population Reports. Population Characteristics. Series P-20, No. 321.

ERIC Educational Resources Information Center

Bureau of the Census (DOC), Suitland, MD.

This report presents a summary of recent trends in school and college enrollment based on the October 1977 Current Population Survey (CPS) and earlier surveys. Enrollment statistics representing growth and decline at various educational levels are evaluated in written summaries. Comparative and distributive enrollment statistics of the population…

Development of a Values Conflict Resolution Assessment.

ERIC Educational Resources Information Center

Kinnier, Richard T.

1987-01-01

Describes the development of a Values Conflict Resolution Assessment (VCRA) and reports on validation and reliability. Items were constructed from theoretical criteria in values clarification and decision making with "ethical-emotional" and "rational-behavioral" components. VCRA scores correlated negatively with…

The role of between-parent values agreement in parent-to-child transmission of academic values.

PubMed

Gniewosz, Burkhard; Noack, Peter

2012-08-01

The present study investigates the intergenerational transmission of academic task values within family in early adolescence. Social learning processes are assumed to operate through the students' perceptions of their parents' values. The major goal of this study is to show that this values transmission is facilitated by between-parent value agreement. Based on a longitudinal data set including 1019 German students, their mothers (N = 847), and fathers (N = 733), structural equation models showed significant effects of the parents' task values regarding math and German language as academic subjects on the respective task values reported by the students, mediated through the student-perceived parental values. This transmission chain was only found if the between-parent agreement was high. The results are discussed in terms of parent-specific mechanisms fostering transmission if both parents agree on academic values, such as an improved perceptive accuracy as well as the increased salience and mutual reinforcement of parental messages. Copyright © 2011 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Retrospective study of reasons for improved survival in patients with breast cancer in east Anglia: earlier diagnosis or better treatment.

PubMed Central

Stockton, D.; Davies, T.; Day, N.; McCann, J.

1997-01-01

OBJECTIVES: To investigate the recent fall in mortality from breast cancer in England and Wales, and to determine the relative contributions of improvements in treatment and earlier detection of tumours. DESIGN: Retrospective study of all women with breast cancer registered by the East Anglian cancer registry and diagnosed between 1982 and 1989. SUBJECTS: 3965 patients diagnosed 1982-5 compared with 4665 patients diagnosed 1986-9, in three age groups 0-49, 50-64, > or = 65 years, with information on stage at diagnosis and survival. MAIN OUTCOME MEASURES: Three year relative survival rates by time period, age group, and stage; relative hazard ratios for each time period and age group derived from Cox's proportional hazards model, adjusted for single year of age and stage. RESULTS: Survival improved in the later time period, although there was little stage specific improvement. The proportion of early stage tumours increased especially in the 50-64 year age group, and adjustment for stage accounted for over half of the improvement in survival in women aged under 65 years. CONCLUSION: Over half of the drop in mortality in women aged under 65 years seems to be attributable to earlier detection of tumours, which has been observed since the mid-1980s. This could have resulted from an increase in breast awareness predating the start of the breast screening programme. PMID:9056796

Critical laboratory values in hemostasis: toward consensus.

PubMed

Lippi, Giuseppe; Adcock, Dorothy; Simundic, Ana-Maria; Tripodi, Armando; Favaloro, Emmanuel J

2017-09-01

The term "critical values" can be defined to entail laboratory test results that significantly lie outside the normal (reference) range and necessitate immediate reporting to safeguard patient health, as well as those displaying a highly and clinically significant variation compared to previous data. The identification and effective communication of "highly pathological" values has engaged the minds of many clinicians, health care and laboratory professionals for decades, since these activities are vital to good laboratory practice. This is especially true in hemostasis, where a timely and efficient communication of critical values strongly impacts patient management. Due to the heterogeneity of available data, this paper is hence aimed to analyze the state of the art and provide an expert opinion about the parameters, measurement units and alert limits pertaining to critical values in hemostasis, thus providing a basic document for future consultation that assists laboratory professionals and clinicians alike. KEY MESSAGES Critical values are laboratory test results significantly lying outside the normal (reference) range and necessitating immediate reporting to safeguard patient health. A broad heterogeneity exists about critical values in hemostasis worldwide. We provide here an expert opinion about the parameters, measurement units and alert limits pertaining to critical values in hemostasis.

A systematic review of utility values for chemotherapy-related adverse events.

PubMed

Shabaruddin, Fatiha H; Chen, Li-Chia; Elliott, Rachel A; Payne, Katherine

2013-04-01

Chemotherapy offers cancer patients the potential benefits of improved mortality and morbidity but may cause detrimental outcomes due to adverse drug events (ADEs), some of which requiring time-consuming, resource-intensive and costly clinical management. To appropriately assess chemotherapy agents in an economic evaluation, ADE-related parameters such as the incidence, (dis)utility and cost of ADEs should be reflected within the model parameters. To date, there has been no systematic summary of the existing literature that quantifies the utilities of ADEs due to healthcare interventions in general and chemotherapy treatments in particular. This review aimed to summarize the current evidence base of reported utility values for chemotherapy-related ADEs. A structured electronic search combining terms for utility, utility valuation methods and generic terms for cancer treatment was conducted in MEDLINE and EMBASE in June 2011. Inclusion criteria were: (1) elicitation of utility values for chemotherapy-related ADEs and (2) primary data. Two reviewers identified studies and extracted data independently. Any disagreements were resolved by a third reviewer. Eighteen studies met the inclusion criteria from the 853 abstracts initially identified, collectively reporting 218 utility values for chemotherapy-related ADEs. All 18 studies used short descriptions (vignettes) to obtain the utility values, with nine studies presenting the vignettes used in the valuation exercises. Of the 218 utility values, 178 were elicited using standard gamble (SG) or time trade-off (TTO) approaches, while 40 were elicited using visual analogue scales (VAS). There were 169 utility values of specific chemotherapy-related ADEs (with the top ten being anaemia [34 values], nausea and/or vomiting [32 values], neuropathy [21 values], neutropenia [12 values], diarrhoea [12 values], stomatitis [10 values], fatigue [8 values], alopecia [7 values], hand-foot syndrome [5 values] and skin reaction [5 values

Changes in values of cholesterol and tryglicerides after weight loss during treatment with aripiprazole in a patient with schizophrenia - Case report.

PubMed

Uzun, Suzana; Kozumplik, Oliver; Sedić, Biserka

2010-06-01

Metabolic syndrome can contribute to significant morbidity and premature mortality and should be accounted for in the treatment of mental disorders. Patients with schizophrenia are at risk of undetected somatic comorbidity. Patients with schizophrenia have metabolically unfavorable body composition, comprising abdominal obesity, high fat percentage and low muscle mass, leading to increased risk of metabolic and cardiovascular diseases. Smoking, poor diet, reduced physical activity and alcohol or drug abuse are prevalent in people with schizophrenia and contribute to the overall cardiovascular disease risk. Side effects of antipsychotics may cause diagnostic problems in deciding regarding the origin of particular symptoms (somatic illness vs. side effects) during treatment of psychotic disorders. Bearing in mind frequent comorbidity between of psychotic and somatic disorders, early recognition of such comorbidity is important, as well as the selection of antipsychotics. The aim of this article is to report a case of changes in values of cholesterol and tryglicerides after weight loss, during treatment with aripiprazole in a patient with schizophrenia. This case report emphasizes the importance of regular monitoring of values of cholesterol and tryglicerides during treatment with antipsychotics.

Patient Care Physician Supply and Requirements: Testing COGME Recommendations. Council on Graduate Medical Education, Eighth Report.

ERIC Educational Resources Information Center

Council on Graduate Medical Education.

This report reassesses recommendations made by the Council on Graduate Medical Education in earlier reports which had, beginning in 1992, addressed the problems of physician oversupply. In this report physician supply and requirements are examined in the context of a health care system increasingly dominated by managed care. Patterns of physician…

Colorectal cancer occurs earlier in those exposed to tobacco smoke: implications for screening

PubMed Central

Mahoney, Martin C.; Cummings, K. Michael; Michalek, Arthur M.; Reid, Mary E.; Moysich, Kirsten B.; Hyland, Andrew

2011-01-01

Background Colorectal cancer (CRC) is the third most common cancer in the USA. While various lifestyle factors have been shown to alter the risk for colorectal cancer, recommendations for the early detection of CRC are based only on age and family history. Methods This case-only study examined the age at diagnosis of colorectal cancer in subjects exposed to tobacco smoke. Subjects included all patients who attended RPCI between 1957 and 1997, diagnosed with colorectal cancer, and completed an epidemiologic questionnaire. Adjusted linear regression models were calculated for the various smoking exposures. Results Of the 3,540 cases of colorectal cancer, current smokers demonstrated the youngest age of CRC onset (never: 64.2 vs. current: 57.4, P < 0.001) compared to never smokers, followed by recent former smokers. Among never smokers, individuals with past second-hand smoke exposure were diagnosed at a significantly younger age compared to the unexposed. Conclusion This study found that individuals with heavy, long-term tobacco smoke exposure were significantly younger at the time of CRC diagnosis compared to lifelong never smokers. The implication of this finding is that screening for colorectal cancer, which is recommended to begin at age 50 years for persons at average risk should be initiated 5–10 years earlier for persons with a significant lifetime history of exposure to tobacco smoke. PMID:18264728

Radioactive materials released from nuclear power plants. Annual report 1991, Volume 12

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

Tichler, J.; Doty, K.; Congemi, J.

Releases of radioactive materials in airborne and liquid effluents from commercial light water reactors during 1991 have been compiled and reported. Data on solid waste shipments as well as selected operating information have been included. This report supplements earlier annual reports issued by the former Atomic Energy Commission and the Nuclear Regulatory Commission. The 1991 release data are summarized in tabular form. Data Covering specific radionuclides are summarized.

Radioactive materials released from nuclear power plants. Annual report, 1982. Volume 3

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

Tichler, J.; Norden, K.

Releases of radioactive materials in airborne and liquid effluents from commercial light water reactors during 1982 have been compiled and reported. Data on solid waste shipments as well as selected operating information have been included. This report supplements earlier annual reports issued by the former Atomic Energy Commission and the Nuclear Regulatory Commission. The 1982 release data are summarized in tabular form. Data covering specific radionuclides are summarized.

Radioactive materials released from nuclear power plants. Volume 11: Annual report, 1990

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

Tichler, J.; Doty, K.; Congemi, J.

Releases of radioactive materials in airborne and liquid effluents from commercial light water reactors during 1990 have been compiled and reported. Data on solid waste shipments as well as selected operating information have been included. This report supplements earlier annual reports issued by the former Atomic Energy Commission and the Nuclear Regulatory Commission. The 1990 release data are summarized in tabular form. Data covering specific radionuclides are summarized.

Radioactive materials released from nuclear power plants. Annual report 1981. Vol. 2

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

Tichler, J.; Benkovitz, C.

Releases of radioactive materials in airborne and liquid effluents from commercial light water reactors during 1981 have been compiled and reported. Data on solid waste shipments as well as selected operating information have been included. This report supplements earlier annual reports issued by the former Atomic Energy Commission and the Nuclear Regulatory Commission. The 1981 release data are summarized in tabular form. Data covering specific radionuclides are summarized.

Radioactive materials released from nuclear power plants. Annual report, 1983. Volume 4

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

Tichler, J.; Norden, K.

Releases of radioactive materials in airborne and liquid effluents from commercial light water reactors during 1983 have been compiled and reported. Data on solid waste shipments as well as selected operating information have been included. This report supplements earlier annual reports issued by the former Atomic Energy Commission and the Nuclear Regulatory Commission. The 1983 release data are summarized in tabular form. Data covering specific radionuclides are summarized.

Does mindfulness prepare adolescents for value-behavior concordance? Examining the role of value content.

PubMed

Warren, Michael T; Wray-Lake, Laura

2017-07-01

Great thinkers throughout history advocated living one's values, yet little research has examined factors that contribute to adolescents' value-behavior concordance (VBC). Mindfulness may foster VBC via heightened awareness of values, but VBC for intrinsic values may be more adaptive than VBC for extrinsic values. To situate mindfulness in developmental context, we examined age and attachment security as predictors of mindfulness. We collected self- and parent-report data from 299 families (M age-adolescents  = 14.45, SD = 1.68; 51% female) from 42 US states to test these ideas. Results indicated that mindfulness was positively associated with intrinsic VBC but was negatively linked with extrinsic VBC, and both kinds of VBC partially mediated the link from mindfulness to meaning (but not life satisfaction). Attachment security was associated with higher mindfulness. Overall, mindfulness may deliver its benefits by helping young people avoid behaviors that align with extrinsic values. Copyright © 2017 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

The distribution of probability values in medical abstracts: an observational study.

PubMed

Ginsel, Bastiaan; Aggarwal, Abhinav; Xuan, Wei; Harris, Ian

2015-11-26

A relatively high incidence of p values immediately below 0.05 (such as 0.047 or 0.04) compared to p values immediately above 0.05 (such as 0.051 or 0.06) has been noticed anecdotally in published medical abstracts. If p values immediately below 0.05 are over-represented, such a distribution may reflect the true underlying distribution of p values or may be due to error (a false distribution). If due to error, a consistent over-representation of p values immediately below 0.05 would be a systematic error due either to publication bias or (overt or inadvertent) bias within studies. We searched the Medline 2012 database to identify abstracts containing a p value. Two thousand abstracts out of 80,649 abstracts were randomly selected. Two independent researchers extracted all p values. The p values were plotted and compared to a predicted curve. Chi square test was used to test assumptions and significance was set at 0.05. 2798 p value ranges and 3236 exact p values were reported. 4973 of these (82%) were significant (<0.05). There was an over-representation of p values immediately below 0.05 (between 0.01 and 0.049) compared to those immediately above 0.05 (between 0.05 and 0.1) (p = 0.001). The distribution of p values in reported medical abstracts provides evidence for systematic error in the reporting of p values. This may be due to publication bias, methodological errors (underpowering, selective reporting and selective analyses) or fraud.

Null Hypothesis Significance Testing and "p" Values

ERIC Educational Resources Information Center

Travers, Jason C.; Cook, Bryan G.; Cook, Lysandra

2017-01-01

"p" values are commonly reported in quantitative research, but are often misunderstood and misinterpreted by research consumers. Our aim in this article is to provide special educators with guidance for appropriately interpreting "p" values, with the broader goal of improving research consumers' understanding and interpretation…

Materialistic Values and Goals.

PubMed

Kasser, Tim

2016-01-01

Materialism comprises a set of values and goals focused on wealth, possessions, image, and status. These aims are a fundamental aspect of the human value/goal system, standing in relative conflict with aims concerning the well-being of others, as well as one's own personal and spiritual growth. Substantial evidence shows that people who place a relatively high priority on materialistic values/goals consume more products and incur more debt, have lower-quality interpersonal relationships, act in more ecologically destructive ways, have adverse work and educational motivation, and report lower personal and physical well-being. Experimentally activating materialistic aims causes similar outcomes. Given these ills, researchers have investigated means of decreasing people's materialism. Successful interventions encourage intrinsic/self-transcendent values/goals, increase felt personal security, and/or block materialistic messages from the environment. These interventions would likely be more effective if policies were also adopted that diminished contemporary culture's focus on consumption, profit, and economic growth.

Economic values and corporate financial statements.

PubMed

Magness, Vanessa

2003-07-01

Corporate financial statements do not include environmental values. This deficiency has contributed to the criticism that company managers do not include environmental impacts in the internal decision-making process. The accounting profession has not developed effective environmental reporting guidelines. This situation contributes to a second problem: the apparent inability of corporate reports to provide useful information to external parties. It has been suggested that by using nonmarket valuation methodologies, financial statements can be used to measure progress toward sustainable development. Nonmarket valuations are not generally accepted by the accounting profession. They are too subjective to support effective decisions, and too costly to obtain. Furthermore, demand for this sort of information appears small. Some of these issues may be resolved over time. The most serious challenge, however, concerns how enhanced financial reports would be used. Financial statements are supposed to help investors assess the amount, timing, and uncertainty of future cash flows. A substantial portion of environmental value is based on nonuse benefits, much of which will never be realized in company cash flows. In other words, the role of financial statements would have to change. Furthermore, since there is no general agreement as to the meaning of "sustainable development," efforts to operationalize the term have been fraught with difficulty. Moreover, monetization of environmental values could jeopardize their preservation, leaving some to question the overall objective of this form of reporting. For these reasons, while it is to be hoped that better reporting of environmental impacts will be forthcoming, the greatest advances will likely be outside the financial statements themselves.

The ICER Value Framework: Integrating Cost Effectiveness and Affordability in the Assessment of Health Care Value.

PubMed

Pearson, Steven D

2018-03-01

What should be the relationship between the concepts of cost effectiveness and affordability in value assessments for health care interventions? This question has received greater attention in recent years given increasing financial pressures on health systems, leading to different views on how assessment reports and decision-making processes can provide the best structure for considering both elements. In the United States, the advent of explicit value frameworks to guide drug assessments has also focused attention on this issue, driven in part by the prominent inclusion of affordability within the value framework used to guide reports from the Institute for Clinical and Economic Review. After providing a formal definition of affordability for health care systems, this article argues that, even after using empirical estimates of true health system opportunity cost, cost-effectiveness thresholds cannot by themselves be set in a way that subsumes questions about short-term affordability. The article then presents an analysis of different approaches to integrating cost effectiveness and budget impact assessments within information to guide decision making. The evolution and experience with the Institute for Clinical and Economic Review value framework are highlighted, providing lessons learned and guiding principles for future efforts to bring measures of affordability within the scope of value assessment. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Moisture Management for High R-Value Walls

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

Lepage, R.; Schumacher, C.; Lukachko, A.

2013-11-01

This report explains the moisture-related concerns for high R-value wall assemblies and discusses past Building America research work that informs this study. In this project, hygrothermal simulations were prepared for several common approaches to High R-value wall construction in six cities (Houston, Atlanta, Seattle, St. Louis, Chicago, and International Falls) representing a range of climate zones. The modeling program assessed the moisture durability of the wall assemblies based on three primary sources of moisture: construction moisture, air leakage condensation, and bulk water leakage; the report presents results of the study.

Timber management and use-value assessment

Treesearch

Paul E. Sendak; Neil K. Huyler

1994-01-01

Describes timber management activity and estimates timber harvest from forest land enrolled in Vermont's Use Value Appraisal (UVA) Forest Land property tax program. Data were compiled from the mandatory management plans and annual conformance reports filed for each property enrolled in the Program. Overall, 31 percent of the UVA properties reported a commercial...

Do self-reported concussions have cumulative or enduring effects on drivers' anticipation of traffic hazards?

PubMed

Preece, Megan H W; Horswill, Mark S; Ownsworth, Tamara

2016-01-01

To investigate the cumulative effect of multiple self-reported concussions and the enduring effect of concussion on drivers' hazard perception ability. It was hypothesized: (1) that individuals reporting multiple previous concussions would be slower to anticipate traffic hazards than individuals reporting either one previous concussion or none; and (2) that individuals reporting a concussion within the past 3 months would be slower to anticipate traffic hazards than individuals reporting either an earlier concussion or no prior concussion. Two hundred and eighty-two predominantly young drivers (nconcussed = 68, Mage = 21.57 years, SDage = 6.99 years, 66% female) completed a validated hazard perception test (HPT) and measures of emotional, cognitive, health and driving status. A one-way analysis of variance showed that there was no significant effect of concussion number on HPT response times. Similarly, pairwise comparisons showed no significant differences between the HPT response times of individuals reporting a concussion within the previous 3 months, individuals reporting an earlier concussion and the never concussed group. The findings suggest that previous concussions do not adversely affect young drivers' ability to anticipate traffic hazards; however, due to reliance on self-reports of concussion history, further prospective longitudinal research is needed.

Evaluating Teachers: The Important Role of Value-Added

ERIC Educational Resources Information Center

Glazerman, Steven; Loeb, Susanna; Goldhaber, Dan; Staiger, Douglas; Raudenbush, Stephen; Whitehurst, Grover

2010-01-01

The evaluation of teachers based on the contribution they make to the learning of their students, "value-added", is an increasingly popular but controversial education reform policy. In this report, the authors highlight and try to clarify four areas of confusion about value-added. The first is between value-added information and the…

Annual Progress Report - Fiscal Year 1982

DTIC Science & Technology

1982-10-01

activity . A published method developed in our laboratory for determining tne antibacterial activity of mouse peritoneal phagocytes in vivo (1) has been...EDITOR’S NOTE This FY 1982 Annual Progress report is a general review of research activities of the U. S. Army Medical Research Institute of Infectious...years earlier. Passive immunization, active immunization using killed or living attenuated whole agent, or immunization with sub-unit antigens achieved

Mechanisms underlying the influence of saliency on value-based decisions

PubMed Central

Chen, Xiaomo; Mihalas, Stefan; Niebur, Ernst; Stuphorn, Veit

2013-01-01

Objects in the environment differ in their low-level perceptual properties (e.g., how easily a fruit can be recognized) as well as in their subjective value (how tasty it is). We studied the influence of visual salience on value-based decisions using a two alternative forced choice task, in which human subjects rapidly chose items from a visual display. All targets were equally easy to detect. Nevertheless, both value and salience strongly affected choices made and reaction times. We analyzed the neuronal mechanisms underlying these behavioral effects using stochastic accumulator models, allowing us to characterize not only the averages of reaction times but their full distributions. Independent models without interaction between the possible choices failed to reproduce the observed choice behavior, while models with mutual inhibition between alternative choices produced much better results. Mutual inhibition thus is an important feature of the decision mechanism. Value influenced the amount of accumulation in all models. In contrast, increased salience could either lead to an earlier start (onset model) or to a higher rate (speed model) of accumulation. Both models explained the data from the choice trials equally well. However, salience also affected reaction times in no-choice trials in which only one item was present, as well as error trials. Only the onset model could explain the observed reaction time distributions of error trials and no-choice trials. In contrast, the speed model could not, irrespective of whether the rate increase resulted from more frequent accumulated quanta or from larger quanta. Visual salience thus likely provides an advantage in the onset, not in the processing speed, of value-based decision making. PMID:24167161

Leadership values in academic medicine.

PubMed

Souba, Wiley W; Day, David V

2006-01-01

To gain a deeper understanding of the guiding core values that deans of academic medical centers (AMCs) considered most essential for their leadership and the major leadership challenges that confront them. In 2003-04, semistructured interviews of 18 deans at U.S. colleges of medicine or AMCs were organized around four dimensions: background, leadership challenges, organizational effectiveness, and systems enablers/restrainers for leadership. A values Q-sort was used to determine how widely core values were shared among deans and how the complex challenges they faced did or did not align with these values. Fourteen of the 18 (78%) deans identified financial difficulties as their most pressing leadership challenge, followed by weak institutional alignment (61%), staffing problems (33%), and poor morale (28%). Open, candid communication was reported as the most effective means of addressing these complex problems. Enacting espoused shared values and having a positive attitude were identified as the most important enablers of systemic leadership, whereas micromanagement and difficult people were the major restraints. Q-sort results on 38 positive leadership values indicated that participants considered integrity most essential. Integrity was positively correlated with humanistic values and negatively correlated with results. Vision, another highly espoused value, correlated strongly with performance-oriented values but correlated negatively with humanistic values. A dynamic tension exists in AMCs between humanistic values and performance-based core values. The ability to manage that tension (i.e., when to prioritize one set of values over the other) is inherent in a dean's work.

The Added Value of Collecting Information on Pain Experience When Predicting Time on Benefits for Injured Workers with Back Pain.

PubMed

Steenstra, Ivan A; Franche, Renée-Louise; Furlan, Andrea D; Amick, Ben; Hogg-Johnson, Sheilah

2016-06-01

Objectives Some injured workers with work-related, compensated back pain experience a troubling course in return to work. A prediction tool was developed in an earlier study, using administrative data only. This study explored the added value of worker reported data in identifying those workers with back pain at higher risk of being on benefits for a longer period of time. Methods This was a cohort study of workers with compensated back pain in 2005 in Ontario. Workplace Safety and Insurance Board (WSIB) data was used. As well, we examined the added value of patient-reported prognostic factors obtained from a prospective cohort study. Improvement of model fit was determined by comparing area under the curve (AUC) statistics. The outcome measure was time on benefits during a first workers' compensation claim for back pain. Follow-up was 2 years. Results Among 1442 workers with WSIB data still on full benefits at 4 weeks, 113 were also part of the prospective cohort study. Model fit of an established rule in the smaller dataset of 113 workers was comparable to the fit previously established in the larger dataset. Adding worker rating of pain at baseline improved the rule substantially (AUC = 0.80, 95 % CI 0.68, 0.91 compared to benefit status at 180 days, AUC = 0.88, 95 % CI 0.74, 1.00 compared to benefits status at 360 days). Conclusion Although data routinely collected by workers' compensation boards show some ability to predict prolonged time on benefits, adding information on experienced pain reported by the worker improves the predictive ability of the model from 'fairly good' to 'good'. In this study, a combination of prognostic factors, reported by multiple stakeholders, including the worker, could identify those at high risk of extended duration on disability benefits and in potentially in need of additional support at the individual level.

Progress Report NORSAR Phase 3

DTIC Science & Technology

1975-01-31

September after one year’s leave ->f absence in the army. 1.2 Property The NORSAR Maintanance Center (NMC) at Stange had a fire 24 November. Even...been down since 24 November due to the fire at NMC. 2.1 NDPC Activity An option for easy access to the model parameters at three different ...Message Ptccggor [TXPl Connection The use of the ARPANET terminal attachment from NORSAR in this quarter does not differ from earlier reported use

Correlation of MIC value and disk inhibition zone diameters in clinical Legionella pneumophila serogroup 1 isolates.

PubMed

Bruin, Jacob P; Diederen, Bram M W; Ijzerman, Ed P F; Den Boer, Jeroen W; Mouton, Johan W

2013-07-01

Routine use of disk diffusion tests for detecting antibiotic resistance in Legionella pneumophila has not been described. The goal of this study was to determine the correlation of MIC values and inhibition zone diameter (MDcorr) in clinical L. pneumophila isolates. Inhibition zone diameter of 183 L. pneumophila clinical isolates were determined for ten antimicrobials. Disk diffusion results were correlated with MICs as determined earlier with E-tests. Overall the correlation of MIC values and inhibition zone diameters (MDcorr) of the tested antimicrobials is good, and all antimicrobials showed a WT distribution. Of the tested fluoroquinolones levofloxacin showed the best MDcorr. All macrolides showed a wide MIC distribution and good MDcorr. The MDcorr for cefotaxim, doxycycline and tigecycline was good, while for rifampicin and moxifloxacin, they were not. Overall good correlation between MIC value and disk inhibition zone were found for the fluoroquinolones, macrolides and cefotaxim. Copyright © 2013 Elsevier Inc. All rights reserved.

Complementary functions of the two brain hemispheres: comparisons with earlier conceptions and implications for individual and society.

PubMed

Zeier, H

1989-07-01

The concept of different functions for the left and right cerebral hemispheres coincides in an astonishing way with earlier philosophical and psychological work which divided the human mind into two complementary functions without having a neurophysiological explanation. Representative are the ideas of Fichte, Hegel and Jung. The latter postulated the two subsystems Ego and Self and associated the conscious functions of the Ego with the intellect, the capacity for rational thought, and the Self with the mind, which also includes the emotional feelings. For the harmonic development and self-realization of man the functions of both systems in complementary interaction are required. Therefore, the current overaccentuation of the intellect and of progress directed technical-scientific thinking should be corrected by making better use of the much neglected functions of the right hemisphere.

Employers' Views on the Value of Older Workers. Final Report.

ERIC Educational Resources Information Center

University of Southern Maine, Portland. Human Services Development Inst.

A study examined the extent to which organizations in three New England states valued newly hired older workers. Telephone interviews were conducted with 105 directors of human resources (DHRs) and with 113 director supervisors from a broad range of organizations. Major dependent variables were general employer motivations and expectations related…

A Scaled-Projective Measure of Interpersonal Values

ERIC Educational Resources Information Center

Kilmann, Ralph H.

1975-01-01

The Kilmann Insight Test is a measure of the interpersonal value constructs. That is how the individual perceives and interprets the desirable and undesirable features of interpersonal behavior. The validity of the test is investigated by explaining its relationship to a self-report measure assessing similar values. (DEP)

Analysis of high-throughput biological data using their rank values.

PubMed

Dembélé, Doulaye

2018-01-01

High-throughput biological technologies are routinely used to generate gene expression profiling or cytogenetics data. To achieve high performance, methods available in the literature become more specialized and often require high computational resources. Here, we propose a new versatile method based on the data-ordering rank values. We use linear algebra, the Perron-Frobenius theorem and also extend a method presented earlier for searching differentially expressed genes for the detection of recurrent copy number aberration. A result derived from the proposed method is a one-sample Student's t-test based on rank values. The proposed method is to our knowledge the only that applies to gene expression profiling and to cytogenetics data sets. This new method is fast, deterministic, and requires a low computational load. Probabilities are associated with genes to allow a statistically significant subset selection in the data set. Stability scores are also introduced as quality parameters. The performance and comparative analyses were carried out using real data sets. The proposed method can be accessed through an R package available from the CRAN (Comprehensive R Archive Network) website: https://cran.r-project.org/web/packages/fcros .

The feasibility, perceived satisfaction, and value of using synchronous webinars to educate clinical research professionals on reporting adverse events in clinical trials: a report from the Children's Oncology Group.

PubMed

Borgerson, Dawn; Dino, Jennifer

2012-01-01

Clinical research professionals are faced with decreased funding and increased workloads; innovative methods of professional development programs are necessary to accommodate these factors. This study evaluated the feasibility, perceived satisfaction, and value of using webinars to educate clinical research professionals on reporting adverse events commonly experienced in pediatric oncology clinical trials. The setting incorporated synchronous web-based educational technology. Constructivist learning provides the theoretical framework for this study. Participants evaluated the professional development program at 2 time points: (a) at the conclusion and (b) 4 to 6 weeks afterward, using survey method. Synchronous webinars were both economical and effective in educating clinical research professionals across institutional sites. Participants reported exceptionally high levels of satisfaction with the accessibility, scope, quality, and interactivity of the professional development program. The vast majority of participants reported that the education would assist with reporting adverse events in pediatric oncology clinical trials and this perception persisted into clinical practice. Although the results of this study were intended to guide future educational efforts of the Children's Oncology Group, they may also apply to other cooperative groups.

Ethnopharmacological values of cassava and its potential for diabetes and dyslipidemia management: Knowledge survey and critical review of report

PubMed Central

Nwose, Ezekiel Uba; Onodu, Bonaventure C.; Anyasodor, Anayochukwu Edward; Sedowo, Mathew O.; Okuzor, John N.; Culas, Richard J.

2017-01-01

Background: Beyond nutritional values are the pharmacological potentials of cassava comparative with other staple carbohydrate plant-based foods such as wheat. The knowledge of applicability to diabetes and its cardiovascular complications management seems not just limited but unacknowledged. As a preliminary study, a community’s knowledge of pharmacological value of cassava is investigated. Methods: Descriptive observational study using questionnaire-based “cross-sectional” survey was conducted. 136 Participants completed the survey and 101 respondents were selected for evaluation. Open-ended questions were used qualitatively to generate experience and view cassava values for diabetes and dyslipidemia. While categorical (yes or no) questions were used quantitatively to generate numerical results for diabetes, critical reanalysis of a report data was performed, especially comparing carbohydrate/fiber and fat/fiber ratios of cassava with wheat in view of dyslipidemia. Result: On the positive side, 42% of the participants believe that cassava has medicinal values. This includes 6% (among the 42) who believes that the plant is useful in treating diabetes and 24% who do not know it may be useful in diabetes management. Critical review showed that cassava may contribute up to sixteen times more fiber and four times less digestible sugar, as well as carbohydrate/fiber and fat/fiber ratios being 14 and 55 times less than wheat. Conclusion: There is evidence that relative to wheat flour meal, for instance, cassava contributes less fat and much more fiber. Since fat is pro-obesity, which in turn is pro-diabetic/metabolic syndrome; and fiber is anti-dyslipidemic; cassava has pharmacological values to be appreciated over some carbohydrate plant-based foods. PMID:28894623

Values and beliefs of psychedelic drug users: a cross-cultural study.

PubMed

Lerner, Michael; Lyvers, Michael

2006-06-01

Psychedelic drugs such as LSD and psilocybin are often claimed to be capable of inducing life-changing experiences described as mystical or transcendental, especially if high doses are taken. The present study examined possible enduring effects of such experiences by comparing users of psychedelic drugs (n = 88), users of nonpsychedelic illegal drugs (e.g., marijuana, amphetamines) (n = 29) and non illicit drug-using social drinkers (n = 66) on questionnaire measures of values, beliefs and emotional empathy. Samples were obtained from Israel (n = 110) and Australia (n = 73) in a cross-cultural comparison to see if values associated with psychedelic drug use transcended culture of origin. Psychedelic users scored significantly higher on mystical beliefs (e.g., oneness with God and the universe) and life values of spirituality and concern for others than the other groups, and lower on the value of financial prosperity, irrespective of culture of origin. Users of nonpsychedelic illegal drugs scored significantly lower on a measure of coping ability than both psychedelic users and non illicit drug users. Both groups of illegal drug users scored significantly higher on empathy than non illicit drug users. Results are discussed in the context of earlier findings from Pahnke (1966) and Doblin (1991) of the transformative effect of psychedelic experiences, although the possibility remains that present findings reflect predrug characteristics of those who chose to take psychedelic drugs rather than effects of the drugs themselves.

Valuing Flexibility Phase 2

DTIC Science & Technology

2012-10-29

longer by adding an additional mid section8.  Radio Frequency Identification (RFID): This established technology is being considered for use to...MONITOR’S ACRONYM(S) 11 . SPONSOR/MONITOR’S REPORT NUMBER(S) 12. DISTRIBUTION/AVAILABILITY STATEMENT Approved for public release; distribution unlimited...Introduction ............................................................................................ 11 3 A Taxonomy of Methods for Valuing

Valuing Flexibility. Phase 2

DTIC Science & Technology

2012-10-29

modules and their interfaces are designed such that the ship can be made longer by adding an additional mid section8.  Radio Frequency ...MONITOR’S ACRONYM(S) 11 . SPONSOR/MONITOR’S REPORT NUMBER(S) 12. DISTRIBUTION/AVAILABILITY STATEMENT Approved for public release, distribution... 11 3 A Taxonomy of Methods for Valuing Flexibility

Value Preferences of Social Workers.

PubMed

Tartakovsky, Eugene; Walsh, Sophie D

2018-04-01

The current study examines value preferences of social workers in Israel. Using a theoretical framework of person-environment fit paradigm and theory of values, the study compared social workers (N = 641, mean age = 37.7 years, 91 percent female) with a representative sample of Israeli Jews (N = 1,600, mean age = 44.2, 52 percent female). Questionnaires included personal value preferences and sociodemographic variables (gender, age, education, religiosity, and immigrant status). Multivariate analysis of covariance showed that value preferences of social workers differed significantly from those of the general population. Analyses of covariance showed that social workers reported a higher preference for self-transcendence and a lower preference for conservation and self-enhancement values. Results have significance for the selection, training, and supervision of social workers. They suggest that it is important to assess to what extent selection processes for social workers are primarily recruiting social workers with shared values, thus creating an overly homogenous population of social workers. An understanding of personal value motivations can help social workers in their own process of self-development and growth, and to understand how the profession can fulfill their basic motivations.

Self-reported hearing loss in baby boomers from the Busselton Healthy Ageing Study: audiometric correspondence and predictive value.

PubMed

Swanepoel, De Wet; Eikelboom, Robert H; Hunter, Michael L; Friedland, Peter L; Atlas, Marcus D

2013-06-01

The baby boomer population will become high users of the health-care system in coming years. Self-report of hearing loss at a primary health-care visit may offer timely referrals to audiological services, but there has been no population-based study of self-reported hearing loss in the baby boomer generation. To determine the clinical value and audiometric correspondence of self-reported hearing loss as a screening tool for the baby boomer population. A population-based study, Busselton Healthy Ageing Study (BHAS), surveying baby boomers born between 1946 and 1964 from the shire of Busselton, Western Australia. A randomized sample of noninstitutionalized baby-boomers listed on the electoral roll (n = 6690) and resident in the shire are eligible to participate. This study reports on data from the first 1004 attendees (53.5% female) with a mean age of 56.23 (SD = 5.43). Data from a self-report question on hearing loss and diagnostic pure tone audiometry was utilized for this study. Analysis included screening performance measures of self-report compared to audiometric cut-offs, receiver operator curve (ROC) to determine optimal level, analysis of variance to compare hearing status to self-report, and binary logistic regression to determine best audiometric predictors. Of the sample, 16% self-reported hearing loss (72.1% males). Logistic regression indicated 4000 Hz as the most important individual frequency related to self-report while the four-frequency average (500, 1000, 2000, and 4000 Hz) >25 dB in the worse ear was the most significant averaged cutoff with 68% sensitivity and 87% specificity. Of those who self-reported a hearing loss, 80% had either a four-frequency average hearing loss >25 dB in the worse ear or a high-frequency average (4000 and 8000 Hz) hearing loss greater than 35 dB in the worse ear. Baby boomer adults who self-report hearing impairment on direct inquiry are most likely to have a hearing loss. A simple question at a primary health care

Parent-Reported Repetitive Behavior in Toddlers on the Autism Spectrum

ERIC Educational Resources Information Center

Schertz, Hannah H.; Odom, Samuel L.; Baggett, Baggett M.; Sideris, John H.

2016-01-01

Toddlers with autism spectrum disorder (ASD) were assessed on the Repetitive Behavior Scale-Revised (RBS-R), which we found to have acceptable internal consistency. Stereotypical subscale scores showed a negligible association with cognitive level, but correlated more strongly with adaptive and social indicators. Relative to earlier reported RBS-R…

Infliximab for uveitis of Behçet's syndrome: a trend for earlier initiation.

PubMed

Guzelant, Gul; Ucar, Didar; Esatoglu, Sinem Nihal; Hatemi, Gulen; Ozyazgan, Yilmaz; Yurdakul, Sebahattin; Seyahi, Emire; Yazici, Hasan; Hamuryudan, Vedat

2017-01-01

The prognosis of uveitis in Behçet's syndrome (BS) has improved over decades. Whether this is related to the use of more aggressive management strategies is not known. This is a retrospective study of BS patients who received infliximab (IFX) for refractory eye disease between 2003-2015. The patients were divided into two groups according to the date of onset of in IFX treatment as before and after 2013. We compared the two groups in terms of disease characteristics at the onset of IFX treatment and response to treatment. There were 43 patients in the old and 14 patients in the new group. The duration of uveitis and previous immunosuppressive treatment before the initiation of IFX were significantly shorter in the new group compared to the old group (p=0.043 and p=0.028, respectively). The baseline visual acuity (VA) at the initiation of IFX was better in the new group, but this was only significant for the left eye. Treatment with IFX was effective in both groups in preserving VA and this was more pronounced in the new group. Attack frequency under IFX was significantly lower in the new group (p<0.001). IFX seems to be initiated earlier and also in less severe cases during the course of BS uveitis than before. Despite the few numbers of patients and relatively short duration of follow-up, our results give a hint that this change has improved the outcome.

Coca-Cola Valued Youth Program. What Works Clearinghouse Intervention Report

ERIC Educational Resources Information Center

What Works Clearinghouse, 2009

2009-01-01

The Coca-Cola Valued Youth Program offers secondary school students who are considered at risk of dropping out the opportunity to serve as tutors in elementary schools. By having these at-risk students serve as tutors, the program aims to improve their basic academic skills and self-esteem, with the goal of keeping them enrolled in school. The…

The Sooner, the Worse? Association between Earlier Age of Sexual Initiation and Worse Adolescent Health and Well-being Outcomes

PubMed Central

Osorio, Alfonso; Lopez-del Burgo, Cristina; Carlos, Silvia; de Irala, Jokin

2017-01-01

This cross-sectional study assesses the association between age of sexual initiation during adolescence and a selection of well-being outcomes regarding that first relationship. High-school adolescents from El Salvador (2,686) and from Peru (3,399) replied to a paper-pencil questionnaire. Those who were sexually initiated replied to several questions regarding their age at sexual initiation, condom use, satisfaction and reasons/circumstances for that sexual relationship. Approximately 19% of participants were sexually initiated (n = 1,179). After retaining participants with valid responses and with sexual initiation ages between 13 and 17, the final sample for this paper consisted of 996 sexually initiated participants (526 Salvadorians and 470 Peruvians). Multiple logistic regression analyses showed that those who initiated sex at earlier ages had worse outcomes compared to those who initiated at older ages. Specifically, they had lower odds of having used a condom, of having good memories of that experience and of having had that first relationship because they were in love. Conversely, they had higher odds of having had that first sexual relationship as a result of peer pressure (“Most of my friends already had sex”), because of partner pressure (“I was afraid to lose him/her,” “My partner told me he/she would leave me” or “I did not know how to say no to a person who insisted”), or as a consequence of different forms of impaired autonomy (“I was under the influence of alcohol or drugs” or “As a consequence of seeing sexual images”). Results show that sex at earlier ages is associated with worse adolescent health and well-being outcomes. PMID:28798715

Make your values mean something.

PubMed

Lencioni, Patrick M

2002-07-01

Take a look at this list of corporate values: Communication. Respect. Integrity. Excellence. They sound pretty good, don't they? Maybe they even resemble your own company's values. If so, you should be nervous. These are the corporate values of Enron, as claimed in its 2000 annual report. And they're absolutely meaningless. Indeed, most values statements, says the author, are bland, toothless, or just plain dishonest. And far from being harmless, as some executives assume, they're often highly destructive. Empty values statements create cynical and dispirited employees and undermine managerial credibility. But coming up with strong values--and sticking to them--isn't easy. Organizations that want their values statements to really mean something should follow four imperatives. First, understand the different types of values: core, aspirational, permission-to-play, and accidental. Confusing them with one another can bewilder employees and make management seem out of touch. Second, be aggressively authentic. Too many companies view a values initiative in the same way they view a marketing launch: a onetime event measured by the initial attention it receives, not by its content. Third, own the process. Values initiatives are about imposing a set of fundamental, strategically sound beliefs on a broad group of people. That's why the best values efforts are driven by small teams. Finally, weave core values into everything. It's not enough to hang your values statement on the wall; it must be integrated into every employee-related process--hiring methods, performance management systems, even dismissal policies. Living by stated corporate values is difficult. But the benefits of doing so can be profound; so can the damage from adopting a hollow set of corporate values.

Values: Relations and Implications. Symposium V C.

ERIC Educational Resources Information Center

De Wit, Jan; Keats, D. M.

Reported at a symposium generally concerned with values and adolescents are discussions of (1) socialization issues and the impact of values on adolescents, and (2) dimensions of Asian youths' confrontation with the problem of modernization. In the first study (by Jan de Witt), the conceptual shift in socialization research to a focus on…

Urging Affordable Access to High-Value Cancer Drugs

Cancer.gov

This infographic highlights some of the main messages from the President’s Cancer Panel report Promoting Value, Affordability, and Innovation in Cancer Drug Treatment. The graphic includes the panel’s recommendations to maximize the value and affordability of cancer drug treatment.

Added Value of Selected Images Embedded Into Radiology Reports to Referring Clinicians

PubMed Central

Iyer, Veena R.; Hahn, Peter F.; Blaszkowsky, Lawrence S.; Thayer, Sarah P.; Halpern, Elkan F.; Harisinghani, Mukesh G.

2011-01-01

Purpose The aim of this study was to evaluate the added utility of embedding images for findings described in radiology text reports to referring clinicians. Methods Thirty-five cases referred for abdominal CT scans in 2007 and 2008 were included. Referring physicians were asked to view text-only reports, followed by the same reports with pertinent images embedded. For each pair of reports, a questionnaire was administered. A 5-point, Likert-type scale was used to assess if the clinical query was satisfactorily answered by the text-only report. A “yes-or-no” question was used to assess whether the report with images answered the clinical query better; a positive answer to this question generated “yes-or-no” queries to examine whether the report with images helped in making a more confident decision on management, whether it reduced time spent in forming the plan, and whether it altered management. The questionnaire asked whether a radiologist would be contacted with queries on reading the text-only report and the report with images. Results In 32 of 35 cases, the text-only reports satisfactorily answered the clinical queries. In these 32 cases, the reports with attached images helped in making more confident management decisions and reduced time in planning management. Attached images altered management in 2 cases. Radiologists would have been consulted for clarifications in 21 and 10 cases on reading the text-only reports and the reports with embedded images, respectively. Conclusions Providing relevant images with reports saves time, increases physicians' confidence in deciding treatment plans, and can alter management. PMID:20193926

Thoughts on Earned Value Assessments

NASA Technical Reports Server (NTRS)

Pido, Kelle

2009-01-01

This slide presentation reviews the concepts of Earned Value reporting and Earned Value Metrics (EVM) and the implementation for the Constellation Program. EVM is used to manage both the contract and civil service workforce, and used as a measure of contractor costs and performance. The Program EVM is not as useful for Level of Effort tasking, for either contractor, or civil service employees. Some issues and concerns in reference to EVM and the process for the use of EVM for Mission assurance are reviewed,

Selected Characteristics of the U.S. Feed Manufacturing Industry, 1984. Staff Report No. AGES880121.

ERIC Educational Resources Information Center

Ash, Mark; And Others

This report summarizes some selected characteristics of the feed manufacturing industry based on the results of a mail survey of U.S. feed manufacturing establishments to obtain information about structural characteristics of the industry in 1984. These characteristics are compared with those reported earlier from the 1975 survey to provide…

False Rumors and True Belief: Memory Processes Underlying Children's Errant Reports of Rumored Events

ERIC Educational Resources Information Center

Principe, Gabrielle F.; Haines, Brooke; Adkins, Amber; Guiliano, Stephanie

2010-01-01

Previous research has shown that overhearing an errant rumor--either from an adult or from peers--about an earlier experience can lead children to make detailed false reports. This study investigates the extent to which such accounts are driven by changes in children's memory representations or merely social demands that encourage the reporting of…

δ15N Values in Crassostrea virginica Shells Provides Early Direct Evidence for Nitrogen Loading to Chesapeake Bay

NASA Astrophysics Data System (ADS)

Black, H. D.; Andrus, C. F. T.; Lambert, W. J.; Rick, T. C.; Gillikin, D. P.

2017-03-01

Crassostrea virginica is one of the most common estuarine bivalves in the United States’ east coast and is frequently found in archaeological sites and sub-fossil deposits. Although there have been several sclerochronological studies on stable carbon and oxygen isotopes in the shells of this species, less is known about δ15N values within their shells, which could be a useful paleoenvironmental proxy to assess estuarine nitrogen dynamics. Modern C. virginica samples were collected in Chesapeake Bay for comparison with archaeological shells from nearby sites ranging in age from ~100 to 3,200 years old. Left valves were sampled by milling the hinge area and the resulting powder was analyzed for %N and δ15N values. Comparison of δ15N values between C. virginica shells shows relatively constant values from ~1250 BC to ~1800 AD. After ~1800 AD, there are rapid increases in 15N enrichment in the shells, which continue to increase in value up to the modern shell values. The increase in δ15N values is evidence of early anthropogenic impact in Chesapeake Bay. These results corroborate the observation that coastal nitrogen pollution occurred earlier than the 19th century and support the use of oyster shell δ15N values as a useful environmental proxy.

2011 Annual Survey of Journalism and Mass Communication Enrollments: Enrollments Decline, Reversing the Increase of a Year Earlier, and Suggesting Slow Growth for Future

ERIC Educational Resources Information Center

Becker, Lee B.; Vlad, Tudor; Kalpen, Konrad

2012-01-01

Enrollments in journalism and mass communication programs declined in the autumn of 2011, compared to a year earlier. Enrollments were down slightly at the senior and junior levels and substantially at the freshman level. Enrollment increased at the sophomore level. The majority of administrators say they have made curricular changes in the past…

Proportion of recovered goose and brant bands that are reported

USGS Publications Warehouse

Martinson, R.K.; McCann, J.A.

1966-01-01

A few more than one-third of the goose and brant bands recovered by hunters were reported to the Bird Banding Laboratory (a rate of 0.361) during the 1962-64 hunting seasons. We calculated this band-reporting rate by comparing the estimated number of goose and brant bands recovered by hunters, based on a mail questionnaire survey, with the number of bands actually reported to the Bird Banding Laboratory. This band-reporting rate is probably representative only of the 1962-65 period. It is likely that, in earlier years, a greater proportion (perhaps about 0.60) of recovered goose and brant bands were reported.

United States Population-Based Estimates of Patient-Reported Outcomes Measurement Information System Symptom and Functional Status Reference Values for Individuals With Cancer.

PubMed

Jensen, Roxanne E; Potosky, Arnold L; Moinpour, Carol M; Lobo, Tania; Cella, David; Hahn, Elizabeth A; Thissen, David; Smith, Ashley Wilder; Ahn, Jaeil; Luta, George; Reeve, Bryce B

2017-06-10

Purpose To estimate cancer population-based reference values in the United States for eight PROMIS (Patient-Reported Outcomes Measurement Information System) domains by age and stage of disease. Patients and Methods For the Measuring Your Health (MY-Health) study, persons newly diagnosed with cancer (prostate, colorectal, non-small-cell lung, non-Hodgkin lymphoma, breast, uterine, or cervical) from 2010 to 2012 (N = 5,284) were recruited through the National Cancer Institute's SEER Program. Participants were mailed surveys 6 to 13 months after diagnosis. Raking by race/ethnicity, age, and stage generated weighted average PROMIS scores for pain interference, fatigue, anxiety, depression, sleep disturbance, physical function, ability to participate in social roles, and cognitive function. PROMIS measures are standardized to a T-score metric, with a score of 50 representing the general US population mean. Clinically meaningful differences were defined as a 3-point difference in scores. Results Several reference values (means) for patients with cancer were worse than the general United States population norms of 50. These include pain interference (52.4), fatigue (52.2), and physical function (44.1). Reference values were highest (ie, showed greatest symptom burden) in lung cancer (pain interference, 55.5; fatigue, 57.3; depression, 51.4) and cervical cancer (anxiety, 53.2; sleep disturbance, 53.4). Reference values for patients age 65 to 84 years reported lower sleep disturbance, anxiety, and depression, and better cognitive function than younger patients. Cancer reference values were poorer among those with advanced disease compared with patients with limited or no evidence of disease, specifically physical function (41.1 v 46.6, respectively), fatigue (55.8 v 50.2, respectively), and pain interference (55.2 v 50.9, respectively). Conclusion In a large, population-based sample of patients with recently diagnosed cancer, we observed symptom severity and functional

Selection for Earlier Flowering Crop Associated with Climatic Variations in the Sahel

PubMed Central

Vigouroux, Yves; Mariac, Cédric; De Mita, Stéphane; Pham, Jean-Louis; Gérard, Bruno; Kapran, Issoufou; Sagnard, Fabrice; Deu, Monique; Chantereau, Jacques; Ali, Abdou; Ndjeunga, Jupiter; Luong, Viviane; Thuillet, Anne-Céline; Saïdou, Abdoul-Aziz; Bezançon, Gilles

2011-01-01

Climate changes will have an impact on food production and will require costly adaptive responses. Adapting to a changing environment will be particularly challenging in sub-Saharan Africa where climate change is expected to have a major impact. However, one important phenomenon that is often overlooked and is poorly documented is the ability of agro-systems to rapidly adapt to environmental variations. Such an adaptation could proceed by the adoption of new varieties or by the adaptation of varieties to a changing environment. In this study, we analyzed these two processes in one of the driest agro-ecosystems in Africa, the Sahel. We performed a detailed study in Niger where pearl millet is the main crop and covers 65% of the cultivated area. To assess how the agro-system is responding to recent recurrent drought, we analyzed samples of pearl millet landraces collected in the same villages in 1976 and 2003 throughout the entire cultivated area of Niger. We studied phenological and morphological differences in the 1976 and 2003 collections by comparing them over three cropping seasons in a common garden experiment. We found no major changes in the main cultivated varieties or in their genetic diversity. However, we observed a significant shift in adaptive traits. Compared to the 1976 samples, samples collected in 2003 displayed a shorter lifecycle, and a reduction in plant and spike size. We also found that an early flowering allele at the PHYC locus increased in frequency between 1976 and 2003. The increase exceeded the effect of drift and sampling, suggesting a direct effect of selection for earliness on this gene. We conclude that recurrent drought can lead to selection for earlier flowering in a major Sahelian crop. Surprisingly, these results suggest that diffusion of crop varieties is not the main driver of short term adaptation to climatic variation. PMID:21573243

Transmitting Values to the Young: A Cross-Cultural Perspective.

ERIC Educational Resources Information Center

Schwartz, Henrietta; Wynne, Edward A.

This section, from a larger report describing a project designed to systematically investigate how religious and traditional values are represented in today's public school curricula, addresses the question of why values should be taught, and if so, what rationale for teaching values is most defensible. Education systems have conducted…

[Reference values of energy for the Venezuelan population].

PubMed

Landaeta-Jiménez, Maritza; Aliaga, Carla; Sifontes, Yaritza; Vásquez, Maura; Ramírez, Guillermo; Falque Madrid, Luís; Herrera, Marianella; María Reyes, Ana; Emilia, Elzakem; Herrera, Ctor; Bernal, Jennifer

2013-12-01

The project of updating the Venezuelan energy reference values respond to the recommendations made by an FAO experts committee, several decades ago for the countries assuming this work. Because of the dramatic changes experienced globally regarding energy intake/expenditure and particularly variations on the Venezuelan nutritional scenario with the presence of "the double burden of malnutrition" it a review of Energy Reference Values (VRE) from a more integral approach is pertinent. This report follows the methodology proposed by FAO/WHO/UNU 2004 experts committee and energy reference values were established by group of age and gender, also average energy values for Venezuelan population were obtained. For calculation of these requirements, the energy expenditure was included by taking into account Basal Metabolic Rate and physical activity level for some specific groups. The score average values updated in 2012 of 2.200 kcal/dia reported to be lower than those of 2000 at all ages for masculine gender except for the 16-17 age group and for feminine gender just until ages 10-12 years and from there are slightly above the values obtained in 2000.

Science, policy, and the transparency of values.

PubMed

Elliott, Kevin C; Resnik, David B

2014-07-01

Opposing groups of scientists have recently engaged in a heated dispute over a preliminary European Commission (EC) report on its regulatory policy for endocrine-disrupting chemicals. In addition to the scientific issues at stake, a central question has been how scientists can maintain their objectivity when informing policy makers. Drawing from current ethical, conceptual, and empirical studies of objectivity and conflicts of interest in scientific research, we propose guiding principles for communicating scientific findings in a manner that promotes objectivity, public trust, and policy relevance. Both conceptual and empirical studies of scientific reasoning have shown that it is unrealistic to prevent policy-relevant scientific research from being influenced by value judgments. Conceptually, the current dispute over the EC report illustrates how scientists are forced to make value judgments about appropriate standards of evidence when informing public policy. Empirical studies provide further evidence that scientists are unavoidably influenced by a variety of potentially subconscious financial, social, political, and personal interests and values. When scientific evidence is inconclusive and major regulatory decisions are at stake, it is unrealistic to think that values can be excluded from scientific reasoning. Thus, efforts to suppress or hide interests or values may actually damage scientific objectivity and public trust, whereas a willingness to bring implicit interests and values into the open may be the best path to promoting good science and policy.

Reporting of nitrogen-isotope abundances (Technical Report)

USGS Publications Warehouse

Coplen, Tyler B.; Krouse, H.R.; Böhlke, John Karl

1992-01-01

To eliminate possible confusion in the reporting of nitrogen-isotope analyses, the Commission on Atomic Weights and Isotopic Abundances recommends that the value 272 be employed for the 14N/15N value of N2 in air for calculating atom percent 15N from measured δ15N values.

The Modified Values Auction: A Data Analytic Classroom Game

ERIC Educational Resources Information Center

Miller, Larry D.

1978-01-01

Describes a modified values auction simulation game, reports on three levels of analysis employing actual classroom data (group, subgroup, and individual), and offers suggestions for utilizing values data in social research. (CMV)

Accuracy of reported flash point values on material safety data sheets and the impact on product classification.

PubMed

Radnoff, Diane

2013-01-01

Material Safety Data Sheets (MSDSs) are the foundation of worker right-to-know legislation for chemical hazards. Suppliers can use product test data to determine a product's classification. Alternatively, they may use evaluation and professional judgment based on test results for the product or a product, material, or substance with similar properties. While the criteria for classifying products under the new Globally Harmonized System of Classification and Labeling of Chemicals (GHS) are different, a similar process is followed. Neither the current Workplace Hazardous Materials Information System (WHMIS) nor GHS require suppliers to test their products to classify them. In this project 83 samples of products classified as flammable or combustible, representing a variety of industry sectors and product types, were collected. Flash points were measured and compared to the reported values on the MSDSs. The classifications of the products were then compared using the WHMIS and GHS criteria. The results of the study indicated that there were significant variations between the disclosed and measured flash point values. Overall, more than one-third of the products had flash points lower than that disclosed on the MSDS. In some cases, the measured values were more than 20°C lower than the disclosed values. This could potentially result in an underestimation regarding the flammability of the product so it is important for employers to understand the limitations in the information provided on MSDSs when developing safe work procedures and training programs in the workplace. Nearly one-fifth of the products were misclassified under the WHMIS system as combustible when the measured flash point indicated that they should be classified as flammable when laboratory measurement error was taken into account. While a similar number of products were misclassified using GHS criteria, the tendency appeared to be to "over-classify" (provide a hazard class that was more conservative

Determination of rifaximin treatment period according to lactulose breath test values in nonconstipated irritable bowel syndrome subjects.

PubMed

Bae, Suhyun; Lee, Kwang Jae; Kim, Young-Sang; Kim, Kyu-Nam

2015-06-01

Small intestinal bacterial overgrowth (SIBO) can partly explain irritable bowel syndrome (IBS), and rifaximin has been observed to improve abdominal symptoms in nonconstipated IBS patients. However, there are few reports on the association of the rifaximin treatment periods with the results of a lactulose breath test (LBT). Therefore, we performed a retrospective review of patient charts to investigate the relation between the rifaximin treatment periods with LBT results in nonconstipated IBS patients. We also evaluated the time to achieve a symptomatic improvement in the IBS patients as compared to the changes in the LBT. We reviewed the charts for patients who showed IBS symptoms with documented positive results for LBT during their initial visit and who had a follow-up LBT after treatment with rifaximin. The LBT values were compared to the subjects' symptom scores. A total of 102 subjects had a follow-up LBT to assess LBT normalization. The subjects were divided into groups according to treatment periods of 4 weeks (n = 36), 8 weeks (n = 43), and 12 weeks (n = 23). The groups with a longer treatment exhibited an increase in the hydrogen gas value at 90 min and its sum during 90 min at the initial LBT. There were significant differences in hydrogen gas value at 90 min and in its sum during 90 min at the initial LBT between the groups treated for 4 and 12 weeks. The most significant treatment response was observed during the first 4 weeks for all treatment groups. Symptomatic improvement occurred earlier than LBT normalization in the treatment period over 4 weeks. The results indicate that different rifaximin treatment periods are needed in accordance with LBT levels to effectively eradicate SIBO.

Review of Recent US Value Frameworks-A Health Economics Approach: An ISPOR Special Task Force Report [6].

PubMed

Willke, Richard J; Neumann, Peter J; Garrison, Louis P; Ramsey, Scott D

2018-02-01

The sixth section of our Special Task Force (STF) report reviews and comments on recent US-oriented value assessment frameworks, specifically those published by the American College of Cardiology/American Heart Association, the Institute for Clinical and Economic Research, the American Society of Clinical Oncology, the National Comprehensive Cancer Network, and the Memorial Sloan Kettering Cancer Center. We review published commentaries that address the validity, reliability, and conceptual underpinnings of these frameworks. We find common themes of critique regarding the strengths and limitations across frameworks. Particular shortcomings of some frameworks pose greater threats to their face validity and utility compared with others. The most significant limitations include lack of clear perspective (e.g., patient vs. health plan) and poor transparency in accounting for costs and benefits. We then review how each framework adheres to core STF recommendations, with particular emphasis on whether the framework can be used to support coverage decisions by health insurers, and whether it adheres to core principles of cost-effectiveness analysis. The Institute for Clinical and Economic Research framework most closely adheres to core STF recommendations. Others have significant limitations that vary widely from framework to framework. We also review how the frameworks follow STF recommendations for addressing potentially relevant issues beyond cost-effectiveness analysis - for example, equity in resource allocation and patient heterogeneity. Finally, we review whether and how each framework uses value thresholds and addresses affordability concerns. We conclude with suggestions for further research, particularly in the areas of testing the measurement and use of novel elements of value and deliberative processes. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Associations between Peer Victimization, Self-Reported Depression and Social Phobia among Adolescents: The Role of Comorbidity

ERIC Educational Resources Information Center

Ranta, Klaus; Kaltiala-Heino, Riittakerttu; Pelkonen, Mirjami; Marttunen, Mauri

2009-01-01

Associations of peer victimization with adolescent depression and social phobia (SP), while controlling for comorbidity between them, have not been sufficiently explored in earlier research. A total of 3156 Finnish adolescents aged 15-16 years participated in a survey study. Self-reported peer victimization, as well as self-reported depression…

Pavement subgrade MR design values for Michigan's seasonal changes : final report.

DOT National Transportation Integrated Search

2009-07-22

The resilient modulus (MR) of roadbed soil plays an integral role in the design of pavement systems. Currently, the : various regions of the Michigan Department of Transportation (MDOT) use different procedures to determine the : MR values. Most of t...

Brief Report: Valued Life Activities and Readiness to Quit Smoking among Mobility Impaired Smokers

PubMed Central

Busch, Andrew M.; Borrelli, Belinda

2011-01-01

Objective People with physical disabilities smoke at a higher rate than their non-disabled peers, with rates as high as 28–40% among non-elderly adults with functional impairments. One possible explanation for these findings is that restriction of valued life activities (social, professional, pleasurable or otherwise meaningful) due to mobility impairment interferes with smoking cessation. Methods Forty-seven smokers (48.9% female; Mage = 48.91) with chronic mobility impairments (i.e., regularly use equipment to ambulate) were interviewed over the telephone. We assessed demographics, self-efficacy to quit smoking, stage of change, current engagement in valued activities, current restriction of valued activities due to physical limitations, and efforts to replace restricted valued activities in a cross sectional design. Results Bivariate results indicate that 74% of those in the preparation stage had satisfactory replacements for their most valued restricted activity, while only 27% in the contemplation stage and 17% in the pre-contemplation stage had such satisfactory replacements. Multinomial ordinal regression analyses revealed that (a) having satisfactory replacements for activities restricted due to physical disability was significantly associated with higher stage of change and (b) more current valued activities and, to a lesser extent, fewer restricted activities were significantly associated with higher levels of self-efficacy to quit smoking. Conclusions These results support the need for the development of treatments for smoking cessation that aim to increase engagement in valued activities, such as Behavioral Activation. PMID:21875204

Cultural Values and Happiness: An East-West Dialogue.

ERIC Educational Resources Information Center

Lu, Luo; Gilmour, Robin; Kao, Shu-Fang

2001-01-01

Examines the relationships between cultural values and experiences of happiness in two samples focusing on university students in Taiwan (n=439) and the United Kingdom (n=344). Reports that the relationships between values and happiness were stronger in the Taiwanese sample. Includes references and an appendix. (CMK)

Radioactive materials released from nuclear power plants. Volume 13, Annual report 1992

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

Tichler, J.; Doty, K.; Lucadamo, K.

Releases of radioactive materials in airborne and liquid effluents from commercial light water reactors during 1992 have been compiled and reported. The summary data for the years 1973 through 1991 are included for comparison. Data on solid waste shipments as well as selected operating information have been included. This report supplements earlier annual reports issued by the former Atomic Energy Commission and the Nuclear Regulatory Commission. The 1992 release data are summarized in tabular form. Data covering specific radionuclides are summarized.

Radioactive materials released from nuclear power plants. Annual report 1989: Volume 10

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

Tichler, J.; Norden, K.; Congemi, J.

Releases of radioactive materials in airborne and liquid effluents from commercial light water reactors during 1989 have been compiled and reported. The summary data for the years 1970 through 1988 are included for comparison. Data on solid waste shipments as well as selected operating information have been included. This report supplements earlier annual reports issued by the former Atomic Energy Commission and the Nuclear Regulatory Commission. The 1989 release data are summarized in tabular form. Data covering specific radionuclides are summarized.

Radioactive materials released from nuclear power plants: Annual report, 1993. Volume 14

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

Tichler, J.; Doty, K.; Lucadamo, K.

Releases of radioactive materials in airborne and liquid effluents from commercial light water reactors during 1993 have been compiled and reported. The summary data for the years 1974 through 1992 are included for comparison. Data on solid waste shipments as well as selected operating information have been included. This report supplements earlier annual reports issued by the former Atomic Energy Commission and the Nuclear Regulatory Commission. The 1993 release data are summarized in tabular form. Data covering specific radionuclides are summarized.

Earlier saccades to task-relevant targets irrespective of relative gain between peripheral and foveal information.

PubMed

Wolf, Christian; Schütz, Alexander C

2017-06-01

Saccades bring objects of interest onto the fovea for high-acuity processing. Saccades to rewarded targets show shorter latencies that correlate negatively with expected motivational value. Shorter latencies are also observed when the saccade target is relevant for a perceptual discrimination task. Here we tested whether saccade preparation is equally influenced by informational value as it is by motivational value. We defined informational value as the probability that information is task-relevant times the ratio between postsaccadic foveal and presaccadic peripheral discriminability. Using a gaze-contingent display, we independently manipulated peripheral and foveal discriminability of the saccade target. Latencies of saccades with perceptual task were reduced by 36 ms in general, but they were not modulated by the information saccades provide (Experiments 1 and 2). However, latencies showed a clear negative linear correlation with the probability that the target is task-relevant (Experiment 3). We replicated that the facilitation by a perceptual task is spatially specific and not due to generally heightened arousal (Experiment 4). Finally, the facilitation only emerged when the perceptual task is in the visual but not in the auditory modality (Experiment 5). Taken together, these results suggest that saccade latencies are not equally modulated by informational value as by motivational value. The facilitation by a perceptual task only arises when task-relevant visual information is foveated, irrespective of whether the foveation is useful or not.

Report of sampling and analysis results, Addison Army housing units, Addison, Illinois. Final report

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

Not Available

1990-09-01

The objectives of this sampling and analysis effort include further characterization of environmental contamination identified in an enhanced preliminary assessment carried out in 1989. The specific activities performed at this site were identification, evaluation of the condition, and collection of samples from specific suspected asbestos-containing materials, including floor tiles, pipe run and pipe fitting insulation, dust in the ductwork, and exterior siding, where present. These evaluation were necessary to clarify potential environmental issues identified in the earlier report, prior to the sale or realignment of the property.

Providing Effective Learner Support for Part-Time Learners. Research Report

ERIC Educational Resources Information Center

Barker, Philip; Crawley, Jim

2005-01-01

Learner support, defined as the strategies which empower learners to establish and fulfill their learning, career and personal potential, continues to be a key issue in current thinking in the post-16 education sector. An earlier project report from the West Country Learning and Skills Research Network (WCLSRN) showed that part-time learners were…

Meaning of missing values in eyewitness recall and accident records.

PubMed

Uttl, Bob; Kisinger, Kelly

2010-09-02

Eyewitness recalls and accident records frequently do not mention the conditions and behaviors of interest to researchers and lead to missing values and to uncertainty about the prevalence of these conditions and behaviors surrounding accidents. Missing values may occur because eyewitnesses report the presence but not the absence of obvious clues/accident features. We examined this possibility. Participants watched car accident videos and were asked to recall as much information as they could remember about each accident. The results showed that eyewitnesses were far more likely to report the presence of present obvious clues than the absence of absent obvious clues even though they were aware of their absence. One of the principal mechanisms causing missing values may be eyewitnesses' tendency to not report the absence of obvious features. We discuss the implications of our findings for both retrospective and prospective analyses of accident records, and illustrate the consequences of adopting inappropriate assumptions about the meaning of missing values using the Avaluator Avalanche Accident Prevention Card.

A revised set of values of single-bond radii derived from the observed interatomic distances in metals by correction for bond number and resonance energy

PubMed Central

Pauling, Linus; Kamb, Barclay

1986-01-01

An earlier discussion [Pauling, L. (1947) J. Am. Chem. Soc. 69, 542] of observed bond lengths in elemental metals with correction for bond number and resonance energy led to a set of single-bond metallic radii with values usually somewhat less than the corresponding values obtained from molecules and complex ions. A theory of resonating covalent bonds has now been developed that permits calculation of the number of resonance structures per atom and of the effective resonance energy per bond. With this refined method of correcting the observed bond lengths for the effect of resonance energy, a new set of single-bond covalent radii, in better agreement with values from molecules and complex ions, has been constructed. PMID:16593698

The interplay of health claims and taste importance on food consumption and self-reported satiety.

PubMed

Vadiveloo, Maya; Morwitz, Vicki; Chandon, Pierre

2013-12-01

Research has shown that subtle health claims used by food marketers influence pre-intake expectations, but no study has examined how they influence individuals' post-consumption experience of satiety after a complete meal and how this varies according to the value placed on food taste. In two experiments, we assess how labeling a pasta salad as "healthy" or "hearty" influences self-reported satiety, consumption volume, and subsequent consumption of another food. Using MANOVA, Study 1 shows that individuals who report low taste importance consume less-yet feel just as satiated-when a salad is labeled "hearty" rather than "healthy." In contrast, for individuals with higher taste importance, consumption and self-reported satiety are correlated and are both higher when a salad is labeled as "hearty" versus "healthy." Study 2 primes taste importance, rather than measuring it, and replicates these findings for consumption, but not for self-reported satiety. There was no effect on the consumption of other foods in either study. Overall, our findings add to earlier work on the impact of health labels by showing that subtle food descriptions also influence post-intake experiences of satiety, but that the direction of the effects depends on taste importance and on the selection of direct or indirect measures of satiety. Copyright © 2013 Elsevier Ltd. All rights reserved.

Final report on CCQM-K80: Comparison of value-assigned CRMs and PT materials: Creatinine in human serum

NASA Astrophysics Data System (ADS)

Camara, Johanna E.; Duewer, David L.; Gasca Aragon, Hugo; Lippa, Katrice A.; Toman, Blaza

2013-01-01

regression was used to establish the key comparison reference function (KCRF) relating the assigned values to the repeatability measurements. Parametric bootstrap Monte Carlo was used to estimate 95% level-of-confidence coverage intervals for the degrees of equivalence of materials, d +/- U95(d), and of the participating NMIs, D +/- U95(D). Because of the wide range of creatinine mass fraction in the materials, these degrees of equivalence are expressed in percent relative form: %d +/- U95(%d) and %D +/- U95(%D). On the basis of leave-one-out cross-validation, the assigned values for 16 of the 17 materials were deemed equivalent at the 95% level of confidence. These materials were used to define the KCRF. The excluded material was identified as having a marginally underestimated assigned uncertainty, giving it large and potentially anomalous influence on the KCRF. However, this material's %d of 1.4 +/- 1.5 indicates that it is equivalent with the other materials at the 95% level of confidence. The median |%d| for all 17 of the materials is 0.3 with a median U95(%d) of 1.9. All of these higher-order CRMs for creatinine in human serum are equivalent within their assigned uncertainties. The median |%D| for the participating NMIs is 0.3 with a median U95(%D) of 2.1. These results demonstrate that all participating NMIs have the ability to correctly value-assign CRMs and proficiency test materials for creatinine in human serum and similar measurands. Main text. To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCQM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

Lipid Extraction and the Fugacity of Stable Isotope Values

NASA Astrophysics Data System (ADS)

Padula, V.; Causey, D.; Wolf, N.; Welker, J. M.

2013-12-01

Stable isotope analysis of blood, feathers, and other tissues are often used to infer migration patterns, diet composition and trophic status of seabirds. Tissues contain variable amounts of lipids that are depleted in the heavy carbon isotope (13C) and may introduce a bias in these values. There is evidence that lipid extraction may affect other stable isotope ratios, such as δ15N. Consequently, correction factors need to be applied to appropriately interpret δ13C and δ15N values for individual species and tissue type. In this study, we collected seven species of seabirds from the Near Islands, the western most group of islands in the Aleutian Island archipelago. We sampled kidney, liver, heart and muscle samples from each bird and after freeze drying, individual tissue samples were divided into two subsamples. We left one subsample unaltered and extracted lipids from the other subsample using a 2:1 chloroform-methanol solution. We found that the change in δ13C values after lipid extraction (Δδ13C) varied widely among categories (eg., species, tissue type) from 0 - 4 ‰, while Δδ15N values ranged from 0 to 2‰. Notably, within category variation was nonsignificant and the Δδ values were linear against the covariant C:N ratio of the isotopic data, which allows us to use arithmetic corrections for categorical values. Our data strongly indicate that the effects of lipid extraction on stable isotopic values, while linear within category, vary widely by species, tissue, geographic area, year of collection, and isotope. Fugacity is usually employed as a thermodynamic quantity related to the chemical potential or activity that characterizes the escaping tendency from a phase (eg. Mackay & Paterson 1982). Here we use fugacity in the earlier, broader sense of fleeting, transitory, or instable states (eg., S. Johnson 1751), and its measure may be approximated by the higher order variance of Δδ13C and Δδ15N among data categories. Clearly, understanding the

Perceived value of national certification for pediatric nurses.

PubMed

Messmer, Patricia R; Hill-Rodriguez, Deborah; Williams, Arthur R; Ernst, Mary E; Tahmooressi, Jill

2011-09-01

This study evaluated whether pediatric nurses who were certified valued national certifications to a greater degree than those who were not certified. The Gaberson, Schroeter, Killen, and Valentine (2003) Perceived Value of Certification Tool (PVCT) was used to measure nurses' perceptions of certification. The PVCT includes 18 certification-related value statements, using a five-point Likert scale response ranging from strongly agree to strongly disagree. A principal factor analysis was performed to identify clusters of related variables. Certified pediatric nurses valued national certifications to a greater degree than those who were not certified. More favorable views of certification were moderately associated with favorable views of the effects of certification on salary. The PVCT was found to have one factor, not two, as previously reported in the literature. Lower perceived relationships were reported between certification and salary, clinical competence, and consumer confidence compared with feelings of professionalism and personal satisfaction. Efforts to improve the relationship between certification and its perceived value at one institution were addressed. More attention may be needed to strengthen relationships, perceived or otherwise, between certification and competency skills, public awareness, and compensation of nurses for holding national certification. Copyright 2011, SLACK Incorporated.

Parasites, democratization, and the liberalization of values across contemporary countries.

PubMed

Thornhill, Randy; Fincher, Corey L; Aran, Devaraj

2009-02-01

the geographic location at high latitudes (and hence reduced parasite stress) of the early democratic transitions in Britain, France and the U.S.A. It, too, is consistent with the marked increase in the liberalization of social values in the West in the 1950s and 1960s (in part, the sexual revolution), regions that, a generation or two earlier, experienced dramatically reduced infectious diseases as a result of antibiotics, vaccinations, food- and water-safety practices, and increased sanitation. Moreover, we hypothesize that the generation and diffusion of innovations (in thought, action and technology) within and among regions, which is associated positively with democratization, is causally related to parasite stress. Finally, we hypothesize that past selection in the context of morbidity and mortality resulting from parasitic disease crafted many of the aspects of social psychology unique to humans.

Freshwater mussels of the Delta National Forest, Mississippi Final Report

Treesearch

Wendell R. Haag; Melvin L. Warren

1998-01-01

Twenty-three species of freshwater mussels were collected during a survey of aquatic habitats in the Delta National Forest, Mississippi. An additional 6 species not encountered in this survey were reported by an earlier study in the Big Sunflower River near the northern proclamation boundary of the Forest. These species are included here, bringing the total species...

REPORT OF THE NAEB STUDY ON THE PROPOSED EXPANSION OF THE MIDWEST PROGRAM ON AIRBORNE TELEVISION INSTRUCTION.

ERIC Educational Resources Information Center

BRONSON, VERNON; AND OTHERS

A TECHNICAL REPORT WAS PREPARED COVERING THE IMPACT OF AIRBORNE TELEVISION TRANSMISSION ON LAND-BASED UHF TELEVISION ASSIGNMENT PLANS. THE REPORT RELATED TO THE PROPOSED EXPANSION PLANS OF THE MIDWEST PROGRAM ON AIRBORNE TELEVISION INSTRUCTION (MPATI). EARLIER STUDIES BY THE NATIONAL ASSOCIATION OF EDUCATIONAL BROADCASTERS (NAEB) HAD LED TO THE…

Value pricing pilot program : lessons learned

DOT National Transportation Integrated Search

2008-08-01

This "Lessons Learned Report" provides a summary of projects sponsored by the Federal Highway Administration's (FHWA's) Congestion and Value Pricing Pilot Programs from 1991 through 2006 and draws lessons from a sample of projects with the richest an...

Determining the value of disease management programs.

PubMed

Selby, Joe V; Scanlon, Dennis; Lafata, Jennifer Elston; Villagra, Victor; Beich, Jeff; Salber, Patricia R

2003-09-01

Increasing prevalence, rising costs, and persisting deficiencies in quality of care for chronic diseases pose economic and policy challenges to providers and purchasers. Disease management (DM) programs may address these challenges, but neither purchasers nor providers can assess their value. The potpourri of current quality indicators provides limited insight into the actual clinical benefit achieved. A conference sponsored by the Agency for Healthcare Research and Quality (AHRQ) and held in October 2002 explored new approaches to measuring and reporting the value of DM for diabetes mellitus. Quantifying the value of DM requires measuring clinical benefit and net impact on health care costs for the entire population with diabetes. If quality is measured with indicators that are clearly linked to outcomes, clinical benefit can be estimated. Natural history models combine the expected benefits of improvements in multiple indicators to yield a single, composite measure, the quality-adjusted life-year. Such metrics could fairly express, in terms of survival and complications prevention, relatively disparate DM programs' benefits. Measuring and comparing health care costs requires data validation and appropriate case-mix adjustment. Comparing value across programs may provide more accurate assessments of performance, enhance quality improvement efforts within systems, and contribute generalizable knowledge on the utility of DM approaches. Conference attendees recommended pilot projects to further explore use of natural history models for measuring and reporting the value of DM.

An experiment shows that a well-designed report on costs and quality can help consumers choose high-value health care.

PubMed

Hibbard, Judith H; Greene, Jessica; Sofaer, Shoshanna; Firminger, Kirsten; Hirsh, Judith

2012-03-01

Advocates of health reform continue to pursue policies and tools that will make information about comparative costs and resource use available to consumers. Reformers expect that consumers will use the data to choose high-value providers-those who offer higher quality and lower prices-and thus contribute to the broader goal of controlling national health care spending. However, communicating this information effectively is more challenging than it might first appear. For example, consumers are more interested in the quality of health care than in its cost, and many perceive a low-cost provider to be substandard. In this study of 1,421 employees, we examined how different presentations of information affect the likelihood that consumers will make high-value choices. We found that a substantial minority of the respondents shied away from low-cost providers, and even consumers who pay a larger share of their health care costs themselves were likely to equate high cost with high quality. At the same time, we found that presenting cost data alongside easy-to-interpret quality information and highlighting high-value options improved the likelihood that consumers would choose those options. Reporting strategies that follow such a format will help consumers understand that a doctor who provides higher-quality care than other doctors does not necessarily cost more.

Detection, attribution, and sensitivity of trends toward earlier streamflow in the Sierra Nevada

USGS Publications Warehouse

Maurer, E.P.; Stewart, I.T.; Bonfils, Celine; Duffy, P.B.; Cayan, D.

2007-01-01

Observed changes in the timing of snowmelt dominated streamflow in the western United States are often linked to anthropogenic or other external causes. We assess whether observed streamflow timing changes can be statistically attributed to external forcing, or whether they still lie within the bounds of natural (internal) variability for four large Sierra Nevada (CA) basins, at inflow points to major reservoirs. Streamflow timing is measured by "center timing" (CT), the day when half the annual flow has passed a given point. We use a physically based hydrology model driven by meteorological input from a global climate model to quantify the natural variability in CT trends. Estimated 50-year trends in CT due to natural climate variability often exceed estimated actual CT trends from 1950 to 1999. Thus, although observed trends in CT to date may be statistically significant, they cannot yet be statistically attributed to external influences on climate. We estimate that projected CT changes at the four major reservoir inflows will, with 90% confidence, exceed those from natural variability within 1-4 decades or 4-8 decades, depending on rates of future greenhouse gas emissions. To identify areas most likely to exhibit CT changes in response to rising temperatures, we calculate changes in CT under temperature increases from 1 to 5??. We find that areas with average winter temperatures between -2??C and -4??C are most likely to respond with significant CT shifts. Correspondingly, elevations from 2000 to 2800 in are most sensitive to temperature increases, with CT changes exceeding 45 days (earlier) relative to 1961-1990. Copyright 2007 by the American Geophysical Union.

Metamorphosis Is Ancestral for Crown Euarthropods, and Evolved in the Cambrian or Earlier.

PubMed

Wolfe, Joanna M

2017-09-01

Macroevolutionary developmental biology employs fossilized ontogenetic data and phylogenetic comparative methods to probe the evolution of development at ancient nodes. Despite the prevalence of ecologically differentiated larval forms in marine invertebrates, it has been frequently presumed that the ancestors of arthropods were direct developers, and that metamorphosis may not have evolved until the Ordovician or later. Using fossils and new dated phylogenies, I infer that metamorphosis was likely ancestral for crown arthropods, contradicting this assumption. Based on a published morphological dataset encompassing 217 exceptionally preserved fossil and 96 extant taxa, fossils were directly incorporated into both the topology and age estimates, as in "tip dating" analyses. Using data from post-embryonic fossils representing 25 species throughout stem and crown arthropod lineages (as well as most of the 96 extant taxa), characters for metamorphosis were assigned based on inferred ecological changes in development (e.g., changes in habitat and adaptive landscape). Under all phylogenetic hypotheses, metamorphosis was supported as most likely ancestral to both ecdysozoans and euarthropods. Care must be taken to account for potential drastic post-embryonic morphological changes in evolutionary analyses. Many stem group euarthrpods may have had ecologically differentiated larval stages that did not preserve in the fossil record. Moreover, a complex life cycle and planktonic ecology may have evolved in the Ediacaran or earlier, and may have typified the pre-Cambrian explosion "wormworld" prior to the origin of crown group euarthropods. © The Author 2017. Published by Oxford University Press on behalf of the Society for Integrative and Comparative Biology. All rights reserved. For permissions please email: journals.permissions@oup.com.

Clinical Evidence for the Earlier Initiation of Insulin Therapy in Type 2 Diabetes

PubMed Central

2013-01-01

Abstract The natural history of type 2 diabetes mellitus (T2DM) is a relentless progression of β-cell failure and dysregulation of β-cell function with increasing metabolic derangement. Insulin remains the only glucose-lowering therapy that is efficacious throughout this continuum. However, the timing of introduction and the choice of insulin therapy remain contentious because of the heterogeneity of T2DM and the well-recognized behavioral and therapeutic challenges associated with this mode of therapy. Nevertheless, the early initiation of basal insulin has been shown to improve glycemic control and affect long-term outcomes in people with T2DM and is a treatment strategy supported by international guidelines as part of an individualized approach to chronic disease management. The rationale for early initiation of insulin is based on evidence demonstrating multifaceted benefits, including overcoming the glucotoxic effects of hyperglycemia, thereby facilitating “β-cell rest,” and preserving β-cell mass and function, while also improving insulin sensitivity. Independent of its effects on glycemic control, insulin possesses anti-inflammatory and antioxidant properties that may help protect against endothelial dysfunction and damage resulting in vascular disease. Insulin therapy and the achievement of good glycemic control earlier in T2DM provide long-term protection to end organs via “metabolic memory” regardless of subsequent treatments and degree of glycemic control. This is evidenced from long-term observations continuing from trials such as the United Kingdom Prospective Diabetes Study. As such, early initiation of insulin therapy may not only help to avoid the effects of prolonged glycemic burden, but may also positively alter the course of disease progression. PMID:23786228

Chemistry, physiology and neuropsychology of schizophrenia: towards an earlier diagnosis of schizophrenia I.

PubMed

Kornhuber, H H

1983-01-01

Data supporting the glutamate hypothesis of schizophrenia are presented. The glutamate hypothesis is linked to the dopamine hypothesis by the fact that dopamine synapses inhibit the release of glutamate in the striate and mesolimbic system. The glutamate hypothesis of schizophrenia may open a way to find better drugs for treatment. The concept of schizophrenia I is described. It consists of "negative symptoms" such as disconcentration or reduction of energy. Schizophrenia I precedes and follows schizophrenia II with "positive symptoms," e.g. hallucinations and delusions. Schizophrenia I so far cannot be diagnosed as schizophrenia unless schizophrenia II appears. Chemical, physiological or neuropsychological methods for the diagnosis of schizophrenia I would render an earlier treatment of schizophrenia possible and thus make social and occupational rehabilitation more efficient. An objective diagnosis of schizophrenia I may also elucidate the mode of genetic transmission of schizophrenia. Several neuropsychological methods distinguish schizophrenic patients as a group from normals. Some of them are based on a specific disturbance of long term concentration. The EEG also distinguishes schizophrenics from normals when analyzed during voluntary movement. For schizophrenics it takes more effort to initiate a voluntary movement, and there are several features of the EEG correlated to this. Moreover, the longer motor reaction time of schizophrenics is paralleled by a longer duration of the Bereitschaftspotential in schizophrenia. Furthermore, there is a difference in the theta rhythm between schizophrenic patients and normals in a task which requires concentration. Some of the children of schizophrenic parents show a disturbance of concentration in both reaction time tasks and the d 2 test.(ABSTRACT TRUNCATED AT 250 WORDS)

Parenting Dimensions and Adolescents' Internalisation of Moral Values

ERIC Educational Resources Information Center

Hardy, Sam A.; Padilla-Walker, Laura M.; Carlo, Gustavo

2008-01-01

This study examined relations between parenting dimensions (involvement, autonomy support and structure) and adolescents' moral values internalisation. A sample of 101 adolescents (71% female; 76% white; M age = 16.10, SD = 1.17) reported on the parenting behaviour of one of their parents and on their own moral values. Four forms of values…

Effective Teaching Practices. Research Watch. E&R Report No. 10.01

ERIC Educational Resources Information Center

Haynie, Glenda

2010-01-01

This paper reports the overall findings of research on effective teaching practices in Wake County Public Schools (WCPSS). It is a cross-case analysis of five earlier studies (Biology, Algebra I, U.S. History, middle school Algebra I, and English I). Despite subject implementation differences, four common themes were found: (1) high academic…

Political-economic values and the relationship between socioeconomic status and self-esteem.

PubMed

Malka, Ariel; Miller, Dale T

2007-02-01

Values concerning the distribution of wealth are an important aspect of identity for many Americans, and such values may therefore influence how Americans experience their own socioeconomic status (SES). Based on this proposition, the present research examines political-economic values as a moderator of the relationship between SES and self-esteem. Results supported the hypothesis that there is a stronger relationship between SES and self-esteem among individuals who report relatively inegalitarian values than among individuals who report relatively egalitarian values. This result was replicated using both objective and subjective measures of SES. Implications of the present findings for the study of values and well-being, psychological conflict, and the influence of economic factors on self-esteem are discussed.

The George Engelmann Mathematics & Science Institute. Scholar Research Program Annual Report 1993.

ERIC Educational Resources Information Center

Missouri Univ., St. Louis. George Englemann Mathematics & Science Inst.

This publication is a comprehensive report on the George Engelmann Mathematics and Science Institute's Scholar Research Program (SRP) and its activities in 1993. The SRP provides high school students who have successfully completed an earlier Engelmann program the opportunity to experience and practice the active components of the scientific…

Value in cardiovascular care.

PubMed

Bradley, Steven M; Strauss, Craig E; Ho, P Michael

2017-08-01

Healthcare value, defined as health outcomes achieved relative to the costs of care, has been proposed as a unifying approach to measure improvements in the quality and affordability of healthcare. Although value is of increasing interest to payers, many providers remain unfamiliar with how value differs from other approaches to the comparison of cost and outcomes (ie, cost-effectiveness analysis). While cost-effectiveness studies can be used by policy makers and payers to inform decisions about coverage and reimbursement for new therapies, the assessment of healthcare can guide improvements in the delivery of healthcare to achieve better outcomes at lower cost. Comparison on value allows for the identification of healthcare delivery organisations or care delivery settings where patient outcomes have been optimised at a lower cost. Gaps remain in the measurement of healthcare value, particularly as it relates to patient-reported health status (symptoms, functional status and health-related quality of life). The use of technology platforms that capture health status measures with minimal disruption to clinical workflow (ie, web portals, automated telephonic systems and tablets to facilitate capture outside of in-person clinical interaction) is facilitating use of health status measures to improve clinical care and optimise patient outcomes. Furthermore, the use of a value framework has catalysed quality improvement efforts and research to seek better patient outcomes at lower cost. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

15 CFR 30.25 - Values for certain types of transactions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Values for certain types of...-Type Transactions § 30.25 Values for certain types of transactions. Special procedures govern the values to be reported for shipments of the following unusual types: (a) Subsidized exports of...

Earlier onset of motor deficits in mice with double mutations in Dyt1 and Sgce.

PubMed

Yokoi, Fumiaki; Yang, Guang; Li, Jindong; DeAndrade, Mark P; Zhou, Tong; Li, Yuqing

2010-10-01

DYT1 early-onset generalized torsion dystonia is an inherited movement disorder caused by mutations in DYT1 coding for torsinA with ∼30% penetrance. Most of the DYT1 dystonia patients exhibit symptoms during childhood and adolescence. On the other hand, DYT1 mutation carriers without symptoms during these periods mostly do not exhibit symptoms later in their life. Little is known about what controls the timing of the onset, a critical issue for DYT1 mutation carriers. DYT11 myoclonus-dystonia is caused by mutations in SGCE coding for ε-sarcoglycan. Two dystonia patients from a single family with double mutations in DYT1 and SGCE exhibited more severe symptoms. A recent study suggested that torsinA contributes to the quality control of ε-sarcoglycan. Here, we derived mice carrying mutations in both Dyt1 and Sgce and found that these double mutant mice showed earlier onset of motor deficits in beam-walking test. A novel monoclonal antibody against mouse ε-sarcoglycan was developed by using Sgce knock-out mice to avoid the immune tolerance. Western blot analysis suggested that functional deficits of torsinA and ε-sarcoglycan may independently cause motor deficits. Examining additional mutations in other dystonia genes may be beneficial to predict the onset in DYT1 mutation carriers.

The evaluation of clinical and cost outcomes associated with earlier initiation of insulin in patients with type 2 diabetes mellitus.

PubMed

Smolen, Harry J; Murphy, Daniel R; Gahn, James C; Yu, Xueting; Curtis, Bradley H

2014-09-01

The treatment for patients with type 2 diabetes mellitus (T2DM) follows a stepwise progression. As a treatment loses its effectiveness, it is typically replaced with a more complex and frequently more costly treatment. Eventually this progression leads to the use of basal insulin typically with concomitant treatments (e.g., metformin, a GLP-1 RA [glucagon-like peptide-1 receptor agonist], a TZD [thiazolidinedione] or a DPP-4i [dipeptidyl peptidase 4 inhibitor]) and, ultimately, to basal-bolus insulin in some forms. As the cost of oral antidiabetics (OADs) and noninsulin injectables have approached, and in some cases exceeded, the cost of insulin, we reexamined the placement of insulin in T2DM treatment progression. Our hypothesis was that earlier use of insulin produces clinical and cost benefits due to its superior efficacy and treatment scalability at an acceptable cost when considered over a 5-year period. To (a) estimate clinical and payer cost outcomes of initiating insulin treatment for patients with T2DM earlier in their treatment progression and (b) estimate clinical and payer cost outcomes resulting from delays in escalating treatment for T2DM when indicated by patient hemoglobin A1c levels. We developed a Monte Carlo microsimulation model to estimate patients reaching target A1c, diabetes-related complications, mortality, and associated costs under various treatment strategies for newly diagnosed patients with T2DM. Treatment efficacies were modeled from results of randomized clinical trials, including the time and rate of A1c drift. A typical treatment progression was selected based on the American Diabetes Association and the European Association for the Study of Diabetes guidelines as the standard of care (SOC). Two treatment approaches were evaluated: two-stage insulin (basal plus antidiabetics followed by biphasic plus metformin) and single-stage insulin (biphasic plus metformin). For each approach, we analyzed multiple strategies. For each analysis

Axisymmetric capillary-gravity waves at the interface of two viscous, immiscible fluids - Initial value problem

NASA Astrophysics Data System (ADS)

Farsoiya, Palas Kumar; Dasgupta, Ratul

2017-11-01

When the interface between two radially unbounded, viscous fluids lying vertically in a stable configuration (denser fluid below) at rest, is perturbed, radially propagating capillary-gravity waves are formed which damp out with time. We study this process analytically using a recently developed linearised theory. For small amplitude initial perturbations, the analytical solution to the initial value problem, represented as a linear superposition of Bessel modes at time t = 0 , is found to agree very well with results obtained from direct numerical simulations of the Navier-Stokes equations, for a range of initial conditions. Our study extends the earlier work by John W. Miles who studied this initial value problem analytically, taking into account, a single viscous fluid only. Implications of this study for the mechanistic understanding of droplet impact into a deep pool, will be discussed. Some preliminary, qualitative comparison with experiments will also be presented. We thank SERB Dept. Science & Technology, Govt. of India, Grant No. EMR/2016/000830 for financial support.

Earlier Detection of Tumor Treatment Response Using Magnetic Resonance Diffusion Imaging with Oscillating Gradients

PubMed Central

Colvin, Daniel C.; Loveless, Mary E.; Does, Mark D.; Yue, Zou; Yankeelov, Thomas E.; Gore, John C.

2011-01-01

An improved method for detecting early changes in tumors in response to treatment, based on a modification of diffusion-weighted magnetic resonance imaging, has been demonstrated in an animal model. Early detection of therapeutic response in tumors is important both clinically and in pre-clinical assessments of novel treatments. Non-invasive imaging methods that can detect and assess tumor response early in the course of treatment, and before frank changes in tumor morphology are evident, are of considerable interest as potential biomarkers of treatment efficacy. Diffusion-weighted magnetic resonance imaging is sensitive to changes in water diffusion rates in tissues that result from structural variations in the local cellular environment, but conventional methods mainly reflect changes in tissue cellularity and do not convey information specific to micro-structural variations at sub-cellular scales. We implemented a modified imaging technique using oscillating gradients of the magnetic field for evaluating water diffusion rates over very short spatial scales that are more specific for detecting changes in intracellular structure that may precede changes in cellularity. Results from a study of orthotopic 9L gliomas in rat brains indicate that this method can detect changes as early as 24 hours following treatment with 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU), when conventional approaches do not find significant effects. These studies suggest that diffusion imaging using oscillating gradients may be used to obtain an earlier indication of treatment efficacy than previous magnetic resonance imaging methods. PMID:21190804

A progress report on seismic model studies

USGS Publications Warehouse

Healy, J.H.; Mangan, G.B.

1963-01-01

The value of seismic-model studies as an aid to understanding wave propagation in the Earth's crust was recognized by early investigators (Tatel and Tuve, 1955). Preliminary model results were very promising, but progress in model seismology has been restricted by two problems: (1) difficulties in the development of models with continuously variable velocity-depth functions, and (2) difficulties in the construction of models of adequate size to provide a meaningful wave-length to layer-thickness ratio. The problem of a continuously variable velocity-depth function has been partly solved by a technique using two-dimensional plate models constructed by laminating plastic to aluminum, so that the ratio of plastic to aluminum controls the velocity-depth function (Healy and Press, 1960). These techniques provide a continuously variable velocity-depth function, but it is not possible to construct such models large enough to study short-period wave propagation in the crust. This report describes improvements in our ability to machine large models. Two types of models are being used: one is a cylindrical aluminum tube machined on a lathe, and the other is a large plate machined on a precision planer. Both of these modeling techniques give promising results and are a significant improvement over earlier efforts.

Western hardwoods : value-added research and demonstration program

Treesearch

D. W. Green; W. W. Von Segen; S. A. Willits

1995-01-01

Research results from the value-added research and demonstration program for western hardwoods are summarized in this report. The intent of the program was to enhance the economy of the Pacific Northwest by helping local communities and forest industries produce wood products more efficiently. Emphasis was given to value-added products and barriers to increased...

The prognostic value of long noncoding RNA Sox2ot expression in various cancers: A systematic review and meta-analysis.

PubMed

Song, Xiaoyang; Yao, Hongyan; Liu, Jinlin; Wang, Qiang

2018-05-19

Several investigations have explored the prognostic value of long noncoding RNA Sox2 overlapping transcript (lncRNA Sox2ot) expression in human cancers, however, with inconsistent results. The aim of this study was to evaluate the prognostic role of lncRNA Sox2ot expression in various cancers. PubMed, Web of Science, Embase, and Cochrane Library were comprehensively searched to retrieve relevant studies. The relationships between lncRNA Sox2ot expression and prognostic parameters were detected, including overall survival (OS), tumor differentiation, clinical stage, distant metastasis, lymph node metastasis and so on. A total of 10 studies involving 943 cancer patients were finally included into the study. High lncRNA Sox2ot expression was significantly related to shorter OS in cancers (HR = 2.06, 95%CI = 1.67-2.55, P < 0.01). The cancer patients with high lncRNA Sox2ot expression tended to have worse tumor differentiation (P = 0.04), advanced clinical stage (P < 0.01), earlier distant metastasis (P < 0.01), and earlier lymph node metastasis (P = 0.01) compared to those with low lncRNA Sox2ot expression. However, there was no distinct correlation between lncRNA Sox2ot expression and age (P = 0.87), gender (P = 0.48), tumor size (P = 0.08), or vascular invasion (P = 0.07). High lncRNA Sox2ot expression was significantly associated with worse OS, advanced clinical stage, worse tumor differentiation, earlier distant metastasis, and earlier lymph node metastasis in various cancers. LncRNA Sox2ot expression might a promising prognostic factor in various cancers. Copyright © 2018 Elsevier B.V. All rights reserved.

Increased body mass index is associated with earlier time to loss of response to infliximab in patients with inflammatory bowel disease.

PubMed

Harper, Jason W; Sinanan, Mika N; Zisman, Timothy L

2013-09-01

Obesity is an emerging problem in the care of inflammatory bowel disease (IBD) patients and has been associated with a diminished response to adalimumab. Whether obesity influences the response to infliximab (IFX) is not known. A retrospective cohort of 124 subjects with IBD initiating IFX, naive to biologic therapy, was identified. Subjects were stratified according to their weight and body mass index (BMI). The primary outcome was the first occurrence of an IBD flare defined as dose escalation of IFX, corticosteroid use, discontinuation of IFX, hospitalization, or surgery. Multivariable logistic regression was performed considering body mass and BMI as categorical and continuous variables. Obese (BMI > 30 kg/m) patients with Crohn's disease were more likely to have an IBD flare than nonobese patients (adjusted hazard ratio [HR]: 3.03, P < 0.001); overweight (BMI > 25 kg/m) patients with ulcerative colitis trended toward a similar observation (HR: 9.68, P = 0.06). When considered as continuous variables, increasing mass and BMI were associated with earlier IBD flare in both Crohn's disease (adjusted HR: 1.06 per unit increase in BMI [P = 0.02] and 1.02 per kg increase in body mass [P = 0.02]) and ulcerative colitis (adjusted HR: 1.3 per unit increase in BMI [P = 0.01] and 1.11 per kg increase in body mass [P = 0.004]). Increased body weight is associated with an earlier time to loss of response to IFX in Crohn's disease and ulcerative colitis, a novel finding given that IFX is the only antitumor necrosis factor agent whose dosing reflects increased body weight.

Fair market value: taking a proactive approach.

PubMed

Romero, Richard A

2008-04-01

A valuation report assessing the fair market value of a contractual arrangement should include: A description of the company, entity, or circumstance being valued. Analysis of general economic conditions that are expected to affect the enterprise. Evaluation of economic conditions in the medical services industry. Explanation of the various valuation approaches that were considered. Documentation of key underlying assumptions, including revenue and expense projections, projected profit, and ROI.

29th Annual Report to Congress on the Implementation of the "Individuals with Disabilities Education Act," 2007. Volume 2

ERIC Educational Resources Information Center

Office of Special Education and Rehabilitative Services, US Department of Education, 2010

2010-01-01

The "29th Annual Report to Congress on the Implementation of the Individuals with Disabilities Education Act, 2007" follows the 2006--i.e., the 28th annual report--in sequence. The "29th Annual Report to Congress" is, however, the first to have three volumes. In the 28th and earlier editions, volume 2 consisted of data tables…

An Algorithm for the Calculation of Exact Term Discrimination Values.

ERIC Educational Resources Information Center

Willett, Peter

1985-01-01

Reports algorithm for calculation of term discrimination values that is sufficiently fast in operation to permit use of exact values. Evidence is presented to show that relationship between term discrimination and term frequency is crucially dependent upon type of inter-document similarity measure used for calculation of discrimination values. (13…

Evolving Evidence for the Value of Neuroimaging Methods and Biological Markers in Subjects Categorized with Subjective Cognitive Decline.

PubMed

Lista, Simone; Molinuevo, Jose L; Cavedo, Enrica; Rami, Lorena; Amouyel, Philippe; Teipel, Stefan J; Garaci, Francesco; Toschi, Nicola; Habert, Marie-Odile; Blennow, Kaj; Zetterberg, Henrik; O'Bryant, Sid E; Johnson, Leigh; Galluzzi, Samantha; Bokde, Arun L W; Broich, Karl; Herholz, Karl; Bakardjian, Hovagim; Dubois, Bruno; Jessen, Frank; Carrillo, Maria C; Aisen, Paul S; Hampel, Harald

2015-09-24

There is evolving evidence that individuals categorized with subjective cognitive decline (SCD) are potentially at higher risk for developing objective and progressive cognitive impairment compared to cognitively healthy individuals without apparent subjective complaints. Interestingly, SCD, during advancing preclinical Alzheimer's disease (AD), may denote very early, subtle cognitive decline that cannot be identified using established standardized tests of cognitive performance. The substantial heterogeneity of existing SCD-related research data has led the Subjective Cognitive Decline Initiative (SCD-I) to accomplish an international consensus on the definition of a conceptual research framework on SCD in preclinical AD. In the area of biological markers, the cerebrospinal fluid signature of AD has been reported to be more prevalent in subjects with SCD compared to healthy controls; moreover, there is a pronounced atrophy, as demonstrated by magnetic resonance imaging, and an increased hypometabolism, as revealed by positron emission tomography, in characteristic brain regions affected by AD. In addition, SCD individuals carrying an apolipoprotein ɛ4 allele are more likely to display AD-phenotypic alterations. The urgent requirement to detect and diagnose AD as early as possible has led to the critical examination of the diagnostic power of biological markers, neurophysiology, and neuroimaging methods for AD-related risk and clinical progression in individuals defined with SCD. Observational studies on the predictive value of SCD for developing AD may potentially be of practical value, and an evidence-based, validated, qualified, and fully operationalized concept may inform clinical diagnostic practice and guide earlier designs in future therapy trials.

Meaning of Missing Values in Eyewitness Recall and Accident Records

PubMed Central

Uttl, Bob; Kisinger, Kelly

2010-01-01

Background Eyewitness recalls and accident records frequently do not mention the conditions and behaviors of interest to researchers and lead to missing values and to uncertainty about the prevalence of these conditions and behaviors surrounding accidents. Missing values may occur because eyewitnesses report the presence but not the absence of obvious clues/accident features. We examined this possibility. Methodology/Principal Findings Participants watched car accident videos and were asked to recall as much information as they could remember about each accident. The results showed that eyewitnesses were far more likely to report the presence of present obvious clues than the absence of absent obvious clues even though they were aware of their absence. Conclusions One of the principal mechanisms causing missing values may be eyewitnesses' tendency to not report the absence of obvious features. We discuss the implications of our findings for both retrospective and prospective analyses of accident records, and illustrate the consequences of adopting inappropriate assumptions about the meaning of missing values using the Avaluator Avalanche Accident Prevention Card. PMID:20824054

Procedures to Help Program Offices with Earned Value Management

EPA Pesticide Factsheets

EPA’s Earned Value Management (EVM) Procedures describe the Agency methods for collecting and reporting performance information on major IT investments. The EVM Procedures explain how EPA Program Offices are to receive, organize, analyze, and report cost.

The association between peer, parental influence and tobacco product features and earlier age of onset of regular smoking among adults in 27 European countries.

PubMed

Filippidis, Filippos T; Agaku, Israel T; Vardavas, Constantine I

2015-10-01

Factors that influence smoking initiation and age of smoking onset are important considerations in tobacco control. We evaluated European Union (EU)-wide differences in the age of onset of regular smoking, and the potential role of peer, parental and tobacco product design features on the earlier onset of regular smoking among adults <40 years old in 27 EU countries. We analysed data from 4442 current and former smokers aged 15-39 years, collected for the Eurobarometer 77.1 survey (2012). Respondents reported their age at regular smoking onset and factors that influenced their decision to start smoking, including peer influence, parental influence and features of tobacco products. Multi-variable logistic regression, adjusted for age; geographic region; education; difficulty to pay bills; and gender, was used to assess the role of the various pro-tobacco influences on early onset of regular smoking (i.e. <18 years). Among ever smokers, the mean age of onset of regular smoking was 16.6 years, ranging from 15.8 to 18.8 years in member countries. 68.1% responded that they started smoking regularly when they were <18 years old. Ever smokers who reported they were influenced by peers (OR = 1.70; 95%CI 1.30-2.20) or parents (OR = 1.60; 95%CI 1.21-2.12) were more likely to have started smoking regularly <18 years old. No significant association between design and marketing features of tobacco products and an early initiation of regular smoking was observed (OR = 1.04; 95%CI 0.83-1.31). We identified major differences in smoking initiation patterns among EU countries, which may warrant different approaches in the prevention of tobacco use. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Crisis in Values. 1970 White House Conference on Children, Report of Forum 4. (Working Copy).

ERIC Educational Resources Information Center

Department of Health, Education, and Welfare, Washington, DC.

Traditionally-expressed American values include health, personal dignity, freedom of choice, respect for the rights and humanity of others, the right to love and be loved. A big gap exists, in many instances, between values professed and values actually lived in pursuit of "success." Our children know this, and the result has been a sense of…

Homogenization of the lipid profile values.

PubMed

Pedro-Botet, Juan; Rodríguez-Padial, Luis; Brotons, Carlos; Esteban-Salán, Margarita; García-Lerín, Aurora; Pintó, Xavier; Lekuona, Iñaki; Ordóñez-Llanos, Jordi

Analytical reports from the clinical laboratory are essential to guide clinicians about what lipid profile values should be considered altered and, therefore, require intervention. Unfortunately, there is a great heterogeneity in the lipid values reported as "normal, desirable, recommended or referenced" by clinical laboratories. This can difficult clinical decisions and be a barrier to achieve the therapeutic goals for cardiovascular prevention. A recent international recommendation has added a new heterogeneity factor for the interpretation of lipid profile, such as the possibility of measuring it without previous fasting. All this justifies the need to develop a document that adapts the existing knowledge to the clinical practice of our health system. In this regard, professionals from different scientific societies involved in the measurement and use of lipid profile data have developed this document to establish recommendations that facilitate their homogenization. Copyright © 2017. Publicado por Elsevier España, S.L.U.

Patients' Values in Clinical Decision-Making.

PubMed

Faggion, Clovis Mariano; Pachur, Thorsten; Giannakopoulos, Nikolaos Nikitas

2017-09-01

Shared decision-making involves the participation of patient and dental practitioner. Well-informed decision-making requires that both parties understand important concepts that may influence the decision. This fourth article in a series of 4 aims to discuss the importance of patients' values when a clinical decision is made. We report on how to incorporate important concepts for well-informed, shared decision-making. Here, we present patient values as an important issue, in addition to previously established topics such as the risk of bias of a study, cost-effectiveness of treatment approaches, and a comparison of therapeutic benefit with potential side effects. We provide 2 clinical examples and suggestions for a decision tree, based on the available evidence. The information reported in this article may improve the relationship between patient and dental practitioner, resulting in more well-informed clinical decisions. Copyright © 2017 Elsevier Inc. All rights reserved.

Three-component hydraulic penile prosthesis malfunction due to penile fibrolipoma secondary to augmentative phalloplasty: A case report.

PubMed

Antonini, Gabriele; Vicini, Patrizio; De Berardinis, Ettore; Pacchiarotti, Arianna; Gentile, Vincenzo; Perito, Paul

2016-01-14

Fibrolipomas are an infrequent type of lipomas. We describe a case of a man suffering from subcutaneous penile fibrolipoma, who twelve months earlier has been submitted to augmentative phalloplasty due to aesthetic dysmorphophobia. The same patient three years earlier has been submitted to three-component hydraulic penile prostheses implantation due to erectile dysfunction. After six months from removing of the mass, the penile elongation and penile enlargement were stable, the prostheses were correctly functioning and the patient was satisfied with his sexual intercourse and life. The diagnostics and surgical characteristics of this case are reported.

Colorimetric values of esthetic stainless steel crowns.

PubMed

Hosoya, Yumiko; Omachi, Koichi; Staninec, Michal

2002-01-01

The colorimetric values of two different kinds of esthetic stainless steel crowns were measured and compared with the colorimetric values of primary anterior teeth in Japanese children. The colorimetric values of resin composite-faced stainless steel crowns (Kinder Krown) and epoxy-coated stainless steel crowns (White Steel Crown) were measured with a color difference meter. The Commission Internationale de Eclairage L*, a*, b*, and delta E*ab values and Munsell value, chroma, and hue were calculated. The data were compared with previously reported colorimetric values of Japanese primary anterior teeth measured with the same color difference meter used in this study. Compared to Japanese primary anterior teeth, Kinder Krown Pedo I and Pedo II showed much higher L* values and lower hue; on the other hand, White Steel Crown showed much higher L*, a*, b* values, much higher value and chroma, and much lower hue. Color analysis revealed that the colors of the White Steel Crown and Kinder Krown Pedo I were substantially different from the color of Japanese primary anterior teeth. The color difference between Pedo II crowns and Japanese primary anterior teeth was relatively high, but the color of Pedo II might be acceptable for clinical use.

Environments Perceived as Obesogenic Have Lower Residential Property Values

PubMed Central

Drewnowski, Adam; Aggarwal, Anju; Rehm, Colin D.; Cohen-Cline, Hannah; Hurvitz, Philip M.; Moudon, Anne V.

2014-01-01

Background Studies have tried to link multiple aspects of the built environment with physical activity and obesity rates. Purpose To determine the relation between residential property values and multiple perceived (self-reported) measures of the obesogenic environment. Methods The Seattle Obesity Study (SOS) used a telephone survey of a representative, geographically distributed sample of 2,001 King County adults, collected in 2008–2009 and analyzed in 2012–2013. Home addresses were geocoded. Residential property values at the tax parcel level were obtained from the King County tax assessor. Mean residential property values within a 10-minute walk (833-meter buffer) were calculated for each respondent. Data on multiple perceived measures of the obesogenic environment were collected by self-report. Correlations and multivariable linear regression analyses, stratified by residential density, were used to examine the associations among perceived environmental measures, property values, and BMI. Results Perceived measures of the environment such as crime, heavy traffic, and proximity to bars, liquor stores, and fast food were all associated with lower property values. By contrast, living in neighborhoods that were perceived as safe, quiet, clean, and attractive was associated with higher property values. Higher property values were associated, in turn, with lower BMIs. The observed associations between perceived environment measures and BMI were largely attenuated after accounting for residential property values. Conclusions Perceived measures of obesogenic environments are associated with lower property values. Studies in additional locations need to explore to what extent other perceived environment measures can be reflected in residential property values. PMID:25049218

Menstruation angina: a case report

PubMed Central